Medical Tuesday Blog

1.Feature Article: A Basic Low-Cost Private HealthCare Proposal Pay cash for your basic outpatient health care and save over half the cost of insurance. Only Hospital care, Surgical care, Trauma and Emergency care require major medical insurance.

Jun 18

Written by: Del Meyer
06/18/2021 1:04 AM 

Actuarial data indicates that Americans pay far more for insurance for basic outpatient health care cost than paying cash for outpatient office and laboratory charges. In many instances the monthly cost of health insurance equals the annual cost of health care if paid for with cash. Health insurance would then be required for the unexpected hospital, emergency, trauma and surgery care.

Pay cash for all office or outpatient care including lab and x-rays and up to your deductible with insurance only for hospital, emergency, trauma, and surgery care will save you more than half of your health care costs. These charges are in the range of our usual household costs for utilities, house and car maintenance. Insurance just increases the cost of any maintenance.  This is the same for car and household insurance.

The usual cost of outpatient care for each decade of life will approach the following:

This is not what you’ll find online, which is if you don’t have insurance, you’re not covered.
But insurance for outpatient health care may be 10 times as expensive as cash.
Purchase health insurance only for coverage of hospital and surgery care.

This will involve a new approach to health care than what you are used to.
But it will be critical that you understand this before all of healthcare becomes unaffordable.

 * * * * *

Ages 20-29 The actuarial costs in the third decade of life should be approximately $300 per year—or $3,000 total for this decade of life.

Health insurance may cost $300 each month—or $3,600 per year or $36,000  for this decade of life.

The twenties are usually a relatively healthy decade of life for the average adult. You should be getting a Medical History and Physical exam from your primary care physician every two- or three-years including checks on your blood pressure and height/weight. This should also be done every year on a self-exam basis. Most smart phones today have an entry to record this.

Screenings tests are necessary for anemia which is a basic complete blood count and for kidney disease which is a complete urinalysis. This should be repeated every two- or three-years. During this decade a chemistry panel for multiple organ disease is advisable which should include a lipid panel to check cholesterol and triglycerides which can be elevated without any symptoms and need treatment, primarily with diet. If normal, no repeats are required during this decade of life. Your doctor might consider other tests based on your medical history and physical examination.

Ages 30-39  The average cost as determined by actuaries during the fourth decade of life should cost approximately $400 per year—or $4,000 total for this decade of life.

Health insurance may cost $400 for each month—or $4800 per year or $48,000 for the decade.

Your thirties are generally similar to your twenties with a continued good health. Many of the recommended checkups are the same as your twenties. A complete Medical History and Physical exam from your primary care physician every two- or three-years should continue as well as a CBC and UA with each exam. Another chemistry and lipid panel should be obtained during this decade. If diseases are diagnosed, additional testing would be needed. This would include a Hemoglobin A1c if diabetes is found as well as other tests to evaluate other abnormalities that are found.

Age 40-49  The average cost as determined by actuaries for the fifth decade of life should cost approximately $500 per year—or $5,000 for this decade of life.

Health insurance may cost $500 per month—or $6000 per year or $60,000 for this decade of life.

As you reach middle age, your body is going to need a few more tests and procedures than in your twenties and thirties. You still need your basic medical checkups by your physician now increased to yearly. Your CBC and complete UA are also yearly during your annual evaluation. Chemistry, cholesterol, Lipid panels may now be required every two to five years if abnormal. Otherwise continue with checks every five-years.

During this decade, men have to get screened for prostate cancer with a PSA and repeat if elevated yearly. Otherwise repeat every two or three years. Women have to begin screening for breast  cancer and gynecologic diseases. Your physician will set the extent and frequency for these. Prevailing recommendations for mammogram and pelvic exams are every two or three years.

A vision exam might be needed as you age. Visual charts are readily available to screen for visual acuity. If you have difficulty in reading or your visual acuity is 20/30 or less, ophthalmologic exam become necessary. Glasses are not required for driver’s licenses unless your vision is 20/40 or less.

Audiology exam may be required if hearing impairment is noted. Audiologist work in ENT and Otology offices where the ENT surgeon will do the general ENT exam and if all is normal, refer you to the audiologist that may be in his office or his clinic. Free standing audiology practices are now available and one can obtain an audiology exam directly. If abnormal, the audiologist will refer you to the ENT or Otologist specialist.

