Tuesday, January 29, 2008

Health Care and Illegal Immigrants

There is no doubt that Americans are paying more now than ever for health care as a result of the effect of uninsured illegal immigrants who are taking advantage of our medical system in the U.S. Currently, illegal immigrants are not eligible to receive public health care services, unless it is emergency care that is automatically mandated by federal law. Preventive care and other clinical and medical services are not available to immigrants unless they can provide proof of legal status or identification that allows them access to general health care. However, false IDs and other papers can be purchased readily by immigrants; and that illegal black market business is very lucrative, alive and well, and flourishing in many parts of the country.

Many services, such as walk-in clinics, do not require proof of citizenship. Therefore, illegal immigrants can make up fake names and social security information to receive treatment. And in many cases, these illegal immigrants are not reported and often not refused medical care. When the patients cannot afford the health care that they have been given, the burden falls to the American taxpayer to foot the bill. This cost amounts to billions of dollars every year. According to a report issued in March, 2005, by the Journal of American Physicians and Surgeons, the increasing number of illegal aliens coming into the U.S. is forcing closure of some hospitals. Also, there are previously reduced illnesses that are now being spread again with serious hidden health care issues.

Babies born in the U.S. to illegal immigrants immediately qualify as citizens for welfare benefits, and about 350,000 per year are born that automatically are eligible for public aid. Each of them also bring in illegal family members. The cost to Medicaid has been enormous as reported in WorldNetDaily. And, not having insurance is not the same as not getting health care. With the estimated 47 million uninsured reported in the U.S., the rate of those being illegal immigrants may be as much as 25% of those without insurance. The Pew Hispanic Center estimates that 59% of the nation’s illegal immigrants are uninsured. The law passed in 1985 referred to as EMTALA requires hospitals to treat uninsured patients without being reimbursed. There are heavy penalties imposed on any doctor or medical facility that refuses emergency treatment for anyone even if the screening is deemed to be non-emergency. Additionally, the fiscal liability to the health care system is tremendous for drug addiction and alcoholism because they are also considered diseases. With the influx of illegal immigrants, the U.S. health care system is now fighting drug resistant strains of tuberculosis, malaria, leprosy, polio, dengue fever, and more that had long been defeated here.

According to that report, the organizations that have been the most guilty of directing illegal immigrants into American health care systems are:

Mexican-American Legal Defense Fund,

National Immigration Law Center,

National Council of La Raza,

George Soros' Open Society Institute,

National Network for Immigration and Refugee Rights,

Southern Poverty Law Center,

and several more.

The Journal report advocated that America close borders, rescind automatic citizenship of the "anchor babies" born by illegal immigrants in the U.S., punish more severely the aiding and abetting of illegal immigrants, end any amnesty programs, and enforce the current laws on the books that penalize employers and others who do not report illegal immigrants. The current debate over the residency status of the illegal immigrants--estimated now to be about 12 million living in the U.S.--is getting short shrift in political circles in 2008 at present. The race for the American Presidency has been largely focused on the economy with the Iraq war coming in second. Last year, there was a lot of attention on illegal immigration, but that has since died out as a primary reason to elect a new president. Why is that? Has the population of illegal immigrants suddenly disappeared or stopped putting a drain on the American economy? NO!

Health care benefits are still extended to most illegal immigrants; and the American taxpayers are still paying the bills, and the medical community is hemorraghing money by the billions of dollars. One thing is clear: illegal immigrants are driving up the cost of health care and the ranks of the uninsured. USAToday online reported recently that because many illegal immigrants are young and healthy for the most part, they usually do not need medical services. At the state and local levels, there is more cost in public health care services than are paid in taxes. In some states, the increase in Medicaid due to illegal immigrants was over 28% in just 4 years. While the government wrangles over how to provide medical coverage to this community, illegal immigrants rely on federally funded clinics--there is little to no charge for basic services and no proof of citizenship required-- and on free samples of medications and over the counter drugs. And seniors who cannot pay their bills are written off by the medical system as uncollectible.

Most of the time, illegal immigrants will forego preventive treatment due to fear of deportation. In those cases, they live with the pain or illness until the health problem is critical and requires emergency care. This mindset makes it worse for the patient and for the medical provider with the taxpayers picking up the tab in most cases. The staggering costs of uncompensated medical care for illegal aliens in California in 2004 are huge according to NewsMax, and taxpayer-funded medical outlays for health care provided to the Texas' illegal alien population amount to about $520 million a year, according to FAIR. In Arizona and other border areas, states paid nearly $190 million in health care costs for undocumented immigrants in 2000, a Congressional Budget Office study reported. The amount, which the study says likely has risen since then, represented one-quarter of all uncompensated health care costs in those states that year. And the unpaid medical bills continue to rise at a very alarming rate.

