Editor’s note: Jeanne Keller is a registered lobbyist for Fleischer Jacobs Group, a health insurance broker.
What if they gave a public hearing on hospital budgets and no one came?
Answer: It wouldn’t be much different from prior years, when fewer than a handful of us pleaded with the Public Oversight Commission (POC) to ask tougher questions. Who were we? Folks who pay for private insurance and wanted someone to stop the cost shifting, who wondered about the explosive growth in outpatient surgery, who asked about the inexplicable variations in hospital use from region to region, who wanted the POC and BISHCA to connect the budget permission with requirements for improving quality and safety, and so on.
I was there as a cost-containment, quality and patient- safety advocate. But it was lonely. I wanted more of the employers, unions and employees paying for coverage to be there. I wanted to hear the single-payer advocates’ viewpoint, but they didn’t show up either.
It’s not surprising, then, that the Public Oversight Commission was disbanded by Act 48 (H. 202) this year, and the usual two weeks of hospital budget hearings collapsed into a single afternoon over VT Interactive Television. One would have surmised from prior years that hardly anyone cared.
This year, the Shumlin administration will be arguing they have tamped down system growth — to below 4 percent (once they give the hospitals “deductions” for numerous items that really, actually, did drive up hospital costs, and for which hospitals will have to collect money from private payers). Whether you use the revenue figure before or after the tens of millions of dollars in “deductions,” however, should not draw attention from the rate increases to be charged to private payers. (See my blog on this topic.) This continues to be unsustainably high.
And once more, people ask: Why are the rates charged to us going up at twice the rate of hospital revenue growth? Because of government cost shifting. Because we have to pay our share of the needed revenue growth, AND Medicaid’s share, AND Medicare’s share.
And, we have to pay hospitals back for the provider tax the Legislature and Shumlin administration imposed on them this year. And down the line, we’ll pay the new tax on medical and dental claims. All of this drives up our insurance premiums faster than the rate of underlying system growth.
We are not given many opportunities to talk back to government about these things. The hospital budget hearing (Aug. 4, VT Interactive Television sites around the state) is probably the only chance we’ll have until the next session of the Legislature.
So, show them it matters to you. Show up for the hearing. Tell them to stop the cost shifting and the shell games with provider and insurance claims taxes. Make them take responsibility today if insurance rates climb in January 2012.
Don’t accept the answer that the single payer will fix everything – that is, unless you can wait until 2017 (ETA, or Estimated Time of Arrival, for the single payer) for that to happen. It’s never too early to start cost containment.
