Recently, the Denver Business Journal presented letters to the editor on the subject of health care in response to “The Pulse” Web survey, asking “Who’s responsible for rising health care costs?” Three different sources –four including the public Web survey audience –proposed their answer for who is responsible. Interestingly, a seamless theme ran through each one: responsibility on the part of the consumer.
John Martie, president of Anthem Blue Cross Blue Shield, points out five tenets to debunk the perception that insurance companies are primarily responsible for rising health care costs. One tenet in particular stated that costs are actually due to rising prices and increased use of medical services, including hospital stays, prescription drugs, new technology, and doctor visits. Why is there an increased use of medical services? Perhaps the fact that our country has a growing challenge with lifestyle choices, i.e. lower activity levels and obesity. Three of the most important health indicators relate to weight: BMI (body mass index), cholesterol, and blood pressure.
In 2007, 50 million people were taking Lipitor, a prescription for high cholesterol. These are the side effects of Lipitor: drowsiness or fatigue, cold hands and feet, weakness or dizziness, dry mouth, eyes, and skin, wheezing, trouble breathing, or shortness of breath, slow heartbeat, trouble sleeping, or vivid dreams while asleep, swelling of the hands and feet, abdominal cramps, throwing up, diarrhea, constipation, back or joint pain, skin rash, sore throat, depression, memory loss, confusion, or hallucinations. Do claims related to obesity breed more claims?
Obesity is clearly associated with diabetes, heart disease, strokes, hypertension, and certain forms of cancer and other diseases. There are 20.8 million people in the U.S. who have diabetes. An estimated 14.6 million have been diagnosed with diabetes, but 6.2 million people (or nearly one-third) are unaware that they have the disease. Diabetes can lead to heart disease, high blood pressure, blindness, kidney problems, nervous system problems, amputation, and other complications.
Duke Health ran a retrospective study on the linear relationship between obesity and worker’s compensation. The study covered more than 11,000 health care employees and 34,000 university employees. Employees with a normal BMI reported 5.8 insurance claims per 100 employees. Those with a BMI of 40 or higher reported double the claims, 11.65 per 100 employees. The cost of medical claims per person was $51, versus $7,503, and the cost of indemnity claims was $59 versus $5,396.
Ralph Pollock, president and executive director of the Business Health Forum, wrote an open letter to policy makers, and bulleted recommendations for overhauling health care. Of the 10 points he made, three related to, again, the consumer. He stressed that one of the current challenges with our system is that individuals seeking coverage are denied based on existing conditions. Pollock went on to recommend that meaningful reform should involve promoting a focus on prevention and wellness, as well as encouraging personal responsibility and a reward system for individuals to be active in their care. Yes and yes!
As for the community respondents, I found it interesting that all of the categories responsible for rising health care costs represented parties other than themselves. Perhaps we’ll give credit to the 8 percent who accounted for “other reasons.” Maybe they saw the possibilities of responsibility starting with that first walk around the block.