So now what? Americans must lobby the government to be diligent on enforcement of the laws pertaining to illegal immigration. We need to ramp up the heat on the politicians who represent us at the federal, state, local levels. Americans need to force the issue with their elected representatives to make illegal immigration a top shelf issue once again. There should be collaboration with the medical community to enforce tougher standards for reporting abuses by illegal immigrants. Americans are tired of footing the bill for free health care of illegal immigrants. Yes, we should be compassionate if someone is critically ill or experiencing emergency conditions that are life-threatening. However, as health care costs continue to increase every year, there needs to be accountability on all fronts. Let's work together to resolve this problem.

Until next time. Let me know what you think.

Monday, January 28, 2008

Health Care and Disease

Managing health care is a tougher job now than it was even 10 years ago. In addition to various health plan choices and a multitude of insurance offers available in the market place, employers and the medical community must also contend with new illnesses and communicable diseases that are getting more and more difficult to control and cure. As our population gets more diversified, Americans now are seeing health issues develop that we are finding more dangerous and more costly to manage. In addition to the SARS scare that came out a few years ago, and the impending pandemic of avian illness, or "bird flu," that is still uncertain as to its ultimate reach and affect, we are seeing increased awareness of new strains of diseases that are causing grave concern in the health care world.

One of these issues is MRSA---Methicillin-Resistant Staphylococcus aureus. MRSA is a strain of Staphylococcus aureus that has become resistant to the antibiotic methicillin according to a definition by Genelabs Technologies found on Google. First noticed in hospitals as a staff infection, MRSA has "jumped the fence" with appearances now in schools, gyms, fitness facilities, and other locations. Previously known as only contracted by touching an open sore, it is now proved to be communicated by skin to skin contact, and by touching items that the patient has touched, such as towels, sheets, and any other object that the infected individual has handled. MRSA infections typically cause skin lesions (such as boils), but also can cause severe illness. Some have died from community-associated MRSA. Just this month as published online by Medical News Today, MRSA has also shown up in gay communities in Boston and San Francisco with a very high rate of persistency and has found to be highly resistant to antibiotics typically used to treat the illness. Elimination of infections and/or colonization of MRSA in a facility through implementing an infection control, establishing rigid hygiene measures, and/or antibiotics is the current way that the disease is controlled.

Are we looking at the threshold of new strains of disease that will one day wipe us out as a race, or are we seeing old bugs with new life that are a lot tougher to kill? It certainly is more expensive now to deal with illness than the last decade. The cost to bring new drugs to market is outrageous as we see the FDA's requirements get tougher each year. According to their website, "the FDA must keep in touch with consumers and firms dealing with regulated products all over the United States .... Regulating almost 124,000 business establishments that annually produce, warehouse, import and transport $1 trillion worth of consumer goods." In 2003, Bain & Co, reported that the cost to bring a new drug to market was very high: the cost for a single new drug averaged $1.7 billion. And just three years later in 2006, the head of science and technology at Eli Lilly & Co. warned that the cost of producing a successful drug could top $2 billion by 2010. Reported in the online version of Digital Healthcare and Productivity.com, he attributed this to including soaring R&D costs, lowered drug approvals, increased development times, the loss of patent protection on several blockbusters, safety issues, and pricing pressures. In addition to cost, the time required to bring new drugs to market can stretch on for several years, anywhere from 12 to 20 in some cases.

The cost to treat medical conditions is well over $500 billion now, as the most recent figures are for 2005--three years ago--published by AHRQ, a government agency that tracks healthcare related issues. Medical News Today online just reported that the ten most expensive health conditions rank in this order from most to least in dollar values: Heart conditions, trauma disorders, cancer, mental disorders, asthma and COPD, high blood pressure, diabetes, Arthritis and other joint diseases, back problems, and normal childbirth. This money is paid out for medications, home health care, clinics, emergency rooms, hospitals, and physician visits. You can track more of this mind-numbing data at their website.

On top of new diseases, Americans still are dealing with medical issues like diabetes. According to the latest report published online with USA Today, uncontrolled diabetes wreaks havoc on the body; and the illness often leading to kidney failure, blindness and death--the nation's unchecked diabetes epidemic also exacts a significant financial toll: $174 billion a year. There are 1 million new cases a year — as more Americans become overweight or obese, according to the study just released this month by the American Diabetes Association. They also report that diabetes costs the nation nearly as much as cancer, whose costs in 2006 totaled $206.3 billion, although cancer kills twice as many people. Obesity is out of control in the U.S., especially in ethnic communities including Hispanics and African-Americans. Most published studies indicate that we are fatter than ever. Maybe putting the country on a weight loss program with a little bit of fitness thrown in for good measure will help us with the upward spiraling costs of health care--old or new.

