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Tuesday, June 8, 2010

As I Said, Wellmark Hiking Rates; Hi-Tech Medicine Not Helping

Two and a half weeks ago, I reported that Wellmark would be raising South Dakotans' health insurance premiums 18.5%. That Sioux Falls paper now confirms: your Wellmark bill goes up July 1. Reporter jon Walker finds out Wellmark wanted a 20.3% hike, but the state Division of Insurance talked them down to 18.5%.

Walker also provides a list of Wellmark's rate increases over the past half decade:
  • 2005: 8.6%
  • 2006: 12.3%
  • 2007: 7.0%
  • 2008: 13.2%
  • 2009: 14.5%
  • 2010: 18.5%
That comes out to almost exactly a doubling of Wellmark health insurance premiums since 2004. And has your paycheck doubled since 2004? Boom: that's a big part of why Americans are wallowing in debt and the recession stings so much.

Walker cites Avera's PR guy Daryl Thuringer saying these health care price hikes (including Avera's own 10% jump) come in part from increased use of CT scans and other great American technology. This comes at the same time as the AP reports all that technology isn't really making us healthier. Americans get more medical radiation (CT scans, etc.) than anyone else. We use fetal monitors that have increase C-sections but have not reduced deaths or cerebral palsy. Suggestions that we pay doctors to conduct end-of-life consultations with patients to help them understand which procedures will actually help them live better and which are a waste of time and money get twisted into angry cries of "death panels!"

I still remember feeling like the doctor might call Social Services on me when I questioned her call for the air ambulance and asked if my newborn daughter would do just as well going to Sioux Falls by ground. But the doctor told me our little one's case wasn't that serious. I declined the chopper, she called the regular ambulance, and I saved the insurance company $5000.

This year's health reform laws are a good start, but if we want cost control, we still need single-payer... and we need some serious, rational discussion about what health care we really need.


  1. I entirely disagree with the assertion that technology is the cost driver. Look at Japan for example. Every clinic has an MRI sitting in the corner waiting to be used (going rate - $45 for a scan).

    I don't have evidence in hand to back this up but I believe that the only reasonable argument for higher costs is long term care for life style induced conditions that are the real cost drivers. Type II Diabetes, heart disease, etc. If we want to curb costs, we need to move to a system that gives wild incentives to those who make positive lifestyle decisions to eliminate chronic, long term care situations and also massively subsidizes preventative care.

    Seriously, right now, people get punished for going to the doctor if they think something might be wrong so they don't to save money. Then, in a few months or years, when it has turned into something catastrophic they get shuttled to the ER for all of the extraordinarily expensive services.

    This is a case where the free market's immediate cost minimization goal is not capable of reaping the rewards of long term care planning. The free market has gotten health care stuck in a local minimum, not the global minimum of the system.

  2. Tony, I agree that we need more support for prevention. You outline the exact reason I won't go to the doctor short of disaster.

    But if not technology itself, then over-utilization of technology appears to be a cost driver as well. AP finds 90% of back pain is best healed by time and rest, not treatment, but Americans with the means keep seeking more expensive (and evidentially unsupported) treatments. Yes, we need prevention and better personal health choices. But in some cases, we also need to read the science and not blindly take the path of greatest technology.


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