Health Costs

HCIA Inc., the Baltimore health data company, said yesterday that it has formed a relationship with Bristol-Myers Squibb Co. to develop uses for U.S. health care data collected for the pharmaceutical giant."

In a short operation yesterday, surgeons replaced the pacemaker of a 115-year-old Baltimore man. The battery in the original one, implanted when John E. Bell was 104, had run out.Because of his general good health and the low risk of the operation, physicians at Johns Hopkins Hospital had little doubt that Bell should get the procedure.His heart's internal system for signaling beats no longer works. Without the pacemaker, he would die."He outlived the battery," said Dr. Ronald Berger, the Hopkins cardiac electrophysiologist who performed the surgery.

EMPLOYERS and government agencies seem to be winning the war against higher health care costs. Last year, hospital charges, doctor fees, MRI scans and other medical costs rose by 3.9 percent. That was faster than inflation generally but still the smallest upward ratchet for health care since 1972.Is the day of double-digit medical inflation over? Some analysts don't think so. Progress recently has come largely from wringing excessive care out of the system, they say. By refusing to pay for unneeded hospital stays and by forcing doctors to work more efficiently, HMOs and other "managed care" insurers have removed much air from the medical balloon.

State officials are building an extensive computer bank of Marylanders' medical records, alarming doctors and civil libertarians who fear it threatens the privacy of patients.Information on a patient's visits to doctors and other health professionals -- whether for a cold, treatment of AIDS or a mental illness -- is being fed into the computer system.Hundreds of thousands of patient records already have been collected this year without patients' knowledge. Experts say Maryland is on the way to having the nation's biggest computerized health profile of patients and doctors.

WE KNOW what the voters didn't like about President Clinton's health reform proposals -- more control by the federal government, employer mandates, higher taxes to cover the poor and, above all, price controls.The question is how long the voters will remain satisfied with what they have now.Two out of three Americans have good health insurance or Medicare, and they assume that their employers or the federal government pay for it.In fact, of course, the primary payers are working people and the taxpayers, since if there were no employer or government-financed health insurance, wages would be higher and taxes lower.

WASHINGTON -- You're probably among the majority of Americans when it comes to health reform, suffering from cerebral gridlock over the dizzying proliferation of plans.Which one's best for you? The question is more timely than ever. After weeks of committee fighting, the congressional reform debate shifts to the full House and Senate, which hope to act before a recess in mid-August.As confusing and complex as the plans are, some conclusions can be drawn:* All the major plans would provide insurance subsidies to very poor people and bar insurers from denying coverage to those with health problems.

WASHINGTON -- In a setback to President Clinton's effort to control health costs, federal officials have discovered that the government no longer collects the data needed to set a health budget for each state, as Mr. Clinton had promised to do in the 1992 campaign.The discovery forecloses one method of controlling health costs and forces the Clinton administration to seek other ways of achieving the same goal, perhaps through direct federal regulation of prices in the health care industry.

DETROIT -- As strategies for 1993 bargaining between the United Auto Workers and Big Three automakers begin to unfold, General Motors shows no signs of backing off an emotional demand: an end to virtually free health care for blue-collar workers.GM's key demands so far:* Payments in excess of $100 per worker per month for basic medical coverage. UAW workers now pay nothing except for office visit charges and $3 to $5 for prescriptions, if they use traditional Blue Cross coverage.* Higher out-of-pocket expenses for workers who have perceived health risks, like smoking, than for workers who don't.

All employers should share health costsI am writing in support of mandatory employer coverage of health insurance.Our business in Baltimore County, of which I am chief executive officer, offers such coverage for our employees on a cost-sharing basis. I believe that the cost of health insurance is part of the cost of doing business and should be the responsibility of the employer.Businesses that fail to provide health coverage to their employees hurt those of us who act responsibly by shifting health costs to our businesses.

While politicians wrangle over how best to solve the nation's health-care crisis, consumers can help themselves now by becoming better shoppers for health services.Taking a more active role in health-care decisions is especially important because employers continue to ask workers to pay a greater share of health costs.Perhaps the biggest barrier consumers face initially is their attitude. Traditionally, consumers play a passive role in the health-care system, going along with whatever doctors and hospitals recommend without asking questions.

