Wednesday, July 15, 2009

More Thoughts on Health Care

One of the problems when trying to calculate the cost of health care is what to include. The cost to fix my broken arm last year is much different than the cost of treating my breast cancer, which is much different than the cost of treating my migraines. Or my pregnancies.

Which of these conditions, if any, should insurance cover? Which should I be responsible for?

My migraines are debilitating. Before I found a medication that was effective, I was out of commission six to ten days a month, but isn't life-threatening. Left untreated, my breast cancer is. My broken arm was a comparatively simple fix: an x-ray, a sling, some physical therapy. My pregnancies had only minor complications, but I also had excellent prenatal care.

I haven't seen any studies cited in the MSM about the percentage of total health care costs is due to treatment, including medications, of chronic conditions such as asthma, high blood pressure, diabetes, osteoporosis, to name a few. Some of these conditions are life-style related, some are genetic, some are age-related--which means some on within our personal control and some are not. The cost of treating these conditions is cumulative over time but the cost of not treating them may be higher.

Maybe the answer is a three-part system: pay out-of-pocket for routine care, much like you pay for routine maintenance on your car; buy insurance for catastrophic illness, like cancer; and set up a Health Savings Account/401(k) type account, to pay for chronic illness or long-term care. And if you are lucky enough to not spend your HSA, then you can pass it along as your heirs.

But, of course, to make this work would require that people plan ahead, exercise the self-discipline to save money for the future. In other words, it would require grown-ups to act like, well, adults.