And now that I’m 50, what I eat and how I take care of myself matters more than ever. We baby-boomers talk about staying fit and active as our kids grow up - and as we do, too. Well, delivering on that will require some discipline and commitment. Let’s get on it.

I am switching back to Harvard after a near 20-year absence as a GIC retiree. I have an idea for creating an incentive for cutting prescription drug costs for health plans, by encouraging consumers/members to comparison shop.

Just as health plans offer incentives for insureds to shop around for “more efficient” doctors and hospitals, you might consider implementing a reward system for filling prescriptions at less expensive pharmacies.

A recent Wall Street Journal article showed, for example, that generic Zocor (simvastatin) costs between $80 and $109 at CVS, while it is only $7 at Sam’s Club and only $12 at Costco. While I pay the same co-pay of $10 no matter where I shop under current rules, this prescription will cost the insurance company $70 at CVS but only $2 at Costco.

Big savings could be reaped, but I have no incentive to shop for the best price. In fact, I have a disincentive to save the insurance company $68 by shopping at Costco. I will then be footing 83% of the total cost of the drug out of my own pocket, and will feel I am not getting value for my insurance premium dollar.

So, to encourage consumers to care about the cost of filling prescriptions, why not offer them a reduction or elimination of the co-pay, or some type of banked savings credits if they shop at less expensive pharmacies? This should NOT be viewed as an opportunity to surcharge those who shop at CVS or Walgreens. Rather, this is to encourage comparison shopping by sharing real savings with members who shop smartly.

Let me know what you think!

Edgar

Our history of comprehensive health insurance nominally paid for by employers (for the most part) makes people less willing to see a doctor if they have to pay more than a nominal share of the cost out of their own pocket. At the same time, they are perfectly capable of maintaining their homes and cars without the benefit of third party insurance payments. Go figure. Conceptually, at least for the upper half of the income distribution, they should find high deductible health insurance plans attractive, but most don’t. We keep hearing that people will wait until they are really sick before they see a doctor if they have to pay more than $10 or $20 out of pocket.

The other factor is what I would characterize as generally much higher expectations as to what constitutes a middle class or upper middle class lifestyle today. From the 1950’s to the 1970’s, a house that would be considered solidly middle class would be woefully inadequate today – not enough space, too few bathrooms, no family room, only a one car garage, etc. Everyone seems to need two or three cars now instead of one. It’s no wonder that both the husband and wife have to work to pay for all of this. Add in the cost of all of the structured activities for kids, expensive summer camp and vacations, the prospect of trying to save for both college and retirement, and it’s no wonder that people feel stressed out. Maybe if lifestyle related expectations weren’t so high, more families could let one spouse stay home (if that were their preference) and provide a calmer, simpler, less stressful and probably healthier lifestyle for the entire family.

My bottom line take on this is: We’ve met the enemy and it’s us!

Towns need to think of ways to expand and maintain their sidewalk systems. This would serve to increase physical activity and connect people within their communities. While I have seen some great new walking paths (in Northern Vermont towns), there seems to be a lack of attention to maintaining a sidewalk system throughout the Boston suburbs. There are many beautiful wooded, winding streets between towns, and most of them are narrow with no shoulder or sidewalk. Every town wants to maintain their own character; a sidewalk system can only be a benefit. Naturally, this is an expensive endeavor. Rather than increasing taxes further, how about another bike/walk to raise money for walks/paths statewide? Or maybe a type of “Healthy Returns” program for town/state workers which can show actual monetary savings. This savings could then be used for sidewalk funding.

Speaking of Vermont, I know that the ice cream moguls do work out (with treadmills, not just spoons). The wellness message has been heard by all, yet we all maintain our own priorities!!

Some grumblings ensued, but no one had the nerve to complain to me directly. People adjusted. (Yes, I know fruit has calories, too, but you have to eat a lot of fruit to get the equivalent of two cookies — especially the cookies at our place!)