COMMENTARY: We Need To Focus On Creating Healthier Communities

The cost of health insurance isn't our only problem, it's our poor health that is the problem.

My original headline for this commentary was “Stop Trying to Create Jobs And Focus On Creating Consumers,” but I decided against it.

The reason, consumers are integral to the supply and demand paradigm, which is where we have decided to focus our resources. But our focus should be on creating healthier communities.

Rising insurance costs are a dominant theme we hear about from federal, state, county and local governmental bodies.  But we don’t have an insurance cost problem. We have health problems, getting along with each other problems, and cost shifting problems. And we’re not really talking about those issues, and this is surprising to me since insurance costs, and fire and police services are a substantial part of our tax bill.

So we water down the coverage, increase deductibles, ask employees to pay higher premiums and talk about giving employees the option to opt out of having health insurance and these may be the painful realities we need to focus on to balance our budgets – but we don’t talk about decreasing the need for healthcare and that's a missed opportunity.

So if we allow employees to opt out of taking insurance, what are the consequences of that? Sure, it may not cost taxpayers when they pay their tax bills, but what will it cost us when the person shows up to the emergency room and doesn’t pay their hospital bill? How often does that happen? What burden are we placing on the hospital and ourselves as health care consumers when costs aren’t covered? Are we making the problem worse?

And sure, we may not be able to afford these insurance rate hikes, but can we afford not to maintain our health and our health insurance?

Here's why I think this should be a concern. I noticed this story on the Milwaukee Journal Sentinel about health insurance premiums going up. America's Health Insurance Plans issued a press release with the following talking points. Here are a few of the takeaways:

  • Prices for medical services continue to rise 
    • Recent data from the S&P Healthcare Economic Composite found that “healthcare costs covered by commercial insurance increased by 7.73% over the year ending July 2011.” 
    • The annual Milliman Medical Index (MMI) found that “between 2010 and 2011, the MMI increased by $1,319 or 7.3%.”  Moreover, the report noted that “even though hospital spending is only 48% of total healthcare spending, increases in facility spending (inpatient and outpatient combined) account for over 60% of this year’s total increase in cost of healthcare.”
    • PricewaterhouseCoopers (PwC) Health Research Institute’s “Behind the Numbers: Medical Cost Trends for 2012”, which examines the medical cost trends for employers in 2012, found that “medical cost trend is expected to increase from 8% in 2011 to 8.5% in 2012.”

We also need to realize that as the state “freezes” enrollment into Badgercare we’ll have more people who don’t have health insurance. So why should we care about that if we’re not footing the bill? Or are we really footing the bill in increased premiums?

We also need to realize the impact of that on our fire departments; the impact of being unemployed on our mental health, and that too has a profound impact on our police departments and our fire departments. We need to look at our calls for service, understand our community’s issues and confront them.

And when I say we, I don’t just mean our political leaders, I mean us. We all play a role in fixing these problems – as taxpayers, police officers, firefighters, political leaders, citizens, health care providers, and health care consumers. So we should be talking to our public health leaders, understanding the issues, the cost, and the benefits of having a healthy community.

When we own our part in fixing these problems we’ll decrease the need for having these services and if we really want our tax bills to decrease, we should be having these conversations. Because at the end of the day if all we’re doing is “decreasing costs,” we’re just shifting the problem onto someone else to pay.



Heather Asiyanbi (Editor) October 23, 2011 at 11:29 PM
Excellent points! Healthcare costs rise because people get increasingly unwell. When costs rise, the increases impact everyone. Folks who are healthier use fewer health services. Easy to connect those dots, right? So what's the problem then, people?! Denise, you are spot on with the needed conversations, which then need to get followed by actionable consequences. I know someone whose employer changed to an HSA plan. Employees only qualify for the company's contribution to their deductible if they have a conference with a health counselor AND participate in a health activity every quarter. Carrot/stick approach to personal responsibility. Obviously, this is not about diseases a person gets through no fault of their own, but more about the everyday health over which we have so much control.
Sherry Koch October 24, 2011 at 03:29 AM
Ha, I liked how you defined "we" towards the end. Most people would assume the vague "we as a nation" or we as in "our politicians" as you say. But in reality, it all boils down to an individual taxpayer, police officer, firefighter, citizen to be a good steward of their resources. This, as for health, more frequently than not these days means getting a high deductible health plan with or without HSA, and managing the "first dollar" expenses as a good steward - individually. By the way, did you know there are some excellent government sponsored health plans (PCIP) already widely available, but highly not-utilized? Greetings, Sher http://highdeductiblehealthplan.org
kevindews27 October 24, 2011 at 05:59 AM
People should never forget that real health depends how well you take care of yourself and not what health insurance you carry but I agree health insurance is important for every one. Search "Penny Health" or online for dollar a day insurance plans.
Heather in Caledonia October 24, 2011 at 01:01 PM
What about the cost of insurance for doctors and other medical professionals? I read that WI is loosing OB's because of the high cost of insurance (in fact, I know one that quit delivering babies because he was an independent doctor and couldn't afford the insurance.) That will drive those who are left to the large monopolies (Wheaton) who can then charge what they want for services since there's no competition left. What about charging people for insurance more if they are less fit? Some things people don't have control over - MS, Type-1 Diabetes, most cancers, etc. Other things we do like BMI (for most people - some have other issue that cause them to gain weight), smoking, drinking, drugs, resting heart rate, etc. We drug test for jobs, we undergo blood work for life insurance, and we have to wait years for accidents to come off our records to lower our car insurance. Why can't health insurance work in a similar way? Of course it would then need to be voluntary because we need to be sure we aren't trying to force a lifestyle on people. This is the U.S. and we should be free to drink, smoke and eat Twinkies as much as we please, but, like with other aspects of our lives, we need to pay the price for our choices. I'm not saying people shouldn't be treated at the hospitals, but insurance can reward those who attempt to stay healthier.
Heather in Caledonia October 24, 2011 at 01:15 PM
Our insurance has started to push towards encouraging health by paying for all "well visits", vaccinations and "maintenance medication" 100%. However, we have a high deductible and feel the pain if we end up in the emergency room. They also charge us more if we smoke, but they don't do testing, so I don't know why anyone would admit to it. :) There are SO many things Wheaton could do to reduce costs (electronic medical records, anyone? Allowing people to book their own appointments online? Allowing email for non-emergency items?), but why should they? Is Aurora offering any of this?
Denise Lockwood October 24, 2011 at 01:22 PM
Interesting points... Heather, I'd love to talk to that doctor you are talking about. I think those are really important stories that we need to pay attention to as we discuss these issues. When I was with the Kenosha News, I wrote a series on Medicaid moms and the access issues they had in trying to get care. There was one doctor that was independent, who delivered a huge number of babies on Medicaid because the moms weren't able to get appointments with other local docs in big medical groups. After the story ran, the state ended up stepping in and working out a more equitable arrangement. While doing the story, I asked him how he managed that high of a case load -- he said, "I induce them a lot."
Heather in Caledonia October 24, 2011 at 01:39 PM
Oh, goodness. Well, this was my sister's OB and he's somewhere out near Lake Geneva. I'll ask her for his name. My doctor as a kid was independent and we were always able to get appointments when we needed. We even had his home phone number and were instructed to call on weekends if needed... as long as it wasn't during a Packer game. :) My dad goofed once and called during a game and was promptly hung-up on! :)


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