THE COST OF MONITORING & MANAGING YOUR HEALTH.

Per Decade of Life If Paid in Cash

Compared with Insurance Costs

Health maintenance is primarily the cost of monitoring your health status before you go to a physician or even need a physician. Monitoring your health is primarily a Self-examination. This can be a self-examination of Blood Pressure, Pulse, Weight, Height, and Vision which should be done yearly. They can be done at minimal cost. Blood pressure instruments are readily available at minimal cost at pharmacies or online. Glucometers to check your sugar if you have symptoms of diabetes, or there is diabetes in the family can be obtained at the pharmacies or online. And very reasonable cost. Check your glucose before meals. If over 126 mg%, eliminate sugars, pastries, and sweets for three months; then recheck and if levels persist over 126%, see a physician.  If you’ve noted diminished vision on reading small print, check your visual acuity. This can be done with readily available eye charts either in the pharmacies or purchase online. Normal is 20/20 visual acuity which is read directly from the chart. See an ophthalmologist if abnormal or if you have eye strain. Glasses are not required for driving if the visual acuity is 20/40 or better.

By careful monitoring of your health on a regular basis, one can avoid many of the expensive costs of health care. By doing this on a regular basis one can significantly trim the cost of healthcare.

The cost of the above charts and instruments is comparable to the cost of other household items which are personal responsibilities and do not require insurance. Hence, basic health insurance is not necessary for the usual monitoring or maintenance of health care as in any HMO (health maintenance organization) without the medical coverage aspects.

Health insurance is necessary for hospital care, for items that are large in cost or unpredictable whether for major medical care, surgery, OBG, emergencies or trauma. Your high deductible health insurance plan should have a deductible equal to the above costs above the levels of the maintenance cost as outlined below.

Utilizing what major clinics deem as the minimal cost of health maintenance or routine care, that is not insurable, presents the following estimates for cost of private health care for each decade of life, which should be paid in cash as are other basic household items. To include these with major health insurance will increase the cost approximately five to ten-fold compared with cash. The only insurance necessary would be coverage for hospitalizations, whether for surgery, trauma or any major medical problems requiring admission to a hospital.

The cost of pediatric and adolescent care including immunizations are essentially known costs. These are mostly predictable and therefore, can be planned for and paid for in cash at time of service. One should never purchase insurance to cover known costs which can be planned for. Your major medical insurance should cover child and adolescent care on the same basis as an adult—primarily for hospitalization, surgery, and trauma. Be sure to read the fine print so the coverage begins after your payment for basic care as outlined above and below.

If this is the first visit, make sure the vaccinations are up to date. They are normally done prior to age 10, except for the annual flu shot. The flu virus vaccine has normally included strains of influenza A, and influenza B. It now may also include strains of the SARS-Co-V which has been known to be present in 20 percent of flu cases since first isolated in 1965. Prophylaxis details are still pending. At the present time, the complication of this vaccine exceeds that disease itself, hence it is not advisable at the present time, especially for children and adolescents. The standard immunizations should include:

• Tetanus-diphtheria-pertussis immunization booster within the last 10 years.
• Chicken pox if you’ve never had a vaccination or the disease.
• Measles-mumps-rubella if you weren’t inoculated as a child.
• Meningitis if you’re under 24 and never had a vaccination.
• Hepatitis A and B if you’re at high risk.
• Annual flu shot which will vary yearly based on prevalence suspected.
  Different strains of Influenza A and Influenza B are normally included.
  Influenza C is ubiquitous, very mild, and herd immunity is developed by age 10.
  The recent SARS-Co-V may be added in the near future. It is a mild form of the flu-like syndrome, but like flu can come in epidemics.
• The 1918 flu epidemic killed one-third of the world (25 million). The currentCovid -19 epidemic of 2019/20 killed less than one percent of those infected. The risk of the. COVID Vaccine at the present time exceeds the risk of the disease itself. This is because of the rapid development and distribution which was a political requirement to bypass the usual appropriate long-term studies which normally requires seven tos ten years in developing a vaccine which would then identify the long-term risks of the Vaccine.
• This is also the first time that a nucleic acid was included in the vaccine with unknown consequences. This borders as a tissue transplant which has not been acknowledged in any permit for the Covid injection.

