Thursday, November 29, 2007

Health Care and Longevity

Americans are living longer now than ever before in our history. The average life expectancy is now about 78 years based on the most recent information available from the National Center on Health Statistics. A number of factors has caused this increase to happen. Over the past 100 years, the increase has been a net gain of 30 years for the average person in the U.S. and continues to get better over time. Some reasons contributing to this advancement in aging have been due to improvements in sanitation and nutrition, and there have been improvements in medicine, health care, economics, and lifestyle.

However, in the past few years we have seen a proliferation of health care cases that are a direct result of unhealthy habits in eating choices and lifestyle issues. Obesity and other medical problems in Americans are now more frequent due to poor choices in diet and lack of physical exercise. Often there are cultural, economic, or demographic reasons for these poor choices. Typically, lower income Americans suffer with shorter life spans due to medical issues brought on by poor nutrition, and the resulting problems are further compounded by lack of preventive care.

Americans need to change their attitude about lifestyle choices. Eating junk food and sustaining a high caloric intake is definitely not good for a healthy body. Never going to the health club or having a personal exercise plan is not a wise way to live. Expect to get fat and unfit, and look forward to health problems such as obesity, diabetes, high blood pressure, and a host of other diseases that will slowly kill you over time. Imagine lying in a hospital bed or an emergency room after you have just had a heart attack because you have been eating burgers and fries every day at your favorite fast food joint. Think about those tubes protruding out of you because your breathing is constricted due to poor circulation and lung capacity from no workouts or walking program. Pleasant thoughts?

Although we are living longer in the U.S., the quality of life for many is not great. This can change and needs to change. Just because your poor or live in a bad neighborhood, or your parents abused you as a child, or your boss is not nice, or any other miriad reasons is no excuse for not taking care of important health needs. Recently, a leading health care professional at John Hopkins University has stated that as Americans get more affluent, we tend to spend more money on health care. However, the problem exists that many people still tend to be lazy. Although income is going up per capita, the rate of health care issues is skyrocketing because people are not using their new economic gains to get and stay healthy. We need to turn that around, and fast.

Until next time. Let me know what you think.

Tuesday, November 27, 2007

Health Care and Insurance

Most Americans get their insurance through their employer. As a result, health insurance is available to the vast almost every household. There are currently over 250 million insured in the U.S. according to numerous organizations that track statistics of uninsured versus insured. Since 2000, the cost of insurance has risen faster than wages and the cost of insurance has increasingly been shifted to the employer. The current expectation is that the cost of insurance will continue to increase over time at about 6% to 8% according to this month. These rates are not as bad as the double digit increases seen five years ago, but are still twice the rate of inflation.

Employees are getting more nervous as employers continue to cut benefits and increase premiums. Cost shifting has become more the norm as insurance companies seek ways to recoup more profits and pass those costs on to employers. Small businesses are having more and more difficulty maintaining benefits for employees, and most small companies are forcing employees to pick up the cost of their health plan as a result. The other option is to cut benefits for employees altogether and hope that they can either find their own insurance or take the risk of not getting sick or have an accident. The cost of processing claims should be going down as we see more companies use electronic filing and record keeping.

Unfortunately, as the American population ages with the first waive of Baby Boomers now starting to turn 60, there are more claims being filed; and the cost of health care continues to increase every year. Americans are living longer and are putting a strain on the health care system as they age. Even those seniors who continue to work past the age of retirement are concerned about how they are going to pay for their insurance until Medicare kicks in. With limited income or restricted access to health care options, many people will postpone necessary medical needs simply due to lack of available funds.

Surveys have shown that one of the leading components of personal bankruptcies over the past few years has been unpaid medical bills. Often, when employees have significant medical needs, their insurance may only pay a portion of the total bill which leaves a large amount due to the medical provider or hospital. Typically, as in any other creditor situation, the billing entity will pursue the payor for the balance. If the issue cannot be resolved favorably, the employee will be sued for what he/she owes. If the illness or accident that caused the medical problem led to long term absence from the job, the employee is most likely terminated. This problem leads to a bigger issue as the employee in most cases no longer has insurance coverage, and there is no income to offset living expenses and payment of outstanding debts.