Until next time. Let me know what you think.

Friday, January 25, 2008

Health Care and Perception

Getting the most out of life is what Americans do best. We find ourselves doing more, going more places, and living longer than our parents and grandparents did "back in the day." That's not to say that we are better people now than those who gave us life, or that Americans have a patent on living. But we tend to think of ourselves as stronger, faster, smarter, wealthier, and better looking than the rest of the world. After all, why does everyone want to come to the U.S. for their share of the "American dream?"

Yes, Americans perceive themselves as healthy, wealthy, and wise! How Americans see themselves in large part determines how they live. We become the result of our collective experiences. So when we make wise decisions in our health care, we can be more comfortable in the fact that over time the likelihood of experiencing a chronic disease and the process of aging will be softened by doing the right things in our lifestyle choices. And the alternative is obvious--poor health decisions result in poor health.
Additionally, perceptions vary among the public and the medical community about the lack of fairness in treatment based upon ethnicity, insured status, money, and other social and cultural factors. Studies have found that perception of fairness varied also on patients' ability to speak English. Inequities in the U.S. healthcare system happen, unfortunately, due to these reasons and more. One of the surveys released about this subject was done by the Kaiser Foundationin June, 2007. Comparison documentation from a variety of testing results confirmed the ways that Americans have perceived inequality in health care. Our best efforts at times are not enough to allow an equitable treatment of patients regardless of need or ability. However, Americans know that we have a better status of patient advocacy in the U.S. than in most of the countries in the world. That's one reason why God allowed lawyers to be created.
It is important the way that people perceive health care. Patients wish to know the status of their treatment and prognosis, and they expect to be treated in a professional manner by health care providers. When problems arise, as they often will--due to incompetance by the medical practitioner or lack of patient information when requested--people want to know when and how the issue will be resolved and by whom. Not everyone who works in health care knows the answers to some problems, and not everyone in the medical field knows the costs involved for certain health care concerns. However, with the current technological advances in price transparency and abilities available to extrapolate data, we can advance the way patients can receive feedback.
Additionally, the way we perceive how the medical community treats those without insurance or Americans who are not the stereotypical model can provide valuable lessons for the future of U.S. health care. The quality of care we expect should be the same for everyone regardless of their status in life. People deserve great health care and equitable treatment from any medical provider. If the overall patient experience is good, then minor inconveniences like behavior, cleanliness, and other incidental issues will be less likely to factor into complaints that may lead to malpractice suits, heavy handed government oversight, or a host of other very unpleasant outcomes. Controlling costs and improving effectiveness should also be a concern for both patients and practitioners. If our perception of the treatment experience is poor, we will undoubtedly perceive that the entire health care system is poor and inequitable no matter what the facts support.
The bottom line is that we should and can do better with the way people in the U.S. perceive health care. Cost containment, key performance indicators, risk management, quality of care, and patient advocacy should be constantly monitored and improved in order to provide the best health care in the world. The medical community needs to take note of when they fail and how to learn from those lessons to not repeat the same mistakes. The insurance community needs to recognize how to fix problems in the market place and with consumers and their customers. And the general public needs to wake up and understand that health care is not to be taken for granted. Health insurance is a privilege, not a right--so don't abuse it! We all play a part in making the U.S. a healthier place to live.
Until next time. Let me know what you think.

Tuesday, January 22, 2008

Health Care and Cost Trends for 2008

The year 2008 is now upon us and fast moving toward mid-first quarter. January is almost over, and February is just a few days away. It seems that the older we get, the faster time goes by. With the days of youth, we feel that we will live forever. But as we get into more mature years, we begin to feel our mortality a little bit more every day that we live. As old "Blue Eyes" was famous for singing in The September Song, "It's a long, long way from May to December..", and when we reach the September of our lives we do have a precious few days. That's why we need to take action on health care trends that make sense. Let's make the most of the days we have whether long or short. As the Latins said, "Carpe Diem!"

There have been some recent publications released about health care cost trends for 2008. One of those has been put out by PricewaterhouseCoopers' Health Research Institute and titled "Behind the Numbers." The report has some interesting statements that share what the charts, graphs, and statistics contained in it support according to the published information. One fact they have determined is that private sector health care costs are cyclical. Costs are influenced by utilization, price inflation of products and services, cost shifting and de-valuation of deductibles and co-pays. Insurance companies use this information to determine plan pricing for the next future year. One key factor in the material is that there will continue to be increases in both transparency and cost shifting to employees for insurance costs. Of course, we have seen these increases taking place over the past couple of years, and likely that will continue in the future.

