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Favorable view of Mass. health costs undone by the data

David Torchiana, president and CEO of Partners HealthCare, once again has recited Commonwealth Fund analyses of federal survey data showing that Massachusetts health insurance premiums are a lower share of median income than prevails nationally (“First, do no harm”).

But federal data on actual health spending contradict Torchiana. Massachusetts health spending per person was 36 percent above the US average, the highest in the world. After deducting Medicare and Medicaid dollars, private Massachusetts health costs per person were 40 percent above the US average, an excess of $11 billion over national average costs. Meanwhile, median income here was only 20 percent above the US average.

And US health spending is no bargain. It’s five times our defense spending. It’s also double the average for rich democracies, while citizens of other nations get more care and live longer.

Health costs fall heaviest on the half of people with below-median incomes. Since income inequality in Massachusetts is third-worst in the nation, our state’s lower-income citizens and their employers have particular trouble affording our state’s high costs and high insurance premiums.


Worse, high health costs propel employers to raise deductibles and co-insurance. These amount to taxes on being sick; they afflict everyone who needs care and fall heaviest on lower-income people.

To paraphrase the Marx Brothers: Who should we believe — Torchiana or our own lying eyes, wallets, and credit card statements?

Alan Sager

The writer is a professor of health law, policy, and management at the Boston University School of Public Health, where he is the director of the Health Reform Program.