Most of us complain about our insurance--it's too expensive; it doesn't pay enough; the insurance company takes forever to pay the medical bill, etc. All these complaints may be legitimate gripes. But the alternative is not something that most Americans really want. People want to know that if they have a medical need, that they have a way to help offset the costs. Insurance can be a great asset, but it can also be a problem if the insured has no idea what benefits they have. That's primarily due to the fact that insurance has a stigma attached to it. The explanation of benefits is a challenge for the insured to understand the complex language written in most policies.

As a licensed insurance agent in all 50 states and the District of Columbia, I have talked with many people over the past 9 years who have no clue what their insurance is or how it works. All they know is that they pay alot for it, and sometimes it works and sometimes it doesn't. Insurance companies like to reap huge profits from premiums and investments, and most of them talk about how many lives they insure. They are proud of their ratings from Weiss and other rating companies that promote how great the insurance companies are in all categories including customer care, assets under management, regulatory compliance, and more. But the honest truth is that insurance is expensive. It's expensive to have, and expensive to keep.

When the choice is made by employers to drop benefits or force employees to pay more money from their paycheck for less coverage, or worse--drop coverage completely as an available benefit--the American worker needs to get smart. There is no incentive to shop insurance plans if somebody else is paying for it. Go to your HR Director and talk with them about considering various options. Search the internet and find plan information about products that work for you. Do some research and compare plans. Take the initiative to find a way to help offset catastrophic medical bills so bankruptcy is not an option. If you don't look out for your health care, no one else will.

Until next time. Let me know what you think.

Monday, November 26, 2007

Health Care and Saving Money

Saving money when we make a purchase is as American as the Fourth of July. We just like to know that when we have bought a new car or a new suit that we got a real deal. No one wants to spend more than they should have when a better price is available. Of course, the same should apply to health care. We want to know that we are getting a good deal when it comes to saving money when we see the doctor or go to the pharmacy. Who wants to pay an outrageous medical bill when the same quality of care is available somewhere else at a better price?

No wonder Wal-Mart, Target, and other retailers have found gold in offering $4 generics. A September 27, 2007 article on quoted the Wal-Mart CFO giving a statistic of $613 million in savings over the prior 12 months for their pharmacy customers. This is huge! You would think that the price would be a loss leader, but Wal-Mart claims to be making money even at $4 per perscription. Good for them, and great for the American consumer! While government, the drug industry, and the FDA try to figure out how to make health care more complicated, private industry steps up to the plate and actually reduces costs.

While there is no "silver bullet" to control the cost of health care in the U.S., there are a few ways for Americans to make sure that they maintain a standard of acceptable care without declaring bankruptcy. One way is to shop for good insurance at affordable rates, and make sure that the coverage works the way you want it to at the price you can afford. There are some very good insurance plans in the marketplace. Don't let an insurance agent talk you into a plan that does not meet your needs. Insurance agents are paid healthy commissions to sign you up for insurance coverage, so make them work for their money. Compare prices and benefits and choose what makes sense for your needs.

Also, check out High Deductible insurance plans and HSAs to save even more money. Insurance should be used to offset catastrophic needs, not every sniffle, minor headache or sore throat. When your deductible is high, your premium is low. Americans have been brainwashed to think the opposite way. So we need to change our thinking when it comes to health care and saving money. Why pay for a Mercedes when you only need to drive a Ford? Don't get greedy. HSAs help with the day to day expenses of going to the doctor, getting new glasses, or seeing a dentist. They force you to save money and use your health care dollars wisely so you can get preventive health care without spending a fortune.

Learn about preventive measures to get and stay healthy. Join a health club and go regularly to help lose weight and get fit. Get some decent regular exercise. Start eating a healthier diet. Go for regular check ups to your family doctor. If you are a smoker, STOP SMOKING. How can anyone continue that habit after all the medical news that has been made public in the last few years about cancer and other fatal diseases related to smoking? Don't do drugs. Don't do drugs. Don't do drugs. Do I need to day it again? Don't do drugs! Make sure that you are taking care of your health on a pro-active basis. Don't wait for something to happen that may take a toll on your health. Learn to be responsible for your own well-being.

