[quote=eavesdropper][quote=briansd1][quote=bearishgurl]I was referring to the same people to go to providers for repeat visits (2-4x mo) for themselves and/or their children and are usually just sent to the store to buy some ibuprofen or some other over-the-counter remedy. Since they have a very low co-pay, they just keep making appointments, even for just a hangnail. I’ve seen this phenomenon all my life, mostly with overprotective parents and hypochondriac adults.[/quote]
There have been empirical research showing that a significant co-pay (like $50) is very helpful in getting patient to use medical service judiciously.
I support higher copays . . .[/quote]
. . . nothing will improve until the public, across the board, is made aware of the high cost of healthcare. And nothing makes one more aware, as many of our less fortunate citizens know, than a direct hit to the wallet.
I remember listening to friends gripe about their high insurance premiums. This was the good old days, 25 years ago, when many of them were paying $600 or $800 per YEAR for family coverage. I’d ask them to pull out their hospital bill for the birth of their last child, and ask them who was going to be paying the $15,000 not covered by their premiums (don’t jump all over me – I am NOT defending the insurance companies. But you don’t want me to get started on them.)
There are people who spend hours clipping coupons each week so that they can get 20 cents off a $2.59 bottle of dish soap, who don’t think twice before going in to see their doctor. Very often, it’s something that medical intervention won’t help (common cold?), or something that they’ve already seen the doctor about but haven’t followed his/her advice, or sometimes it’s simply for the care and attention.[/quote]
eavesdropper, a good example for your scenario here is a young mom in SD County on Tricare (“Prime” at <=$600 per yr per active-duty family) running to the doctor with her kids weekly for every scrape and ache and complaint. I witnessed this a lot when I was on Tricare Standard (a deductible and 25% co-pay plan) and knew moms that did this. If not on Tricare, they would have almost always been sent to the drugstore for an over-the-counter remedy but since they were on Tricare, they got those over-the-counter remedies written up as prescriptions (for something common like ibuprofen) so they could obtain the item free at a military pharmacy (another long line to wait in). Guess they all had more time than $$ but the bottom line is, they didn’t need to visit the provider in the first place for this minor ailment, they could have just gone directly to “Rite Aid” (or the Navy Exchange) and bought the item they needed. They made a medical appt JUST to get the free over-the-counter remedy. THE RULES OF THE GOVERNMENT’s OWN health plan is part of the “problem” of why many patients’ abuse it.
Over the course of my F/T “working life,” I saw the same employees, many young, week after week take off at least once a week for a medical appt. Back then, we had to list a reason and the same employees conjured up a new reason every week (to leave early from work), even though they appeared healthy. Guess this is just a function of a “liberal sick-leave policy.”
[quote-eavesdropper]Until we get people to invest more of their own money in their healthcare, they won’t realize the true value of it, and how fortunate they are to have it. I agree with Brian: raise those co-pays on basic doctor visits, and reward patients who don’t abuse the system. I don’t mean to make this as simple as it sounds – it’s not simple at all. Medicine is far from an exact science. But there are high-maintenance patience who overutilize health services because they refuse to change their lifestyle choices and continue to engage in risky behavior . . .[/quote]
eavesdropper, I have $40 co-pays for a primary-care provider or “internist” and $50 co-pays for “specialists.” Obviously, I’m not going to make an “appt” for a hangnail or common cold. EVERY SINGLE health plan I have ever had was a plan where I GOT THE BILL for services rendered, saw what the ins. co pd and saw what my cost-share was of the bill. Because of this I KNOW what healthcare costs and have seen how much it has risen over the years. I don’t believe in HMO’s and other types of plans which hide the true costs from the consumer. Every insured person should have access to their EOB’s so they can see what everything costs. I DO appreciate how much it costs and do not utilize healthcare for stupid reasons.
[quote=eavesdropper]. . . It’s understandable that most people form opinions based on their own experiences; unfortunately, that’s been a major hurdle in health care reform. The problem isn’t that there are many people who simply don’t want to pay for insurance; it’s that they CAN’T get insurance, at any price. There’s also an assumption that all people receiving employer-sponsored health insurance are paying the same premiums and receiving the same coverage. Nothing could be further from the truth.[/quote]
Good point, eavesdropper. I believe a lot of the current “employer plans” are watered-down versions of individual plans, made more “palatable” to the employer (and employee) in the form of lower “group-price” premiums. Most employees don’t want a high-deductible plan but these are actually the BEST PLANS to have, ESPECIALLY if you should become seriously ill!
[quote=eavesdropper]But the real problem is that health care has become very, very expensive. And this will become exponentially worse as the Baby Boomer generation ages. Health care delivery as it stands today, will be unsustainable in the future. If middle-class America wants to be able to access decent healthcare in the future, we need to adjust our expectations, and we need to take some personal responsibility.[/quote]
Yes, totally agree here, eavesdropper. The older “Baby-Boomer” group was notoriously bad about taking care of themselves and many suffer today from risks they took with their health in their much younger years. It IS their “personal responsibility” to pay attention to their diet and exercise so they are not a drain on society before becoming eligible for Medicare. I DO see a lot of them (and also the WWII generation which preceded them) trying to work out regularly and follow strict diets but there are SO MANY MORE that made grave mistakes with their health when younger that have or will come back to haunt them. All of us in individual plans in the same demographic are now “subsidizing” these individuals’ now-mandated “reasonable” premiums, because “somebody has to.” What better poor-slob policyholder to do this than someone in your own “demographic?”
FWIW, I have kid(s) who are in the age-group the OP is referring to here. It is truly a “blessing” that [they] get to stay on their Dad’s “family plan” at work for a few more years, if needed. A CA State College is no longer just a “four-year endeavor” with all the budget cuts in recent years. Even after graduation, there is no guarantee of a job with benefits. All this part of the “healthcare reform” legislation succeeds in doing is keeping these kids off the public dole if they have a serious medical issue. There ARE still community clinics available for them but if they should need surgery or x-rays for any reason, they will be able to recieve them for a while longer. I applaud the 23-26 year-old group being able to remain on a parent’s health plan a few years longer, if needed. This doesn’t cost the taxpayers anything.
