The high costs of medical care touched city employees and retirees this year. For the first time in eight years, your monthly contribution rose dramatically.

Advances in medical technology, an aging population, high inpatient and outpatient hospital costs, nurse shortages, and pharmaceutical companies passing the high cost of their intense marketing on to you, have driven costs upward.

The cost of the city’s medical plan is projected to be more than $200 million for the plan year that ends April 30, 2005.

The three categories that are most responsible for pushing the cost of the city’s medical plans higher are prescription drugs and inpatient and outpatient facility use. From November 2003-January 2004, inpatient use cost more than $8.5 million, prescription drugs cost almost $7 million and outpatient facility use cost about $5.5 million.

Just as city government must tighten its belt, so also must the people who make it work.

HMO members’ monthly contributions to their plan premiums have risen. Some employees have elected the new PPO plan, which requires higher monthly contributions and greater out-of-pocket expenses.

More than ever, employees must be smart, cost-conscious consumers of health care. Maintaining your health and your wallet is a job that calls for special tools. This edition of Benefits Pulse gives you a box of “tools for healthy living.”

Use office visits wisely
You shouldn’t leave the tool of the doctor’s office visit in the box, unused, just so you can keep the copayment money in your pocket.

Dr. Patrick Carter, Kelsey-Seybold’s chief of family practice, urges patients to choose wisely as they make decisions about doctors’ office visits.

“The biggest change I’ve seen in a plan where patients have more money coming out of their own pocket is a drop off in visits,” Carter said.

“They still tend to come in if they’re sick or in pain, but they might not come in as often as they should for preventive care and chronic illnesses such as hypertension and diabetes.”
Carter also lists mammograms and pap smears for women, prostate exams for men and colorectal exams for everyone starting at age 50, or earlier for those with risk factors, as crucial tools for preventing serious illnesses.

The city’s health plans cover employees’ physical exams. Preventive wellness checkups are free for HMO members. Employees in the compensable sick leave plan who have been here for one benefit year can take eight wellness hours to visit a doctor without using sick or vacation days.

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Dr. Patrick Carter, chief of family practice at Kelsey-Seybold.