Almost a quarter of Americans (23 percent) report they or a family member had problems paying for medical bills in the past year. Difficulty paying bills can lead to tough choices as people negotiate tight budgets. In an effort to allay costs, roughly half (52 percent) report foregoing or delaying medical care in the past year. What is ironic about these numbers is that people who delay medical care now are often going to wind up paying both a higher price later in dollars and quality of life.
Overall U.S. spending on medicines totaled $325.8 billion in 2012, down 1 percent from 2011, according to the report from the IMS Institute of Healthcare Informatics. Adjusting for population, per capita spending fell 3.5 percent to $898. A press release from the Department of Health and Human Services states that seniors have saved roughly $6 billion on prescription drugs following the closure of the infamous donut hole. While the media likes to talk about the cost prescription drugs they still represent only 10% of every healthcare dollar spent.
According to the Agency for Healthcare Research and Quality, the five most expensive diseases/conditions in the U.S. are trauma, heart disease, cancer, mental disorders, and pulmonary disorders. While a trauma patient (car accident) is something almost impossible to manage, the others are very often either preventable or are manageable with care routines different from those currently practiced. Unfortunately, these latter disorders are problems that patients can act to increase the probability of occurance. To make matters worse, our cost-plus reimbursement system encourages providers to spend a lot of money to solve both these problems and related additional health issues
Insurers are making a lot of money because fewer people are going to their doctor and more are putting off medical procedures because of the expense. Rather than look at the strategic implications on their bottom line insurers are only looking at how nice their quarterly numbers are for Wall Street. Some are so flush with cash that they are starting to purchase back their stock to keep their stock prices moving north.
Insurers should not make patients pay anything out-of-pocket for a visit to a health care professional. Getting care before a minor issue becomes a bigger problem could save the healthcare system billions of dollars. It could even be combined with a promotional program called healthy heart month wherein patients would be urged to go to their doctor to get blood workup without any co-pays. If someone, for example, is found to be prediabetic than the health insurer should work with the HCP to get the patient some wellness counseling such as diet recommendations.