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Blue Cross actuary: Help health care by reallocating money

U.S. politicians have grappled for years with what to do about rising health care costs and the growing number of uninsured Americans.

But in an hour Wednesday morning, John Friesen, an actuary with Blue Cross and Blue Shield of North Carolina, laid out some simple concepts that don't require reorganizing the entire system or throwing out the parts that work.

“We can solve this problem if we put our minds to it,” Friesen told about 150 people at a conference sponsored by the Charlotte Chamber.

“We have over-insured people,” he said, as well as uninsured people. “It's a question of redistributing the dollars.”

Friesen, who said his ideas are not necessarily backed by Blue Cross, suggested that the federal government should provide coverage for those who make less than double the federal poverty level, which is $21,000 for a family of four.

Part of that expense could be offset, he said, by reducing the tax deduction for employers who provide “rich benefit plans.” Friesen said any health plan with a deductible of less than $1,000 should be considered a “very rich plan.”

If people have to buy their own health insurance, they often choose a $2,500 deductible to get lower premiums. But he said employer-based plans cover 75 percent of the cost of insurance, and that's why health care keeps going up.

“If you can buy something at 75 percent off,” he said, you're going to use it. “Greater cost-sharing reduces unnecessary medical expenditures. It wakes you up, and you start asking questions.”

In addition, Friesen suggested providing incentives to encourage healthy lifestyles and trim health costs. That long-term strategy might include taxing junk food, requiring restaurants to list calories and carbohydrates on menus, and setting higher insurance premiums for people who smoke or are overweight.

The United States tops all other countries, with 32 percent of its population qualifying as obese, compared with 23 percent for the United Kingdom and 15 percent for Canada, where Friesen spent the first half of his life.

“Food is the new tobacco,” Friesen said. “Food is addictive. Train your body to become addicted to a healthy diet.”

He offered four suggestions for healthy living, so Americans “can get as good as those other countries.”

They are: not smoking; maintaining a healthy weight; eating five servings of fruits and vegetables each day; and exercising for 30 minutes a day, five days a week.

Only 3 percent of the U.S. population meets all four of those guidelines, he said.

“How about making a resolution?” he asked. If you can't do all four, “I challenge you to add one more.”

At the end of Friesen's talk, someone asked why Blue Cross doesn't do more to combat obesity by covering visits to weight-loss clinics.

A spokesman for Blue Cross said the insurance company covers four visits a year with a physician for evaluation and treatment of obesity and six visits a year for nutrition counseling with a licensed dietician. Blue Cross members also qualify for discounts to join selected fitness and weight management centers.

Mark Stephens, chairman of the Chamber's Health Services Council, which sponsored the meeting, said the group wants to increase awareness that “health care is a major economic driving force.” Its goal is to lower health care costs by encouraging companies to promote wellness and disease prevention.

Stephens, a senior account manager with Pfizer, praised Friesen's ideas. “It's not a comprehensive plan, but it was a lot of common-sense things that we could do to make things better.”

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