"I Can't Afford to Get Sick" (page 4 of 4)

Are There Answers?

Solution #1: Reduce Unnecessary Spending
Make no mistake, consumers will be paying more into the system. But they may have more control, too -- over costs, providers, and even treatments.

What divides experts is whether "control" would lead to wiser use of medical resources, or whether consumers would make agonizing (and perhaps uninformed) decisions about which treatments they really need and can afford. Both outcomes are possible. Advocates of patient control agree that consumers are usually clueless about the real costs of health care.

"Health care is the only industry where a consumer can walk into a doctor's office, not know how much it costs, and walk out without paying," says Beth Bierbower, vice president of product information at Humana. A 2005 survey by Great-West, a health care and financial-services company, found that consumers can guess the price of a Honda Accord within $300 and estimate the tab for a coast-to-coast round-trip ticket within $37, but they're off by $8,100 for a four-day hospital stay. Still, if they did know the typical cost of a procedure -- say, $3,300 for a colonoscopy -- would they be qualified to give it a green light or turn it down?

One high-profile idea, a key initiative of President Bush, is the health savings account (HSA). Available since 2004, these accounts work like an IRA. Almost anyone can set up an HSA, usually through a bank or credit union, as long as they link it to a high- deductible health plan. Each year you can invest dollars roughly equal to the deductible of your plan, but the money is yours, even if you change jobs. And you can spend it tax-free if you're paying for medical services.

The HSA plan assumes that people will use a portion to pay for routine care, keep the rest invested to build up a health care nest egg, and use the high-deductible plan for catastrophic care. Their premiums, meanwhile, will be less costly.

Young, healthy people could benefit from investment returns on the HSA money over the long term.

For the poor, the elderly and the sick, the math looks very different. Frequent doctor visits could quickly deplete the account, taking away the key investment benefit. Worse still, people might forego important tests and treatments rather than dip into their accounts.

For more information on these accounts, go to treasury.gov.

Solution #2: Stop Wasting Time and Money
All agree that the system is dangerously outdated and inefficient. "Paper kills," declares former Speaker of the House Newt Gingrich, now a vocal advocate for health care reform. While society has jumped into the Internet age, health care is using 19th-century systems, Gingrich says. Medical information is still kept on handwritten charts and in bulging files, a situation that encourages missed diagnoses, incorrect drug dosages, miscommunication between specialists, and frustration for patients. Gingrich estimates that electronic prescriptions could save over $25 billion a year and tens of thousands of lives now lost to medical errors. He and an unlikely ally, Senator Hillary Clinton, both argue for electronic patient records as well, not only for quick and error-free transmission between caregivers, but so individuals can access their own health files.

Software companies are beginning to realize that consumers need tools that help them organize their health records as well as their finances in order to track -- and, if need be, contest -- their health care expenses. Software giant Intuit has created Medical Expense Manager, a program that helps patients manage their bills and payments, as well as take full advantage of tax benefits.

Solution #3: Focus on Prevention
Ron Bachman, a senior fellow at the Center for Health Transformation in Washington, D.C., says patients with chronic illnesses should join disease-management programs, treating illness early and often with a view toward long-term cost reductions. Since 20% of health care consumers eat up 80% of expenditures, reducing demand among this minority could reap big savings.

Lynette Swartz is already on board. Her husband, Rob, was a lifelong smoker. Lynette joined a smoking-cessation program at work. Her employer hopes that encouraging a healthy lifestyle will push down costs over time.

Finding ways to make our health care affordable means nothing short of re-engineering the system from the ground up. This can only happen if all the players -- insurers, employers, doctors and patients -- abandon the blame game and look for solutions. "We're all in this together," says Humana's Carol McCall. "There is no 'them.' Everybody in this ecosystem has a role to play in bringing costs down."

From Reader's Digest - April 2006

 

• • National Health Care
• • Your Medical Care
• • Health Insurance
• • Medical Dramas

• Tips on Choosing Your Health Insurance Plan
• It pays to do your research before selecting a health plan.
• 
• Reader's Digest Health Care Poll
• Read our fascinating findings about the underinsured middle class
• 
• Insurance-Speak Translation
• 20 health care terms to know.
• 
• Secrets of Great Doctors
• An insider's guide to getting the best medical treatment.
• 
• Buying Medicine Over the Internet
• Proceed with caution when purchasing from online pharmacies.
• 
• Is Your Hospital Gambling With Your Life?
• Your health -- even your life -- is increasingly at risk in hospitals, doctors' offices and outpatient clinics.
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