Insight

Improving Your Health Can Reduce Healthcare Costs

Ken Waltzer, M.D. on Retirement Daily - TheStreet

August 9, 2019

It should come as no surprise that one way to lower your healthcare bills is to be healthier so that you need fewer doctor visits, treatments and medications. While some people were dealt a lousy hand genetically or otherwise, and will always need a lot of medical care, health behavior can have a huge impact on how we feel and function, and on our medical spending as well. Below I describe a number of simple (though not always easy) things you can do to improve your health. First, let’s look at how much control you might have over your healthcare expenses.

Which are the biggest out-of-pocket healthcare costs?

A study by Mercer Health and Benefits indicated that a medium-risk 65-year-old woman will spend between $3,200 and $6,600 a year on health insurance premiums and out-of-pocket
medical, dental and vision costs. About $1,800 of these annual costs are from insurance premiums, leaving $1,400 to $4,800 for other out-of-pocket costs.

These out-of-pocket costs vary tremendously with health status. A low-risk woman can reduce these costs to between $1,200 to $2,500, saving a median of $500 a year. On the flip side, a high-risk woman could shell out as much as $19,200 a year, with median spending of $4,200 more per year than the low-risk woman. Thus, the range of annual expenditures is $1,200 to $19,200, a potential difference of $18,000 per year.

Men may be wondering about their numbers. While the Mercer study only looked at women’s healthcare costs, I can tell you from other studies and my own experience that men’s expenses are a bit lower. Men go to doctors less often and receive fewer treatments over time. Also, men don’t live as long as women, so their expenses extend over fewer years. Congratulations, men, your shorter lifespans and relative neglect of your health means you spend about 20% less than women on healthcare.

Which expenses have the greatest impact on out-of-pocket healthcare expenses? In a word: drugs. Medication expenses can be substantial, and insurance coverage varies. In another column, I’ll describe how to reduce medication costs by choosing less expensive options and by managing your insurance. Today, we’ll focus on minimizing the number of drugs that you take by working on staying healthy.

Whether your goal is to reduce the number of medications you take, visit the doctor less, have fewer surgeries, spend less time in rehab, or avoid paying for medical equipment, the approach is the same: adopt a healthier lifestyle.

And the benefits go far beyond reducing healthcare costs; in fact, a significant side effect of a healthier lifestyle is improved well-being, whether that means less pain, more energy, improved mobility or a sharper mind. With people living longer as a result of vaccines, better sanitation, and the miracles of modern medicine, the golden years keep getting extended. But living longer doesn’t necessarily mean living better: your goal should be to add life to your years as well as years to your life.

Maybe you’re already in perfect health and live a pristine lifestyle. Good for you. But most of us have room for improvement, and to make a real difference, lifestyle changes don’t have to be dramatic or sudden. And they can start at any age. They’re not costly either; you don’t have to take handfuls of expensive supplements to be healthy. Below I outline actions you can take to improve your health, helping to lower your healthcare costs and feel better at the same time.

These recommendations apply equally to people with chronic medical conditions. You may need to discuss some of these with your doctor, but even if you have heart disease, cancer, arthritis, diabetes, lupus or another condition, you can benefit from the suggestions below.

How to Be Healthier

These recommendations come from hundreds of studies and have strong scientific support. I have left out areas where there is controversy or where the data remain inconclusive.

1. Don’t smoke. You’ve heard this a million times. The downside is that you might live several years longer and have to budget for more years of living expenses. The upside is that you will dramatically lower your risk of emphysema, lung cancer, heart disease, stroke and many other diseases that reduce both longevity and quality of life. I know from patients how hard it is to quit smoking; don’t get discouraged if you fail on the first or even the 10th try. One recent study suggested that it takes an average of 30 tries to finally quit for good!

2. Drink alcohol in moderation. Modest amounts of alcohol are beneficial; large amounts are harmful. This doesn’t mean you should start drinking if you currently don’t, and certain people, such as recovering alcoholics, should avoid alcohol entirely. How much is good? For men, up to 2 drinks a day, and up to 1 ½ for women (women with high risk of breast cancer should drink less or not at all). A “drink” is a 4-ounce glass of wine, one 12-oz. beer or one shot of liquor. Some beverages are higher in alcohol that average, and you should drink less of these. And don’t drink your weekly allotment all at once! Binge drinking is distinctly dangerous.

3. Get enough sleep each night. For most people, this means 8 hours; some people need less, others more. But most of us don’t get nearly enough, and over time, that takes a toll on the body. Contrary to popular belief, we don’t need less sleep as we age, we just have more trouble staying asleep. There are lots of articles on the web about sleep hygiene if your sleep is poor. If you are waking up early and unable to fall back to sleep, consult your physician: you could be suffering from depression.

