Health care costs and insurer/employer intrusion.

Redrant: The basic premise is the "settled science" that says that since something has been "proved" the costs are "proved". Junkscience.com calls this "chasing numbers": IE lower cholesterol numbers or lower weight directly translate to lower medical costs. The link isn't really there.
At Hennepin County the "single" health insurance costs tended to rise at single digit rates while the family coverage rose at double digit rates. You might argue that a lot of single people are young but Hennepin County has a very low turnover and relatively few "starter job" young hires. We subcontracted out a lot, 3M probably did in the last decade. The workforces at major employers is aging.
Katherine Kerstine of the Strib recently had an article about how legislated mandates add more than 20% to Minnesota Health care/insurance costs. They basically need a "boogieman" to try to blame the costs on.
On a personal level: On Friday I got "Shanghaied" into Health Partners for a physical under threat of not renewing my prescription for generic blood pressure medications. Seems I haven't been in there in three years. I am significantly overweight but no health problems. The doctor told me to lose weight and keep taking the meds but otherwise OK. I tend to believe that "sugar" is the big culprit nowadays. One pound of sugar can last me years at home. The only time I drink "sugar pop" is at a bar when I don't want to drive beer. I usually eat cereal that it unsweetened and drink only "skim milk". It's amazing the number of people who seem to live on a sugar based diet! I had one of those little disposable salt shakers I brought from work a year ago. It still isn't empty. I have "religiously" taken at least one aspirin a day for my entire adult life (always those little aches and pains). It's amazing how few people do this and keep doing it. I tell them to get a big bottle of cheap generic aspirin, it's all USP anyway. I try to lose weight but it's mostly for "quality of life" reasons.
Relatively few "office workers" in major corporations now smoke. The Hennepin Government Center has a daytime population of probably 10,000 people but I see only a handful smoking outside. Sedentary work and smoking are a more "toxic" combination but most smokers are in the "trades" where the work is more physical or in smaller employers.
One little "secret" is that in any Health Plan group a very small portion of the people use the vast majority of the services. It can be as high as 10% using 90%. It would probably be "un-PC" to profile these "frequent fliers". They have the accounting to easily do this. I didn't get a letter detailing costs when I got a flu shot at a HP flu shot "event" but they send me cost details for other things. If they can do that they can do a detailed analysis of who really costs the insurance in each subcategory. For example, the rise in rates for those with single coverage rises a lot less than those with family coverage. They could easily factor age in there. They can use these cost figures like an accounting spreadsheet where they can look at any factors they want.
HP didn't charge me the copay because this was an annual physical. I would predict that I will get a statement that this visit and the blood work cost HP $200, all done by HP in-house. The costs to insurers by smokers is probably lower than they say because smokers usually "tough out" colds and flue rather than go to the doctor for every sniffle

Greg Lang