Spending on Health Care: A Couple of 'Trick' Questions

Do you know what the average life expectancy is in the United States? Now, do you know what the average life expectancy is in Canada or Great Britain? One more; do you know the average life expectancy of practitioners of the 'Christian Science' faith?

As a percentage of our GDP, we in the U.S. spend far more than any other country. Those that practice 'Christian Science' by definition spend hardly anything. I'd wager the life expectancy of all three populations is about the same. So can one conclude the amount we spend on health care does not translate to a longer life . . . . . or even better outcomes?

I think we spend so much more on health care as a nation is largely because as the richest country in the world, we can! (Perhaps I should use the past tense as something about our current financial crisis suggests we may never again have the luxury of such excess.) The 2.6 trillion dollar question becomes, who will be the governor of how much we spend going forward? And related to that, is it "fair" for some to have unlimited health care resources while others will not?

Many countries allocate their defined health care budgets equally throughout the entire population. Long waits and rationing are the means by which the budget is not exceeded. Those that can afford to do so, just go elsewhere and pay for whatever care they want and can afford.

Health care research and technology has evolved to the point where it will bankrupt our country unless limits are set. I wonder if all the talk about ways to reform health care is just a stall tactic until we dare to take on the ultimate question: how much should we spend on any one life? Our country's history suggests we will develop a unique and very special way of solving this most vexing riddle.

Penny Wise And Pound(s) Foolish!

The local papers are reporting on school districts cutting various programs in an effort to balance strained budgets. On the chopping block: physical education! How can that make sense?! With child obesity almost epidemic, shouldn't we be spending more time in schools teaching the values of exercise and nutrition? (Was there ever a more rhetorical question?)

Every health care reform proposal includes wellness and prevention as a top priority. Employers have assumed the responsibility for promoting wellness but why not start at an earlier age. This should be a top legislative priority.

Health Insurance Renewals for Small Groups: Mid Year 'Report Card'

Our Agency works with many small businesses who have health insurance primarily on a fully insured basis with one of four insurers. We've pretty much completed January 1 thru June 1 renewals so I asked for a comparison of last year's renewals to this year. Here are the mid-year results:

2008 +17.31% vs 2009 +16.86%; clients of Insurance Co. A

2008 +20.26% vs 2009 +22.08%; clients of Insurance Co. B

2008 +16.40% vs 2009 +19.88%; clients of Insurance Co. C

2008 +10.61% vs 2009 + 8.45%; clients of Insurance Co. D

All Clients Combined: +16.96% 2008; +19.18% 2009

The above increases are almost always reduced to single digits after plan design changes and/or underwriting with a new insurer. Never the less, what does it say about 'our' insurer's ability to "manage care" if during such troubled economic times and with all the political pressure to contain costs, premium increases like these are still needed to cover more expensive health care and greater utilization!?

Results like these are used by many as proof we need to move to a government run plan as the pace of health care inflation is clearly unsustainable. But such a conclusion misses the more important point. Simply changing payers will either lead to the bankruptcy of the government or rationing of care. Fortunately, as serious reform talk heats up in Washington, the brightest prospects for meaningful "change" address systemic reform of the way we deliver health care.

And might I add that under our current system, at least I have the option of moving to Insurance Company D!