Newtown, CT – October 13, 2017
A battle in New England may, once again, ignite a revolution – Two weeks ago the clock ran out on negotiations between Hartford Health Care (HHC) and Anthem in Connecticut. They had been negotiating for several months and HHC expected to go through the usual kabuki dance and end up with what it wanted, significant fee schedule increases. Fortunately for residents and businesses of the Nutmeg State, Anthem held the line and should continue to hold it. The backdrop for this battle is important because it highlights the fiscal straights that many states in the union find themselves in, and the increasing understanding by state legislators, governors, and municipalities that we’ve arrived at a zero-sum game. There’s no more that can be levied from households or businesses. In fact, the level of local and state taxation has reached such heights in Connecticut that businesses and residents have left and continue to leave. And while the tax base is shrinking, the health systems have grown ever bigger, gobbling up smaller facilities and being allowed to do so under the guise that they’re “saving them.” Of course, that salvation comes with an immediate price hike, which is then passed back to those same municipalities, businesses and residents as an implicit tax via higher premiums. This game has been going on for some time and as health systems have become larger, they have become accustomed to asking for ever higher fees without delivering higher value. “Our revenue model demands it, if we’re to continue our great mission work” is the justifying cry. But what exactly is the benefit of that “mission” when it comes at the expense of urban development, education, fixing roads and bridges, and all the social services that are essential to the well-being of so many? And for once, someone has stood up and is paying a price for it.
What this means to you – It’s funny how some “missionaries” can turn to bullies when they don’t get to fleece the public at will. In this nasty battle HHC has provided the email address of Anthem’s CEO to its network providers and even her cell phone number to some. The HHC docs are passing the information to patients, encouraging them to barrage Anthem with emails, phone calls, and texts. They’re doing everything they can to force Anthem to cave under pressure, including filing some lawsuits. A few years ago, when I sat on a hospital’s finance committee, good news was announced to the cheers of all but me: double digit fee schedule increases had been extracted from the evil and greedy insurers. I wasn’t cheering because I had recently done the math on the burden of health care costs for my town’s school district and knew that a 10% increase in premiums would cause the reduction of at least two educators. So I reminded the other committee members that these increases weren’t coming out of magic secret coffers but out of the budgets of municipalities, school systems, small businesses, individuals, basically all the people the hospital was there to serve. The City of Hartford is on the verge of bankruptcy, the state of Connecticut has yet to pass a budget, and a double digit increase in costs of care will add to the misery. And for what? To deliver higher value care? Not according to our analyses. We’ve been crunching data for commercial insurers and Medicaid in the state for 5 years and I can tell you unequivocally that HHC is barely average in quality of care. We also note that Hartford Hospital has declined to respond to the Leapfrog group and we imagine why. After all, they have barely two stars on Medicare Compare and we all know how easy it is to be at least average on that rating system. No, this is simply the business-as-usual attitude of the privileged who don’t care how many people’s livelihood they crush as long as they keep getting their own. The battle is on and I’m on Anthem’s side because in this fight Anthem is on the people’s side. And if Anthem wins this battle, the tide may turn against all others who, like HHC want a lot and don’t give anything in return. And for those in Connecticut who are angry about HHC being out of Anthem’s network, do yourself and your family a favor and go to St. Francis instead. It’s delivering far better quality and, under the national leadership of Rick Gilfillan, it understands the importance of being an active actor in bringing about a high value health care system. It seems that HHC needs to understand that lesson the hard way, and they will when they lose this battle. And from this small corner of New England a new revolution may start from which we can shed the yoke of oppressive health care costs.