4. Don’t skip meals, especially breakfast. People who eat breakfast actually weigh less than those who don’t. The best breakfasts contain both protein and fiber, which leaves out a donut and coffee. (Speaking of coffee, it may actually be good for you, but if you drink the caffeinated variety, keep it to 4 cups a day or less.) You can find a lot of quick and healthy breakfast suggestions online.

5. Speaking of weight, keep yours in a healthy range. I know, losing weight and keeping it off is hard. But you don’t need to look like a fashion model or bodybuilder to be healthy, and if you are overweight, even modest weight loss will improve your health and well-being. Better, forget about weight and focus on waist circumference; it may be a better measure of health risk. For men, keep it under 37.5 inches, and for women, under 32. Higher numbers increase the risk of heart disease, diabetes and high blood pressure.

6. Eat good fats, avoid bad ones. For years, the USDA told us that fat was bad. So, we all ate less fat and more carbs. That’s one reason for today’s epidemic of diabetes. But fat isn’t bad; bad fat is bad. Which are the good ones? Basically, any that are liquid at room temperature (i.e., most vegetable oils). Fats that are solid at room temperature (most
animal fats) are generally harmful. So, eat olive, canola, safflower and similar oils and stay away from lard and hydrogenated fats.

7. Minimize red meat. I know how much people love their steaks. But hear me out. Red meat is a major cause of heart disease and stroke, and it’s not just because of the solid fat that comes with it. The other culprit is iron, specifically the kind found in red blood cells (iron from vegetables like spinach is fine). This means that even the leanest of cuts is bad for you. You can tell how much iron is in meat by its color: redder is “badder.” Even dark meat turkey has a lot of iron, but not the white meat. Same with chicken and lighter cuts of pork. (Processed meats, like bacon and pastrami, are the worst of all.)

8. Bulk up on fiber. As with fat, carbs can be good or bad. Sugar, white bread, cookies, cake, and candy are bad. Fruits, vegetables, beans, and whole grains are good. The difference is the fiber content, which slows the absorption of sugar into your bloodstream. And while white is a healthy color for meat, it’s the opposite for carbs. Try to avoid white bread and white rice. If you’re interested, check out the glycemic index and glycemic load of various foods. You can find one such table here. Aim for glycemic indexes under 50 and loads under 10.

9. Eat your fruits and veggies. Of course, you know this already. But I can’t overemphasize how important this is. Most Americans eat way less than they should. (French fries and ketchup don’t count.) Try to make every plate half vegetables and eat fruit rather than baked goods for dessert. Don’t like steamed vegetables? Neither do I. Try sautéing them in olive oil or roasting in the oven. There are hundreds of recipes online that make vegetables taste delicious. Try them. (Nuts, by the way, are healthy as well; just don’t eat too many as they are relatively high in calories.)

10. Eat more fish. I’m not going into the mercury thing here, except to say it’s not an issue for most people unless you’re pregnant or plan to be. In general, fish is good for you, and the fat in fish like salmon, trout, tuna, and herring is some of the best fat around. It’s really hard to overdose on fish. Even shellfish can be healthy; don’t be scared away by the cholesterol content, which is irrelevant for most people.

11. Be physically active. The data keep rolling in, not only that moving is good, but that sitting on your butt is bad. At least get up from your chair once an hour. And move around as much as you can; exercise doesn’t have to be structured to be beneficial. The best exercise? The one you’ll do. I like to ride my road bicycle; my wife walks briskly on hills. All it takes is raising your heart rate for 2½ hours each week (or only 75 minutes if the exercise is intense). Adding resistance training with weights, body weight, or bands, as well as stretching, provides additional benefit, particularly as you age. These exercises can help prevent falls, a major concern for older people.

12. Make your house safe. Speaking of falls, most of them happen at home. Look for fall hazards around your house, such as uneven flooring, poor lighting, or a stairway or
bathroom that could use a handrail. Fixing these things could avoid a head injury or broken bones.

13. Spend time with others. Humans are social animals, and contact with other people is as essential to our health as eating or sleeping. Some people become isolated as they age, particularly if they live alone. Look for community activities where you might meet new friends. If you have a chronic medical condition, consider a support group and/or classes to help you manage it. You’ll kill two birds with one stone by socializing and learning to manage your condition at the same time.

There are more healthy behaviors I could have listed, and I certainly could have gone into more detail. But there’s enough in the 13 items above to make a difference in how you feel and function, and could also save you big bucks in medication and other healthcare costs.

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