The Reasons Why We Pay More and How to Pay Less for Our Healthcare
Health costs are inevitably going to increase as we age. It is a biological fact that our bodies experience the effects of aging. The most rapid aging periods are around 44 and then at 60. After 60, we see decreased muscle mass, increased body fat, drier and more wrinkled skin, achy joints, weaker bones (increased risk of osteoporosis), declining vision, reduced hearing, slower metabolism, potential changes in heart function, and a less efficient immune system, often leading to more noticeable signs of aging like bruises and age spots. It’s no wonder the cost of maintaining our wellness increases.
Wasteful insurance spending is driven by unnecessary services by doctors, the poor health of the American population, expensive healthcare technology, limited insurance carrier options, disinterested and uninformed patients, malpractice lawsuits, inflation, and the percentage of our population over 60, are all contributing factors to soaring healthcare costs. Let’s examine these reasons and ways to control your healthcare costs.
Our health is not the only reason healthcare costs increase as we age. This country’s insurance industry plays a part as well. Most health insurance companies, including Medicare, pay doctors, hospitals, and other providers using the fee-for-service system. This works by reimbursing the provider for each test, procedure, or office visit. The more services a doctor provides, the more money they receive. This leads to excess testing, overtreatment, or overprescribing. This is particularly true for patients with poor health and a low probability of getting better.
New, innovative, and advanced medical medications, technologies, and procedures are expensive and challenging to become available to the general public. Faced with an unyielding medical community, testing requirements, and FDA regulations, getting them to market and making them available to patients is daunting. Medical advances can offer improved health and extend our lives. However, upgraded and new technology can also lead to increased medical spending and overuse. Many individuals associate advanced technology and newer procedures with better healthcare; however, it is oftentimes more expensive.
An estimated 153 million American workers get a health insurance policy through their employers. This benefit is limited to the insurance plan offered, and the patient cannot choose the carrier or the plan. Employers often decide the health insurance policies for their employees based on budget, available health insurers, location, and administrative burden. That means half of Americans don’t have a choice between their insurance carrier or coverage.
Most patients in this country do not research or gather information on their health. Despite the enormous amount of information available online, most patients remain uninformed about their treatment options and the cost of healthcare. We spend more time researching cars, clothes, vacations, and scrolling on social media than we do our health. According to a statistic by the Milkin Institute, only 12% of Americans educate themselves about their health, treatments, or costs associated. This lack of knowledge leads people to make uninformed choices when choosing their medical care, which can increase healthcare costs.
The medical field is fraught with malpractice lawsuits. We as a society are “sue happy”; it’s the American way. This fear, called “defensive medicine,” leads doctors to order unnecessary testing and treatment out of fear of a lawsuit. Statistics show that about 60% of US surgeons have been sued by a patient during their career. To avoid potential litigation, some surgeons and medical providers perform unnecessary tests and procedures to try and mitigate potential lawsuits, which leads to wasteful spending.
Inflation in the US affects healthcare costs. There is a direct correlation between healthcare provided and the costs involved. The more medical services, supplies, administration, and facility costs are involved, the more expensive it is for patients. Healthcare facilities have also been affected by higher operating costs due to staff shortages and lower wages. As of June 2024, the annual inflation rate was 3%, but the medical inflation rate was even higher at 3.3%.
The US percentage of the population over 60 is growing. Baby Boomers make up almost 21% of the US population, and the number of retirees is increasing rapidly. According to the US Census Bureau, Americans aged 65 and older will be nearly 23% of the population by 2050. This means the US healthcare system will have more Medicare enrollees. Older individuals tend to spend more on healthcare than younger people. They often need more primary care services, prescription drugs, or treatment for chronic conditions. These services and medications can lead to wasteful spending and higher medical bills.
Our country is heading into a healthcare crisis, but there are ways to control your health and the related healthcare costs. Getting older does not mean getting unhealthy; that is an individual choice. Taking responsibility for our wellness through holistic aging practices can profoundly affect healthcare costs.
Choosing a healthy lifestyle is key to fewer chronic illnesses and increased wellness. Paying attention to daily habits like activity level, diet, mental well-being, and environment all contribute to overall wellness, leading to fewer doctor visits, testing, procedures, and chronic illnesses and, thus, lower healthcare costs.
Researching and becoming informed on medical conditions, including diagnosis, treatments, and prognosis, can lower healthcare costs. An unlimited amount of data, statistics, and medical information is available to us today. Knowledge of your health can lead to questioning healthcare professionals by taking control and making informed decisions together rather than being led into unnecessary medications, procedures, and testing. Just because a person has an MD after their name does not mean you can’t be a part of planning, executing, and choosing your medical path.
Shopping annually for Medicare supplemental plans, reviewing benefits, or looking at the insurance offered through an employer can also lower healthcare costs. Reviewing car insurance costs and coverage, homeowners insurance, and rental insurance is done annually, so why not do it for health insurance? The premiums connected to health coverage are expensive, and deductibles and pre-existing conditions all contribute to costs. Annual reviews and adjustments can lead to lowering them.
We are a country that demands individualism. We want the right to choose. That includes healthcare. Most of the population is in declining health due to poor daily eating habits, activity levels, stress, and environment. Most people ignore their patient care and rely on doctors driven by insurance and pharmaceutical companies and malpractice fear to tell them what is best. Our focus is not on our ability to control our healthcare costs. Instead, we blame insurance companies, old age, and soaring medical expenses, diverting our responsibility.
Wellness is a choice. Healthcare costs are often self-induced through poor individual choices. Knowledge is power, action creates momentum, and choice creates effect. Choosing to adopt positive, holistic aging practices is a way to discover the endless possibilities of aging and controlling healthcare costs.