The Third Decade of Life: Ages 20-29

The twenties are usually a healthy decade of life for the average adult. You should be getting a Medical History and Physical exam from your primary physician every three-to five years. You should check on your blood pressure and height/weight every year on a self-exam basis. The cost of monitoring equipment such as a blood pressure device is quite reasonable and will service an entire family. Most pharmacies have a BP chair near the pharmacist which is available to check vital signs. Most smart phones today have an entry to record this.

Screening tests are necessary for silent diseases such as anemia and kidney disease.  Since these will be paid in cash, one can obtain the lab tests for approximately $100 per year plus an office call to your personal physician, which can vary. There are now laboratories that will allow you to do these basic screening on a walk-in basis and the authorization is signed by its medical director of the laboratory.

The average actuarial cost during this third decade of life should average about $300 per year—or $3,000 total for this entire decade of life.

Health insurance to cover these monitoring or maintenance items may cost $300 each month—or $3,600 per year or $36,000 for this decade of life. Thus, it is obvious that paying cash for health monitoring or maintenance will save thousands of dollars from insurance costs.

Screening tests are necessary for silent diseases such as anemia which can be checked with a standard complete blood count (CBC). Screening test for kidney disease requires a complete urinalysis (CUA). These should be repeated every two- or three-years or twice during this decade. Also, a chemistry panel during this decade for organ-based disease is advisable and should include a lipid panel to check cholesterol and triglycerides which can be elevated without any symptoms and need treatment, primarily with diet. If normal, no repeats are required during this decade of life. Your doctor might consider other tests based on your medical history and physical examination. If you have relatives with diabetes, or you have urinary frequency or urgency your doctor will want to screen you for this with an “a1c” test, the screening test for diabetes in addition to the CUA.

The Fourth Decade of Life: Ages 30-39 

Your thirties are generally like your twenties with continued good health. Many, of the recommended checkups are the same as in your twenties. A complete Medical History and Physical exam from your primary physician every three-five years should continue as well as a CBC and CUA with each exam. Another chemistry and lipid panel should be obtained during this decade if the previous one was abnormal, or you have a strong family history of heart attacks or strokes. If diseases are diagnosed, additional testing would be needed. This would include a Hemoglobin “A1c” if diabetes is suspected as well as other tests to evaluate other abnormalities that are found.

The average actuarial cost during the fourth decade of life would be approximately $400 per year—or $4,000 total for this entire decade of life.

Health insurance may cost $400 for each month—or $4800 per year or $48,000 for this decade. This makes it even more obvious that paying cash for health maintenance monitoring will save thousands of dollars from insurance costs. Thus, your deductible on your major health policy for hospitalization and surgery, OBG, and trauma should be the same as your basic cash costs or $400.

The Fifth Decade of Life: Age 40-49

As you reach middle age, your body is going to need a minimal of increased attention, with a few more tests and procedures than in your twenties and thirties. You still need your basic medical checkups by your physician now increased to every two or three years. Your CBC and complete UA should also be during your medical evaluation. Chemistry, cholesterol + Lipid panels may now be required every two to five years if abnormal. Otherwise continue with checks every five-years.

The average actuarial cost for the fifth decade of life should be approximately $500 per year—or $5,000 for this entire decade of life if paid in cash.

Health insurance may cost $500 per month—or $6000 per year or $60,000 for this decade of life. This proves how costly insurance is compared to recommended screening, with health insurance only above this level, generally referred to as high deductible health insurance.

During this decade, men should get screened for prostate cancer with a digital prostate exam plus a PSA (prostate screening antigen) and repeated yearly if elevated. Otherwise repeat every two or three years. Women must begin screening for breast cancer and pelvic disease with a PAP smear. Your physician will set the extent and frequency for these. Prevailing recommendations for mammogram and pelvic exams are every two or three years.

A vision exam may be needed as you age if you notice diminished vision. Visual acuity charts are readily available to screen for visual acuity. If you have difficulty in reading or your visual acuity is 20/30 or less, ophthalmologic exam may become necessary. Glasses are not required for driver’s licenses unless your vision is 20/40 or less.

