Are Mass. health care costs rising too quickly?

But there’s a good reason for all this spending: Health care is vital and valuable.

To make sure people get necessary care, but don’t overspend, the Massachusetts Legislature set a goal for the state: Health care spending — from patients, organizations, and state government all together — shouldn’t grow any faster than the state economy.

By that standard, 2014 was disappointing. Total health care spending grew 4.8 percent, according to a recent report from the Center for Health Information and Analysis, the state’s official health care number crunchers. That’s a substantial jump from the year before and well ahead of economic growth.

Is this a blip or the sign of a growing crisis?

There are certainly reasons for concern, like the increase in prescription drug costs. But the big picture is more reassuring. Compared to where we were a decade ago, when health care spending was increasing by 8 and 9 percent per year, 4.8 percent remains relatively tame.

What caused the uptick in health spending?

First, let’s rule out a few things.

Private insurance didn’t get that much more expensive. By CHIA’s calculations, the cost of your work-sponsored insurance plan actually grew a fair bit slower than the economy.

Another candidate is fallout from the 2014 failings of the state’s Health Connector website, but this is likely to explain only a small portion of the increase. When the Connector was inoperable, and it was difficult to determine which plans people were eligible for, the state made room in MassHealth, the Medicaid program.

While this certainly led to more MassHealth spending, it’s not clear why this would substantially increase health spending overall. Had the connector worked, many of these MassHealth enrollees would have ended up getting other insurance and visiting the doctor just as frequently. Their insurance would be different but not their medical spending. (Things get a little trickier for people with two forms of coverage, but the effect is likely small).

Ultimately, there are two things that can really boost health care spending: higher prices and greater usage. And in 2014, Massachusetts seems to have had a little of each.

One site of higher prices was the pharmacy, where CHIA found spending increased 13 percent, possibly because of new, expensive drugs.

As for greater usage, there are several reasons people may have spent more time with a doctor in 2014. Some of it is just the advancing age of the population. But last year also seems to have brought a substantial number of newly and lightly insured people into MassHealth. For these previously underinsured folks, enrollment in MassHealth would provide a genuinely new opportunity to seek and get care, which would increase overall health spending.

What can be done to reduce health spending?

Massachusetts, like much of the United States, is in the midst of a great experiment, trying a host of approaches in search of something to effectively tamp down health care spending.

In 2012, the Legislature passed a health care cost control law, establishing the principle that health spending shouldn’t outpace economic growth and setting up a commission with the ability to name and shame providers who fail to keep costs down.

Also in recent years, private and public insurance groups have started changing their reimbursement policies, making sure doctors get paid to provide good care, not just order tests.

What is more, there are efforts to get consumers more involved. One facet of this is the push to raise deductibles and increase out-of-pocket spending as a way to ensure that people think twice before opting for expensive, and possibly unnecessary, procedures.

Here’s the problem, though. One person’s spending is another person’s income. The rapid rise in spending can be seen, from another angle, as the rapid growth of the health care sector — just change the headline from “health care spending jumps 4.8 percent” to “health care industry grows at rapid 4.8 percent rate.”

A fast-growing health care sector has its benefits, including more money for doctors, nurses, insurers, and pharmaceutical companies.

This isn’t a reason to abandon the goal of health care cost control, but it’s a reminder of the mission’s real purpose: not to cut spending arbitrarily but to cut waste.