Additional news from PricewaterhouseCoopers is that although growth in insurance premiums has been declining slowly over the past five years, costs are still going up for the employee. The average American this year will likely pay $13,704 for his employer sponsored health insurance to cover his family according to Towers Perrin. Their annual health care cost survey shows that companies with a rigorous, comprehensive style of managing employee health care have lower premiums than companies that do not monitor expenses and health care benefits. The more aggressive employers will manage employee participation, purchasing, and health risks on the job to bring down the costs associated with insurance and health care expenses.

With this type of approach, benefit designs that encourage employee accountability, price transparency, performance factors, communication and decision support, and other strategies that encourage a healthy lifestyle mindset and work environment will help keep cost increases to a minimum. Overall, Towers Perrin anticipates that employees will have to chip in 22% this year for their insurance coverage, in addition to out of pocket expenses. Employees in the U.S. will need to adjust how they perceive health care and expenses in order for them to receive the true value of what they are purchasing. Monitoring personal progress and maintaining healthy lifestyle habits will make a definite difference in how much is spent on health care needs.

Mercer reported late in 2007 that small companies may be forced to pay even more for health care in 2008, based on claims history, plan design, and size of the group. The increase for small employers may be even a 15% increase (with a range between 10% and 17% for companies who have under 50 employees) over last year in certain parts of the country. The national average is expected to be a 9% increase overall. Mercer also indicates that certain parts of the U.S. will have cost increases higher than others based upon population age, lifestyle, and plan design. Employees who are used to rich benefits are often more willing to pay more for them than to sacrifice benefits for cost. Rates will soften when employees are open to change plan designs and employers manage health care costs on a more aggressive basis.

A survey released by Hewitt in late 2007 indicates that some employers are continuing to shift a significant percentage of health care costs to employees. Often, this strategy will force those workers to elect not to seek preventive care and wait til the health care need is more critical. Although up front this will save money initially, the long term effect with this type of thinking will lead to ultimately higher health care expenses, decreased productivity at the workplace, and more unhealthy employees. Lost time due to preventable urgent care is less cost efficient. A healthy workforce is invaluable for the economy and the overall physical and mental health of Americans. Some options that Hewitt promotes to reduce health care costs are 1.) offering incentives to employees to use generic prescriptions when possible, 2.) establishing stricter vendor requirements and best practices, 3.) closer monitoring of costs and health risks, 4.) offering value based or new plans that promote savings, such as high deductible plans combined with an HSA.

So we know that it's going to cost more to stay healthy, and that we have a few more options this year than we have had in the past, and that we should expect to stay healthy if we make the effort to do so. All the studies and surveys each year indicate about the same type of information, but justify it with factual evidence gathered from a composite of health care data. What we can count on is that it's better than the alternative--no coverage, poor health, and death. Every American needs to be accountable for how they live and the choices they make, especially when health is on the line. If health care costs continue to spiral out of control, we have no one to blame but ourselves.

Until next time. Let me know what you think.

Friday, January 18, 2008

Health Care and Healthy Lifestyles

Americans have lifestyles that are among the best in the world compared to people living in most other countries, especially third world nations and underdeveloped parts of many countries. Our standard of living is also among the best in the world, especially for the incomes realized by most people in the U.S. as compared to other nations. Granted we do have a federal poverty level that is published every year, and about 12% of the population will be below this level--compared to Mexico at 40% and Austria at 5%. In 2008, an American family of four meeting this criteria will earn $21,200. Not a lot to live on, but about enough to prevent starvation. And compared to Canada, the average standard of living in the U.S. is much higher. These figures, presented by the CIA Factbook, give an indication how the U.S. population stacks up against the rest of the world from an income perspective.

Unfortunately, many people living below the poverty level in the U.S. usually do not have insurance; and access to health care is a luxury versus a reality. Although there are people living around the world that make more money than some Americans, the comparison of economic living standards based only on nominal per capita income is not really an accurate view of health and well-being. In the U.S. there is a difference paid for goods and services based on where we live. For example, it costs more to live in New York or California than it does in Nebraska or Mississippi. A person making $40,000 per year in Los Angeles is going to pay more for gas, groceries, utilities, and health care than someone making the same income in Biloxi. Americans are feeling economic stress even though the economy has been growing over the past five years.

Many Americans have had retirement benefits cut and also are paying a bigger chunk of their health care expenses. Costs for core health services will continue to increase annually more than the overall economy according to a report published in the Los Angeles Times in February, 2007. Out of pocket expenses will likely double by 2016. Health and Human Services Secretary Mike Leavitt said then that our "per capita health spending is the highest in the world." And Families USA has forecast that as health care costs continue to increase and outpace earnings, more and more Americans will be uninsured because insurance will be unaffordable. The market place will need to find a sustainable alternative to ever increasing health care costs.

