Health Care Spending in Mass -> higher than the rest of us.

Strangely, per capita spending on health care has increased faster than the national average in Massachusetts even since the initiation of Commonwealth Care. I think early on there was this fantasy that providing care to the uninsured would help control costs. Wrong.

The problem is not complicated. Our health care costs so much because of (1) economic incentives for all parties involved (providers, insurers, hospitals, manufacturers, drug companies); (2) consumer and physician over-reliance on expensive, unproven technology; (3) refusal to ration health care resources.

#2 is a current hot topic in the Obama effort to restructure the health care system by investing in ways to study cost-benefit of new technologies with clinical evidence. The idea is that the government will pay for a new medical widget or procedure only if the best evidence shows that it improves health outcomes that seem to be a reasonable investment for the cost of the widget.

#1 is why socialized medicine will a tough struggle in the reform effort.

#3 is the elephant in the room nobody wants to talk about, but will inevitably enter the discussion of reform with #2.