blogs: Barbara Day 

Reigning in Health Care Costs the Old Fashion Way I attended the Kentucky Worksite Wellness Conference in Lexington on Thursday, February 25. The conference was presented by the Kentucky Chamber of Commerce. The conference objectives were for companies to learn how wellness can help reduce health costs and increase productivity in today's economy. I was torn between staying home and watching Obama's Health Care Summit Show or going to the wellness conference. After seeing some of the highlights of Obama's show, I was so glad I opted to go to the wellness conference, because the conference was excellent. In fact, listening to the speakers gave us an overview as to why the U.S. spends more than any other industrialized nation in the world. We're FAT and FAT is expensive. With 34% of Americans overweight or obese and 1/3 of our children overweight as well, it doesn't take a rocket scientist to figure it out why health care costs continue to climb. As a result of obesity spiraling out of control, so are our health care costs. Obesity Costs $200 Billion per Year Obesity estimated costs $200 billion per year. In 2008 health costs totaled to $2.2 trillion. But, here's a bulletin for you: 70% of disease is preventable and 87.5% of health care claims are due to an individual's lifestyle choices. Many of today's companies offer employee health insurance. They typically cover 60% of their employees health insurance premium while the employee pays 40%. Many businesses are offering worksite wellness programs to help combat higher premiums. Comparing health insurance to car insurance, if you have a wreck, your insurance typically goes up. At the KY Worksite Wellness Conference, Brian Caveney, MD, JD, MPH, from Duke University Medical Center, discussed how obesity and diabetes affect businesses health care costs and workforce performance. Here's some information Dr. Caveney presented which may help you understand why America is big roller when it comes to health care spending. Health risks associated with obesity: premature death, type 2 diabetes, heart disease, high blood cholesterol, stroke, hypertension, gallbladder disease, osteoarthritis, sleep apnea, asthma, breathing problems, increased surgical risk, cancer such as colon, endometrial, kidney, gallbladder, and post menopausal breast cancer), complications of pregnancy, menstrual irregularities, stress incontinence, and psychological disorders such as depression. Many of these diseases cost a tremendous amount of money to treat. Our health care costs have gone up because Americans health has been compromised by poor lifestyle choices. According to data presented by Dr. Caveney, 1 of every 5 health care dollars are spent on diabetics. Does Health Insurance Mean Keeping You Healthy or Just Paying the Bills? Consumers expect their health insurance should literally pay for everything from diagnostic tests, to office visits, if you have diabetes you expect all your medical testing equipment and gadgets to paid for, plus you expect all your drug therapy to be paid for, too. Lifestyle changes is really what the doctor needs to order rather than drug therapy but many physicians are reluctant to write an order like exercise 30 minutes per day because they know consumers won't do it. In fact, many consumers expect to have their lap band surgeries covered 100% (that's about $18,000). A company's yearly premium rate is based on their employees health status and also how many consumer health dollars the insurance company has to pay for health care. If your company has a chronically sick and frequently injured workforce, their premium rates go up. I have a family member who is 100+ pounds overweight. He could have personally afforded lap band surgery but waited for months until the Anthem – Norton Healthcare contract was resolved to have his surgery. His employee health insurance paid for his surgery. However, this cost seems minor to some because after all you ARE paying for health insurance but in the big picture these big dollar costs may end up increasing the cost of every employees premiums for his company as a result. Medicare Pays for Obesity Surgery FYI, Medicare actually pays for lap band surgery. Take a look at all the advertising locally promoting lap band surgery to get Medicare patients. One might argue that it's cheaper to perform lap band surgery all obese patients than treat them over the years. That might seem to be a logical train of thought but unfortunately not everyone who loses the weight keeps it off permanently. It's easier to pop a pill (and expect your health insurance company to pay for your prescription drugs) and have surgery than make inexpensive lifestyle changes. The ABCs of Cost Containment Presented at ObamaCare's Summit Senator Tom Coburn, MD, a practicing physician, presented some interesting data at President's Health Care Summit. In fact, he said Malcolm Sparrow, a researcher from Harvard found that “20% of the cost of federal government health care is fraud.” Dr. Coburn also said according to researcher, Thomson Reuters, $625 billion and $850 billion a year of health care dollars are wasted. Dr. Coburn reported that fraud in the private sector is about “1% as compared to 20% in Medicare and Medicaid.” Why is the federal government not looking at fraud and waste as a way to decrease the cost of health care? Dr Coburn also said “there's estimates that there's $15 billion worth of fraud in Medicaid a year in New York City alone.” If the federal government just cracked down on waste and fraud, health care costs would go down considerably. Dr. Coburn recognized that these suggestions would not solve the rising costs in private health insurance. But if you look at the earlier discussion in this column on the fact that 35% of Americans are obese and also other health risks that could be cause by obesity, it's easy to see that Americans have become avid health care spenders. Any business person can tell you that as your costs of doing business rise so do your rates. Many private insurance companies employ nurses, dietitians and health educators on staff to help engage their clients in the concept of taking care of their health before their health concern becomes uncontrollable. Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master's Degree in clinical nutrition. The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers. Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 9 grandchildren.

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ADD A COMMENT

	Rebeckalinn   tue mar 02 2010 at 6:38 pm         ·  That blows me away the medicare will pay for the lap band. Since I quit smoking my son has told me I am get pudgy, so I started working out with my Wii. I think doctors should write orders like excersie 30 minutes a day. I think if a patient shows progress, figure out away to benit he or she in someway.
	GuiltyByDesign   wed mar 03 2010 at 4:37 am         ·  I Agree with pretty much everything you have said! I've been working in health care since I gradated high school, and it didn't take long for me to catch on to how much *fraud* there is on not only a federal level but state level as well! As a tax payer, I can't help but get pissed off when someone missuses and abuses their state or federally funded insurance! We should be allowed to say no! No, we will not take you to the ER for your stubbed toe while you are fully mobile and have 5 fully functioning vehicles in your drive way, simply because you have passport and and don't want to pay for gas! Yeah sure we as a company will get paid becuase passport will pay for it, but what happens to when somebody else has a real emergency and ooops we have no ambulances available? Patients arn't the only people guilty either. I can't count the number of times doctors have written medical necessity forms to transport patients back home that are completely ambulatory! Another pet peeve of mine seeing a mentally or physically handicapt person working then picking up some 28 year old who is living on disablity because they have "anxiety"! P.S last ER visit I had I got charged $570 for an IV...how is that kind of inflation even legal...A plastic bag of water $20, 5 minutes of a nurses time $10 dollars...realizing that in the end even though I have real insurance that I pay for in the end I'm still getting screwed priceless! I could go on forever on this!!!!!
	GuiltyByDesign   thu mar 04 2010 at 12:42 am         ·  Yeah like this whole fibromyalgia thing...which is a crock!
	Florence Wright #325340   thu mar 04 2010 at 8:18 am         ·  I am glad to see that fraud was a focused topic at the conference. After reading information about Medicare fraud at http://www.planprescriber.com/Medicare/newsletter-nov2009-medicarefraud.html I was shocked at how far reaching it is. I think all Americans need to get involved to stop healthcare fraud by knowing how to recognize it and how to prevent it from happening to them. You can also access the fraud resource at: <a href="http://www.PlanPrescriber.com">PlanPrescriber.com