This week I was paid back on a loan I had made to my daughter. I was going to use it to pay in full a hospital bill I have been paying $150 a month on – but I got the nerve to call and ask if they would reduce the bill if I paid it now in full – and (ta da!!!) they reduced it by 25%!! I saved over $300 – just for asking. Thanks for all your great ideas!

The comparison of per capita spending health care across countries is an exercise in futility or political spin. No effort is made in such comparisons to measure such non-priced costs as patient convenience, lost productivity, pain and disability due to delays in treatment, etc. If it costs me and my insurer $2,000 in the U.S. to have a couple of bone spurs in my foot removed which are making it excruciatingly painful to walk, and I can do it in two weeks in the U.S. or in two years in the U.K. where it will cost the U.K. taxpayers only $1,200, which country’s health care is really more “expensive”? For me, it would unquestionably be the U.K.’s. YMMV.

It can be hard to implausible to lower that deductible later, when you aren’t so healthy…which could mean that today’s quick budget-helper could later be a decades long budget buster.

My parents owned their own business, so basically had to self-insure. Since the premiums were so expensive, they increased their deductibles to $10,000 per year at one point – to help their budget. Over the years, even with those high deductibles, their premiums kept rising, and now they are paying a ton in premiums, and they rarely meet the deductible in a years’ time…so their premiums are mostly just thrown away money each year.

My mother now has Lupus, which would now be considered a “pre-existing condition” if they tried to switch providers. What’s worse is that if they try to now lower their deductible with their current provider, they would be re-assessed as if it were a new account – meaning her pre-existing condition would kick in and result in an exclusion. So effectively, they are stuck with the super-high premiums they set long ago, thinking they were saving money.

They can’t even qualify for those health savings plans, that were designed to be used with high deductible policies, because their deductible is higher than the limit those plans allow!

“The federal government released its latest estimates of health spending last week, and they allow for some telling comparisons. In 2008, the country spent $2.3 trillion on medical care, or 16.2 percent of gross domestic product and $7,681 per person …… In per person terms, government agencies spent roughly $4,500 on medical care, while the private sector spent roughly $3,000. Here’s what’s notable about that $4,500 figure: It’s more than what a lot of other rich countries spend on health care — including both the public and the private sectors. All told, Canada, Belgium and Germany each spend about $4,000 per person on health care. Australia and Britain spend about $3,500 each. Japan spends a little less than that”

1. Take a basic first aid course and stock a decent medicine cabinet, buying products on sale BEFORE you need them. You’ll have a better idea of when it is really necessary to seek medical assistance, whether you must go to the ER (most expensive), an urgent care walk-in clinic (less expensive), your doctor’s office (even less expensive), or just to bed with an ice-pack or an aspirin (basically free).

2. If you AVOID problems, you won’t have to pay to treat them. Read all package inserts on BOTH prescription and all OTC medications and supplements and ask your pharmacist lots of questions. Just because something is sold over-the-counter does not mean it can’t kill you.

The combination of Tylenol and alcohol can destroy your liver.

Thousands of people die each year from gastrointestinal damage from aspirin.

Vitamin E and aspirin are both blood-thinners which in combination or with other prescribed blood-thinners can cause uncontrollable bleeding.

Medicines that induce drowsiness cause fatal car crashes and occupational injuries.

Not all health care spending happens at doctors’ offices or hospitals. Some of it happens at the tire shop (good tires), the home improvement store(fire extinguishers and smoke detectors, safe ladders, well-sharpened knives because they’re safer, safe cleaning supplies), the sports equipment store, and of course the grocery store.

3. If you don’t have prescription coverage and use meds for a chronic condition, sigh up for the drug company’s patient assistance program. Almost everybody qualifies for some savings, and low income people might get their medication free. Also, Internet coupon sites have discount cards and coupons that actually can save a lot. I used one a few weeks ago to cut the cost of a prescription from $36 to $17 – more than 50% off.

4. Ask for copies of your lab reports and keep a chart on yourself. A spreadsheet that allows you to compare lab results over the course of years will identify trends your doctor might miss because they are not yet at clinically abnormal levels. Jot down significant medical events, surgeries, prescriptions, etc. A thorough and complete medical history can be a great help even just for your own use, but especially if someone else must help manage your care during an illness or disability.

5. Donate blood and sign up for the organ donor program. You’ll get some free testing done! Use the blood pressure monitor at your local grocery store. Some health clubs sponsor blood draws for lipid levels (cholesterol, etc.) at low cost.

6. Don’t automatically sign up for the insurance program with the lowest deductible. You can save substantial money with higher deductible policies, especially if it will encourage you to be restrained in your use of medical services.

