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Wellness in the Headlines
(Don's Report to the World)
A Recommended Personal Strategy for Dealing with Future Health Care Cost Increases and Benefit Reductions
Surely you have heard by now -- the cost of health insurance is going way, way up in the years to come. Not that it's cheap now, but hold your hat, or whatever -- it's going to get REALLY expensive. Naturally, I have a wellness strategy for dealing with this problem, but first, a little history lesson is in order.
To appreciate my strategy for ways that you can personally deal with the expected cost increases for medical care AS WELL AS benefit reductions from your health insurance, assuming you HAVE health insurance, first be aware of how we got where we are today. Health insurance for employees got started during WW II when wage controls were in effect. This was done to prevent inflation. Instead of higher salaries, companies offered an inexpensive new benefit to attract and retain workers. This cheap benefit was the start of employer-provided health insurance. Before the war, nothing like it existed. People who wanted medical care paid for it -- right out of their pockets, or bank accounts (or, in Alabama, with moonshine!) With health insurance, employers began to subsidize medical bills through an insurance program with third parties, like Blue Cross.
At the time, this attractive benefit only cost companies about five percent of workers' salaries, which was not much considering that they did not have to pay wage increases during all the war years. It was a pretty good deal all around. When the war was over, the "free" insurance fringe benefit was retained. The government policy of not taxing these benefits also continued and soon became engrained in law and culture. Today, more than half a century later, company health insurance benefits are a tax-free subsidy for the employed. Of course, nothing is really free, not lunch and certainly not health insurance.
At this point, I should also note that citizens not employed full-time were left out of this benefit package during the war, after the war and to this day. However, medical benefits were made available for the very poor and/or elderly in 1965, with passage of Medicaid and Medicare. Although the AMA and other established health professional organizations vehemently opposed the legislation that created these two massive federal programs, they soon changed their tune. Why? Because physician incomes and hospital budgets rose rapidly over the years, due in good part to these very programs they once opposed. However, other developments were not so pleasant for the doctors and other health professionals. Lawyers wanted to get rich too, so malpractice insurance rates started to go up for health care professionals, in the range of eight to thirty percent annually! Other change factors were seen in the development of new "wonder" drugs. Before long, those covered by health insurance or Medicare or Medicaid wanted nothing but the best care known to science, regardless of the costs, since for the most part they were not paying them, at least not directly.
Not surprisingly, double-digit annual increases in total health care costs were experienced from the mid-sixties to the early nineties. The percent of the GNP devoted to the health care system went from five to 13.5 percent in this period. This equates to one of every seven and a half dollars! Efforts to control the growth of the medical sector, improve access to care and gain other advantages led to health maintenance organizations and other forms of managed care. All this, in turn, prompted lots of new controversy, stress and change, but costs rose anyway, though not as rapidly as during the previous few decades.
What did NOT happen, it should be noted, was better overall national well-being! The American population, as a recent Surgeon General report on the obesity epidemic indicates, had not become more fit, healthier or much happier with their health care system. Reform proposals continue to be offered in varied forms, but not many experts expect lower costs for medical care in the years to come or, as it is euphemistically called, health insurance at easily affordable rates. In fact, the Robert Woods Johnson Foundation projects that spending for health care will take nineteen percent of GNP within the next five years! At present, the average citizen spends $4000 annually on health care (I spent only $2400 on health care last year but I got lucky, lived prudently and carried a very high deductable -- and no doubt many people spent even less) but by 2007 this figure will reach $10,200 per person! What's worse, the number of uninsured will reach 65 million. In part because Americans are getting older (baby boomers take note), Medicare is expected to reduce benefits, increase age requirements, add more price controls, require more co-pays and develop further spending limits.
So, that's the history. Now the question can be asked and addressed: What can you personally do in order to mitigate the costs and other risks that you will face with respect to the medical system?
You know what the answer is, of course, but it somehow eludes the masses -- namely, live well, be sensible, seek exuberant good cheer and exercise like hell! Make the most, or at least much, of the options that science, reason, common sense and your genetics make possible. Also, if you have the good fortune to enjoy employer paid health insurance, recognize that the high costs of providing this benefit could be redirected, at least in part, toward income for you rather than payments to insurance companies. Ask for a menu of health or medical payment plans, rather than the "one-size-should-fit-all" approach that is the norm. Some employers provide stipends to workers to spend in this market, and redirect the savings for higher pay, other benefits and/or higher declared profits. If you are staying well and believe you have a fair chance of continuing to do so in part because of your willingness to accept responsibility for your health and live a wellness lifestyle, you may not need the high-end model of medical insurance benefits that your employer is paying to a third party. Better these funds should go into your pocket, directly or indirectly.
It might be something to think about and look into.
All the best. Be well and look on the bright side of life.
Domain: mentalSubdomain: effective decisions
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