How to Save on Health Care Costs

In the long run, prevention is the key to both better wellness and lower health-care costs. The nation and each of us individually should put there energy and resources here. Over time, it is more important than addressing the high cost of new technologies and drugs or their incorrect overuse.

We focus on treating illness when it occurs and pay for nursing assistants but not on preventing it in advance. Which means today the U.S. basically has a medical system instead of a health care system.

According to a recent New England Journal of Medicine article, there are about 465,000 preventable deaths per year in the U.S. from smoking, 395,000 from high blood pressure, 216,000 from obesity, 191,000 from inactivity, 190,000 from high blood sugar, and 113,000 from high cholesterol.

These are for the most part due to our lifestyles: One-third of Americans are too heavy, another third are obese, and 20% smoke. We eat too much packaged and prepared food rather than nutritious foods, and we do not exercise. This issue makes for paying out money for health care, Nursing Asisstants and hospitalization. Even children’s physical activity now declinesOur own lifestyles are mostly to blame for needing care from nursing assistants or hospitalization: A third of Americans are overweight, another third are obese, and 20% smoke. We eat too much packaged and prepared food rather than nutritious foods, and we do not exercise. Even children’s physical activity now declines.

This helps explain why the U.S. ranks 39th for infant mortality, 43rd for female mortality, 42nd for male mortality, and 36th for life expectancy — but is first for per capita spending on health care, nursing assistants and hospitalization. Clearly, there is something frightfully wrong with this figure. There will be a diabetes epidemic, more heart disease, cancer, arthritis and other chronic illnesses. Life spans will shorten rather than lengthen unless we seriously start working on preventing these diseases.

I firmly believe that each of us must each take responsibility for our own preventive health care. That said, other players in society should assist us in the following ways:

Our government should insist that restaurants post calorie counts and fat content and schools restrict the accessibility of sodas and other non-nutritious foods in cafeterias. In addition, it can provide a food pyramid — recommended diets or eating plans — that is not influenced by vested interests. Something our government can do is insist that restaurants post calorie counts and fat contents. Schools should deny the availability of sodas and other non-nutritious foods in cafeterias. In addition they can provide a food pyramid, recommended diets or eating plans, that are not influenced by vested interests.

Second, our employers should provide wellness programs like Safeway’s, which encourage staff to utilize smoking-cessation, weight-reduction, stress-management, and nutrition counseling at no charge. Those who participate are given a decreaseIn a Wall Street Journal op-ed describing the program, CEO Steven A. Burd reported that over four years Safeway’s per capita health-care costs (including both the company’s and employees’ portions) did not rise while those for most American companies had increased 38%. In addition, the company had less absenteeism and higher employee productivity. Our employers should provide health programs like Safeway’s, which encourage staff to join smoking-cessation, weight-reduction, stress-management, and nutrition counseling at no charge. Those who participate are given a reduction.

Lower premiums should be offered by insurance plans to subscribers for not smoking, for being at reasonable weight, and for exercising.

Physicians, especially primary care physicians, should spend the time necessary to provide good preventive medicine, including counseling, screening tests (high blood pressure, weight , cholesterol, cancer), and immunizations.

Prevention is of value at any age. At the Erickson Retirement Communities, residents can opt for a program that includes health-promotion classes for all (similar to Safeway’s) and care coordination for those who do develop a chronic illness and need nursing assistance. The physicians limit themselves to about 400 patients (compared to about 1,300 to 1,500 for most primary care physicians) and offer same same-day visits and as much time as needed per visit. They use an electronic medical record system, nursing assistants assisting with care coordination, visits to each hospitalized patient, and an automatic office visit within 72 hours of a hospital discharge.

The results are striking: lesser hospitalizations, shorter lengths of stay for those who are hospitalized, and a drop in the “bounce rate” (i.e., unplanned readmissions to the hospital in the 30 days after discharge) from the national Medicare average of (an outrageous) 24% to less than 10%. Basically, better health, better care and reduced costs.

To sum it all up, a combination of nudges and incentives can help us in achieving our responsibilities for health promotion and disease prevention. These responsibilities commensurate with the new right of Americans to have insurance.

This would be a start toward a true health care system and away from a medical care system.

More Health Care Articles