The other day I was sifting through a stack of mail at home and noticed a letter from TriWest. It turned out to be an Explanation of Benefits from my kid’s recent trip to the neighborhood pharmacy. Most people probably don’t open them — much less read the fine print — on these statements, but since I’m in the medical business, I took a look.
The first item listed was a medication for acne. The price paid by TRICARE was a whopping $863 for a 30-day supply. As I mentally calculated the annual cost of this drug — more than $10,000 — it occurred to me this high-priced medication was not intended to save someone’s life from cancer or some exotic illness, but merely to deal with an everyday skin condition that most people eventually grow out of. My contribution to the $835 cost? A $12 copay.
See anything wrong with this scenario? I do. With huge costs like this buried in the fine print — and routinely paid for by “somebody else†— is it any wonder our nation’s medical costs have gotten out of hand? Is it any wonder healthcare reform is the dominant political issue of the day?
In truth, it’s not healthcare that is the problem; it’s the paying for it. Those of us fortunate enough to have full coverage through TRICARE have no “skin in the game.†In fact, we’re so insulated from the dollars and cents of our medical care that we barely notice the constant drumbeat of news headlines about rising healthcare costs.
But the truth is it now costs the average employer $20,000 a year to insure a family of four, with $3,200 of that coming from the employee. A trip to the emergency room averages $1,300, and a hospital stay averages $9,200.
What do we get in exchange? The most advanced medical care in the world, no question! But at some point, even “the best†can be too expensive. Overwhelming medical bills are now the leading cause of personal bankruptcy — and bankruptcy hurts everyone.
So what can you do to fight the high cost of healthcare?
Keep your appointments. A medical appointment at the 56th Medical Group costs the Air Force $262. Because most expenses are fixed, it costs that much for an appointment whether you keep it or skip it.
Use an urgent care center instead of an ER after hours. Unless it’s a true emergency (i.e., threat to life or limb), a UCC saves the Air Force hundreds of dollars. An upper respiratory infection (common cold) treated in an ER costs $515; in a UCC it’s 72 bucks.
Most importantly, get healthy and stay healthy! Most of the healthcare dollar goes to people with long-term diseases, and most of those are related to diet, activity level and personal habits. Maybe you can score a 99 on the physical training test today, but a steady diet of junk food and cigarettes will eventually catch up to you!
Our nation today is grappling with a historic healthcare crisis, and it’s unclear how it’s all going to work out. What is clear, though, is that each of us should do our part by managing our own health actively and using the healthcare system wisely.
