The Cost of Healthcare
For a company to stay open and serve the community, keeping costs low in a moral way is crucial. Healthcare plans are often discussed and changed for companies looking to save some money. The United States has the most expensive healthcare system, and as 3 trillion-dollar industry you would figure that the United States has the best healthcare system, right? Wrong. In 2010, the average life expectancy of a US citizen is 78.84 years, and that person is paying $8157.42 per year. Japanese citizens have the highest average life expectancy at 83.33 years, and are only paying $3951.95 a year (that’s about an extra 4 and a half years of life at half the cost). The United States also has the highest child and maternity mortality rate compared to health expenditure in the entire world (maternal mortality has even increased from 10.5 deaths per 100,000 live births in 1979 to 14 deaths per 100,000 live births in 2015). I think everyone wouldn’t mind spending the most in healthcare if that meant higher life expectancy, but that is not the case with the United States. So that begs the question: what is the disconnect with our healthcare system?
Inefficiencies of the System
From those previous stats, there are plenty of inefficiencies that are leading to higher healthcare costs, for both employees and employers. What exactly are those inefficiencies? Short answer: multiple things “working” off each other that create more inefficiencies. Some of inefficiencies stem from insurance companies in that for a chiropractor (or any other professional) to be in-network with an insurance company, there is an automatic write-off of services the practitioner must make, per their contract agreement. Reason why is because that chiropractor will be “referred” patients there for being in-network, according to the insurance company. Often, chiropractors must increase their fees, so that write-off doesn’t affect their bottom line. What that means is higher costs for the patient/employee. The example I use to explain all of this, is let’s say my time is worth $50 for every regular office visit. Being in-network there is an automatic write-off (let’s say $30-that’s typical). For the chiropractor to keep their doors open, they factor in the write-off into their cost per regular office visit, meaning that the patient is now paying $80 if there isn’t a copay- consequently, the $80 will still go towards their deductible. If there is a copay, the insurance company will pay the chiropractor a certain amount of money (agreed on their contract), however, often those payments are delayed or even declined due to “improper” record keeping. There are cash clinics sprouting up throughout the United States (including mine), and the purpose behind them are keeping costs as low as possible while delivering a high-level of care (result-based care rather than money oriented-based care). Going off the previous example: my time is worth $50 per regular office visit, and I will charge the patient $50 (rather than the insurance company keeping that $30 to offset their other costs for inefficient ways of treatment by chiropractors, medical doctors, surgeons, and other healthcare practitioners that don’t fix the issue). As a side note, another thing that my clinic does is provide the billing codes on the patient’s receipt, so depending on their plan, for example if they have a Health Savings Account (HSA), the patient can get reimbursed.
U.S. Pill Consumption
Another facet of the healthcare industry that has inefficiencies is our culture and how we perceive treatment for illnesses. According to the CDC, 86% of our healthcare costs go towards chronic and mental health conditions, with the most frequent reason for a physician (all physicians, not just prescribing medical doctors) office visits is for medication. The US only makes up 4.5% of the world population, yet is consuming 52% of the world’s prescription drugs. That was back in 2000- I have read as much up to 75% today, but the references were not the best. Considering US citizens spending the most on healthcare, with the majority of that being spent on chronic and mental health conditions and consuming the most prescription drugs, but still not having the highest average life expectancy, it is clear to see that prescription drugs are not the answer for the healthcare industry when treating chronic and mental health conditions. If prescription drugs were the answer to chronic and mental health conditions, then the US would have the highest average life expectancy. Prescription drugs and the rest of the medical community are absolutely fantastic when it comes to trauma and life-saving emergency situations, however, that model of healthcare doesn’t translate well over to chronic and mental health conditions. Depression is not a Prozac deficiency, and Type II diabetes is not a metformin deficiency. Those chronic and mental health conditions are LIFESTYLE issues that cannot be fixed by a prescription drug, and should it be dealt with appropriately by diet and exercise as well as the proper profession, like a psychologist, nutritionist, or whatever other profession that is appropriate. Lifestyle issues can be improved, if not resolved, by proper diet and exercise. When most US citizens are going to medical doctors for these lifestyle issues, they are given prescription drugs because medical doctors aren’t getting enough training in nutrition (lifestyle) while in school. There lies the inefficiency in our culture, in that they are not going to the proper healthcare physician to deal with their chronic or mental health condition.
Invasive = Expensive
My philosophy is that you should always try the least invasive option first (which is usually the cheapest), and work your way to more invasive therapies if the previous therapies don’t work. For example since I’m a chiropractor, someone that tweaked their back during yard work should go to the chiropractor first to get adjusted to see if that resolves the pain. If that doesn’t work, I would suggest seeing another chiropractor first, because every chiropractor is unique and adjusts differently. When it is determined by the patient that chiropractic cannot help, then that patient should move on to the medical doctor and get prescribed something like a muscle relaxer in this example (not my scope of practice). If that still doesn’t work, then the patient should consult with an orthopedic specialist and/or surgeon. By doing it that way and having chiropractic work, the patient will save money (see starred references at end) and avoid the risk of being addicted to opioids and any complications that could happen from surgery. Opioid addiction is on the rise, and often that leads to heroin usage and potentially death. If a patient were to go to a chiropractor first for low back pain, their odds of having low back surgery is 1.5 %, compared to 42.7% when a surgeon was sought out first. However, I realize that there are situations where chiropractic cannot help, the more invasive forms of treatments should then be pursued.
So, what does all of this mean for your business? If there is an employee with any chronic or mental health condition, they should seek out the least invasive forms of therapy (chiropractic, nutritionist, psychologist, etc.) first before moving onto medications and surgery. This will ultimately save your company money in the long run. Particularly at Functional Wellness and Chiropractic Center, we utilize chiropractic, nutrition, neurological, and soft tissue therapies to work with a wide array of conditions to get patients better, quicker and optimizing peoples’ lives so that they can live the best possible life.
About the Author
Dr. Eric Johnson, Doctor of Chiropractic and Diplomate of the American Clinical Board of Nutrition as well as owner of Functional Wellness and Chiropractic Center in Madison, WI, is a functional medicine doctor that identifies root causes of pain and/or dysfunction. His systems-based, not symptoms-based, approach is a comprehensive, holistic approach that helps identify mental, chemical, and physical stressors that are underlying numerous health conditions. If you are in the Madison, Middleton, Verona, Waunakee area and looking to not only feel better, but live better, contact Dr. Eric at (608) 203-9272.
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