The best option for Americans is NOT universal health care. An increased role by government will be a poor way to provide services to uninsured and underinsured people. We would be faced with increased consumption and limited medical resources. Bureaucratic logjams, delayed treatment, deterioration in quality of care, longer waits in emergency rooms and clinics, and other detramental effects would be the result of a single-payer system mandated by the government. We have a moral obligation to provide health care to everyone who needs it, but we don't need the American taxpayers to subsidize it or the government to control it.

Dr. Donald Condit who writes for the Acton Institute offers some realistic options. Among them are free market reforms including tax law changes that would improve insurance portability and affordability. Also, he offers the interesting concept of decreasing premium costs by increasing interstate competition for insurance companies--it would even get many Americans removed from the ranks of the uninsured with an increase in the standards of health care quality. Add to these options the ability of faith based groups providing care from incentives available to them from government grants and private foundations. We also should not penalize those who are healthy by making them pay more year after year. Additionally, stacking punitive costs on employers who don't offer health care to employees is not a positive incentive to get them to participate in the debate for workable solutions. There are ways to make health care more affordable. We need to think outside of the box to help Americans continue not only financially but also physically to stay healthy.

Until next time. Let me know what you think.

Thursday, January 17, 2008

Health Care and Baby Boomers

Baby Boomers are now reaching retirement. It's hard to believe that those kids first born after World War II are now ready for for Social Security. Who knew that Boomers would be the first generation to have one of the greatest economic impacts in American history? And as this group starts to retire this decade, there will be a huge impact on health care needs for them, the government, and the health care system. And according to a recent survey released by the Robert Half group, Boomer retirement will also significantly impact the workplace. By 2010, 76 million will begin to be eligible. The watershed moment of aging for this generation, of which I am one, started in 2006. Every 7.5 seconds a Boomer will be turning 60 for another 17 years from now.

Most Americans do not grow old gracefully; they stumble into it with little to no planning for their health care in their mature years. All of a sudden, they wake up one morning and feel "old." Many people get there faster than they realize, and then they have to worry about how they are going to pay for expenses that were once taken for granted as part of their employer-paid health plan. Ooops! Now it's too late for many people who never watched their health as closely as they should have; and based on income levels, Americans with less household income are going to be more concerned about improving physical health than any other issue. A recent survey by AARP released in 2007 indicates that about a third of individuals 60 and older are physically doing worse than they anticipated.

Boomer lifestyles can lead to major health issues. Although some do a really good job of keeping physically and mentally fit, others work too much and are fatigued at the end of the day with the responsibilities of their job as well as pressures at home from children, aging parents, household chores, and more. There is little time left for a fitness regimen, sufficient sleep or rest, and proper eating habits. Also, stress is a major factor in leading to health problems for many Boomers. Too often, Americans are overweight and inactive. This type of lifestyle, especially for those 60 and above, will definitely cause a reduced quality of life and lead to a rise in health care costs. Although most people anticipate retirement as a good thing, we need to have a sense of purpose to live longer, better lives. Many studies have shown that being challenged both physically, spiritually, and mentally will definitely increase our standard of living as we grow older.

Additionally, as Boomers get older, this demographic group will need some form of long term care. Getting older is an inevitable fact. Spending on health care issues continues to increase with nursing home and home health care costs going up as well. Costs for prescription drugs, physician services, hospital care, and other health care services have risen. It really costs more now than ever to be sick. Boomers who delay health issues until they become either catastrophic or impossible to ignore are forcing themselves into paying more for health care. The Baltimore Business Journal reported this month that health care spending in the U.S. hit $2.2 trillion in 2006. The real challenge is to figure out how we can get the best value for what we spend.

Increased health care spending has definitely brought most Americans longer life, better health, and more options than in the past. However, too much money is wasted with costs spiraling upward, and we have sometimes little to show for the expense. Also, although more often the exception than the rule, health care fraud is a definite contributor that increases health care costs. Boomers have many options now that our parents did not have. There are more medications on the market that treat illnesses that once were considered untreatable, and there are more technologies available to diagnose health issues that were at one time medical mysteries. More money goes into research and development, and much more emphasis now is spent on transparency in health care. So, there are advances in health care for Americans, but they are not cheap.

Major decisions about how Boomers what happens with their health care will not only affect the industry itself, but also make a critical difference in the status of their own health, wellness, and lifestyle in their later years. To function effectively, Boomers will need to keep up their health for longer time frames. As Americans live longer, we will need to adjust to stretching our financial ability to pay for health care expenses not covered by either government or private programs. Maintaining a healthy lifestyle will enable Boomers to endure the economic challenges of aging.

Until next time. Let me know what you think.