For those non-Americans commenting here on our health care system, please be aware – it works beautifully and affordably for a substantial majority of people. Having explored treatment delay data from Canada and the U.K., I, for one, am not looking forward to greater government control over my health care. Perhaps if I were indigent, it would offer some improvement in care of chronic conditions, but as a middle-class person, there’s simply no doubt that it is going to raise my costs and lower the quality and timeliness of my care.

* If you’re healthy, switch to a plan with a higher deductible.

This is an autoimmune disease, and if I had not figured it out and gotten it treated I would end up with a cauliflower nose like my father had when he died. It isn’t a good look at all.

And, since I had that diagnosis, years later when my eyes went dry, I was able to figure out that I had ocular rosacea, which can cause blindness. I also have a related autoimmune disease, Sjogren’s Syndrome. Which, by the way, cannot be prevented or treated by even the most fantastic diet and exercise plan in the world.

Nobody has mentioned using safety precautions in other aspects of their lives, either. Wear your seatbelt. Wear a helmet when skiing, biking, sledding, or doing any other activity that puts your head at risk. Wear hats and sunscreen in the sun. Wear steel-toed shoes when you mow the lawn, and hearing protection. Get a gasoline can with a “dead man’s” latch, so it closes when you let go. These will pay off far greater and far faster than eating “right” and exercising.

“this is clearly an INDEPNENDENT, …”

… and the “trimming shelter costs” typo is still in the footer.

I honestly don’t think Trent even reads these comments.

I can’t tell you how many people I see who would greatly benefit from simply improving their lifestyle choices and following the instructions they are given by their health care providers.

Number one on the list is STOP SMOKING. Almost everyone I take care of is a smoker, often the entire family smokes. At a conservative $5 a pack and an average of 2 packs a day (yes really) that is $10 a day going up in smoke. That is $3650 per year. You can buy a lot of insurance for that.

Get to know your pharmacist. They can often come up with cheaper alternatives to the expensive medications that are equally effective and help you with prsenting the information to your doctor who is quite often completely ignorant about actual costs. I did this with my father’s cardiologist who prescribed a med that would not be covered by the VA and thus would cost my dad hundreds of dollars he did not have. When I called the doctor and explained the cost and the alternative the VA would pay for he was shocked and immediately wrote for the cheaper med.

Stop smoking, stop drinking, stop eating fast food. These few things will vastly improve your life.

I can tell you that if you recieve no prenatal care and show up in labor to a hospital, your bill is going to be significantly higher due to the testing that will need to be performed on the baby after birth (most of which would have not been done or be done for MUCH cheaper in an outpatient setting). And yes that testing is important. One of the above options should be available to you and will greatly benefit both you and the baby.

At my last physical (with a new doctor), I was told that running a screen for sexually transmitted disease was a part of her standard physical. I said “sure okay.” When I got my insurance record about a month later I found out my insurance covered everything but these two screenings which totaled up to $98! Next year I will be sure to stipulate that I don’t want these tests run.

The same thing happened when my husband went to a new dentist. They said it was standard protocol to use a fluoride treatment that we had never used at other dentist office. A month later when we received our insurance records we realized it was something not covered by our insurance. It would have been nice to save that $56 for something else.

I’m not dissing these medical treatments, because for some people they are worthwhile. But each and everyone of us knows our body, and if you have strong healthy teeth and have never had a cavity, at age 30, then why do you need a fluoride treatment?? Be sure to ask your doctor questions about their standard protocols.

THERE IS NOT A SINGLE COLD TREATMENT THAT REQUIRES A PRESCRIPTION OR NEEDS A VISIT TO A PHYSICIAN!

Colds are self-limiting, and frankly those of us in health care get very frustrated with misguided people like yourself who run to the doctor for every sniffle. While you are being seen, someone who needs medical attention is waiting. AND…you are spending money on nothing.

Which was the original intent of my commenting….save the doctor’s visits for when you are really sick, and the ER visits for times when the pain, shortness of breath, change in mental status, injury or whatever is severe enough that you would cheerfully pay for immediate treatment. And please, PLEASE understand that antibiotics are not only useless against ALL viruses, they can and do lead to antibiotic resistant bacteria that can make you and yours sicker later, or even kill you.

BTW, not all countries in Europe do a single-payer plan. Where I live, it’s privatized, just like in the US, with the key difference being that the plans are affordable and actually cover the cost of care.

I absolutely agree with the point that maintaining a healthy lifestyle is paramount to cutting health costs. Getting regular checkups is also ABSOLUTELY NECESSARY if heart disease or Type II diabetes runs in your family.

On a more frivolous note, I kind of resent that vet bills aren’t included in this category. For many of us (myself included) my pets are like family members, and while I never make the mistake of treating them like kids, I do feel obligated to ensure that they stay healthy, too.

In our overworked society of today where no one has enough time for anything, it seems to be almost a bragging right with some people at how little sleep they get.

Lack of daily sleep can have its health consequences as well.