Additionally, you may want to opt for a discount savings plan for ancillary medical needs. In lieu of insurance, these plans can save you alot of money over rack rates charged at the point of service. There are networks involved, so check out who is participating in your area before you sign up and go. Verify, verify, verify. Remember, there are plenty of businesses ready to take your money. Make sure you are dealing with a reputable company that is registered to do business in your state. Also, you will want to get a copy of the Terms and Conditions before you sign up. Check on the refund policy, and talk with a supervisor if you are not happy with the sales rep who sold you the plan. These plans do save money, and they can be a good alternative if you are not insured. They also can work in conjunction with some insurance plans to help save even more health care dollars.

Let me know what you think.

Tuesday, November 20, 2007

Health Care and the Uninsured

According to the most recent U.S. Census update released in August, 2007, there are about 47 million uninsured Americans. From all apparent resources available who keep these statistics, this number has continued to grow each year. A variety of reasons exist that have caused this figure to increase over time, and currently there are efforts to help control the numbers of uninsured on both a state level in certain key areas and on a national level. Even some municipalities like San Francisco have jumped into the arena to try to draw down the number of uninsured in that city.

Aetna reports that the impact of the uninsured on society is enormous. The cost of care, when accessed, is shifted to the government, medical professionals, and the insured population in the form of increased annual insurance premiums. The Institute of Medicine attributes over 18,000 deaths per year to a lack of coverage. And 42% of the uninsured have no usual source of care—they miss out on preventive screenings and care for chronic conditions. The Kaiser Foundation notes that about 50% of the uninsured postpone health care because of cost. Because they do not receive early treatment and regular preventive care, the uninsured are highly likely to be hospitalized and die from preventable causes.

In January, 2006, the Seattle Post-Intelligencer had this to say about the uninsured: it can mean that no allergist will test your asthmatic child for avoidable and dangerous signs. No gastroenterologist will perform a colonoscopy to rule out cancer when you are suffering from classic digestive symptoms. Uninsured patients suffer untreated ailments, preventable complications, and less than ideal treatments from family physicians who are unable to assist in specialized care—or they do nothing and go without care. The problem hits primarily the working poor, who cannot afford insurance but earn too much to qualify for public assistance, government-funded coverage, or “charity care.”

The Hispanic PR Wire reported in 2005 that more than 8 in 10 of the uninsured come from working families—70% from families that have one or more full-time workers. Low-wage workers are even at greater risk, as are those employed in small businesses, service industries and blue-collar jobs. Relative to their numbers in the overall population, members of racial and ethnic minority groups make up a disproportionate share of the uninsured population.

The Kaiser Foundation also has reported that new medical treatments, rising prices and growing demand from aging baby boomers are expected to continue to fuel rapid inflation in healthcare for years. The underlying health care costs are not going down. The cost of health care is going up much faster than wages, and medical costs affect our lifestyle. Also, Cover the Uninsured has said that by 2012, we can expect to spend more than $3 trillion on healthcare. Primary factors driving healthcare costs include increases in utilization of services and dramatic increases in hospital and physician services, pharmaceuticals, and technology. Changing demographics—including an aging population—and excessive regulation are also driving up costs.

In 2005, USA Today reported that Americans are living longer and are more healthy than ever, with estimates by the Census Bureau of over one million centenarians by 2050; but although great for society, the cost is a major dilemma for fiscal institutions and the government. The paper also reported that the aging of 79 million baby boomers, scheduled to hit 65 by 2011, will place major stress on Medicare.

So with all this doom and gloom, where do we go to find the answers to solving the crisis of uninsured Americans? Certainly, private industry, government, and concerned citizens need to mobilize and find solutions that do not bankrupt the country or individual families. Resolving this issue will not happen overnight. Yet, there are ways to make it happen.

We can consider some of those ideas in future blogs.

Let me know what you think. Until next time, thank you.

Monday, November 19, 2007

Health Care and the Average Joe

Welcome to "Your Best Health Care" Blog. Over the past 9 years, I have been involved in health insurance and the health care industry. I have watched the cost of insurance and health spiral upward to the point of ridiculously high rates and cost of care. As a result of increased costs in the U.S., health care is an issue that has come to the front of the political parade over the past couple of years, and is a major concern for most Americans, especially the Average Joe. USA Today reported in 2005 from several sources that the cost of health care is going up much faster than wages, and medical costs affect our lifestyle.