Everybody complains about energy costs. Although gas prices have plunged from last summer's highs, energy is still one of the most visible culprits in the inflation that eats away paychecks, government budgets and corporate profits. But $4-a-gallon gas was nothing compared with what's going on in medicine. If petroleum prices had kept pace with health insurance costs over the last three or four decades, we would now be paying $8 a gallon for gas and perhaps looking forward to $15. A small but not insignificant step in the march of the health care monster will take place Wednesday morning before the Maryland Health Services Cost Review Commission.

A single-payer system is better health choice The Sun's editorial "Handling health costs" (March 9) notes that all the choices for reining in the cost of Medicare and Medicaid are "unpleasant." The Sun neglects to mention the most meaningful choice available to us: to stay with the system we have right now or to adopt a single-public payer system in which the federal government would fund health care for all. What we have now is a single-payer system funded by federal and state governments for those eligible for Medicare and Medicaid, and a private-payer system for all others.

Medicare and Medicaid cost $627 billion last year - almost a quarter of all federal spending. That amount is expected to double within 10 years as baby boomers overwhelm the Medicare program. Yet you won't hear much on this subject from Sens. Hillary Clinton, Barack Obama and John McCain. They fear discussing it because all the conventional choices for reining in the cost of these programs are unpleasant. They include limiting care, raising taxes, reducing payments to providers and asking wealthier beneficiaries to pay more.

There's nothing more important than your health. It sounds like something a parent would say. But, now, many employers seem to be just as concerned. This fall during open enrollment, the period when workers can re-elect or pick new company benefits, you may find several changes in health-plan options, all stressing healthier lifestyles - and fewer costly claims. "Companies want to get employees more involved in managing their health care," said Scott Ziemba, a senior consultant at Watson Wyatt Worldwide Inc., a human resources consulting firm.

WASHINGTON -- Government figures released today show that Americans might be getting a respite from the torrid pace of increases in health care spending, but experts warn that it is too soon for a national sigh of relief. The data show that in 2005, spending on health care grew 6.9 percent. That was the smallest rate of increase since 1999, and marked the third straight year in which the pace had moderated. In 2004, for example, spending grew by 7.2 percent. Because of the time required to collect and analyze data, the 2005 numbers are the latest to be released.

Some political issues - immigration, crime, gas prices - can heat up rapidly, rising to the top of lists of voter concerns, and cool down just as quickly. Health, however, often seems stuck at lukewarm. It is an issue that almost always gets mentioned in campaigns, but often not in detail. It is always somewhere on the list of serious voter concerns, but is almost never at the top. In Maryland this year, major candidates have issued proposals and position papers on health, but the issue hasn't been a major feature of most campaign ads. The problem is: Health care - and paying for it - is a large and growing concern for most Americans, including many in Maryland, but neither politicians nor voters have many fresh ideas on what to do about it. Since the year 2000, the number of uninsured in the country has increased from 39.8 million to 46.6 million, according to the latest estimates from Census Bureau surveys.

Business owner John Wagner is thinking hard about establishing health savings accounts for himself and the roughly 50 workers for whom he provides medical insurance. The accounts, created in 2003 by the Bush administration, allow employees or individuals to save money in tax-advantaged investment vehicles for routine health needs not covered by accompanying high-deductible insurance plans. Contributions to HSAs are tax deductible, and withdrawals are tax free if used for qualified medical expenses.

DUBLIN, Ohio -- President Bush, speaking at the home office of the nation's third-largest purveyor of hamburgers and French fries, talked yesterday about good health and his plan to help the nation pay for it. In the lobby at the headquarters of Wendy's International, Bush urged Americans concerned about health care costs to consider a fledgling government program built around high-deductible insurance for catastrophic illness or accidents and tax-free personal...

WASHINGTON - For the first time in five years, employer costs for health insurance didn't increase at a double-digit rate this year, according to a national survey released yesterday. At 9.2 percent, the rise in cost wasn't much below the double-digit marker, and was more than triple the growth of workers' wages. And the percentage of employers offering health coverage continued to tick downward, to 60 percent - from 63 percent last year and 69 percent in 2000, according to the random survey of more than 2,000 employers.

WASHINGTON - At a time when Congress has been torn by partisan battles, 24 ideologically disparate leaders representing the health care industry, corporations and unions, and conservative and liberal groups have been meeting secretly for months to seek a consensus on proposals to provide coverage for the growing number of people with no health insurance. The participants, as diverse as the liberal Families USA, the conservative Heritage Foundation and the U.S. Chamber of Commerce, said they had made progress in trying to overcome the ideological impasse that has stymied action on the problem for eight years.