November 15, 2006

 

 Health insurance costs - November 15, 2006

 

Health insurance is expensive. Not being insured can be even more costly.
posted November 1, 2006
 

A study recently published in the New England Journal of Medicine puts a dollar amount on the growing cost of medical care in the United States. The analysis, which was supported by a grant from the National Institute on Aging and the Lasker Foundation, concludes that, while Americans are enjoying greater longevity today, improved health has come at a price. According to the study, a person born in 2000 can expect to spend over their lifetime on average more than six times as much for medical care than a person born in 1960.

Even a relatively healthy year can be expensive without health insurance. A quick visit to the family doctor to check out a sprained ankle might cost $80, for example. A screening mammogram could cost $150. A well child check-up with the appropriate vaccinations could cost nearly $500. Maintaining a healthy cholesterol concentration through a prescription drug could easily exceed $1,000 a year in pharmacy expenses alone.

It should come as no surprise that individuals who have health insurance are more likely to seek preventive care and to seek care earlier. For individuals who put off routine health visits and preventive care, the costs—health and financial—can be steep. Something as simple as a sore throat taken care of at a physician's office could total around $100, even with a strep culture test. A person who puts off the same problem could end up in the emergency room on a Saturday night, and the cost could triple or quadruple or increase even more. A small skin cancer removed at a dermatologist's office in the early stages not only saves thousands of dollars compared with treatment of advanced skin cancer, it can also save the patient's life. For AVMA members insured through the AVMA Group Health & Life Insurance Trust, having sound insurance protection in place offers peace of mind.

A review of claims paid out on behalf of GHLIT participants for the 12 months ending in April 2006 revealed that the top diagnoses in terms of expense were joint disorders, closely followed by back disorders. During that period, GHLIT disbursed more than $5.6 million for joint disorders, including arthritis and derangement of the knee. Another $4.9 million was disbursed for back disorders, including spondylosis, disk disorders, and spinal stenosis.

With heart disease and cancer being two major health concerns in the United States, it is no surprise that they were also the leading diagnoses for GHLIT participants. Conditions related to the heart accounted for more than $5 million in claims paid on behalf of GHLIT participants over that same 12-month period. More than $4.3 million was paid in claims for treatments of malignant neoplasms of various organs, along with lymphatic and hematopoietic cancers, including Hodgkin's disease and leukemia.

Not all claims paid out were for such serious diagnoses, however. In the same year, GHLIT paid a little more than $2 million for care associated with pregnancy, labor, and delivery for the many participants and their families who welcomed new babies.

Along with benefiting individuals, preventive care and early care can sometimes prove cost-effective for all participants, considering GHLIT insurance premiums are based on the claims experience of AVMA members and their families—no other outside groups. When funds received exceed those required to operate the GHLIT program, the excess is returned to members in the form of lower costs or improved coverage. The Trust recently announced a 10 percent rate reduction across the board for all Health Savings Account-qualified plans, on the basis of positive claims experience over the preceding 12 months.

The GHLIT has provided coverage to veterinarians and their families since 1957. The trustees, who are veterinarians serving without compensation, act as a review board to assist any participant who experiences a problem with the insurance program. Participants may phone Dr. Jody Johnson, director of member services, at (877) 679-8854 to discuss concerns they have regarding their GHLIT coverage.

All GHLIT programs are underwritten by New York Life Insurance Company. Offerings include preferred provider organization plans, traditional indemnity plans, dental coverage, hospital indemnity, high-deductible/HSA-qualified plans, professional overhead expense insurance, accidental death and dismemberment insurance, short- and long-term disability income insurance, and term life insurance programs. Special student plans are also offered.

For more information on AVMA GHLIT plans, including eligibility, rates, renewal provisions, exclusions, and limitations, or to find a GHLIT agent in a particular area, call the Trust office at (800) 621-6360.