Health care costs are very much on people’s minds.
As I travel our Senate District, I hear concerns about cost - from a farmer paying $1900 a month for just his own health insurance, from local county board members worried about rising employee health costs, from union members worried about losing health benefits, from small business owners with double digit increases in health costs.
Why are health care costs so high? As compared to other countries, higher prices for drugs, doctor and hospital care make all of us pay more for health insurance. Did you know an MRI scan in the U.S. costs eight times more than a similar scan in Britain?
In addition, we use more services. We don’t see the doctor more. (The Japanese see the doctor 14 times a year compared to the American average of five visits.) But when we do see the doctor, we get more tests, scans and other procedures - which cost more.
Finally, paperwork costs us. The U.S. spends about fifty-percent more on paperwork than our Canadian neighbors.
Last week I participated in a conference about making health care more affordable. Participants came from all over the country to share ideas on what might work.
The newly passed federal Affordable Care Act gives us many different directions to go to try and lower health care costs.
One route to reducing costs is to collect and make information on cost and quality public. Making medical cost information easy to understand helps people more easily compare costs - either for a health insurance plan or a procedure.
‘Easy to understand’ is not a description of Medicare Part D insurance. Jonathon Gruber, an MIT researcher, explained when seniors had over 50 choices of Medicare Part D plans with confusing information that was not easy to understand - only 12% chose the most cost effective plan. Researchers discovered elders could save an average of 30% by switching to a plan that better matched their needs.
A way to help control costs for business is the idea of having small businesses band together to create one large risk pool. And getting businesses information about and helping them evaluate a reasonable number of health insurance choices is the cost-saving function of a small business exchange.
The Small Business Exchange would offer a choice of plans that compete with each other. Every plan offered would be required to meet standards for low cost, high quality and benefits.
Another path to lowering costs focuses on getting people more involved in making health care decisions; helping people with chronic conditions live healthy lives and coordinating care among many doctors, especially for people with many chronic diseases.
Sometimes the best and well known way to treat a certain illness is not followed by some doctors. For example, we know an aspirin a day for someone who had a heart attack helps prevent another. But it is difficult to tell doctors how to practice medicine.
South Carolina looked at the difference between research on appropriate use of drugs and what doctors actually prescribed. The five-year study found over 30,000 gaps in care where doctors were not providing the correct drug
By simply sending a letter to doctors needing to change a patient’s medication, nearly 100% of doctors prescribed patients the correct drugs. By either stopping, starting or changing drugs, the state saved about $20 million and patients were healthier.
Sometimes the approach to lower medical costs is healthier people. Exercise is an important tool. I learned that a quarter of all trips people make are within a mile of their house; but three quarters of the time those folks get in the car to make the trip.
‘I’ll just run to the store’ for most people doesn’t actually mean running. Too many of us get in the car. Of course for some there is no choice. But every hour a day you spend in your car increases your risk of obesity by 6%.
So next time you leave the car keys at home and head to the store - you are making an investment in your health and keeping health insurance costs lower!