How Health Care Costs Affect Small-Town Living

21 Feb 2014
Health care costs are measured in trillions of dollars and typically illustrated on a national scale. This wide-angle view can be difficult to relate to and comprehend, but zooming in to look at the spending in one town offers a home perspective that people can understand. China, Maine, a small town with just over 4,500 residents, has started a ripple effect across the country and is spreading the word about the rising costs of health care and its impact upon municipalities.
Town manager of China, Maine, Dan L’Heureux, who is also a board member of Maine Quality Counts (MQC), leading partner for the Maine Aligning Forces for Quality (AF4Q) Alliance, has spent a lot of time thinking about the cuts he’s had to enforce as a result of health care costs. L’Heureux and Rosemary Gibson, a senior advisor at the Hastings Center and author of The Treatment Trap, about the overuse of unnecessary medical services, met at a meeting of MQC last year, and L’Heureux opened the event by painting a picture of China, its good people, natural beauty, and hardships. According to Dan L’Heureux, China has 11 municipal employees, and the annual cost of providing them with health insurance is close to $200,000. The cost of health insurance for one individual with dependents is equal to the town’s entire annual parks and recreation budget or the operation’s budget for one of the town’s three volunteer fire departments, added L’Heureux.
According to the Kaiser Family Foundation, Health Research and Educational Trust, Employer Health Benefits 2010 Annual Survey, health insurance premiums have increased nationally by 138 percent between 1999 and 2010, while wages have gone up 42 percent in that same period. In the 10 years, health insurance costs have risen by 141 percent in the town of China. During the same time period, the overall budget for the town went up only 42 percent. Something has to give.
L’Heureux and Gibson took their stories to the Lown Conference in Boston last December, where they led a session on the high cost of inappropriate and unnecessary care. The conference, From Avoidable Care to Right Care, featured several other high-profile speakers including Don Berwick, Shannon Brownlee, Rosemary Gibson, and Elliot Fisher. Speakers and participants alike reported they had never fully considered the vast impact of rising medical costs until attending L’Heureux and Gibson’s session. Kellie Slate Vitcavage, MS, director of communications for MQC, said their efforts have inspired a “firestorm of a discussion.”
Last week, US News & World Report, featured China’s story in an article, “How Health Care Costs Affect Small Town Living.” The piece uses China as a centerpiece for a problem plaguing towns across the nation: “The links are not simple cause-and-effect connections. But every time a school arts program is cancelled, or a bus schedule is cut back, or a road gets patched instead of re-surfaced, or a municipal swimming pool falls into disrepair, or bridge inspections are carried out less frequently, it’s a good bet that somewhere lurking in the shadows of a public budget is a whopping increase in health care costs.” 
“We are fortunate to have L’Heureux and appreciate his efforts in bringing this issue to the forefront. He is an outstanding representative of MQC’s mission,” said Lisa Letourneau MD, MPH, Project Director for the AF4Q Maine Alliance.
Read more about MQC’s efforts to strike a balance and improve health care for its residents here.