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Health Spending Flattening Out
Old 04-29-2012, 07:54 AM   #1
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Health Spending Flattening Out

http://www.nytimes.com/2012/04/29/he...1&ref=business
Good news - "The slowing of the growth rate is partly explained by the recession, but evidence suggests that changing behavior of health care providers and consumers also partly accounts for it."

As a healthcare consumer or provider, have you been changing your behavior ? If so, how ?
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Old 04-29-2012, 10:50 AM   #2
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Quote:
Originally Posted by obgyn65
http://www.nytimes.com/2012/04/29/he...1&ref=business
Good news - "The slowing of the growth rate is partly explained by the recession, but evidence suggests that changing behavior of health care providers and consumers also partly accounts for it."

As a healthcare consumer or provider, have you been changing your behavior ? If so, how ?
I have always been fairly healthy and have not accessed healthcare too often. But when I was working, and had my healthcare provided, I always went for a yearly check up. I skipped it this year because I have a HD plan. The local hospital had a health fair day and they did blood panel workup for $10. Got my BP checked by nurse there for free. Saved me a few hundred bucks. Numbers were all good so I will skip the visit. I just noticed in paper today another place was offering free skin cancer check ups. I wont go to this, but I do notice a lot of free or cheap screenings available if you pay attention to the local newspaper.
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Old 04-29-2012, 12:12 PM   #3
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Originally Posted by obgyn65 View Post
As a healthcare consumer or provider, have you been changing your behavior ? If so, how ?
A friend turned down an MRI for a possible ovarian cyst because she couldn't afford it. When she had an employer sponsored plan, she would've had it done.
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Old 04-30-2012, 01:43 AM   #4
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As a healthcare consumer or provider, have you been changing your behavior ? If so, how ?
Thankfully, I've maintained relatively good health over the years so far.

I know a few people at work have reluctantly switched to the high deductible health plans because they're cheaper....but they still gripe and moan about the high deductible, without bothering to check and realize that it's still cheaper after they pay for a few meds, and without stopping to realize "Hey, wait a minute, maybe I don't really need to go to the doctor if I have a runny nose".

It's the same mentality of people that hire a 'financial advisor' without bothering to spend a mere 5 minutes trying to learn something. They have the mentality of "there's a 'professional' out there that will do _______ for me, so I'll just pay them to do it".

Over the next 10 years, I think that people might finally start to wake up and think about healthcare in more rational terms for the basics (minor stuff that you either don't need a doctor for, or an urgent care center is more appropriate for instead of the ER).

Of course, there will be unfortunately situations like eridanus mentions where people will have to face a situation where there may not be able to afford a test/care due to the cost. I hope that if enough people focus on not wasting dollars on the 'minor stuff', enough people will be able to save up some money to afford the 'big stuff' that will come up at some point.
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Old 04-30-2012, 04:57 AM   #5
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I see no flattening in my household. The pathetic pharmaceutical industry continues to jack prices like always. As an example I will use the monthly price of Copaxone:

January 2006 : $1678
October 2007 : $1763
March 2008 : $1983
September 2008 : $2179
January 2009 : $2394
March 2009 : $2631
January 2010 : $2787
June 2010 : $3063
January 2011 : $3519
October 2011 : $3590
February 2012 : $4026

I suspect that it has actually gotten cheaper to produce so they are raking in hoards of cash.
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Old 04-30-2012, 11:23 AM   #6
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Our retiree health plan uses Express Scripts for prescriptions. Our price for losartan (generic) went nice and low ($30/90 days) and then jumped up in price ($180/90 days) and stayed high. So I'm going outside of Express Scripts and buying elsewhere. I do the same for a few other Rxs that I can get locally for less ($5.89/90 days) than our mail order plan ($15/90 days).

Our deductible is $550/person. If I buy the losartan from Express Scripts DH would exceed the deductible but I'd rather not spend it to begin with and buy elsewhere.
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Old 04-30-2012, 11:51 AM   #7
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I was optimistic after reading the NYT article title, but the content of the article seems to contradict the "hopeful" headline pretty convincingly. The accountable care trend was the only really encouraging part of the article...
Quote:
Much of the slowdown is because of the recession, and thus not unexpected, health experts say.