Monday, January 14, 2008

Health Care and Wellness

Wellness has become the new buzzword in the health care world of the 21st century. Everyone wants to talk about wellness, especially insurance companies and major employers. With wellness programs we can cure the common cause of large butts and employees who are listed as MIA. Billions of dollars are lost every year in productivity and profits as employees and insurance claimants are sick due to causes related to bad habits and poor health choices. But with wellness programs, we can make these all go away. Yeah, right.

Most Americans make New Year's resolutions about their health, but in the vast majority of cases there is extremely poor to no follow through. Or, those resolutions fade away shortly after their program starts, and the wellness plan melts away like a snowflake on a warm woolen mitten.

Wellness programs are one way to help reduce employee absences and decrease insurance claims, but they are not the only way. The biggest way to stop the bleeding is to get people to change the way they think about their personal health and the way they live. Lifestyle choices are largely based on how people see themselves in the mirror. To make a difference in your health, you need to analyze your daily routine and see what you want to change to become a healthier person. If you are already in great physical, mental, and spiritual shape, then good for you! However, you may want to develop a maintenance program involving all those aspects that will keep you at the top of your game.

But the bottom line is that most people are not proactive about their health. A recent study released by Blue Cross Blue Shield of Arizona said that 87% of the respondents revealed their health could be improved. About 25% of employees surveyed admitted missing at least one day of work per quarter due to poor health, and over 50% said that their health impaired work performance. The Phoenix Business Journal this month stated that the U.S. Surgeon General reported that 75% of the health care dollars spent in the U.S. is to treat chronic diseases that could be prevented by healthier lifestyles. Employers are tired of paying for sick workers. Yet, more and more employees are signing up for company wellness programs in order to reduce health care expenses. Participation in wellness programs have been proven to increase employee retention and productivity, and the primary motivation is to stay healthy.

The motivation must have an incentive for it to work. According to a study published February 2007 on Inc.com, Principal Financial and Harris Interactive reported increased rates of participation in wellness programs including health screenings, fitness plans, and additional modules like smoking cessation and more. The survey proved that both employers and employees want the same thing--a healthier workplace and lifestyle. Wellness benefits encourage workers to work harder and have an increased incentive to stay with their current employer. Yet with all this increased activity, employees need to have a carrot at the end of the stick in order for them to want to get involved with a wellness plan. Some may do it just for the end result of a healthier life, but most employees want additional benefits beyond a smaller waist line and lower blood pressure and cholesterol.

Employers want to know how to get their workers to buy into a wellness program. By and large, wellness, wellness programs themselves have been proven to be successful. But employers are looking for ways to increase profits and improve employee motivation to stay on the job. Stimulating workers to exercise and diet is not easy, and just telling someone to improve their health for themselves and for the good of the company and they will feel better does not jump start a high rate of participation. And saying to the employee "Lose weight or get fired," doesn't help much either. That's a lawsuit waiting to happen. Some forward thinking companies use rewards--gift cards, keepsakes, travel packages, bonuses, etc--as incentives. They make a short term impact with long term results. Tracking participation, progress, and costs will help improve profitability and employee satisfaction. Keeping the cost of employee insurance down is one way to make wellness programs worthwhile, but the best return is to have an increase in the number of employees who don't miss work due to illness and who want to work.

Change in behavior and attitude are the real reasons that wellness programs are successful. Profits and a happy workforce are the benefits from instituting wellness programs. A pleasant workplace environment with healthy employees is a much better way to get more work done, and healthy workers have a much better attitude about themselves, their employer, and their jobs. Wellness works, but attitudes and behavior have to change first. Old habits die hard, but new ones are easier to form.

Until next time. Let me know what you think.

Wednesday, January 9, 2008

Health Care and the Top 10 Reasons to Stay Healthy

Late night comedian David Letterman has made the Top 10 a must see routine on his show. He has been giving us laughs on all sorts of topics since instituting his lists on his late night shows. As a tribute to him, I am offering a Top 10 List for the Reasons to Stay Healthy. Health Care is no laughing matter, but some times we need a little humor to make sure that we understand the seriousness of the topic. So here we go!

#10: The cost of being sick is more expensive.

#9: You look really awful when your health is bad.

#8: Smoking, drinking, and doing drugs makes you look older than you are.

#7: Friends. After, all, no one wants to hang around with "Sickies."

#6: You feel better when you are healthy.

#5: You'll be able to use cool new buzz words like buff, ripped, hot, and more.

#4: People will see you as a "hottie."

#3: Long life.

#2: Less stress.

And the #1 Reason for staying healthy: Death can be a real bummer, especially if you are not ready.

Until next time. Let me know what you think.

