I am writing with a concern that health care costs be manageable in Cook County and elsewhere in our country. Now a retired health care actuary living in Grand Marais, I was a professional actuary accredited in all states. For more than 35 years, my clients included hospitals, physicians, employers and insurers.
Here is a misfortune in our health care system that I witnessed more than once: An employer offers incentives to its employees and their families if the employees embrace healthy lifestyle options such as exercise, no tobacco use, or weight reduction.
However a Culprit comes along. Due to the Culprit, our example employer and employees have no idea if their healthy efforts are paying off.
The Culprit is the unchecked hospital emergency room care provided to their community’s uninsureds. This service is legally required of hospitals. The cost for this care of the uninsureds is passed along to insured plans including our example employer’s plan.
The Culprit grows larger. Uninsureds generally have no primary care physician and consequently no preventive care and even no history of health conditions and past medical services. Also, because of the lack of an uninsured’s history, a wrong diagnosis or treatment further aggravates health care costs.
The Affordable Health Care Act minimizes the number of uninsureds and initiates medical histories on the same. This Act disables the Culprit. If this Act is repealed, any replacement legislation needs to address the Culprit—the health cost effects of uninsureds treated in hospital emergency rooms.
With the Culprit gone, it will be possible for citizens of Cook County and beyond to see future health cost payoffs from healthy lifestyle efforts.
Doug Sanders
Grand Marais
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