Comments on: Costs and Demographics… http://www.letstalkhealthcare.org/health-care-costs/costs-and-demographics/ Tue, 06 Jan 2009 22:26:24 +0000 http://wordpress.org/?v=2.5.1 By: Susan L http://www.letstalkhealthcare.org/health-care-costs/costs-and-demographics/#comment-1710 Susan L Sat, 11 Aug 2007 01:37:01 +0000 http://www.letstalkhealthcare.org/?p=124#comment-1710 The Japanese approach to the problems of an aging population is interesting. In particular, there's their idea of making better use of an underutilized resource, older people. How is this good economics concept applied in a health care system? Well, one way would involve more public education about medicine. As with the science of high triglycerides and their effect on LDL/HDL. (Which I mention because I just looked at the NCEP-ATPIII data. Startling. Among men aged 45 to 65, at least 25% have TGs in the high range, over 200 mg/dl. It's 1988-94 data, of course, and it might be better now. Might be worse, with more obesity.) Another good use of older people would involve more training of nurse practitioners. Especially, I would hope, of specialized NPs. The Japanese approach to the problems of an aging population is interesting. In particular, there’s their idea of making better use of an underutilized resource, older people.

How is this good economics concept applied in a health care system? Well, one way would involve more public education about medicine. As with the science of high triglycerides and their effect on LDL/HDL. (Which I mention because I just looked at the NCEP-ATPIII data. Startling. Among men aged 45 to 65, at least 25% have TGs in the high range, over 200 mg/dl. It’s 1988-94 data, of course, and it might be better now. Might be worse, with more obesity.)

Another good use of older people would involve more training of nurse practitioners. Especially, I would hope,
of specialized NPs.

]]> By: Alijor http://www.letstalkhealthcare.org/health-care-costs/costs-and-demographics/#comment-1680 Alijor Fri, 10 Aug 2007 11:17:21 +0000 http://www.letstalkhealthcare.org/?p=124#comment-1680 That problem could be attacked on two different levels, though: A great deal of it comes simply from the fact that other states do not force young people to have insurance, nor provide for the 55 and over population. As the first state, Massachusetts bears this consequence. However, if other states follow it’s path, the demographics will be most likely evened out. Also, there are many ways to create incentives for young people to move to Massachusetts, it just takes a bit of public policy creativity. Cheers, Alijor alijor.blogspot.com That problem could be attacked on two different levels, though: A great deal of it comes simply from the fact that other states do not force young people to have insurance, nor provide for the 55 and over population. As the first state, Massachusetts bears this consequence. However, if other states follow it’s path, the demographics will be most likely evened out. Also, there are many ways to create incentives for young people to move to Massachusetts, it just takes a bit of public policy creativity.

Cheers,
Alijor
alijor.blogspot.com

]]> By: sean grady http://www.letstalkhealthcare.org/health-care-costs/costs-and-demographics/#comment-1616 sean grady Thu, 09 Aug 2007 14:27:10 +0000 http://www.letstalkhealthcare.org/?p=124#comment-1616 Charlie - Should the last person out of Massachusetts turn the lights off? I understand your point about the aging population and increased healthcare costs but I would say this is much more of a Medicare issue at the federal level (as opposed to the state or region). My experience with commercial and Medicare utilization is that the 55-65 year old age group does show an increase in costs but the HUGE jump comes with the 65 and older group who have mostly aged into a Medicare product. Take a look at a daily hospital inpatient census (maybe Paul Levy can verify this at his facility) and you will see 80% of the med/surg admissions are people born prior to 1942 (making them 65 or older and likely on Medicare). As the first wave of baby boomers hit Medicare the costs are going to explode and result in either huge payroll tax increases or huge cuts in provider reimbursement (a big threat to providers) if they have any hope of keeping it solvent. The 55+ group will impact us here in Massachusetts (and healthcare costs will continue to rise) but the real disaster looming ahead will be the growth in the 65+ Medicare group at the federal level. It amazes me that there is not more panic at the federal level regarding this looming crisis because the Medicare problem is so huge and so expensive it is going to make everything else look insignificant. Charlie - Should the last person out of Massachusetts turn the lights off? I understand your point about the aging population and increased healthcare costs but I would say this is much more of a Medicare issue at the federal level (as opposed to the state or region). My experience with commercial and Medicare utilization is that the 55-65 year old age group does show an increase in costs but the HUGE jump comes with the 65 and older group who have mostly aged into a Medicare product. Take a look at a daily hospital inpatient census (maybe Paul Levy can verify this at his facility) and you will see 80% of the med/surg admissions are people born prior to 1942 (making them 65 or older and likely on Medicare). As the first wave of baby boomers hit Medicare the costs are going to explode and result in either huge payroll tax increases or huge cuts in provider reimbursement (a big threat to providers) if they have any hope of keeping it solvent. The 55+ group will impact us here in Massachusetts (and healthcare costs will continue to rise) but the real disaster looming ahead will be the growth in the 65+ Medicare group at the federal level. It amazes me that there is not more panic at the federal level regarding this looming crisis because the Medicare problem is so huge and so expensive it is going to make everything else look insignificant.

]]> By: Paul Levy http://www.letstalkhealthcare.org/health-care-costs/costs-and-demographics/#comment-1545 Paul Levy Wed, 08 Aug 2007 09:43:04 +0000 http://www.letstalkhealthcare.org/?p=124#comment-1545 Right, Charlie. I can't tell you how many of my 55+ friends have said to me that their recent or pending visit to our hospital is the first on their adult life (other than childbirth). And they are not coming in for some elective sports injury repair, but rather for a serious tertiary care problem. Meanwhile, their parents are living longer and come in for repeat visits as well. When we look at that trend, we find we need to add bed capacity and staff to handle the increased volumes. Even with full fledged programs to improve quality and increase efficiency, the cost trend is definitely up. Right, Charlie. I can’t tell you how many of my 55+ friends have said to me that their recent or pending visit to our hospital is the first on their adult life (other than childbirth). And they are not coming in for some elective sports injury repair, but rather for a serious tertiary care problem. Meanwhile, their parents are living longer and come in for repeat visits as well. When we look at that trend, we find we need to add bed capacity and staff to handle the increased volumes. Even with full fledged programs to improve quality and increase efficiency, the cost trend is definitely up.

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