Solving the rising health care costs

Health care is a basic need like transportation, according to Dr. Arnold DoRosario, vice president of PriMed L.L.C. and one of five panelists who spoke at a Bridgeport Regional Business Council. (BRBC) forum at the Trumbull Marriott last week.

"Unfortunately," DoRosario said, "we've come to

Employers should expect up to a 15 percent increase in health benefits in 2003, according to the BRBC. And the numbers aren't expected to get any better.

"You know what your cost is today. Multiply that by two and you have your cost in five years," said Jim Winkler, health care benefits consultant of Hewitt Associates. "The health care system as we know it today, is broken. We've told customers that they can take the bus or the limo for the same 10 bucks and that's our fault."

Winkler thinks a short-term strategy of changing the health care Plan design is necessary. Copays should vary and "we need to ask people to pay more out of their paycheck for health care," he said.

Barry Averill, president of Health Net of the Northeast, Inc., said that 25 percent of the total cost of the health system could be avoided if there was better quality of care. To do this, information needs to be provided to physicians so they can help patients better understand the best place to go for needed care. This will result in an increased survival rate, he said.

Preventive care

DoRosario said that cancer screenings lead to better diagnosis, which in turn leads to cost-effective treatment. "Unfortunately, providing some of these benefits has led to the demand of other benefits," he said. "I think our focus needs to educate the public in prevention care. That costs nothing."

DoRosario suggested a push for lifestyle changes such as exercising to avoid injury in a society where expensive tests that can be avoided are considered the best solution. "People need to understand limitations of health benefits. Some of the burden has to be with both the provider and the consumer," he said. "How can we work as a team so it's not 'I have insurance, I need this, so why can't it be done?'"

Dr. Anne Manton, an associate professor at Fairfield University's School of Nursing, said that diagnostic tests should not be taken for granted. Provider behavior will change consumer behavior, she said. Other possible solutions include not requiring healthy 20-year-olds to undergo yearly physicals to play sports, and people not needing doctor's notes when they are out sick. In some cases, chronic disorders need management, not treatment, which could cut down on costs, she said.

Financial incentives

Manton said pharmaceutical companies are also to blame. "Pharmacudecal advertisements are encouraging patients to request prescriptions for almost everything," she said.

"It's our job to work with employers to offer alternatives," Averill said. "Our obligation is to provide information that a patient understands."

Malpractice suits are essential, DoRosario said. "I think bad care needs to be punished." But he suggested the state appoint experts to look at potential lawsuits to determine if a case should go to lawyers.

Susan Cogswell, commissioner of the Connecticut Department of Insurance, said Connecticut's health services and insurance costs are one of the highest in the nation. "The employers can't continue to pay for the rising costs," she said.

Winkler said 25 percent to 35 percent of people with chronic problems are not diagnosed and that they need to be given financial incentives to get the appropriate care to get better.