Lowering Healthcare Costs in New Hampshire: Where to Start

Lowering Health Costs Can Be Overwhelming

The U.S. today has the highest healthcare costs globally but ranks below other Western countries in health outcomes. The U.S. also has one of the highest infant mortality rates among developed countries, at about 5.4 deaths per 1,000 live births. Comparable countries, like Norway or Japan, have rates closer to 2.0-2.5 deaths per 1,000 live births. Millions of Americans remain uninsured or underinsured, creating barriers to accessing preventive and routine care.

In contrast, countries with universal healthcare systems (e.g., Canada, the UK, or France) ensure coverage for nearly all citizens, leading to earlier detection and management of illnesses.

In 2022, U.S. healthcare spending exceeded $4.5 trillion, representing 17.3% of GDP. Here in New Hampshire, costs are substantial too, with average per-person expenditures at $11,793 and the cost of family premiums and deductibles adds up to nearly half (49%) of average wages. Rising deductibles and limited access to preventive care lead to poorer health outcomes, creating tough choices for many Granite Staters. Across New Hampshire, people are feeling the impact: many are forced to ration medication, wait months for appointments, or choose between paying for healthcare and feeding their families.

Factors such as hospital mergers and provider consolidation, labor shortages, and high deductibles make accessing care increasingly challenging. For example, growing maternity care deserts mean pregnant patients often need to drive over an hour to reach a provider or hospital. Rising healthcare costs have an unsustainable negative impact on individuals, families, businesses, and even state resources, and we must take decisive action toward more accessible, affordable healthcare. 

While there’s no single solution, by focusing on several key areas of improvement, New Hampshire can move toward a more sustainable and equitable healthcare system.

Shifting Investment to Primary and Preventive Care

Preventive care saves money and improves outcomes, yet our healthcare system resources are largely focused on more acute care and treatment for chronic disease. More investment in these frontline services can improve overall population health and reduce costly, avoidable hospitalizations, emergency room visits and expensive specialty care. More knowledge and accountability about current primary care spending levels would help guide these interventions. Policies that measure and report on primary care and require more investment in primary care by setting spending targets should be a priority action for achieving more cost-effective care. 

Expanding Resources for Consumer Protection

We know that high costs are a problem, but for many people, it is the complexity of the system and the difficulty in understanding how and where to access care that are equally daunting. Providing patient navigators, advocates and legal services to help individuals understand their rights, avoid overcharges and receive fair treatment in the health care system will enhance access and help restore some trust.

Creating More Health Care System Oversight

Establishing a Commission to examine current health cost trends and offer policy solutions to promote an affordable, efficient, and transparent health care system will advance the knowledge and the dialogue among stakeholders for addressing health costs. Working to enhance the existing authorities at the Department of Insurance, the Department of Health and Human Services and the Department of Justice, we need more tools and transparency for assessing system spending and affordability, and more resources dedicated to analyzing and promoting options for system improvement.

The New Hampshire Health Cost Initiative: Moving Forward Together

The New Hampshire Health Cost Initiative (NHHCI) seeks to address these complex issues by bringing together healthcare consumers, providers, business owners, and community leaders to develop practical solutions. By focusing on trust, transparency, and collaboration, we’re working to ensure that all Granite Staters have access to affordable, equitable, and high-quality healthcare. Through community engagement and sharing the experiences of patients and families, we can find pathways to reduce healthcare costs and improve outcomes, benefiting patients, supporting businesses, and strengthening communities across our state. Through dialogue and partnerships, NHHCI aims to lift up the voices of those most affected by rising costs and provide accurate information and new perspectives to drive meaningful change.