In 2009 and 2010, total nationwide health care spending grew less than 4 percent per year [flattening], the slowest annual pace in more than five decades, according to the latest numbers from the Centers for Medicaid and Medicare Services. After years of taking up a growing share of economic activity, health spending held steady in 2010, at 17.9 percent of the gross domestic product.

The growth rate mostly slowed as millions of Americans lost insurance coverage along with their jobs. Worried about job security, others may have feared taking time off work for doctor’s visits or surgical procedures, or skipped nonurgent care when money was tight.

She argued that the unusual decline in not just income but also wealth during the recession might be one factor cutting down on use of the health care system.

But many other health experts say that there is just enough data to start detecting trends — even if the numbers remain murky, and the vast complexity of the national health care market puts definitive answers out of reach.

Many experts — and the Medicare and Medicaid center itself — point to the explosion of high-deductible plans, in which consumers have lower premiums but pay more out of pocket, as one main factor. The share of employees enrolled in high-deductible plans surged to 13 percent in 2011 from 3 percent in 2006, according to Mercer Consulting.

That means thousands of consumers with an incentive to think twice about heading to the doctor. One study by the RAND Corporation found that health spending among people who shifted into a high-deductible plan dropped 14 percent
— though the study also found that enrollees cut back on some care that tended to save money in the long run, like vaccinations.

“If you asked me, ‘How confident are you that this is not just the recession?’ I’d say 75 percent,” said Professor Cutler of Harvard. But he said he was less confident that this trend would continue.
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Old 04-30-2012, 12:54 PM   #8
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My main medical costs are for health insurance and prescriptions.

My health insurance didn't go up this year, but hidden in the fine print one can discover the reason for that - - it doesn't cover as much as it used to. So, I am paying the same price for a lesser policy.

Because of this my share of the cost of my prescriptions is higher. The sum of both health insurance and prescriptions is 16% higher this year than the sum of both last year.

Quote:
As a healthcare consumer or provider, have you been changing your behavior ? If so, how ?
To be honest, when I have the slightest doubt as to whether to make a doctor appointment, I don't (even when I would have done so a few years ago). It is stupid that I have changed my behavior in this way and this could eventually be detrimental to my health.
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Old 04-30-2012, 12:57 PM   #9
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I was optimistic after reading the NYT article title, but the content of the article seems to contradict the "hopeful" headline pretty convincingly. The accountable care trend was the only really encouraging part of the article...
So I take it you're not thrilled with the thought that health care costs are rising at 1.5 x inflation and this achievement is probably the result of people cutting back because they can't afford their higher share of cost? FWIW I share the sentiment. The headline was so promising...
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Old 04-30-2012, 01:09 PM   #10
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As a healthcare consumer or provider, have you been changing your behavior ? If so, how ?
Years ago, when we had the kind of health insurance in which we never even saw how much stuff cost, I went to the doc for any little ache or twitch.

Now, much less. This is partly because I am a recovering hypochondriac.
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Old 04-30-2012, 01:31 PM   #11
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Years ago, when we had the kind of health insurance in which we never even saw how much stuff cost, I went to the doc for any little ache or twitch.

Now, much less. This is partly because I am a recovering hypochondriac.
Blood Pressure -- Experiments and Stategies

I don't think the recovery is working !
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Old 04-30-2012, 02:23 PM   #12
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Blood Pressure -- Experiments and Stategies

I don't think the recovery is working !
Oops, good point.
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Old 04-30-2012, 03:08 PM   #13
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As a healthcare consumer or provider, have you been changing your behavior ? If so, how ?
My HMO requires that I wait Sooooo long for service, that by the time I can get in to see a specialist, I have already operated on myself with my Swiss Army knife.

At least theire isn't a co-pay

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Old 04-30-2012, 07:38 PM   #14
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"operated on myself with my Swiss Army knife."

You could spend the same and get a cleaner result with a better knife and a stick of kindling instead of the pricey ammo.... might keep the dental costs down, too.
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Old 05-01-2012, 12:16 AM   #15
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Years ago, when we had the kind of health insurance in which we never even saw how much stuff cost, I went to the doc for any little ache or twitch.

