Americans Reconsider Value of Health Care as Costs Skyrocket

Article excerpt

NEW YORK - Can any amount of health care be too much?

We Americans, with our renowned capacity for wretched excess, historically would have answered that question with a resounding ""No!'' But now, with an estimated $420 billion a year going just to pay off the nation's health-care tab, an unusual coalition is forming around the idea that enough's enough - and that some medical bills these days would make you sick.

In the forefront of this movement are some of the leaders of corporate America, which in 1984 shelled out $87 billion for group health insurance alone. Suddenly, cost-consciousness about this vaulting bill is everywhere.

It is, at best, a deeply sensitive issue - and few companies want to appear as heartless skinflints, consigning their employees to less than adequate care. Everybody (including the top corporate officers) wants to feel secure about the help that will be forthcoming if illness strikes.

But the feeling that the price of implementing that care has burgeoned out of proportion to the added benefits has led to major new cost-cutting efforts - involving both the carrot and the stick.

Medical sources say many companies, in order to trim their health-insurance premiums, are not just paying for second and third medical opinions, but also influencing which opinion the patient accepts. Corporate America not only exhorts doctors and hospitals to keep treatment to the necessary minimum, but also is beginning to refuse to pay fully for days and procedures they feel are unwarranted- even if the patient's doctor insists that the treatment is necessary.

Here are some specific examples of recent changes in corporate health-insurance programs:

- IBM workers must pay 40 percent of the first day's room charge during a hospital stay, plus a variable deductible of $150 for those earning $50,000 or less and .75 percent of annual salary for the higher-paid employees.

- Quaker Oats doles out cash bonuses to its employees if the annual medical bill for its work force is below the company's expectations.

- Lockheed requires new employees to enroll in less-costly health maintenance programs (HMOs) rather than traditional arrangements with a personal physician.

In fact, many would-be patients are surrendering frequent doctor visits to avoid increasing out-of-pocket expenses caused by less-comprehensive coverage and higher deductibles. …