They don't get much media coverage, but the Health Care Cost Trend Hearings being held by the state government right now offer a variety of opinions about the current health care situation in Massachusetts. The prepared statements of the witnesses are available here.
If you only have time to read one thing, look at this statement from the Attorney General. It is as thoughtful and comprehensive a view of the Massachusetts market as can be imagined. Excerpts:
Price variations are correlated to market leverage as measured by the relative market position of the hospital or provider group compared with other hospitals or provider groups within a geographic region or within a group of academic medical centers.
Variations in providers’ per member per month expenses are not correlated to the methodology used to pay for health care, with expenses sometimes higher for globally paid providers than for providers paid on a fee-for-service basis....
These findings have powerful implications for ongoing policy discussions about ways to contain health care costs, reform payment methodologies, and control health insurance premiums while maintaining or improving quality and access. The report raises concerns that existing systemic disparities in prices may, over time, create a provider marketplace dominated by very expensive “haves” as the lower and more moderately priced “have nots” are forced to close or consolidate with higher paid systems.