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Posted on August 28, 2001

HMOs eyeing surcharge for high-end care

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Boston Globe
August 28, 2001
by Liz Kowalczyk

"Several managed-care companies, including Tufts Health Plan in Massachusetts, will introduce plans in 2002 that level a surcharge on consumers who choose to visit more expensive (teaching) hospitals. Aetna is planning a similar product in Massachusetts next year and the HMO giant PacifiCare in California will introduce a surcharge on certain hospitals in eight states. The charges, or co-payments will be in the range of several hundred dollars per visit."

Kevin Counihan, Tufts senior vice president for sales and marketing:

"This is what our employers want. They're looking for a greater level of consumer engagement."

Jon Kingsdale, Tufts senior vice president for planning and development:

"We're not talking about bankrupting people here."

<http://www.boston.com/dailyglobe2/240/nation/HMOs_eyeing_surcharge_for_high_end_care+.shtml>http://www.boston.com/dailyglobe2/240/nation/HMOs_eyeing_surcharge_for_high_end_care+.shtml

Comment: "Greater level of consumer engagement," but short of bankruptcy... at the same time that premiums will be rising 8 to 15 percent next year in Massachusetts. Cost containment has not been possible under the current model of marketplace health plans. Both employers and insurers are shifting more and more of the costs to the benificiary-employee-patient. In a personal communication, a very prominent professor of public policy and economics wrote, "My guess is that around 2004-5 all hell will break loose in American health care, if current cost trends continue." It is imperative that we immediately place before the American public the plan that will contain costs while bringing equity to our health care system: a globally budgeted, publicly administered, universal program of health insurance. We may not be able to enact it until "all hell breaks loose," but, if we are not prepared, the scavengers will move in and devour what is left.