If you have a family history of heart disease, or are at high risk for heart disease, or have lipid abnormalities, then your doctor may want to begin screening for coronary heart disease. If you have hypertension, he may begin treatment.

If you have asthma or difficulty in breathing, your doctor should begin screening your pulmonary function and begin treatment usually with inhaled broncho-dilators

Ages 50-59  The average costs as determined by actuarial data during the sixth decade of life should  be approximately $600 per year–$6,000 for this decade of life.

Health insurance may cost $600 per month—or $7200 per year or $72,000 for this decade of life.

In your 50s, one would continue with annual Medical Examinations by your physician with continued annual baseline screening tests which may now include annual chemistry and lipid panels. At this time screening for colon cancer should be started. This may include a simple stool exam for blood or a sigmoidoscopy.

Screenings for Type II diabetes maybe considered as well as an electrocardiogram if cardiac disease is suspected. Screenings for prostate cancer, breast and gyn cancers should continue.

Screening for depression or other psychiatric problems may be required.

If you become ill, that’s when you need your major surgery/hospital insurance plan.

Ages 60-69  The average cost for the seventh decade of life as determined by actuarily analysis should be approximately $700 per year–$7,000 for this decade of life.

Health insurance may cost $700 per month—or $8400 per year or $84,000 for this decade.

The sixties were formerly thought to be the onset of your aging years. But we are really healthier now than when social security was implemented in the 1930s or Medicare in 1965. Your body isn’t ready to slow down or retire from work. It is important to keep on top of your health. In addition to all the screenings you had done in your fifties, you’ll need to continue these in your 60s and become more aware of health risks before disease steps in.

Your doctor may want to do screenings for osteoporosis and might consider screenings for abdominal aortic aneurysm, and carotid artery ultrasound. These can be done by the panels that become available in most communities on an annual and very inexpensive basis. Skin cancer, oral cancer, lung cancer, might be considerations based on your health history.

Depression should also be monitored along with signs of dementia and Alzheimer’s disease.

This is decision time when Medicare becomes available. Medicare has become more restrictive with the passing of time with many items no longer approved. One should do a careful cost analysis. If you’re in good health and still employed, you may find that continuing to pay for usual care and private health care may improve your life when people of yesteryear were calling it quits. This is not a recommendation not to enroll in Medicare when you turn 65. However, with Medicare projecting to go bankrupt in the next decade or so, this program may require serious consideration and give you medical freedom that you will not have in a government program.

Aging is something everyone has to go through. There is no fountain of youth. It’s a part of life. As you age, it’s important to keep tabs on your health. The need to see a doctor in your twenties isn’t as pressing as it is in your fifties, sixties, and seventies. But that doesn’t mean you shouldn’t go. Determine if you’re seeing the doctor often enough or getting checked up on the correct things with this quick guide.

Ages 70-79  The average cost as determined by actuaries during the eighth decade of life should  be approximately $800 per year–$8,000 for this decade of life.

Health insurance may cost $800 per month–or $9600 per year or $96,000 for this decade of life.

We are healthier in our 70s and living longer with life expectancy into the 80s. We have less medical costs in our 70s than we had in our 60s when Medicare was started. Medicare is scheduled to go bankrupt in the next decade. Hence, our extrapolation into the 70s and 80s is to show us that health care costs will not be insurmountable even after Medicare goes bankrupt and we resume with our usual health insurance prior to Medicare. The only thing that can save Medicare is to increase the age of benefit from 65 to 72 years. And to increase the age for early benefits from age 62 to age 65.

The above is for basic outpatient health care. Hospitalizations, Trauma/Emergency and Surgical care require major health insurance coverage which will be less expensive than current insurance for total health care.

Ages 80-89  The average cost as determined by actuaries during the ninth decade of life should  be approximately $900 per year–$9,000 for this decade of life.

Health insurance may cost $900 per month–or $10,800 per year or $108,000 for this decade of life.

If you look at the obituary columns in the papers, you will be surprised at the number of people that live into their ninth decade—also at the number that live into their 10th decade and were working into their 9th decade. We are healthier at this stage of life than we have ever been. Of course we should always have the safety of major medical should we develop a major illness or require hospitalization or surgery.

Reference for a similar program can be found here-Read cautiously-Annual tests overdone.

Checkups Men Need For Every Decade of Life – | Simplifying Healthcare

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