Health

Out-of-Pocket Costs for Out-of-Shape Patients

Looking ahead to 2017, a few concerns related to health insurance

There are many uncertainties about health care as we approach a new year. President-Elect Donald Trump’s promise to repeal and replace the broken Obamacare system has many Americans, while supportive of bringing in a much better system, also wondering exactly how the changes will affect their health insurance coverage.

Will their physicians still be part of their network? What will it all cost?

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In terms of consumers’ overall expenses, “nothing much will change in [the new] year from [the current year],” said Dr. Ramin Oskoui, a cardiologist in Washington, D.C., and CEO of Foxhall Cardiology PC. “Insurance companies need so much lead time to make actuarial decisions. That’s good and bad for consumers who are struggling with out-of-pocket costs.”

Health care expenses are considered a top health industry issue in 2017, according to a new report — in more ways than one.

“Unless costs are controlled, we are going to see care rationed,” said one physician.

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The concern isn’t only how much consumers will pay, but how they’ll pay their health bills. A surge of Americans have been paying their doctor bills with credit cards — due in large part to increasingly higher deductibles. Industry leaders are working to modernize payment systems to manage the change and better manage the billing process overall — as one in four consumers stated their experience with hospital billing and payment damaged their opinions of the organizations.

PwC’s annual Health Research Institute (HRI) report showed prescription drug pricing is another issue high on the list of the “Top Health Industry Issues of 2017.” The prediction is that “pharmaceutical companies will likely better engage with patients to justify prices, show value and satisfy calls by regulators.”

Managing infectious disease, antimicrobial resistance, industry consolidation, and emerging technologies such as artificial intelligence, drones, virtual reality, and 3D printing, are expected to impact not only patient care, but business models, operations, workforce needs, and cybersecurity risks.

Related: It’s Time the Health Care System Serve the People

“Identity fraud risks are unknown and likely significant, both for health care systems and patients,” said Oskoui. “Look at Uber. If you own a smartphone, cybersecurity warrants minimizing the use of any apps. Recently a flashlight app was used to access contact data. If you want to sleep at night, keep these gimmicks off your phone.”

One other notable issue expected to impact health care is an industry-wide shift toward nutrition as a way to prevent costly medical problems and improve patients’ overall health.

As someone who works inside the industry, Oskoui shares concern for the year ahead: “I’m increasingly pessimistic that costs of actual unsubsidized care will fall in the next two-to-four years. Take care of yourself.” He also says: “Don’t count on the system as we know it being there for us. Unless costs are controlled, we are going to see care rationed.”

Related: Unhealthy Kids ‘Make Me Sad’

While the goal is to make health care costs more manageable and health care accessible to everyone, it’s going to take time. And while that’s getting worked out — doctors absolutely want their patients to start taking better care of themselves. Everyone should eat right, exercise both body and brain, take prescribed medications, and do as much preventative care as possible to avoid unnecessary trips to the doctor — not just now, of course, but always.

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