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Living Below Your Means
How to Save a Ton of $$$ on Healthcare

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By xerohype
August 12, 2002

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Some healthcare money-saving tips

Here I am again trying to introduce an on topic discussion to this board. I've just got to stop doing that!

As some of you know (or maybe don't) I am a physician. I used to practice as a primary care physician in the U.S. Air Force, and now my task is to finish my Orthopedic Surgery training. My wife is also a physician; she practices as a Family Physician in a rural community.

I see a lot of money wasted by people in healthcare, money that could have been much better used if people took better care of themselves. Here are some tips to keep healthy and to avoid paying through your nose on healthcare. Most of these tips deal with preventive health measures. Avoiding sickness and injury is the best way to cut your health care costs (duh!).

1. Quit smoking! This simple action will not only save you thousands of dollars in direct costs, but the health gains will be enormous. Smoking is a major risk factor in all kinds of cardiovascular disease (stroke, heart attacks) and cancers, just look at this pie chart.
 
Here are some TMF resources to help you do just that:

  • Quitting Smoking FAQ
  • FAQ supplement
  • Rebecca's Quit Smoking web site FAQ
  • beccapooka's Quitting Smoking Weekly
  • How to Quit from the CDC

    2. Live healthier by losing weight and exercising, this will definitely keep you from spending money, as you get older. Obesity is associated as a risk factor in diabetes and cardiovascular disease. A moderate amount of exercise will greatly decrease your chances of getting a heart attack. Only 30 minutes, three times a week of brisk walking will do it.
  • Fools Fighting Fat FAQ
  • Eating healthier is also encouraged, here's the Vegetarian Board FAQ.
  • There's also a whole board dedicated to health and nutrition.
  • Check out these statistics from the Surgeon General
    HEALTH BURDENS THAT COULD BE REDUCED THROUGH PHYSICAL ACTIVITY
    Millions of Americans suffer from illnesses that can be prevented or improved through regular physical activity.

    *13.5 million people have coronary heart disease.
    *1.5 million people suffer from a heart attack in a given year.
    *8 million people have adult-onset (non-insulin-dependent) diabetes.
    *95,000 people are newly diagnosed with colon cancer each year.
    *250,000 people suffer from a hip fractures each year.
    *50 million people have high blood pressure.
    *Over 60 million people (a third of the population) are overweight.
  • Healthy Eating Tips
  • Physical Activity Tips
  • Here's a study that examined the health care costs of inactivity.
    A study in the October issue of "The Physician and Sportsmedicine" found that physically active individuals had lower annual direct medical costs than did inactive people. The cost difference was $330 per person, based on 1987 dollars.

    The potential savings if all inactive American adults became physically active could be $29.2 billion in 1987 dollars, or $76.6 billion in 2000 dollars.

    This is the first study ever to examine direct medical costs associated with various levels of physical activity by reviewing actual medical expenditures. Previous studies in the field have used estimates to project the economic costs of physical inactivity. The CDC researchers analyzed the relationship between physical activity and medical expenditures from the 1987 National Medical Expenditures Survey (NMES), the most comprehensive healthcare information source available. They found that Americans 15 years and older who engaged in regular physical activity�at least 30 minutes of moderate or strenuous physical activity three or more times a week�had average annual direct medical costs of $1,019 versus costs of $1,349 for those who were inactive. Persons with health conditions that limited regular moderate physical activity were excluded from the study.

    3. Always wear a seat belt when you drive, a helmet when you ride a bike (pedal or motor). Remember to wear protective equipment, this will avoid you a great deal of injury. I've seen a lot of people who could have avoided major injury by following this simple advice. If kids wore wrist guards I wouldn't have to put on so many casts at night. Being a physician in a Level I trauma center brings this point home every single day. As a corollary to this, always put your younger children in car seats and your older children in booster seats.

    Just a few nights ago I saw a 6-year-old child who broke her tibia (leg bone) because she was sitting in the front seat with a seat belt that didn't fit her properly. She slipped under the seat belt and ended on the floor of the car. Luckily she didn't suffer any major injuries besides her fractured tibia.

    Last night I was operating at midnight removing a drill bit embedded into the index finger of a careless 13 year old. It made for an impressive x-ray! Safety needs to come first.

    CDC links on injury prevention.

    Also, whatever you do, DON'T DRINK AND DRIVE! Alcohol consumption and driving do not mix. Alcohol in moderation has some health benefits, but in excess can lead to liver cirrhosis and other ills. Auto accidents are definitely a costly affair, especially if someone is injured.

    Here are some statistics on impaired driving.
     
    An important one: Of the 41,967 traffic fatalities in 1997, 39% were alcohol-related (i.e., either the driver of the crash vehicle or an affected person not in a vehicle (e.g., a pedestrian or a bicyclist) had a blood alcohol concentration of at least 0.01 gram per deciliter (g/dL).

    4. Get a physical exam once a year. Most health plans will pay the entire cost of an annual physical. Your doctor can go over preventive health items for your age group. For women this includes a pap smear to help prevent cervical cancer. For men this should include a testicular exam and if over 40 a prostate exam. High blood pressure is a silent killer, an annual physical will screen for this.

    Here are some prevention web sites geared to specific groups from the CDC:

  • Children and Adolescents
  • Women
  • Mothers and Infants
  • Minority and Ethnic Groups
  • Older Adults
  • Men

    5. Ask for generic drugs when available and use mail order pharmacies. Both of these will save you lots of money. It's not a big secret that physicians are courted by pharmaceutical drug reps, and now with direct marketing patients will ask for drugs by brand name. Many generic alternatives exist to the most popular drugs.

    AARP has an excellent mail order drug purchase plan, but most health plans will offer a mail order option that will save you money.

    6. Call your primary care physician before going to the Emergency Room if you can. There are many people who use the ER as their primary care physician (PCP). This is an incredibly expensive option. Even when you are not paying for the visit out of pocket it increases everybody's costs, and insurance plans then feel justified in increasing rates. If you don't have a PCP then get one. You may avoid an ER visit if you contact the PCP and may be able to get a prescription phoned in or an early appointment the next day.

    Bonus tip: When scheduling a doctor's appointment it is a good idea to schedule it for the earliest available, if you are seen early in the day it is much more likely that your visit will be short and involve lots less waiting. Physicians tend to run late as patients accumulate, especially when you see people with multiple/complex medical problems that require lots of attention and the schedule (dictated by financial pressures) many times gives you only 15 minutes to see these patients.

    7. Review your health insurance to see what is covered, what is not, and whether or not there are alternatives that are similar to what you already have. Most plans are offered by employers, but there are usually a few choices and there might be some critical differences between plans. Make an appointment with your company's benefits rep if you have such a person.

    8. Offer your physician barter or services in trade. I've heard that this can be done with physicians in private practice and in some places they have "barter bucks".

    Here's one such list in Sonoma County, CA

    As I stated before the key thing in saving money on healthcare is to engage in preventive maintenance.
  • Prevention Magazine has some good general articles on health and fitness.
  • Positive Health Magazine has a huge collection of health links.
  • Here's a good list of Canadian Health and Safety links.
  • In the U.S. the U.S. Dept. of Health and Human Services is a good portal.
  • Included there is the Centers for Disease Control and Prevention (CDC).
  • I would highly recommend checking out their Health Topics from A-Z page.

    Knowledge about health topics can really pay off in increased awareness and prevention of injury and disease, so by all means be an informed consumer of health care. If you all stay healthy I'll get much more sleep at night ;^)

    Hope some of this helps.

    -xerohype


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