HEALTH EXPERTS DEBATE COSTS; INSURANCE CHIEF CLAIMS POOR LIFESTYLE DRIVES UP PRICES

The nation's society is "doomed" if lifestyle isn't addressed as a factor in surging health care costs, a leading health insurance official says.

Roy Heimburger, chief executive officer of Blue Cross & Blue Shield of Missouri, underscored that point Saturday at a health-care symposium at Drury Lodge sponsored by Southeast Missouri Hospital. The symposium, "Health Care Costs: Understanding the Issues," drew about 190 people, including representatives of business, industry and education.

Heimburger explained how health insurance premiums are determined. Seven other speakers, including U.S. Rep. Bill Emerson, R-Cape Girardeau, and a number of health-care officials, addressed the symposium's audience.

Last year, health care across the nation cost $650 billion, said Heimburger.

"Half of that, $325 billion, is basically self-inflicted wounds," said Heimburger. Those wounds, he said, are attributable to the public's lifestyle.

As an example, Heimburger said the nation has 6 percent of the world's population, but uses 60 percent of the world's heroin and cocaine. Nationally, he said, half of all admissions for outpatient health care is due to alcohol abuse.

Heimburger said people should concentrate on prevention of health problems because "it's a lot easier to prevent than to cure."

"Diet and exercise is a lot better than a bypass," he said. "We've got to convince people there's a better way."

He said a poor diet, infrequent exercise and high-risk sexual practices all lead to health problems.

Avoiding such practices and using seat belts can help, he said.

Once these precautions are taken, health insurance premiums will come down and the nation's scarce health-care dollars will be spent on real illness rather than self-inflicted illness, said Heimburger.

To highlight the increasing cost of health care, he compared how much the cost would have been if one of the audience's middle-aged members had been born premature, compared to the cost of caring for a premature child today. That cost has jumped from the $1,000 to $1,200 range to about $250,000 today, he said.

As for health insurance premiums, Heimburger said their costs are tied to health-care costs.

"There's not much voodoo, there's not much sleight of hand in determining premiums. It's not a process determined by the darkness of the moon back in an old graveyard somewhere. It's actually pretty simple."

Phil Larson, manager of the Procter & Gamble plant north of Cape Girardeau, presented the audience with a local businessman's view on employee health benefits.

Procter & Gamble's fastest increasing cost relates to health care, Larson said. Every year the cost increase is more than 16 percent, he said.

Larson correlated the health-care cost increase to the eventual cost of diapers manufactured by Procter & Gamble. Right now, he said, diapers sell for about $10 a package. But by the end of the decade, he said, if health-care costs continue at their present rate of increase and the cost of diapers follows along, those same diapers would sell for $40.

"How many diapers are we going to sell at $40 per package? We have trouble selling diapers at $11 a package today," he said, adding that consumers don't want to pay more than $10 per package.

Missouri Hospital Association President Charles Bowman presented an overview of charges by Missouri hospitals in comparison to the rest of the Midwest and nation.

Bowman said 60 percent of the states have health care that is cheaper than Missouri's. The reason that Missouri's health care costs more, he said, is because of the state's high number of elderly residents.

The state ranks sixth or seventh in the number of elderly, he said, but is ranked 47th in reimbursements for Medicare, the federal health-care insurance program for people aged 65 and over, and for the disabled.

At some hospitals, he said, 90 percent of their business is made up of Medicare, Medicaid, or uninsured patients. Medicaid is the federal-state program that helps pay for health care for the needy, elderly, blind, and disabled, and for low-income families with children.

"First thing you have to ask yourself is how those hospitals survive," Bowman said. "Many of them don't."

It is a miracle, Bowman said, that the hospitals in Cape Girardeau have been able to control costs like they have.

Emerson, in his address, said the nation's 35 million people who don't have health insurance present a serious problem. A possible solution, he said, may be in some sort of tax credit system that will permit those people to deduct more from their income taxes.

"We've got to make it attractive for them to purchase health insurance if we want them to have this health care," Emerson said.

With everyone working together, he said, he is sure the challenges of the health care dilemma will be overcome. Congress will continue to address the problem, he said.

Southeast Missouri Hospital Administrator James Wente, who was instrumental in organizing Saturday's symposium, spoke on keeping charges at a reasonable level in the community hospital.

Wente told audience members, Southeast doesn't discount hospital rates and doesn't plan to in the future. Although people may think the rates are higher in Cape Girardeau than in St. Louis, he said, they aren't.

In St. Louis, he said, a semi-private hospital room runs upwards of $280 a day, compared to $202 in Cape Girardeau. The cost for a private room in St. Louis is between $295 to $360; in Cape Girardeau, it's $222.

For intensive care, Wente said, the cost in St. Louis runs between $797 and $1,300. The Cape Girardeau cost is $589.

The president of the Cape County Area Medical Society, Dr. Richard L. Kies, presented a survey indicating that the fees for Cape Girardeau physicians were lower than those charged by St. Louis physicians for the same procedures.

Also speaking Saturday was Missouri Court of Appeals Judge Stanley A. Grimm, a member of the Southeast Missouri Hospital Board of Trustees. Dr. Jean Chapman, a Cape Girardeau allergist, served as symposium moderator.