Audiology exam may be required if hearing impairment is noted. Audiologists work in physician ENT and Otology offices where the ENT surgeon will do the general exam. If the exam is normal, you may be referred to an audiologist that may be in the surgeon’s office or his clinic. Free standing audiology practices are now available, and one can obtain an audiology exam directly. If abnormal, the audiologist will refer you to the ENT or Otologist specialist if you haven’t had an ear/nose/throat medical exam. Audiologists are now authorized to prescribe and dispense hearing aids directly.

If you have a family history of heart disease, or are at elevated risk for heart disease, or have lipid abnormalities, then your doctor may want to begin screening for coronary heart disease. If you have hypertension, begin treatment with a low salt diet on your own. Normal blood pressure has been redefined by the American College of Cardiology as 130/85. If this does not control your pressure within a few months, see your physician.

If you have difficulty in breathing or experiencing shortness of breath, your doctor should begin screening your pulmonary function and if abnormal begin treatment usually with an inhaled bronchodilator. If abnormal, you may monitor your oxygen level which you can do with the purchase of a pulse-oximeter. My first pulse-oximeter while in training cost me $700. My current one obtained online cost $50. Use it to check your oxygen saturation level whenever you become short of breath. If your saturation of oxygen (SaO2) is less than 95, see your physician or see a pulmonologist.

The Sixth Decade of Life: Ages 50-59

In your 50s, one would continue with annual Medical Examinations by your physician with continued annual baseline screening tests which may now include chemistry and lipid panels if the prior tests were abnormal.

At this time screening for colon cancer should begin. This may include a simple stool exam for blood or a sigmoidoscopy, a visual exam of your rectum and colon.

Screenings for Type II diabetes maybe considered if you have a family history of diabetes with an elevated hemoglobin A1C plus an elevated glucose level. Glucometers can now be purchased at pharmacies or online.

A baseline electrocardiogram may be considered if cardiac disease is suspected. If normal, it does not need to be repeated in this decade. Screenings for prostate cancer, breast and gyn cancers should continue.

Screening for depression and mental cognition and other psychiatric problems may be required. A convenient memory test increasingly used by physicians is having ten objects on display, and having the patient identify each, and make a sentence with each. Then at the end of the appointment check recall. If 7 or more are recalled, consider cognition normal. If 6 or less, refer to neurologist for an Alzheimer evaluation. Many physicians now use the five-object test during their annual exam as a screening test for memory or Alzheimer impairment. If three are recalled, no further cognition evaluation is warranted.

Be sure that you have hospital insurance for major Medical, Surgery, Trauma, or any hospitalization including psychiatric for unplanned major adverse or unsuspected health problems.

The average actuarial costs during the sixth decade of life should be approximately $600 per year–$6,000 for this decade of life.

Health insurance to cover these maintenance items may cost $600 per month—or $7200 per year or $72,000 for this decade of life. When one looks at the insurance costs compared to the cash costs, it is becoming more obvious why the cost of healthcare is rising so fast. It is generally not because you or your doctor are over utilizing care, but more likely due to the hidden costs of insurance and hospital care of relatively healthy people in middle age.

The Seventh Decade of Life:  Ages 60-69

The sixties were formerly thought to be the onset of your aging years. But we are really healthier now than when social security was implemented in the 1930s or Medicare in 1965. Your body is not ready to slow down or retire from work. To retire may decrease your life expectancy. It is important to keep fit and stay on top of your health and remain active. All the screenings you had done in your fifties, you’ll need to continue in your 60s & 70s and become more aware of health risks before disease sets in.

The average actuarial cost for the seventh decade of life should be approximately $700 per year–$7,000 for this entire decade of life.

Health insurance may cost $700 per month—or $8400 per year or $84,000 for this decade. This should confirm where excess healthcare costs really are. The cost of insurance which frequently is for unnecessary lab tests.

This is decision time when Medicare becomes available. Medicare has become more restrictive with the passing of time with many items are no longer approved or denied when your doctor orders them. One should do a careful cost analysis. If you’re in good health and still employed with normal screening, you may find that continuing to pay for usual care and private health care above this level may improve your life span. People of yesteryear would generally be calling it quits. This is not a recommendation not to enroll in Medicare when you turn 65. However, with Medicare projecting to go bankrupt in the next decade or so, this program may require thoughtful consideration and give you medical freedom that you will not have in a government program.

