It’s crucial that we cut health care costs.
It’s not just about the economy, although rising health care costs are wreaking havoc on budgets from the city level to the federal government. It’s also about access: if health care gets too expensive, many people simply cannot afford it.
In an effort to tackle this problem, many insurers are using “tiers.” In this system, hospitals and health care providers are placed into tiers based on cost. If employers or consumers use hospitals and doctors in the higher-cost tiers, they have to pay more to do so.
At first glance, this seems like a good idea. There appears to be freedom to choose among tiers, and it gives an incentive to hospitals and doctors to cut costs, so that they can move to a less expensive tier.
But tiers can cause real problems, especially for patients with complex medical conditions. In some cases employers purchase plans that place essential services or providers in higher-cost tiers. And some consumers can’t afford the additional costs of those tiers. This can actually keep patients from the care they need. That’s why James Mandell, MD, CEO of Children’s Hospital Boston, joined Edward Benz, MD, president of the Dana-Farber Cancer Institute, to write this Op-Ed for the Boston Globe.