The Free Press, Mankato, MN

December 15, 2013

Affordable health care elusive

WHY IT MATTERS: Changes by health care providers and our own lifestyles have a better chance of achieving affordable health care.


The Mankato Free Press

---- — Even with the advent of the Affordable Care Act, many Americans still say they are putting off medical treatment because of cost. To them, it’s not affordable.

In a recently released Gallup poll, it was found that even those who are insured cite out-of-pocket costs in foregoing medical treatment including Medicare (22 percent) or private health insurance (25 percent).

It also found that the percentage of Americans putting off treatment for a serious condition because of cost has increased since the early 2000s.

“One possible explanation for the higher numbers since then is the increase in the number of high-deductible plans,”Gallup notes. “Americans with serious conditions who have insurance may be putting off treatment to avoid high out-of-pocket costs.” It has been noted in some news reports that health insurance options available with ACA are affordable because the low monthly premiums are being offset by higher deductibles.

So it would suggest that even with health care insurance coverage, we are still going to see many Americans putting off needed treatment because of costs.

It also noted that with the ACA, “the possible uptick in the number of Americans seeking medical treatment may put additional strain on the healthcare system, creating new problems.”

Clearly, the ACA is not an answer to curbing the rise in health care costs and this has been noted in the past by many health care providers.

In an interview with CNN Money, Mayo Clinic chief Dr. John Noseworthy acknowledged that America’s health care spending is growing faster than GDP and said some lawmakers are suggesting there should be less paid for each unit of work.

Noseworthy said that’s not the whole answer. “We’re spending too much on health care because it’s fragmented and the quality is so uneven in our country.”

Mayo, for one, has been focusing on this fragmentation and working to get more integrated and less specialized. It may mean, in some cases, not seeing a physician when it’s more practical to see a nurse.

The Rand Corporation suggests four ways to lowering costs to health care. They include:

n Focusing less on volume and more on value. Policies should move from paying for the amount of work performed and focus more on the benefits spent per dollar.

n It also suggests medical providers can determine best practices for identifying ways to reduce waste without compromising care. This can be accomplished through “emerging comparative effectiveness reviews.”

n Enhancing public safety which would reduce needless complications, readmissions and even deaths. Such errors increase providers’ liability which affects your cost.

n And we need to strengthen primary care. This doesn’t mean having more general practitioners but rather finding ways to help people live healthy lifestyles and making better choices. Keeping people out of the hospital lowers overall costs and improves care.

So while the ACA may not make health care more affordable, changes by health care providers and changes in our own lifestyles have a better chance of achieving that goal.