Morning Read: Health insurance battle in Mass. heats up

Highlights of the important and interesting from the world of healthcare:

Health insurance battle in Mass. heats up: In what’s become a bit of a poker game in Massachusetts, health insurers have just pushed a bunch of their chips into the center of the table. Most insurers in the state have stopped offering new policies to individuals and small businesses, the Boston Globe reports.The move comes after six insurers, including Blue Cross Blue Shield, filed a lawsuit over the state’s plan to impose what amounts to rate caps on small-business premiums. The insurers argue that the caps are a “reckless decision … based in politics.” A little background: last week, Gov. Deval Patrick’s administration shot down 235 of 274 rate hikes that insurers sought, with those rateincreases averaging between 8 and 32 percent. The state says any increase should be closer to the medical consumer price index, which has a 4.8 percent inflation rate. The insurers say they’ll lose hundreds of millions of dollars if the rate increases don’t go through.

Small businesses, not surprisingly, are on the state’s side since the caps would save them money. Politics are in play, too, as Patrick’s potential election opponent this year is a former insurance company executive. This is one that bears watching, because if the Massachusetts rate caps stand, other states will no doubt want to follow suit. And that would make health insurance a far less desirable business to get into.

Complex and costly spinal surgeries on the rise: Call this example No. 5,001 of the power of marketing to trump medicine. Complex fusion surgeries to treat spinal stenosis increased 15-fold from 2002 to 2007, Reuters reports. Yet studies show complex spinal fusion surgeries offer little benefit over simpler procedures for most patients, and increase the risk of complications. So while the number of overall spinal-stenosis procedures (both complex and not) fell slightly, the cost of hospital procedures to treat the condition jumped 40 percent, according to a study in the Journal of the American Medical Association. So why do these procedures persist? They apparently don’t benefit patients. But they do benefit device companies like Medtronic, Stryker and Johnson & Johnson.

So once again we see when it’s left to the market to determine what’s thebest medicine, pretty much everyone loses–except those who stand to profit from selling the idea that more and costlier care equals better care.If this sort of thing persists–and it will–the failure of the private market will leave us with no other choice than government intervention. When that happens, don’t shed a tear for the device companes–they’ll have brought it on themselves.

Health reform = “mass confusion”: Those of us who have closely followed the health reform debates can easily lose sight of an unfortunate reality: Despite the fact that reform deliberations in Congress stretched on for months, much of the public remains relatively clueless about the substance of the new laws. The Miami Herald reports that consumers are calling insurance brokers asking about “free Obamacare” and inquiring if they can sign up immediately. It’s tough, however, to fault people who aren’t all that interested in health policy for their ignorance. Health policy and insurance isn’t the most exciting of topics and it can be complicated. So it’s good to hear that the Obama administration is embarking on a years-long public education campaign about the overhaul, with an emphasis on “years long.” With many changes not scheduled to happen until 2014, the administration has some time. And Obama and friends are going to need every minute of it.

Photo from flickr user Norman B. Leventhal Map Center