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3/5/2007
What are YOU doing to control health care costs?
I know, I know…. Doctors and corporate health care CEO’s are paid too much. Shareholders are reaping huge profits. Too many tests, too many non-emergencies in the Emergency Room. Oh, and the insurance companies. Of course – they’re skimming bucks off at every stop.
It’s always someone else’s fault.
Well, it’s not everybody else. It’s you and I that have to fix this thing.
Two articles that are “required reading” show up in FoxPolitics News today:
Pay-for-performance; employees need information (Jrnl Sntl)
Torinus: Health care CONSUMERS are the answer (Jrnl Sntl)
Last week, FoxPolitcs News linked to an article on the upcoming expansion of Kohl’s, including on-site medical care for employees. John Torinus’ Serigraph in West Bend continues to lead the way in creative approaches to employee health care and employee health care costs.
This is a test:
- Do you know how much your physician charged the system for your last visit?
- Do you know the most you might pay for an MRI? The least? Where?
- Do you know how much your insurance company (or your employer’s insurance company) paid in health care costs on behalf of you and your family in 2006?
- Do you know how much you paid for health care, including prescription drugs, in 2006?
- Do you know how much your employer pays annually for health insurance for you and your family?
- How recently have you called a number of drug stores to determine the best price for a prescription?
- How recently have you asked your doctor if she prescribed a generic drug? If she didn’t, have you asked if there’s a generic option?
- If you use any kind of prescription drug or product, how much does it cost (not just you – the whole system)?
- Do you and your family members – parents, aunts, uncles, sisters, brothers… have health care directives in place?
- Have you talked with your family about how much treatment you or they will want as they near life’s end?
- Do you smoke? If yes, when will you quit?
- Do you drink excessively, eat excessively, loll around on the couch excessively?
It’s all about “Value-Driven Health Care;” paying for your health care like you do almost everything else around you – like a smart, educated consumer who wants the best product at the lowest price. Gasp! Unheard of by most Americans these days….
John Torinus, a leader in reducing employer and employee health care costs, put it this way in yesterday’s column: “The ultimate answer for the introduction of competitive dynamics to what is now a non-marketplace, is to create consumers (my italics). As employers adopt consumer-driven health plans, they turn loose an army of buyers with their own money at stake.”
Go out and do your part.
COMMENTS
There is one and only one driver of health care costs that matters and that is cost shifting. In Wisconsin the balance between commercially insured health care, self insured health care and publically insured health care is moving in the wrong direction. The commercialy insured population in Wisconsin has declined 35% since 2000 while the publically insured population has increased by 23%. The publically insured programs pay far less for the same procedures and the cost is shifted to the commercial carriers and the self insured. Employers are in effect subsidizing the publically funded populations, and that is a major driver of cost increase. We are currently rearranging the deck chairs on the Titanic. Shopping for cheaper health care is not the solution until we arrive at a truly equitable solution and some form of control. The only practical thing we all, including employers, can do is stay healthy. Eat more skinless chicken breasts and drink more water and exercise. Additionally we can begin charging extra for smoking, obesity and other conditions that are known to cause disease. So as employers we need to increase wellness expenditures, hire wellness experts and understand the benefits of wellness. We can also purchase insurance products from companies with documented fixed reimbursement in place, preferably for 3 years. We also need to discuss the cost shift issues with legislators and participate in negotiations with providers. There are no simple solutions. Health care in America is broken.
Bob Pedersen (Mon Mar 05 08:47:31 2007)
This article is a bunch of bunk. When you have a certain health plan it doesn't matter what doctors charge, you can only go to certain doctors who are contracted with your precise plan. It is the same situation with buying drugs. So my point is choice is NOT there.
The insurance companies are cheating whoever they can (patients and/or providers) in every transaction made. They find ways to NOT pay whenever they can. They contract with doctors for huge unfair discounts, they charge large monthly premiums for health care to patients and businesses, and then the insurance companies in many cases refuse to pay fairly or try to skim money any way they can. You see... I am a medical biller and I have done billing for my husband’s private practice for the past 6 years and I am personally involved. And as far as Medicare and Medicaid, they have made so many cuts and they mandate what they will pay (since when do you provide a vital service and some entity tells you what your service is worth and that amount is so out of whack with reality and you have to accept that amount ...no negotiations...no accept ions that is the price take it or leave it and then be stigmatized that you don't care about the old and poor people if you do not!) It hardly pays enough for a doctor’s gas to drive to work to see the patients covered by those governmental systems.
The health care premiums are so high because the government medical insurances pay sooo little that doctors raise their prices to private insurers to make up the difference. (A nice hidden tax the government just kind of snuck in there)
These are the true facts about our money crazed healthcare system. I know for a fact that a shortage is coming because of this greed. Who would want to spend 12 grueling years in school and residency to become a doctor just to be pushed around by big insurance companies and a government that does not value them?
My conclusion to this dilemma is for a nice big "Doctor Revolt". So doctors will be appreciated and given back their integrity. So they can do their jobs and really help the people and get paid fairly with out all the pimping off their intelligence and education.
Elizabeth V (Mon Mar 05 09:02:56 2007)
Since my husband and I turned 55, the magic 'bump' year for health insurance rates, we were priced out of our insurance company. The insurance company upped our yearly out-of-pocket expense from $2500 to $20,000 per calendar year and our monthly premiums to over $1,700. Even though we have a HSA, we simply could't afford those increases that were simply imposed on us.
The problem with just thinking that consumers will drive the changes in health care is that it is impossible for an individual to actually purchase a product on the market. Change will only occur when employers loudly disclose what the total costs are annually to pay for health benefits at their companies and refuse to be the only conduit for health insurance purchase.
If everyone were required to purchase their own insurance, the insurance companies and health care providers would be forced to present cost structures that are more open to scrutiny. It would also level the marketplace for all so that no matter what size company one works for, one still has a chance to purchase insurance.
I also recommend that patients call their doctors and clinics when they receive their bill. I have been successful getting our bill reduced when I speak to the provider directly.
Phyllis Klee (Mon Mar 05 14:30:06 2007)
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