Remember that old song?  God help me, this really dates me.  That was the title of an album by Bob Dylan, released in (Help me again, God!) January, 1964.  Holy cow, that was 49 years ago!!

Anyhow, it took 49 years for Bob to be correct, at least insofar as health care is concerned.  But it is finally happening – despite the best efforts of politicians everywhere.

You see, politicians like to believe that they’re more than posturing, bloviating blowhards.  They’re not, but if they can keep us fooled they’ll have a job and power for life.  So they want us to think that they can somehow affect the laws of economics.  Stupid, stupid, stupid.

Let me explain.  For years health care costs have been rising faster than inflation.  Stupid politicians like those in Massachusetts (from the top, i.e. governor, on down through both houses) think that they can wave their magic wand and declare that – going forward – health care costs will rise only so fast as inflation (actually, after some near-future date, at a rate 0.5% BELOW inflation).  So they passed a law that says that has to happen.

Just how stupid ARE they?  Rates may stay at that level, but NUMBER OF SERVICES will rise.  Doctor’s aren’t – nor should they BE – WILLING TO put themselves out of business or reduce their income to satisfy the ego-driven whims of a bunch or room-temperature-IQ dolts on Beacon Hill – or in Washington, DC.

Costs have gone up faster than inflation because another group of economically stupid people have created over the last 70 years a system in which the employee has NO STAKE IN THE GAME.  It used to matter not at all where you got your care – most expensive hospital, least expensive hospital, high quality, low quality … whatever.  You – the patient – PAID EXACTLY THE SAME NO MATTER WHERE YOU WENT.

So why should patients even care where they go?  They focused on things like closest, most convenient, best reputation.  All of which are ephemeral.

Now carriers are loading in deductibles under which THE PATIENT PAYS FOR THE COST of the treatment.  Suddenly, rates of increase of medical cost have dropped precipitously in the last five years, to about half or less of what they were in 2005-2007.

And carriers are now going to the next step – interactive, easy-to-use internet portals where you can shop – within the specifics of the particular plan you’re on – for the highest quality, lowest cost provider for the service you need.  Harvard Pilgrim, one of the “Big Three” of Massachusetts health is rolling out a site named, appropriately enough,  “Now iKnow.”

It will allow employees, based on their specific health plans, including benefits, deductibles and out-of-pocket costs to:

• Help them locate physicians and hospitals and give price comparisons for them.
• Show providers’ quality ratings using national benchmarking data.
• Enable consumers to “shop” for alternate physicians and hospitals while displaying costs relative to their yearly deductible totals and out-of-pocket expenses.

Is it a useful tool?  OF COURSE IT IS.

Did it come from the elected dolts in Massachusetts or Washington?  OF COURSE IT DIDN’T.