Today’s ice encrusted morning here in a bleary NY helps crystallize one thing: The Affordable Care Act has focused us on the expense and associated responsibility of our own health. The main story lies beyond the individual mandate to have coverage or the penalties for non-compliance. It is the choices we each make concerning our own health which are often determinative of 2 outcomes: our health and our wealth. Our own behavior holds much of the solution – the holy grail of bending the healthcare cost curve is in our own hands more often than not.
Maybe the groundhog went back for another 6 weeks this year to contemplate his choice of: (1) How to best game the healthcare system vs. (2) How to stay healthy and thereby come out way ahead of the system. I vote for coming out way ahead with the understanding that certainly to some, health is not as much a choice as a circumstance they find themselves in. For those of us with the choice, however, The Lion King’s Old Rafiki had it right, “It is time… to develop healthy habits to save our good health and, in the process, save the many dollars we’ll need to enjoy an extended good health!” That is, of course, what the wise mandrill implied in his exhortation to Simba.
Real Cost Containment
Speaking as a career insurance agent and Chartered Financial Consultant, I listen to and engage with many individuals and business owners, solo-preneurs, employees, professionals and those from many walks of life and employment. What is singly clear is their shared perception that ACCESS to the healthcare system is most important, then surely the QUALITY and CHOICES of that healthcare, and then, of course, the COST of that Access to Quality. Healthcare ACCESS affords the peace of mind to go about earning a living, paying taxes and medical premiums, and, at claim time, paying the ‘cost share’ portion of deductibles and co-insurance. The real “play” is to achieve and maintain good health to minimize the huge outlays in our changing system (e.g. estimated at over $250,000 for a retiree). A low health insurance premium today in no way equates with low out of pocket costs over the long haul. The ‘deals’ are gone and services are expensive, no matter the plan choice, for a sufficient network.
No one wants to come out of pocket.
What is the best way to avoid out of pocket costs? The maximum out of pocket costs in your plan (referred to now as the “M.O.O.P.”) can be as high as $6,350/year for all in-network services… the plan you choose simply spells out how quickly you’ll get to your maximum. Staying healthy is the absolute best way to avoid it all. Aside from genetic intervention, here we go in all simplicity:
Join the healthy, ‘Fit Bit’ -style generation – Make a habit out of regular exercise AND control your diet while making it a group effort where possible. Select healthier foods, keep hydrated and get the sleep your body’s immune system needs. Find a “fit-mate” to exercise with – guaranteed you’ll do more exercise. I’ve found that even the complaining burns a few more calories if your friend can tolerate it!
What we as humans in the most affluent country can do to Afford ourselves the care we require is to Act. Let’s get through winter in good health and well managed wealth. Let YOUR affordable care ACT be what actions you take to be ABLE to AFFORD the healthcare you need.
In other words, The Affordable Care Act is not some inexorable trap or scarcity-based cost we must accept but truly a call to ACT now to establish the healthy habits needed to help us keep our money and enjoy it long, long term.
What do YOU think? Like to hear your thoughts on this.
Lawrence J. Thaul, CLU, ChFC, CLTC