I haven't been following the news too carefully, but I understand there is a push to reform health care and that part of that conversation has been reducing costs by making people healthier. I even hear there could be incentives to live healthy or penalties (taxes) for living unhealthily. I mean, if we are all going to pay the bill, that makes sense. Or. . . not:
From the New England Journal of Medicine:
"In our study, lifetime costs for smokers can be calculated as $72,700 among men and $94,700 among women, and lifetime costs among nonsmokers can be calculated as $83,400 and $111,000, respectively. This amounts to lifetime costs for nonsmokers that are higher by 15 percent among men and 18 percent among women."
http://content.nejm.org/cgi/content/full/337/15/1052
So, do your part to help lower the cost of health care in this country! Light up! Dying young of lung cancer or a stroke or a heart attack is much cheaper than fighting and scraping to spend a little more time here on Earth. By most reports, President Obama is still a smoker. Now I know why. . .
9 comments:
Do you think it could also be that smokers are just less healthy, so they don't go to the doctor as much as healthy people? You know, for check-ups, physicals, immunizations, etc...? Did they say it was really because of a shorter life span? -Val
I haven't read the report that closely. But I would be very disappointed if the study didn't control for a wide range of variables. In other words, before they say "smoking" is the cause of the lower costs, they need to make sure it isn't the case that (for instance) smokers just happen to live in places where health care costs less. That would be considered a spurious correlation. Spurious correlations are pretty useful as predictors, but not as a basis to form recomendation or conclusion about cause/effect.
Hey I know. Instead of creating silly disinsentives like taxes to try to keep people healthy, why don't we just let people decide between eating good foods and dying early? This isn't really about trying to help people live healthier/longer. It's about trying to find a way to pay for a government healthcare program.
The real problem with healthcare is everyone is looking the wrong direction. Having government healthcare isn't going to make it cheaper; on the whole it's going to make it more expensive. The real problem is hospitals can charge too much and consumers don't know the difference. We pay our monthly premium and if the hospital charges $5 for two Aspirin pills, so what? But what if that bill was presented to you personally? You'd call the hospital, yell at them, and not go back to that hospital. If you really want to see healthcare prices drop, start making people pay out of pocket when they go to the doctor.
My work has a high deductible insurance plan, so essentially we pay everything out of pocket (half of which is reimbursed), but it really makes us think twice about going to the doctor (i.e. kids got a fever, might need stitches, etc.). Also, I think people receive procedures that may be beneficial but not entirely necessary, or maybe not since I can't think of a good example.
The last two posts pretty much sound like Ron Paul. He practiced medicine for many years and says he noticed a big change when everyone started being insured with small or no deductables. From his view, it used to be that a Doctor tried to charge his patients as little as possible, because if he charged much he wouldn't have clients. Once people no longer had deductibles and never saw bills, the game became trying to bill as much as you could.
My sister had an experience where she was looking over the bill the Dr. had sent to her insurance. Aparently, they billed a large amount for a "surgery" or "operation." The proceudure? Taking off a bandage. Maybe she can tell the story, but I seem to remember she called them and they pretty much said "Well, your insurance agrees to pay that much for it if we call it that. . . "
We are looking through are new insurance plan options. Our options are (like everyone) low premium with high-deductible or high-deductible with low premium. I did some math in my head and am pretty sure the yearly difference in premiums is more than the difference in deductible. So with a little discipline we should be able to go with the low premium plan, save the difference to use to pay deductibles, and most years save thousands of dollars. But, still, it seems like we should get the higher-premium, lower-deductible plan. . . silly math.
ohhh, yes. I had forgotten about that. Riley had a soft cast on her leg when she broke it. It consisted of a splint and an ace bandage. we went in for the last ckeckup and the doctor said, "well, it's time to take it off." I proceeded to hold riley on my lap and unwrap the ace bandage and remove the splint. Bill for that appointment: $700, surgery. And, yes, I did call and fight it, but they said that was the only code they could use for insurance reasons. They questioned me over and over. Why do you care so much when you only have to pay 20%? Soo mad. The doctor didn't even remove the splint - I DID!!
I let them know they were the problem with insurance prices. It was four years ago.
And it's very hard to believe a government run health insurance program will handle it better. I guarantee government workers will care even less if doctors overcharge.
Actually, the Government doesn't care what doctors charge. I worked in a medical billing office for years, and with Medicare, the governement comes up with an amount that they are willing to pay, and the doctors either accept that amount or not. If they accept the amount they are able to take Medicare patients at their facility. If they are unwilling to accept the amount the government is willing to pay, they can not take Medicare patients at their facility. However, a medical facility can not turn away patients even if they are unable to pay, so you are better off accepting what the government will pay you, than not getting anything at all. And as for Val's bandage problem, if your facility is billing an insurance company using a code incorrectly (such as calling a bandage removal "surgery" when it really wasn't) just so they can get paid for it, that is insurance fraud, and they can get in extremely big trouble for that!!
What the article doesn't treat at all is who bears the costs. I may be a snob, but I actually suspect the percentage of smokers on Medicaid is higher than the percentage of non-smokers. So even if the costs of non-smokers are greater, those costs are more likely to be born by the individual non-smokers, leaving others less affected. Perhaps not the case for smokers, at least not to the same degree.
From what I understand insurance companies never pay what the doctor's bill either. There was an interesting article on Slate a while ago about how medical costs are calculated. The costs are basically based on the degree of skill required for the procedure. Thus calling removing a bandage a surgery will get you a lot more money. Likewise a surgery that takes 15 minutes but required the doctor to have extensive post-school training will get a lot more money than a 30 minutes spent in discussion with a patient while trying to diagnose some unknown malady.
Also, from what I understand only emergency rooms are required by law to treat people, not every medical facility (like an urgent care center). I think emergency rooms generally receive funds from Medicare to cover associated costs.
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