Health Insurance in Massachusetts: You Get What You Pay For ...

Health insurance premiums in Massachusetts are relatively high, but a new ranking from U.S. News & World Report suggests residents are at least getting a lot for their money.

Massachusetts? insurance plans ranked highest of any state, with all plans evaluated earning 4 or 5 stars (out of 5). Here?s how the ranking was compiled:

A plan?s score depended on completeness of coverage in as many as two dozen benefit categories and subcategories??and how much of the cost consumers have to pay.

This is undoubtedly positive for the state, suggesting that Massachusetts health plans offer substantial value for their price tag. But just because we pay a lot to get a lot doesn?t mean the state?s health insurance system is perfect. Far from it.

There?s still the question of efficiency, the most important piece of the ?costs? puzzle. Healthcare costs are rising nationally at unsustainable levels, and getting them under control is key to both providing citizens quality healthcare as well as to addressing the federal deficit. But discussions of ?costs? have a tendency to conflate several different things.

There?s the ?cost? that consumers pay in the form of premiums and co-pays, there?s the total amount of money that gets spent on healthcare, and finally there?s the amount that a specific unit of healthcare costs to administer. That third piece is most important in terms of getting healthcare costs under control; we need to squeeze more efficiency out of the system to get more for less. (This should be quite doable as the current system is highly inefficient compared to other nations.)

So next time you hear someone in Massachusetts complaining about their healthcare premium, feel free to point out that they likely get quite a bit for their money. But don?t forget that they should be able to get quite a bit more.

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Understanding Healthcare Costs in 5 Charts

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  The U.S. spends the most per capita on healthcare of any industrialized nation, but the evidence suggests we don't get superior health outcomes from that spending. (Graph via The Commonwealth Fund.)

  

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  You can see from this nice breakdown of where our federal taxes are spent that 21% of it goes to healthcare, in the form of Medicare, Medicaid, and CHIP (health insurance for children.) [Chart via the Center for Budget & Policy Priorities]

  

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  Healthcare spending isn't distributed equally throughout the population. Instead, a small fraction of chronically sick people account for the majority of spending. This has a number of implications for health innovation and policy. [Chart via NIHCM]

  

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  Unsurprisingly, healthcare spending skews toward the old. Look at how those top three blocks representing 55+ represent a huge fraction of the top 5% and top 1% of healthcare spenders. Demographics are putting strain on the healthcare system. [Chart via NIHCM]

  

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  The 2006 reform passed in Mass. helped decrease the % of uninsured dramatically to under 2%. The key challenge today remains curbing costs. [Chart via Health Affairs]

  

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Understanding Healthcare Costs in 5 Charts

1 - The U.S. vs. Other Nations

The U.S. spends the most per capita on healthcare of any industrialized nation, but the evidence suggests we don't get superior health outcomes from that spending. (Graph via The Commonwealth Fund.)

2 - Taxes and Healthcare

You can see from this nice breakdown of where our federal taxes are spent that 21% of it goes to healthcare, in the form of Medicare, Medicaid, and CHIP (health insurance for children.) [Chart via the Center for Budget & Policy Priorities]

3 - Chronically Sick People Cost a Lot

Healthcare spending isn't distributed equally throughout the population. Instead, a small fraction of chronically sick people account for the majority of spending. This has a number of implications for health innovation and policy. [Chart via NIHCM]

4 - Age and Spending

Unsurprisingly, healthcare spending skews toward the old. Look at how those top three blocks representing 55+ represent a huge fraction of the top 5% and top 1% of healthcare spenders. Demographics are putting strain on the healthcare system. [Chart via NIHCM]

5 - Mass. Healthcare Reform

The 2006 reform passed in Mass. helped decrease the % of uninsured dramatically to under 2%. The key challenge today remains curbing costs. [Chart via Health Affairs]

Source: http://bostinno.com/2012/11/02/you-pay-for-what-you-get-massachusetts-health-insurance-gets-high-marks/

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