Now, much less. This is partly because I am a recovering hypochondriac.
Al, I hate to tell you this: Hypochondria is terminal (and no one ever really recovers.)

But seriously, I have begun doing whatever I can to be a "responsible" consumer of health care. I shop for all of my meds (and DW's). I go so far as to buy some meds for cash (NOT through insurance) when I'm on the mainland instead of here in Paradise because Walmart et. Al. charge higher prices here than there for some items. I have spent about 5 hours this year already, just figuring out how to get the best prices on meds. The good news is that I'll save a couple of hundred dollars for the time.

My doc insists on seeing me every 3 months (to "read" my blood work - chaCHING, $80 - $15 my cost plus over $25 - my cost - for the tests) because I take a med which could cause kidney damage. I've been calling in, changing my appointment time (first by a month, then two, then three) as my blood work is always just fine WRT the kidney factors. This past time, I put it off 3 months (6 months since last blood work). The doc mentioned it while arching his eyebrow. I noticed he only wrote my usual 1-year script for that med for 3 months (subtle!) but didn't inform me of the little slight-of-hand. Apparently, he was too chicken to mention his "gotcha". But, I prevailed! DW - who used to take THAT med and got all those SAME high-priced blood tests - found out HER doc MISSED her kidney damage over a 5 year period. Her new doc took her off that med and now I have her stash of left over meds. Looking at the 5 years of data on a graph could have been interpreted by a 9th grade algebra student. Too bad I hadn't looked at it either. (From now on - Trust but verify).

I now "shop" for all dental work. I will continue to "shop" for any non-emergency or elective medical procedures or treatments. I'll continue to shop for meds (asking the doc to prescribe the off-patent version of a class of meds).

I'm becoming my and DW's health advocate. I use my time with the doc to pump him for info about my own situation and I always do the same with my wife's docs. That way, I try to get my money's worth if I'm forced by "policy" to pay for a visit.

Even with all this additional "work" on my part, last year's HC bill (HC insurance, co-pays, meds, etc. etc.) was nearly $11K. (DW's new KIDNEY doc was VERY expensive!)

So, yes, Obgyn65, I think you could say I've been changing my HC behaviors. I'm also toying with the idea of recouping some of DW's costs from her old doc.
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Old 05-01-2012, 09:02 AM   #16
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I have a VERY thorough physical each year--several days of tests including that lousy annual colonoscopy. But in between I have basically not seen a local doctor. I HAVE gone to the emergency room, but each time I was admitted for at least four days, and for unquestionable cause. I can remember going for a flu-no more. We have right now, knock wood, virtually no co-pays for most things. But I'm always aware of the cost to the whole system, whereas 20 years ago I had the thought, "But 'I' don't have to pay--it's part of my employment compensation."
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Old 05-01-2012, 09:35 AM   #17
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Both my wife and I use physician's assistants as our "primary care" providers.

I've read that there are more drugs coming off patent than new drugs coming into the market. So the cost of prescription drugs is not going up as fast as it was.
My wife was taking post-chemo drug that was $10/day. Now that the patent expired it's about $1/day.
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Old 05-01-2012, 09:55 AM   #18
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My rule of thumb is to double recommended intervals for routine checkups. For example "annual" checkup every two years.
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Old 05-01-2012, 10:12 AM   #19
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My rule of thumb is to double recommended intervals for routine checkups. For example "annual" checkup every two years.
I used to go to the dentist every 3 months, her recommended interval. Then I spaced it to every 4 months, 3 times/year instead of 4. Now I go every 6 months, have been for many years. I brush 2-3 times/day and floss once/day and I don't think my teeth are any the worse for it...and my cost has been cut in half as far as I can tell (I'm not having more cavities or other dental expenses etc.)
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Old 05-01-2012, 03:17 PM   #20
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I asked the dentist if I could come in every 9 months, and he said yes. Lena too. This is a benefit of a sugar-free diet.

I've been putting off the X-rays, and they made me promise I'd allow them next time.
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