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Medical overuse can inflate health insurance costs

People who want their health insurance to cost less may have to learn to take better care of themselves and their families.

That theme surfaced repeatedly Wednesday when about 30 people met to talk about rising health-insurance costs in Southern Oregon. Human resource managers, medical professionals and insurance agents agreed that employer-paid health insurance and low co-payments for drugs and doctor visits often mask the real costs of medical care.

— — — For more information

— People who attended Wednesday's meeting agreed to talk — again about ways to hold down health-insurance costs, but set no meeting date. For more information, — call Sally Densmore at 770-5115, or e-mail her at: — sallyden@medford.net — — You ask a man in the street how much it costs for a prescription and he?ll say $10, whether it costs $100 or $1,500, said insurance consultant Sally Densmore, who arranged the meeting.

Densmore said teaching people about the real cost of a visit to the doctor or a trip to the emergency room could encourage them to use fewer medical services and ultimately hold down insurance premiums.

Somehow we have to bring our expectations (about health care) and reality together, she said.

Representatives from government and private business shared horror stories about rising insurance premiums and strategies they've tried to hold costs down. Several said workers who pay a portion of their own insurance premiums have a greater interest in controlling costs.

Medford city employees, for example, were much more willing to accept a higher co-payment for doctor visits when they started paying a portion of their insurance premiums out of their own pockets, said Bob Calkins, the city's risk manager.

Calkins said the city has been developing a wellness program that will encourage city workers to eat a healthy diet and exercise regularly to reduce their vulnerability to lifestyle diseases such as diabetes and heart attack.

We're trying to get control of controllable risk factors, he said.

Calkins said the wellness program might initially cause physician visits to increase, but it's expected to reduce health-care costs over five years.

Teaching people how to avoid unnecessary trips to the emergency room can reduce health-care costs, said Sharon Johnson, a member of the Senior Advisory Council of the Rogue Valley Council of Governments. She said some organizations give employees a checklist to consult during medical emergencies to help them decide if they have a genuine emergency or a less urgent matter that could be treated at a doctor's office.

Doctors can help reduce the demand for medical services, too, said Mike Bond, chief executive of PrimeCare, Jackson County's association of independent physicians. Bond said somebody with a backache, for example, probably doesn't need expensive diagnostic tests such as an MRI, but patients need to be educated so that they understand why they don't need those tests the first time a problem appears.

Bond noted that educating doctors about the medical criteria that would justify an MRI for a patient cut the demand for that procedure by 20 percent.

There's education on both sides of the house, Bond said. Doctors can learn they don't always need the most specialized procedures.

He said spouses must be included in any program to encourage family wellness, because the spouse may be the member of the family who coordinates family health care.

Bond said educating people can make them more knowledgeable health-care consumers, but employers must show their workers a real commitment to reducing health-care costs, even if that means taking time out of the work day to learn more about health care.

The message you have to send, he said, is that you believe in this strongly enough to give (employees) time to learn about it.

— Reach reporter at 776-4492, or e-mail