Tuesday, January 8, 2008

Health Care and Employee Costs in the New Year

This year, 2008, we are facing increased health care costs including higher rates for insurance, medical procedures, hospital charges, prescriptions, and much more. In December, 2007, the California Employer Health Benefits Survey was released and showed dramatic increases in that state's employer-based health insurance premiums. The national gain was over 6%, a little more than two points behind California. The study researches coverage, cost, availability, benefits and enrollment not only in that state but also across the nation. Costs rose for both HMOs and PPOs. The forecast for 2008 indicated that 41% of companies with over 200 employees were very to somewhat probable to increase what their workers would pay toward insurance this year.

As a matter of fact, health care costs are increasing on an ongoing basis. You really don't need a study to tell you that. Just look at what you pay for medicine or for your insurance. Health care is the Number One concern with employees. According to the study released recently by the Center of State and Local Government Excellence, the top rated aspect of a job is the health insurance plan of the employer according to 84% of the participants surveyed. Health benefits are extremely important to employees and their families, and they are the primary factor in job satisfaction. That is one reason why about half of all employers estimate benefit costs as a percentage of payroll to be 31% or more according to the International Society of Certified Employee Benefit Specialists.

Just very recently, Employee Benefit News online reported late in 2007 that costs for the most popular health plans in the U.S. are expected to increase by double digits into 2008 from information gathered and analyzed by Buck Consultants. Prescription costs are anticipated to rise by almost 12%, and dental costs were expected to increase by 5-6%. Cost shifting to employees is a major concern in the market place, with workers, and among employers. At the end of December, 2007, the Detroit News reported that some employers will no doubt pass on health insurance increases to employees--some companies will absorb the increased costs, and some will pass all of it on to workers. The majority of employers will share the added expense with employees. This translates to higher costs for the vast majority of Americans who receive their health insurance from their jobs. Employees will be grappling with higher premiums, more expensive co-pays for doctor visits and prescriptions, higher deductibles, and possibly reduced benefits. I personally had to deal with this issue and now must pay more into the system with decreased benefits because our rates went way up for this year. "I feel your pain"!

Each year, more and more costs are being shifted to employees. Now the emphasis is toward setting up incentivized wellness plans, especially in companies where the cost of benefits has increased so much that employers are forced to the point of cutting back on coverage. Significant changes are taking place in the workplace that will make both employers and employees to make difficult choices in health care and insurance coverage. This can be anything from a high-deductible health plan offers and flex plans to more participation by employees in health risk appraisals and aggressive lifestyle programs at work and using generic medications versus name brands.

Whatever the situation, the cost of staying healthy is going up. There are a number of reasons why health insurance costs are going up: an aging population, more expensive technologies, raises in medical personnel salaries, and less Medicare coverage by the government. Employers still handle the majority of benefit costs; however, the days are gone when employees could expect 100% coverage as part of their job. The inflation in health care continues, and it will keep going up until a workable solution comes along. And although health care is more expensive now than ever, most American workers still find the insurance plan offered to them as acceptable. Either way, get ready to open your wallet.

Until next time. Let me know what you think.

Friday, January 4, 2008

Health Care and You

When you start looking around for health care plans, there are alot to choose from but few that may actually help you based on individual needs. Many health plans are only offered through employers, and some are only available in certain regions of the country or at certain times of the year. Usually, the choices come down to cost as many health care plans often have similar benefits. "What can I afford" is the most commonly asked question when most people are evaluating a plan for themselves or their family. Tragically, the cheapest ones may not be the best.

According to the latest report issued the last day of December, 2007, by the US Census Bureau, more than 303 million Americans greeted the New Year. After massaging all the births, deaths, and net immigration figures, the country is growing at the rate of one person every 13 seconds. That's a bunch of new faces! And in all this growth, the people looking for health care also continues to increase each year. With choices ranging from full catastrophic coverage with High Deductible Health Plans, to PPOs and HMOs trying to manage care, to Mini-meds, to Discount Health Plans, to Big Box Health Clinics who cater primarily to the uninsured, there are a variety of options to consider. Care clinics, although convenient, are not a quick fix to the nation's health care crisis; but they are just one step in getting consumers the necessary care they may need if no primary medical practitioner is available. According to the US Census report issued in August, 2007, there are approximately 47 million Americans with no insurance--some by choice, some due to lack of availability, and some because of lack of funds.

Additionally, Wal-Mart, Target and other retailers are offering generic prescriptions for their customers at highly competitive pricing--hundreds of medications are available for as low as $4, driving down costs and applying that to the health care business. Four dollar meds will get your attention fast, especially if you are a senior citizen or without insurance coverage. And consumer groups have applauded this action by these companies. Let's face it. Everyone needs a break once in a while, and these cheap prices offered to consumers for generic medications have been a tremendous savings mechanism generating hundreds of millions of dollars to Americans. Health care is expensive with a plan, and without a health plan it's even more costly.

