Health Care Costs

More and more, open enrollment in company-sponsored benefits can be a confusing time, with a plethora of choices and additional responsibility falling on employees. Workers are given a stack of handouts each fall and are asked to choose among medical plans with varying coverage options, allocate pretax dollars to health and dependent-care savings accounts, and participate in wellness programs to save money. The burden of rising health care costs is shifting from employers to employees.

The health care industry - doctors, hospitals, medical facilities and pharmaceuticals - will do this country in and only the rich will survive ("Costs vary for same treatment," May 9). It does not make sense for hospitals to charge varying and outrageous prices for the same procedures. No wonder Medicare is in trouble. When doctors take the Hippocratic Oath, they vow to do no harm, but these outrageous prices seem like a defeat for the oath. lola J. Massey, Owings Mills Text NEWS to 70701 to get Baltimore Sun local news text alerts

The city's two largest unions set aside their collective differences with Mayor Martin O'Malley's administration and approved new contracts this week that provide pay raises to offset increases in health care costs. The City Union of Baltimore, whose members ratified the two-year deal Tuesday, signed the agreement yesterday. The American Federation of State, County and Municipal Employees Local 44 approved an identical agreement Sunday and signed it Tuesday. The Board of Estimates is scheduled to formally approve the agreements Wednesday, ending a contentious negotiating season for the city with its five unions.

The talk in Washington and among opinion leaders around the country's budget issues today centers on "balance" and "responsibility. " Many conservatives declare that these terms mean that there should be no new revenue, only spending cuts to programs such as Social Security and Medicare. They also propose to reduc cost of living adjustments for all Social Security recipients, a group of Americans who have seen traditional pensions eliminated and savings devastated by the Great Recession - and who rely more and more on our Social Security system, into which they paid during their entire working lives.

The military is proposing raising health care fees and deductibles for its 3.1 million retirees younger than 65 and their dependents, as well as co-pays for prescription drugs for all retirees this year, according to the proposed Department of Defense budget. Military associations have attacked the proposal - one of them sent more than 25,000 e-mails to members of Congress and inserted letters into its magazine that can easily be torn out and mailed to elected officials. The debate over the increases, which would nearly triple premiums for some retired officers between now and 2008, is likely to intensify as veterans accuse the Bush administration of disloyalty and broken promises, and as Defense Secretary Donald H. Rumsfeld and other top Pentagon leaders use charts and data on skyrocketing health care costs to make their case.

Contract negotiations with unions representing 1,700 Baltimore firefighters went to arbitration yesterday after the two sides failed to reach an early agreement. The firefighters' contract expires June 30. The early snag threatens to complicate scheduled contract talks with other city unions representing 16,000 municipal workers as Mayor Martin O'Malley embarks on crafting his first city budget. Baltimore faces a projected deficit of $153 million over the next three years. "The challenge that is created this year is that they [negotiations]

Irate state employees packed an auditorium last night, lining up to express outrage over increases in their prescription drug co-pays and other health care costs that took effect three weeks before the governor announced a billion-dollar budget surplus. Some in the audience of about 175 talked of cutting their pills in half to make them last longer. Others said they have given up their medicine altogether because of prohibitive cost. The increase in prescription co-pays took effect July 1 over the protests of state workers, but what renewed outrage over the issue, they said last night, was Gov. Robert L. Ehrlich Jr.'s announcement July 19 of a $1 billion-plus surplus in the state budget.

WASHINGTON - President Bush, laying out his domestic priorities in the days leading up to his State of the Union address, visited the National Institutes of Health in Bethesda yesterday to promote his plan to control health care costs. Telling an invitation-only audience that putting the federal government in charge of health care would be "bad medicine for the American people," Bush argued for private solutions instead. He pushed his proposals - including widening the use of inexpensive, high-deductible private insurance plans for individuals - with the help of a panel of like-minded citizens from around the country, put on stage by the White House to give testimonials to his program.

CLEVELAND - President Bush prodded doctors and hospitals yesterday to make better use of computers to share patient information, saying the health care industry's continued reliance on paper records inflates costs and undermines care. Participating in a talk show-style "conversation" with Cleveland-area medical personnel, Bush said the development of a nationwide data-sharing network was an integral part of his agenda for reducing health care costs. "Most industries in America have used information technology to make their businesses more cost-effective ... and the truth of the matter is, health care hasn't," Bush said.

The Baltimore County school board is asking the County Council to reallocate $1.2 million in this year's school budget so that teachers, administrators and nurses can get an extra few dollars a week to offset increased health care costs. Approval of the request would be a small step in smoothing relations between the county and school employees, who are upset that County Executive James T. Smith Jr. did not include cost-of-living pay increases for them in this year's budget while making them foot more of the bill for health costs.

