Monday, February 13, 2012

One-Man Health Care Reform

A friend sent me this LA Times editorial this morning. Whom shall we blame for out-of-control health care costs -- insurance companies? health care providers? the uninsured (who drive up costs for everyone else)?:

Defending insurers is a bit like expressing sympathy for the devil, given how their premiums have skyrocketed. Not so long ago, this page blasted Blue Shield of California for proposing three rate hikes in quick succession that threatened to raise some customers' premiums by nearly 60%. Since then, however, the nonprofit has pledged to cap its net income at 2% of its revenue. The cap means that any future increases in premiums will be driven by higher charges from doctors and hospitals, not by increases in Blue Shield's operating margins.

Hospitals costs have risen particularly rapidly, with the average daily fee for a bed in an acute-care ward more than tripling since 2000. UCLA's reimbursements from Blue Shield have almost doubled in the last five years alone, the insurer says. That's partly because the university has been shifting onto Blue Shield some of the expense of treating patients with Medicare, Medi-Cal or no insurance. But it's a trend that even University of California officials acknowledge cannot continue.

One more culprit occurs to me: I and my fellow discretionary overweight insured. I can hold down health care costs and insurance premiums by losing 30 pounds and reducing the chances and expenses of adult-onset diabetes, cancer, heart disease, and stroke. I decided this morning I couldn't wait for Lent. Hold me accountable, reader!


MK said...

Good advice for all of us. My tip? Walking (combined with a sensible diet) is a wonderful way to get and stay in shape! I gained a bit of weight a few years ago when I injured my knee and stopped my daily walks. Lost it all and then some by committing myself to one or two hour long walks each day. Back down to what I weighed during 1989, my last year as a NARA employee.

Listening to my fave music on my iPod Shuffle a nice way to do it! Of course, it requires the right conditions to take the type of walks I do. I'm lucky I work near Capitol Hill which is a nice place to walk. And I live in the close-in suburbs where there are good sidewalks in the nabes and many shops within walking distance. And enough hills (which I look for in picking a route) to get some resistance.

Walking + listening to music = perfect thinking time for me! Much of what I blog about forms in my mind as I take walks and mull over what I've read, seen, or experienced. Added bonus? I've made so many friends among all the neighborhood dogs, LOL! Don't know all the neighbors; do know their dogs, ha.

Fr. John said...

All good advice, MK. For some reason this time of year, my 4-5 weekly walks slip to 2-3. Plus I'm an undisciplined snacker!

Susan Brown Snook said...

Ah, John, those evil insurance companies. As a person married to a health actuary, I have heard lots and lots about health insurance costs and reform. Here's one huge problem: in a pay-for-service insurance system, there is no supply-and-demand curve to hold down costs. In a normal business, if the price increases, the consumer's incentive to buy decreases, so the provider has an incentive to keep costs low. Not so in health care. If the consumer isn't paying, she will want every treatment possible, and frequently, so will the doctor.

Here's one anecdote to help explain why insurance costs are high. My daughter had frequent headaches. I took her to our hometown family practitioner, who ordered an MRI and a CT scan, and referred us to a neurologist. I had the tests done. At home that evening, my husband reacted with astonishment when I said that both tests had been done, and expressed his actuarial opinion that the CT scan was not necessary, as the MRI gave the same information plus some. He wondered why there is even a need for a CT scan machine in our small town, population 25,000, when anyone could drive into Scottsdale 10 minutes away. When we got to the neurologist, he reacted in exactly the same way - there was no medical need for the CT scan, a very expensive test. My husband wondered whether our GP even had an interest in the CT scanner, right next door to his office. How was I to know? I did what the doctor ordered, and had no financial incentive to do otherwise. It was all covered by insurance. This is the sort of thing that makes our insurance system hopelessly expensive. (My daughter was diagnosed with migraines, and is doing very well.)

Fr. John said...

Thanks for your thoughtful comment, Susan. I'm glad your daughter's doing well with her migraines. On the health care costs issue, don't insurance companies have ways to restrain doctors in what they prescribe? I know it happens a lot these days with drugs. Why not with unnecessary CT scans? As long as the doctors advising insurance companies are making reliable decisions, that is!