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[...]... help us understand and, hopefully, control the cost of healthcare A lot of money is being spent on healthcare; andthe goal here is to show how we can spend wisely onhealthcareand maybe even reduce the cost of healthcare by becoming educated consumers Explaining theHealthcare Cost Pyramid Primary Prevention At the top of the pyramid is primary prevention Primary prevention is doing the things that... institution, to postpone going to one, to reduce the amount of time spent there, or to minimize what they have to do to us there, theless expensive the cost of healthcare will be Who Pays forthe Cost of Healthcare? The government pays for almost half of the cost of healthcareand private insurance pays for a third Most of the rest comes out of our pockets The programs that are available to help us with the. .. health, andprescriptiondrugs are usually excluded • The application process can be long and very intrusive Some states have created laws to help control these practices They include: • Preventing insurance companies from eliminating coverage for preexisting medicalconditions These laws do not, however, force the insurance companies to accept an applicant, only that if the applicant is accepted then their... secondary prevention Part 4 of this book considers secondary prevention in light of some of the major HEALTHCARE COSTS 7 chronic diseases I have focused on these chronic diseases because these are the ones that people have to live with for very long periods of time So as you can expect, chronic diseases are the most costly to manage The most important physician in your life is you The things you do... Physician and clinical services Home and nursing care Drug Manufacturers $420 billion $289 billion $133 billion $130 billion The rest goes to medical equipment and other services like dental care and research Take a look at the diagram onthe next page I call it thethehealthcare cost pyramid.” Have you heard of the food pyramid? The food pyramid is a guide to help us achieve proper nutrition The healthcare. .. more of your money doing the things you enjoy doing instead of giving it to health professionals, as much as we love them and need them Good luck and be well P A R T O N E Where We Are and Where We Should Be CHAPTER 1 Healthcare Costs Where They Come From and Who Pays for Them The Cost of HealthcareThe cost of healthcare is now over a trillion dollars a year The benefactors of this money transfer... the size of the box, institutional care is bigger than secondary prevention, meaning that it costs a lot more We prevent falling to the bottom of the pyramid by strictly following the instructions from our doctors and other healthcare professionals Whether we practice only conventional therapy, also known as Western medicine, or add on to that complementary or alternative medicine—in other words nonconventional... section—part two—to prescription drugs, to show how any individual, regardless of insurance status or income level, can get medications at low or no cost Institutional Care At the bottom of the pyramid is institutional care This is where you now have to leave the comfort of your home to get taken care of, either 8 THEBEST HEALTHCARE FORLESS in a hospital or a nursing home, because your condition now... for $500 andthe insurance company determines that only $400 is allowable, the insurance company will pay 80 percent of $400, or $320, and you end up paying $180 Indemnity programs also have 14 THEBESTHEALTHCAREFORLESS yearly maximum amounts that they will pay Once they pay up to that amount, any other charges for that year that you incur will be your responsibility Challenges and Solutions for Small... with a chronic disease You can A 1 2 THEBEST HEALTHCARE FORLESS take charge of your state of health and become the most important physician (and accountant!) in your healthcareThe more educated you become about your disease, what caused it, how it is controlled, and what it costs, both financially and emotionally, the better you will be at managing it and not letting it take over your life In the end, . class="bi x0 y0 w1 h1" alt="" The Best Healthcare for Less Save Money on Chronic Medical Conditions and Prescription Drugs DAVID NGANELE, PH .D. John Wiley & Sons, Inc. fmatter.qxd 2/25/03. Data: Nganele, David, date. The best healthcare for less : save money on chronic medical conditions and prescription drugs / David Nganele. p. cm. Includes bibliographical references and index. ISBN 0-471-21849-9. Where They Come From and Who Pays for Them 5 2 How Not to Get Sick: Primary Prevention 17 PART TWO Prescription Drugs 27 3 Prescription Drugs and Healthcare Cost 29 4 Saving on Prescription Drugs