how to optimize your health care dollars

The Chicago Tribune had an interesting article on how to spend less money on health care. Their advice: use fewer health care resources. The rationale is that the list of things that we know help us live longer is “pretty short.” So quit smoking, exercise, and only spend money on the essentials. Here is what they claim is the list of essentials:

•Skip the annual physical examination. “It’s an unnecessary expense,” said Dr. Ranit Mishori, a family physician who teaches at Georgetown University School of Medicine.

•If you have a cold or an upset stomach, ask if your doctor will do a phone visit. “There may be a charge, but it may be less than even the co-pay for an office visit,” [Dr. Emily] Gottlieb said.

•If your doctor proposes an expensive imaging procedure, such as an MRI for the pain in your knee, ask what it’s for. “If the outcome of the test won’t change the treatment plan, why do it?” Mishori said.

•Instead of a colonoscopy to screen for colorectal cancer, you could opt for an inexpensive test for blood in the stool. “If there’s something wrong, you can follow up with colonoscopy,” Mishori said.

•Consider having a mammogram every two years. “We don’t have any evidence that doing it every year is better than every other year,” [Dr. Ned] Calonge said.

•Ask if you can have a Pap test once every three years. “If you’re over 30 and have had three normal Paps in a row, that shouldn’t be a problem,” said Dr. Linda Hughey Holt, an obstetrician-gynecologist in Skokie. “Only women at increased risk for cervical cancer need annual Paps. And those who have had a total hysterectomy don’t need them at all.”

•Drop your health club membership and walk a mile a day instead. “We know that exercise is very important to prevent diabetes and heart disease,” Gottlieb said. “It’s also important for people who are depressed. But there’s no need for a trainer or a lot of fancy machines.”

•Ask about cheaper equivalents of your prescription drugs. Some chain pharmacies, including Wal-Mart and Target, have $4-a-month prescription plans for the most common generic drugs. You may be able to substitute lovastatin at $4 for Lipitor, which costs about $140.

•For dental work, continue regular checkups to avoid long-term, expensive problems. If you have good oral hygiene and no history of problems, you can consider increasing the intervals for cleanings and X-rays, some experts say. As a general rule, adults usually can delay cosmetic dentistry and orthodontia. But in children, “early orthodontia can save money later,” said Dr. Robert Sandusky of Evanston.

•Talk to your doctor about dropping your cholesterol medication altogether, especially if you’re over 85. The consequences of high cholesterol aren’t felt for 10 or 15 years, Gottlieb said, so pausing or even stopping treatment may not significantly affect your health.

•Insist that your health care providers use the latest operations research innovations so that they can provide the same level of service for less.

OK, so I made up that last item, but wouldn’t that be cool? Many economists have noted that we spend so much for health care in the US because we pay for unnecessary treatment. I don’t know enough to make a comment, but the list looked pretty reasonable to me. What do you think?

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2 responses to “how to optimize your health care dollars

  • Francisco Marco-Serrano

    Taking the European way, you can imagine how difficult would be convince the masses to reduce their health expending since most of the costs are hidden (National Health Systems paid by taxes). This is a brute force attack analitically reduced to a prisoner’s dilemma where the optimum is [regretfully] to do all the oposite to the points you are stating…, except the last one which I find awesome to try give a 180 degrees to the expenditure in Europe (it has to come from the root of it).

  • Laura

    Thanks for the European perspective. I still support increasing access to health care, but my support is waning. I am constantly reminded that we need to use health care resources wisely and that few medical procedures are actually evidence-based. Maybe we need to start optimizing what isn’t covered?

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