Choosing the right health care options can be confusing, especially when you start reading the language in most health plans and insurance offers. Spend some time doing research online and with others whose opinions you respect. Find out what works for them, and where they found it, and any other resources you can dig up. Don't just go with the first thing you see. A little self-education goes a long way when you are sourcing health care options.

The Joint Commission International Center for Patient Safety has some great tips for evaluating health care. Look on their website to get an idea of topics and considerations when choosing various health care options. They have great questions to ask when looking for health plans, long term care, and many other health care choices. Discover queries on everything from coverage and fees, to access, to member rights, to quality, and more. These questions should be asked when looking at your options. This is just one source, and it is a good way to get started. The internet is a phenomenal source for research, and studying your options intelligently with good, reliable information is a great way to find out what you should consider for your health care.

Until next time. Let me know what you think.

Thursday, January 3, 2008

Health Care and 2008

We have a New Year--2008! It promises to be a great one for health care but with challenges. In each new year most American consumers anticipate that they will be healthy with little to no health issues. Some years that is true; and sadly, in some years it is not. The NY Times online had an Op-Ed article published today (1.03.08) that speaks to the case of the uninsured. The editorial makes a case for making insurance available to all Americans. The writer makes a point of telling us that everyone deserves insurance, and that the reason is based upon information disseminated by two recent studies--one by the Harvard Medical School, published by JAMA, and the other by the American Cancer Society.

While it is true that the uninsured receive less medical assistance than those Americans who have insurance, there is a percentage of people who do not want insurance and are very qualified to purchase it, either directly as a consumer or through their employer. The 19-29 age bracket is particularly unwilling to be insured, primarily because the common mindset is one of indestructibility--"I'm going to live forever, and I never get sick!" These young immortals, the Twenty-somethings, have the lowest rates of health insurance coverage in the country according to a survey by the Commonwealth Fund. Yet, when offered insurance on the job over 70% will take it. Also, children and the elderly are eligible for Medicaid and Medicare. However, young people, considered among the healthiest demographic part of our population, are more often ineligible for public programs.

Young adults commonly find themselves without health insurance, in many cases due to ineligibility or poverty. The Commonwealth Fund survey found that over half went without medical care, including doctor's appointments, tests and prescriptions, and had significant trouble paying their medical bills. Another risk of going without health insurance, even for a short time, is the possibility of being unable to resume coverage. Often, young adults are faced with a very difficult decision to make--forcing a choice between staying healthy and being financially solvent.

The NY Times editorial also was quick to recommend moving the uninsured to government sponsored programs including Medicare. Although the studies mentioned do make a case for how much better those on the assistance programs did versus those who are uninsured, by no means should the American public be forced to pay for universal health care. At the current rate of spending, the American Academy of Actuaries points out:"Total Medicare spending was $309 billion in 2004, or 2.6 percent of the nation's Gross Domestic Product (GDP). Medicare spending will likely increase to 3.3 percent of GDP in 2006, and then is expected to double to nearly 7 percent of GDP by 2030, continuing to rise thereafter. If total federal revenues continue at their historical average of about 19 percent of GDP, and if no changes are made to the program, Medicare spending will take up a third of all federal revenues by 2030."

In his State of the Union address in 2005, President Bush said, “One of America's most important institutions -- a symbol of the trust between generations -- is also in need of wise and effective reform. Social Security was a great moral success of the 20th century, and we must honor its great purposes in this new century. The system, however, on its current path, is headed toward bankruptcy. And so we must join together to strengthen and save Social Security.” Amen to that!

This year, there will be a big push toward universal health care both on individual state levels, and at the federal level. Health care has become the Number One hot button only second to the War in Iraq, and in some cases even more of a focus. US News & World Report online has stated in August 2007 that the percentage of Americans without insurance has had a consecutive year of increase to about 47 million people in 2006 according to the US Census Bureau Division of Housing and Household Economic Statistics. Forces are coming to bear pushing for a solution. Groups including the Commonwealth Fund and Families USA feel that this trend will serve as a catalyst for some form of universal health care. Even the Consumers Union is advocating a rededication by Congress and the President to expand health insurance for everyone.

How do we fix this problem and others in the health care arena? The answers will need to be carefully thought out. There is no quick fix. Demanding that the American taxpayers pick up the tab is not a reasonable option, nor is ignoring the facts. Over time, the process of figuring out how to resolve many issues in the health care market, including insurance and other products and services, should be addressed by private industry, government, and consumers in a way that will move us in the right direction. So far, most of what we see and hear to date are proposals that are typically one-sided--usually in favor of the proponent. Let's get our thinking caps on and find a way through to a positive outcome. We want to know that the light at the end of the tunnel is the sun, and not an oncoming train.

Until next time. Let me know what you think.