The statistic was so attention-grabbing that Mayor Stephanie Rawlings-Blake stopped and repeated it: Nearly half of Baltimore's municipal employees and retirees have a "critical or chronic" illness Rawlings-Blake emphasized the statistic as part of last month's speech at the Walters Art Museum , during which she released a consultants' report about the city's long-term finances. The unhealthy state of Baltimore's workforce contributes to the high cost of municipal health care, the mayor said.

The home medical equipment industry has been growing ever since it became clear that getting patients out of the hospital sooner would reduce overall health care costs. Home medical equipment companies provide the products that disabled, elderly and infirm people need in order to live independently. They deliver the equipment, train patients and caregivers in its use and repair or replace it when needed. But in Maryland, a conflagration of regulatory events threatens to dismantle the industry.

Friday, forecasters expect the Labor Department to report the economy added 155,000 jobs in December - substantially less than is needed to pull unemployment down to acceptable levels. The tax and spending package passed by the Senate and House provides little prospect of improvement, as the U.S. economy continues to suffer from insufficient demand and will continue growing at a subpar 2 percent a year. Factors contributing to weak demand and slow jobs creation are the huge trade deficits with China and other Asian exporters, as well as on oil. However, on the supply side, increased business regulations, rising health care costs and mandates imposed by Obamacare - and now higher taxes on small businesses - discourage investments that raise productivity and competitiveness and create jobs.

Bob Duggan frequently refers to "our national disease-care system" when he talks about his new book, employing a term he has used across his 40-plus years as a healing-arts clinician and educator. As co-founder and former president of Tai Sophia Institute, a North Laurel graduate school of complementary medicine, wellness-based education and research, he believes that labeling our current system "health care" is a gigantic misnomer — and a point of national disgrace. In "Breaking the Iron Triangle: Reducing Health-Care Costs in Corporate America," Duggan offers a vision of a sustainable, wellness-based future in which corporations and entrepreneurs are able to slash rising health-care costs by investing in programs that focus on wellness instead of disease.

There's a good chance during open enrollment this fall that you will be offered a high-deductible insurance plan with a savings account - if you haven't already been nudged into one. Increasingly, employers are offering this as a way to rein in their health insurance costs. The high deductible means lower premiums, benefits experts say. And employees - confronted with the prospect of potentially paying thousands of dollars before insurance kicks in - are less likely to run to the emergency room for minor problems, which also keeps costs down.

I was flabbergasted by Stanley Glinka's recent letter criticizing President Obama's performance in office ("Obama made U.S. weaker, more vulnerable," Oct. 31). He obviously lives in a different country than the rest of us. Let me point out that over the last 32 years the White House has been occupied for 20 years by Republicans and 12 years by Democrats, counting President Obama's first term. So I marvel during this campaign season at how, according to the Republicans, all the nation's problems supposedly begin and end with President Obama.

Last month, the National Coalition on Health Care released studies that examined the issues of cost, access and quality of health care.The problems identified in the three studies are:* Health care costs are increasing at twice the rate of inflation and consuming an increasing share of national spending.* Despite one of the greatest periods of economic growth in U.S. history, the number of uninsured people continues to increase, with more than 40 million Americans without health care coverage in 1995.

On Thursday, the day the Supreme Court upheld Obamacare, a 47-year-old Baltimore woman went to the drugstore, and pulled out her debit card to pay for a prescription refill. But she didn't have enough money in the account to cover the $425 charge. So she asked the pharmacist and staff for a favor. "I asked them to break up the prescription to give me one-third," says the woman, who would not allow her name to be published because she didn't want to disclose her medical conditions.

You might not have received your open enrollment package yet, but you probably know what to expect: Higher premiums. More out-of-pocket costs. Enticements to participate in wellness programs. This may be the last predictable open-enrollment season. Next fall, open enrollment will incorporate the changes from the Affordable Care Act, which takes full effect in 2014. "We will see a lot of change for 2014," said Melissa Jimeno, a principal in the Baltimore office of benefits consultant Mercer.

Tuesday, Sept. 18 Author appearance Bob Duggan, Tai Sophia Institute co-founder and author, will discuss and sign his book, "Breaking the Iron Triangle: Reducing Health-Care Costs in Corporate America," at 6:30 p.m. at 7750 Montpelier Road in Laurel. Information: 410-888-9048 or tai.edu . Wednesday, Sept. 19 Meeting Chapter 1734 of the National Active and Retired Federal Employees Association meets at Howard County Library's East Columbia branch, 6600 Cradlerock Way, at 10 a.m. Light refreshments will be served at 9:30 a.m. Guest speaker is John Sarbanes.