Entries for July 2008

It doesn't take a whole lot to derail people from keeping a date with their dentist. Even if you have dental insurance—and about 100 million people don't—it generally maxes out after just a few thousand dollars. With the economy uncertain and prices high, it's easy to put off making time to pay someone to poke around in your mouth.

But instead of avoiding your dentist entirely, do yourself a favor and keep up with your regular preventive care. As in so many things, you'll save yourself pain and expense if you prevent dental problems from occurring in the first place, experts say.

Long-term care has been in the spotlight this week, with a Government Accountability Office report just out, a congressional hearing today, and new survey results on the subject. But all the concerned commentary about how we're going to meet the need for long-term care as baby boomers age really only highlights how elusive solutions are.

Today, Medicaid and other government programs pay for most long-term care, whether it's in a nursing home or for assisted-living services at home. Only about 10 percent of long-term care costs are covered by private insurance. But as many as two thirds of people over 65 eventually may need some sort of long-term care, according to some estimates. Many policy experts, estate planners, and others advocate long-term care insurance as a good way to provide financial security and stability for people against this unknown as well as to relieve the burden on an already stretched Medicaid program.

Anyone who's had to use our healthcare system lately will not be surprised to learn that a performance scorecard released this week found several areas in need of improvement. Access to care is one example. In that category, the Commonwealth Fund report gave the United States a score of 58 out of 100 in 2008, nearly 10 points lower than in 2006, when the first national scorecard was released. That's in part because last year, 42 percent of adults—some 75 million people—were either uninsured or underinsured, the report found, compared with 35 percent in 2003.

Overall, the country scored a 65, down slightly from 67 in 2006, based on indicators in five areas: healthcare outcomes, quality, access, efficiency, and equity.

According to a new study, employees don't like wellness programs very much, and employers don't think they're very effective at mitigating healthcare costs or improving employee performance. Yet nearly half of the 561 companies that responded to the PricewaterhouseCoopers survey said they plan to expand their wellness programs over the next two years. What's up with that?

After years of asking employees to pick up more of the tab for their health insurance, many employers believe they're reaching the limit on how much they can shift costs, says Michael Thompson, a principal in the firm's New York health and welfare practice. But costs continue to rise. Premiums rose 6.1 percent in 2007, less than the double-digit growth earlier in the decade but still far outstripping the 3.7 percent increase in worker earnings, according to the Kaiser Family Foundation. Something's got to give, and employers hope healthier employees will cost them less. "There's a strong belief that we need to get at the underlying issues and decrease the demand for healthcare, and a major way to do that is to change lifestyle," says Thompson.

You're still trying to get through that case of aspirin you bought last December, and you've never worn the prescription sunglasses you picked up about the same time. Instead of buying a bunch of stuff you don't really want at year-end to avoid losing the money in your flexible spending account, this is a friendly reminder as we pass the midpoint of the year to start spending NOW.

Procrastination may be understandable. But about a third of people leave an average of $168 unspent in their FSAs every year, according to Hewitt Associates. The funds go back to their employers—and that's just idiotic. The typical balance in an FSA is about $2,500, says J.D. Piro, principal and chair of the health law consulting practice at Hewitt. "As a percentage of the account, $168 is fairly low, but it's very high if it's your $168."