Contrary to public opinion, health care in the United States is not a right. It is a privilege. Most working age Americans pay for their health care via employee based health insurance plans. Often, those who are self-employed purchase insurance directly from an agent who represents an insurance company and pays a hefty price for the premium, especially if there are any health issues that may need additional coverage. And the age of the insured is taken into account, as well as a host of other issues that health underwriters must consider. New medical treatments, rising prices and growing demand from aging baby boomers are expected to continue to fuel rapid inflation in healthcare for years. The underlying health care costs are not going down.

Now that health care has become the new political football, there are a variety of proposals in the market that are being propogated. Politicians and legislators are calling for universal coverage, which translates to free health care for those who don't want to or cannot pay for it. However, free health care is not free. Someone has to pay for it--the American taxpayer either directly though higher taxes or indirectly through higher insurance premiums to offset care for the indigent and the uninsured. The Memphis Business Journal reported in August, 2006, that
young adults (19-29) account for a huge percentage of under-65 uninsured—over 10 million healthy adults with no insurance; covering the uninsured is another topic too large to include in this initial blog.

The Average Joe needs a way for relief in health care. We cannot expect to provide free coverage like Canadians and those that live in the U.K. receive. That would bankrupt the government and be horrific for anyone who needs medical attention. Besides, who wants Uncle Sam to tell you what doctor to see and where you can go to get medical attention? The increased spending on health care, combined with the trend by private insurers to pass more costs to consumers, means fewer people, particularly the working poor, will be able to afford health care in the coming years. Americans cannot afford to pay for universal health care.

Health care in the United States is the best in the world, and Americans deserve the best. As a result, our costs are higher. And costs continue to escalate. There are solutions, and we need to think outside the traditional health care box to contain increases in the cost of care without decreasing the quality of care. Let's work on it.

Let me know what you think.

Health Care and the Average Josephine

The Average Josephine in the America feels that health care is an automatically inherent right to be awarded simply because she lives in the United States. Merriam-Webster's online dictionary gives us the definition of what inherent means--"involved in the constitution or essential character of something : belonging by nature or habit." However, as much as health care has become the current political football this year in the race for the Presidency in 2008, we must realize that free or universal health care is not free. Someone has to pay for it, and the American taxpayer is the one on the hook to pay the bill.

As I mentioned in the previous blog, health care is a privilege, not a right. Many people feel that they deserve to have some form of health care and not have to pay for it, or perhaps are entitled to health care at a radically reduced rate (if not free)--paid for by the government, such as Medicaid. One of the reasons that health care has become so outrageously expensive is because of the entitlement programs that have stressed the American health care system. Another reason is that so many uninsured people that are overburdening the U.S. health care system. The latest U.S. Census report says that over 47 million Americans are uninsured. The topic of why this number is so large will be discussed in a separate blog. The issue of the uninsured deserve its own discussion.

Over the last few decades, our society has been brainwashed to think that we all deserve insurance to take care of us for every little event--from a simple cold to a minor cut. Insurance was originally designed to protect us in the event of catastrophic situations. Insurance helps protect us from total financial loss in case we are unable to work or pay our bills. Instead, we have played the game of having it take care of every little item using a co-pay to reduce our out of pocket expenses, and now the average American pays over $10,000 a year in premiums for a family plan. According to an article published online with the Philadelphia Inquirer in February, 2006, by 2015, one in every $5 spent in the U.S. will go toward medical costs—a reflection of the aging baby boomers, the cost of the Medicare prescription-drug benefit, declining rates of insurance coverage, and rising hospital costs—with health care costs averaging $12,320 per person.

In order for the American health care system to not implode in the next few years, there should be certain ways for costs to be reduced both at the point of service and in the infrastructure of the health care system itself. We can study these over time in additional blogs, and consider various alternative options for additional discussion. In the interim, the most important consideration is for Average Josephine to figure out how to stay well and not abuse the best health care system in the world.

Your thoughts are welcome. Until next time, thank you.