2005-10-28 / Columnists

Health & Harmony

Health Benefits
By Dr. Nancy Gahles

DR. nancy gahlesDR. nancy gahles I am using the term “health benefits” loosely. I use that term because it is the term we associate with insurance coverage. “Benefits” is fast becoming an obsolete word. A benefit is usually something that you get over and above your just compensation. It used to be that when you worked for someone, they paid you a salary and you got the benefit of paid health care as additional compensation for a job well done. That was in the old days when workers were valued for their service.

Recently, headlines in most major newspapers have brought our attention to the fact that employers are cutting your health benefits across the board with regard to services for which you used to be covered. They are increasing your premium rates, passing along more of the cost to you in co-payments and giving you less services for your dollar. The big corporations like General Motors in the automotive industry as well as some of the major airlines are cutting retirees health benefits. Let me reiterate that: Cutting retirees health benefits.

Retirees, generally speaking, are in the 55-65 year old age bracket. In our society, this is a time when evidence of chronic degenerative disease manifests. Diabetes and hypertension have become all too commonplace and require constant medication and medical monitoring. Obesity and its complications have reached epidemic proportions. The chronic degenerative diseases such as osteoarthritis need management on a continued basis. Who will pay for these services? As these retirees advance in age, so do their diseases advance in chronicity and severity. Who will manage these people on an ongoing basis?

The Wall Street Journal reported last week that this is the time of year when companies are looking at new policies and many are choosing what is now being called “consumer driven health plans”. Basically, this means that you are on your own! Very simplistically, it goes like this. The employer will give you a high deductible plan and allow you to use pre-tax dollars invested in a health savings account to pay for your own medical needs up to the amount of your deductible at which time the insurance kicks in. Usually this is about $1,000. There are several permutations to this plan and some are very advantageous to the healthy and knowledgeable. This leaves out most of the population. Few people will understand how to use or manage their health care dollars. We have not been trained to prevention or wellness models. We are accustomed to go to the doctor when we are sick for one or two visits upon which we then resume our lifestyle until we become sick again. In the interim we “manage” our health with medications, which may or may not be a covered benefit.

The facts are clear. Insurance companies are being hit hard in every arena from health care to environmental disasters and we are paying for it in our premiums. This is not going to disappear. It is being restructured as employers are not willing to carry the high cost nor are employees willing to bear that burden along with the decrease in quality care that has become apparent with the low fees being paid to the doctors. What to do?

Forewarned is forearmed, as the saying goes. It may not hit you now, but be assured “the times they are a changin’.” My advice is to prepare yourself.

Speak to your personnel or human resources director and find out what plans they have for changing your coverage. Look at all the options for yourself. Read the policies with understanding of your health care needs. Be a forward thinker. Plan for eventualities. Consider the state of your health now and look at your weak areas that could turn into health challenges in the future.

Speak to your accountant about health savings accounts. The money you deposit in these accounts is pre-tax dollars. You will want the one that travels with you should you change jobs. You also want the account to roll over from year to year so that you grow your own health savings. This is your insurance. You will have good health years and bad health years. It is wise to plan ahead for this and have a savings account available to pay for the deductibles and any co-payments or medications and appliances that your insurance doesn’t cover. In my experience, these uncovered services can mount up!

Speak to your health professional about your needs. What do you spend in a given year on office visits, medications and other uncovered services? How much do you spend a year on preventive health care? What portion of your present expenditures could be eliminated or decreased if you changed your lifestyle? If you quit smoking, could you decrease or eliminate the inhaler and allergy medication? If you changed your diet, lost weight and started exercising, I am certain that your health would change. How much do you need to spend on the gym, a chiropractor, nutritionist, yoga, homeopathy, massage and acupuncture to facilitate a healthy lifestyle that will serve you into your retirement years?

Ask yourself these questions. Open up your mind to the future. Protect yourself. You are, after all, your own best investment.

As a community service, Health & Harmony Wellness Education will be presenting a seminar series to educate you on these and other issues. If interested in attending, please e-mail me at askDrNancy@aol.com.

May The Blessings Be!

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