So much for America’s ability to manage health care costs without health reform: health costs will increase in the double-digits this year, according to Buck Consultants21st National Health Care Trend Survey.

This annual survey monitors medical trend — the factors that drive cost increases. These include inflation, service utilization, technology, adding new programs, changes in service mix, and benefit mandates.

The chart illustrates that medical trend varies across plans — but not my much. High-deductible consumer-driven health plans expect growth of 10.4%: hardly a significantly lower rate of growth than for the most open, rich plans (PPO, POS).

Buck Consultants notes several driving trend factors that haven’t ameliorated growth rates in the U.S. Among them:

  • The practice of so-called defensive medicine and increases in malpractice premiums, costs for which are passed on to payors and plan sponsors.
  • Advances in medical technology.
  • Mandated benefits such as mental health.
  • Hospitals’ bargaining leverage as they consolidate into larger systems, among others.

Buck Consultants conducted this survey among 108 insurance organizations in the second half of 2009. Plans included Aetna, CIGNA, Blue Cross/Blue Shield plans, Kaiser Permanente, United HealthCare, and other plans and TPAs. The plans surveyed represent 78.2 million covered lives.

Health Populi’s Hot Points: The double-digit cost increases that Buck Consultants expect are over twice the rate of general inflation in the U.S. expected in 2010. Thus, the marketplace isn’t nearly moderating health costs on its own without the influence of health reform.

As this survey was completed during the second half of 2009, employers were continuing to lay off workers and the newly-jobless received subsidized COBRA payments to access health insurance. But the anticipated increasing medical trend will continue to negatively impact both employers, their active employees who share in paying for a health benefit, and those without jobs. If there’s a statistic that should re-focus and -concentrate the minds of health policymakers, it’s this one.

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