Healthcare Matters

A week ago, I was going through my files to find a form I needed in order to fax a prescription over to an online pharmacy when I stumbled upon a stack of monthly health insurance bills starting in May 2001 when I first obtained an Individual HMO plan with Empire Blue Cross Blue Shield.  I became self-employed at about that time. 

Before I go further, it is important for me to state that I am a healthy individual.  I don’t smoke and I don’t drink, except for maybe a glass of wine about once a week.  I live a healthy lifestyle, I am physically active and I don’t consume sweetened beverages and I avoid foods that are loaded with sugar.  Apart from the seasonal allergies I get in Spring, I am hardly ever sick (my health records will attest to that) and the only times I have ever been hospitalized was once when I broke an arm back when I was a young 7 year old and a second time when I had my appendix taken out when I was still in my teens.  I probably see my Primary Care physician once a year when I have an annual physical check-up to be sure I’m doing OK and nothing is out of the ordinary.

That first month back in May 2001, my premium was $337.65 which worked out to be $4,051.80 per year.  I flipped over the stack of bills to August 2006 – the last month for which I remained on that plan - and the premium for that same coverage had gone up to $616.82 or an annualized $7,401.84, a whopping 183% of what I was paying back in May 2001.

Out of curiosity, I went online to get a quote for the same plan today and the premium has shot up to $1,549.30 a month or $18,591.60 annualized.  That works out to 251% of what I paid back in 2006 (less than 4 years ago) or 459% of what I paid back in 2001.

If the premiums keep increasing at that pace, the monthly premium for an Individual HMO plan would cost about $7,800 in another 10 years time when I will qualify Medicare.  I know I can’t afford that in-between period – I don’t think any self-employed or unemployed individual can.

As unemployment soared and as the duration of people staying unemployed increased with the latest recession, it has become abundantly clear that an employment-linked health insurance is not the solution.  COBRA has its limitations and is more costly for the individual as the former employer no longer picks up any part of the premium.

Even if one is fortunate enough to remain employed or is able to get a new job thanks to the job stimulus bill that was recently passed, rising health insurance premiums would force employers to shift more of the burden of healthcare plans over to their employees. 

The claim that “we have the best healthcare system in the world” is misleading – it confuses availability with affordability.

We need healthcare reform AND MORE. We need a “medical tort reform”, defining what is the standard of care that should be expected so that doctors are not over-prescribing tests and treatments that serve only to enrich the pharmaceutical companies and medical equipment companies.  We need a “prescription drug reform”, making medications more affordable – there should be no reason why Americans pay more for the same drugs than in other countries.  We need reforms that encourage healthy lifestyles and more physical activity for both the young and the old.

We need to continue the debate about what healthcare should or should not be but not let it hold us back from enacting what should be the first of all the necessary reforms.  As we gain experience from the present reforms, we need to refine those provisions that prove to be less than satisfactory.  Nothing will be perfect from the get-go and we need to be mature enough to keep working at it and make it better.

Health Care

A friend forwarded me an email with amusing cartoons about the “Golden Years” and appended at the end of all the email was the following poem (author unknown):

A row of bottles on my shelf
Caused me to analyze myself.
One yellow pill I have to pop
Goes to my heart so it won't stop.
A little white one that I take
Goes to my hands so they won't shake.
The blue ones that I use a lot
Tell me I'm happy when I'm not.
The purple pill goes to my brain
And tells me that I have no pain.
The capsules tell me not to wheeze
Or cough or choke or even sneeze..
The red ones, smallest of them all
Go to my blood so I won't fall.
The orange ones, very big and bright
Prevent my leg cramps in the night.
Such an array of brilliant pills
Helping to cure all kinds of ills.
But what I'd really like to know
Is what tells each one where to go!

Funny and yet scary thoughts at the same time. I certainly don’t want to have to be popping all those pills just to keep going.

As medical advances come up with all kinds of drugs and medication which permits us to live longer, the question we are all forced to face is whether or not the ends justify the means. How much of a burden are we leaving to the next generation as the cost of healthcare sky-rockets and tax the Medicare and Medicaid systems?

As the United States push forward to adopt a more universal health coverage, it is inevitable that the quality of care will drop off unless the government is able to fund the added costs. It is like a triangle with one of its angles representing “Scope”, the second angle representing “Quality of Care” and the third angle representing “Costs”. By expanding the “Scope” angle to bring more people into the healthcare system, the “Quality of Care” angle will tighten, unless, of course the “Costs” angle is expanded at the same time.

In order to keep the costs down so that more people can benefit from the universal health coverage without an increased tax burden on everyone, Americans will have to be taught how to take better care of themselves. It is not an impossible task – a popular TV show has demonstrated to the world that it is possible for even the grossly obese to lose weight and become healthy enough to get off their blood pressure, diabetic and other medication.

Millions of dollars are spent every year to encourage smokers to quit and to dissuade young people from taking up the habit. What we need is a similar push to get people off their couches and to start exercising and to rid themselves of eating habits that are detrimental to their long term health. Schools should have compulsory “healthy living” classes so that the next generation grows up armed with all the knowledge they need to stay away from poor eating habits and bad diets. Parents can set the example for their children to follow by adopting a more active lifestyle, getting their kids away from computers and video games and onto the playing fields, or their bicycles or scooters, and onto the path of a better and healthier life.

Despite the very vocal objections, cities have successfully banned smoking in public places, pubs and restaurants, realizing that an unhealthy public is a drain on the cities’ resources. They need to take similarly drastic actions to force restaurants to serve healthier food as the city authorities themselves strive to provide more parks, facilities and occasions for their residents to get moving. To fund these new healthy-living programs, they should implement a “Fat Tax” and make it applicable across the board for all sales of food / drinks that are high in empty cholesterol and fat.

Lifestyle changes are the hardest but the most effective way to trim health-care costs.