July 21, 2003
Demand for services contributes to rising costs
- by Ralph H. Weber, M.D., Vice president, medical affairs, Blue Cross and Blue Shield of Kansas
Like other forms of insurance, health insurance was first created to protect people from catastrophic financial loss. However, through the years, our expectations have changed regarding health insurance. We don’t expect our auto insurance to pay for new tires, tune-ups or minor repairs; but we do want our health insurance to pay for every office visit, drug, test and procedure. The premiums that Kansans pay today are a reflection of what it costs to receive all those everyday medical services as well as protection from catastrophic loss.
As we demand more services, the premiums we pay go up because insurance companies must charge enough to pay for all the claims they receive. There are many reasons why health care costs are rising due to an increase in patient demand for services.
One reason is the rapid increase in rates of chronic diseases like obesity, diabetes, congestive heart failure, asthma and their associated health problems. As more Kansans live with these and other chronic diseases, they will require more services to diagnosis and treat those conditions.
Because most Kansans receive health care coverage through their employer, and employers pay the majority of the premiums, consumers have been sheltered from the true cost of health care. This has resulted in an over-utilization of medical services.
Another reason is our aging population. As people reach middle age and older, they tend to require more medical services. One formula suggests that a 64-year-old person requires nearly $4,500 more a year in health care services than an 18-year-old. That is of concern in Kansas because nearly one in three people is age 45 or older, including the large generation of Baby Boomers. The number of medical services Kansans will need in the future is going to increase greatly as our population continues to age.
A fourth reason patient demand is increasing is simply because we all want the latest test or the newest drug. Our own insatiable desire contributes to the rising cost of health care.
There are steps that we all can take to curb our demand for services, thereby controlling health care costs for everyone:
- Prevent chronic conditions, or properly manage them, by eating a balanced diet and exercising regularly.
- Make informed choices of when, how and from whom you receive medical care.
- Learn which ailments you can self-treat at home, and which require the care of a medical professional.
- Avoid unnecessary medical tests and treatments. Talk with your doctor to make sure you have a clear understanding of what each procedure costs and how it will help you.
- Avoid hospitalizations when outpatient services are available.
- Don’t repeat tests unnecessarily. For example, if you change doctors or visit a specialist, ask to have your records and test results forwarded to your new health care provider.
- Don’t expect a prescription for medicine each time you visit your doctor. If you do need medication, ask whether a generic version or an over-the-counter drug is available.
Kansans will use more medical services as we age, and the medical community will continue to find more advanced and more effective ways to treat illnesses. We will all share in the increased cost of better health care, so we all have a role to play in keeping it affordable. That means doing what we can to stay healthy and avoid chronic diseases, and working with our doctors to understand the costs and benefits of all treatment options.
Ralph H. Weber, MD, is vice president of medical affairs for Blue Cross and Blue Shield of Kansas. He spent 10 years in private practice in Salina before joining the health insurer in 1988. He was promoted to vice president in 1990.
Blue Cross and Blue Shield of Kansas is an independent licensee of the Blue Cross and Blue Shield Association. BCBSKS is the state's largest health insurer, serving all Kansas counties except Johnson and Wyandotte.