How Consumers Can Force Health Reform

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Let's get real here.......

Our health care system is bankrupting the populace because it is a large for profit system. It is not the consumer that is driving the prices up and it sickens me to read that in this article.

Many folks eat healthy, exercise, and still have the misfortune to end up in the health care system through no fault of their own.

Our healthcare policy in the United States is a disgrace leaving children, women, and young adults and many older citizens without any care at all. When are we going to wake up and actually begin acting like a United States instead of being citizens that just think of themselves and no one else?

Wellness

In general, a small minority of sick members generate disproportionate health cost and a majority of healthy ones account for a commensurately small share. We live in a society of choice and the choices that people make should hold them accountable for their choices. Why should an individual who doesn’t smoke, eats healthy and exercises pay the same premiums as ones who smoke, lay around and enjoy snaking on the good American apple pie, potato chips and donuts. Then for dinner, they take their families to all you can eat restaurants or McDonalds and wonder why their pants feel tight. It people in high risk groups were forced to pay higher premiums, this would not only prolong their lives but reduce health care costs.

The Health Risk Spectrum

Low Risk*

65-80%

Healthy or

“undiagnosed” members

Chronic Risk (+)

10%

Medically stable, compliant, well-controlled patients

with milder conditions

Chronic Risk (-)

5-10%

Less stable, less compliant patients,

at times poorly controlled, with more serious conditions

Acute Risk

3-5%

Unstable, frequent admits, multiple complications,

candidates for immediate intervention including case management

* Note: approximately 10% of Low Risk members have an undiagnosed condition or one that they have chosen not to properly manage. This subset is are “False Negatives” by claims analysis

Chronic and Acute Risk Groups Claims Data

(Millions of Dollars)

Medical claims Pharmacy claims Total claims

Chronic Risk Group 11.9 1.9 13.8

Acute Risk Group 14.5 1.1 15.6

Total Chronic/Acute 26.4 3.0 29.4

By Arvid Saunaitis-

Health Insurance over billing

The University of Michigan had their own Insurance called M-Care, it was sold last year and now, I am getting letters from Collections companys in Ohio near Ohio State telling me that I did not pay co-pays to see the Doctor's in the year of 2007 the year that the Insurance company was sold. I did pay and with no proof, I am now told by the billing department of the U of M Medical Center that it is too bad, I have to pay again or they will keep sharing this information with the credit bureau to damage my credit history. The letter sent to me said I owe $25.00 and after, I called I am now told that I owe $72.00 for co-pays when I had the m-care insurance that I did not pay. I did pay but with no proof, they told me oh, too bad, it looks like I have to pay again. if this would happen to me at the age of 52, I just keep thinking that the seniors that are alot older than me are getting treated the same way from the University of michigan health care system and they are paying for their bill twice or maybe even more. This is not right, and no one at the u of m cares.

James E. Staley

former M-Care patient

Ann Arbor, Michigan

How Consumers Can Force Health Reform

“Now, with exorbitant costs being the overriding concern, consumers—who drive those costs—may well be the system's best hope for reform.”- I do agree. Good health/wellness isn’t just an individual choice; it is our culture and extends to co-workers and family. Health and wellness should start at home.

>Eat out less and eat healthy at home. At the grocery store, start reading labels and buy only what’s healthy.

> Exercise- Bike, gulf (no gulf cart), hike, take your dog for long walks and whatever else tickles your fancy. Family activities also keep families together.

Employer participation:

>Increasing participation in Healthy Choice programs

>Install bike racks

>Initiate bike-to-work activities, ride-to-work-win a bike

>Have a biking safety lunch and discuss healthy food choices

>Golf events or alternate activities, receipt contests (fun categories like picnics, snacks, ect.)

>Have a stair claiming week- it can be fun and it’s environmentally friendly.

>Make participating in the activities count as a health/wellness activity and award the participants.

These activities will not only build employee self esteem, reduce stress and time off work, but will also increase productivity.

Based On 5-year Study, An Unmanaged Population Will See Approximately 7% Per Year Of The Well Population Migrate Into The Chronic And Acute Risk Groups

Health Care Costs in The U.S.

One can't be smart enough to shop for Health Care in the U.S.

The only answer is for the Government to put a cap on costs and that cannot be done in this country. The Lobbyists run "our" congress and the AMA et al are too powerful.

Thanks to these legal lobbyists we have now reached third world status with our 10 trillion dollar debt, our propped up economy near total collapse and our Asian issued credit cards.

We are told that 700,000 Americans are bankrupted each year from medical debt. Methinks our politicians on our payroll have great medical care......

Health care costs

In my time I have seen health insurance go from a benifit every employee receives , to your lucky if you can afford to pay the premiums. Health insurance was used to attract employees when pay was usually low, it was a incentive to attract people to work a particular workplace. Insurance was something that only the goverment provided for its own employees,and filled a important gap for young families to protect themselves from illness and its costs. Todays high costs are a direct result of many layers of government to insure themselves at any cost! Without negoiating for a lower price by our goverment enties prices climbed every year for insurance. To reduce prices we need the goverment to negoiate a lover than market price,purchasing leverage will reduce price more than a individual can.

You can't be a smart health care consumer

If you are a patient in a hospital you will never get an answer from anyone about how much things cost. Please let me know where else you can go and spend 10 hours other than an emergency room (most of it waiting) and they may bill you for $1,000 or $10,000 and the only way you will know is to go home and wait for the bills to come in the mail. When you leave they won't even be able to tell you who is going to bill you or how many bills you will get. Our current health care system is insane there is no rhyme or reason.