With lawmakers still weighing the House and Senate plans to cut health care costs in Massachusetts, the Globe asked experts to lay out their own strategies to bring down prices. Have more ideas? Send them to healthcare@globe.com.
Stop building hospitals
“The presence of so many hospitals in Boston — along with high numbers of physicians, particularly specialists — contributes to the enormous amount of unnecessary medical care that gets delivered in the state. Unless Massachusetts finds a way to limit growth in the supply of both hospitals and specialists, the state’s efforts to control health care spending are likely to be thwarted. . .
“Governor Deval Patrick should also use his executive power to put a halt to hospital expansion plans. Even with an aging population and greater access for citizens who were once uninsured, Boston has all the hospital capacity it needs.”
— Shannon Brownlee
Lift insurance rules
“Under political pressure. . . far too many mandates and fees have been enacted, which shift costs onto the backs of consumers and taxpayers. . . In vitro fertilization coverage, required in Massachusetts, is just one example. Everyone should have preventative and hospital coverage. Yet consumers should be given the option to buy other coverage only if they want or need those services — not by government mandate. To tell consumers that they must buy health insurance under the law, and then make them pay for benefits and assessments they don’t want, will never use, and can’t afford, is inflationary and unfair.”
— Jon B. Hurst
Scrap the middleman
“Why exactly do we pay private insurers 10 cents of every premium dollar? The plan that covers all 13 million residents of the Canadian province of Ontario has overhead of only 1 percent. Adopting that single-payer approach in Massachusetts would save about $2 billion in insurance overhead in 2013 alone.”
— Dr. David U.
Himmelstein and Dr. Steffie Woolhandler
Improve end-of-life care
“I, along with a loose network of 100 physicians, patients, and families from around the country, have created a library of digital videos to better inform patients about their medical options as they approach the end of life. . . [The videos] empower patients with the knowledge needed to make informed decisions. . .
“Some people have accused me of advancing video decision aids to decrease cost. I cannot deny that a patient-centered approach may indeed lead to decreased costs — and this is a reason to be vigilant about the way they are used. Potential cost savings must not overshadow the primary goals of videos, which are to improve quality, patient-centeredness, empowerment, and ethical outcomes. When a patient opts for aggressive treatment after being fully and truly informed, then this choice should absolutely be embraced.
“But, I have seen that many patients are not informed, and I have seen that relying on verbal means of communication is prone to failure. When informed, most people with an incurable illness prefer to limit aspects of their care. . . I cannot see how an intervention that first and foremost leads to better patient-centered health care, and that happens to lower health care costs, is anything but a good thing.
— Dr. Angelo Volandes
Read more at bostonglobe.com/opinion/specials/health