If there's one thing everyone in the health care debate agrees on, it's that whatever reforms we embrace have to lead to more affordable health care. Businesses, individuals, hospitals and insurers face the same problem: how to moderate ever-higher health care expenses.
Stemming these rising costs was the primary reason given recently when the Maryland Health Services Cost Review Commission set hospital rates at a below-inflation rate of increase for the coming year. Unfortunately, the commission's action to limit the increase in hospitals' charges to 1.49 percent could harm health care delivery in Maryland. Moreover, it is unlikely to stem the rise in health insurance premiums.
Hospitals have been hammered by the recession. The commission's decision further stresses hospitals financially and may drain resources from needed health care programs and community services. Hospitals are concerned that vital care professionals could face layoffs at the very time the state is looking to health care to help lead us out of the recession.
Despite restraint in the rise of hospital rate increases, insurance premiums have consistently risen faster than inflation. Employers have reacted by decreasing coverage and shifting costs to employees. In the long term, these moves, which are driven out of economic necessity, will likely harm the health of the whole community.
So, what is driving costs up? And what can be done about it?
One cause is that we are overusing our health care resources. Needless duplication of tests, diverging incentives for hospitals and physicians, preventable hospital readmissions, a failure to recognize the value of primary care, and a lack of care coordination especially for the chronically ill - all of these things waste resources. In Maryland, we are beginning to attack health care's true cost drivers.
Maryland hospitals are working on a number of fronts to reduce complications and associated costs. The Anne Arundel Medical Center used a multidisciplinary team approach to produce drastic reductions in preventing ventilator-associated pneumonias. At Johns Hopkins Bayview Medical Center, careful coordination has resulted in the elimination of all bloodstream infections for more than one year.