Aging is something everyone has to go through. There is no fountain of youth. It is a part of life. As you age, it is important to track your health. The need to see a doctor in your twenties isn’t as pressing as it is in your fifties, sixties, and seventies. Determine if you’re seeing the doctor often enough or getting checked up for the correct things with this quick guide.

The Eighth Decade of Life: Ages 70-79

We are now healthier in our 70s and living longer with life expectancy into the 80s. We have fewer medical costs in our 70s than we had in our 60s when Medicare was started. Medicare is predicted to go bankrupt in the next decade. Hence, our extrapolation into the 70s and 80s will show that health care costs will not be insurmountable even after Medicare goes bankrupt and we resume the usual self-care we had prior to Medicare. The only thing that can save Medicare is to increase the age of benefit from 65 to 72 years. That shouldn’t be difficult since most of us continue working. Medicare should also adjust the age for early benefits from age 62 to age 65. Many will see this as a reduction of entitlement and difficult to accept thinking it is too risky. However, the cost with this personalized health maintenance plan, especially when seen with all the Medicare denials, and lack of coverage, may be acceptable.

Many in their 70s are as healthy as they were in their 60s. We are healthier despite the new 50-years of a working lifetime than the previously 40-year work-life. This means we could continue with our full income for the additional 10 years.

The average actuarial cost during the eighth decade of life should be approximately $800 per year–$8,000 for this entire decade of life.

Health insurance may cost $800 per month–or $9600 per year or $96,000 for this decade of life. High deductible insurance should start above the average cost of self-care, starting at $800 per year during this decade and will be considerably less expensive than the usual complete insurance. This remains the individual’s responsibility to cover.

These illustrations are for basic outpatient health care monitoring and maintenance. Hospitalizations, whether for Medical, Surgeries, Trauma or other Emergencies require major health insurance coverage.  This will be less expensive than current insurance for total health care which includes major profits to insurance companies for covering the healthy young people and those in midlife under 50.

The Ninth Decade of Life: Ages 80-89

At this time your doctor may want to do screenings for osteoporosis since falls and fractures occur more frequently in this decade. Your doctor may also consider ultrasound screenings for abdominal aortic aneurysm, as well as carotid artery ultrasound for stroke evaluation. These can be done by the panels that become available in most communities, frequently by mail invitation, on an annual basis and are relatively inexpensive. Skin cancer, oral cancer and lung cancer screening may be considerations based on your health history, including your cigarette consumption history. If you have a chronic cough, a chest x-ray (CXR) may be advisable if it persists after treatment and discontinuation of your cigarette habit.

Depression should also be monitored along with signs of dementia, loss of memory, confusion e.g. Alzheimer’s disease or other causes of inability to care for oneself.

The average actuarial cost during the ninth decade of life should be approximately $900 per year–$9,000 for this decade of life.

Health insurance may cost $900 per month–or $10,800 per year or $108,000 for this decade of life. High deductible insurance to start above the average cost of self-care or $900 per year during this decade, will be considerably less expensive than usual complete insurance, but remains the individual’s responsibility to obtain.

If you look at the obituary columns in the papers, you will be surprised at the number of people that lived into their ninth decade—also at the number that lived into their 10^th decade and were working into their 9^th decade. We are healthier at this stage of life than we have ever been. Life expectancy has increased 15 years during this time. Of course, we should always have the safety of major medical/surgery/ER insurance in the event we develop a major illness or require hospitalization or surgery. This type of insurance should always be less expensive than the usual total insurance.

You may want to take the risk of MEDICARE denials with intermittent lack of care rather than continue this personal care plan for which you pay, and also control.

The Tenth Decade of Life: Ages 90-100

Keep looking at the obituary columns in the papers and you will continue to be surprised at the number of people that live into their tenth decade—also at the number that live into their 11^th decade or beyond 100 and were working into their 90s or 10^th decade. We are healthier at this stage of life than we have ever been. We have already exceeded the life expectancy of age 65 by 25 years when Medicare was implemented. Of course, we should always have the safety of major medical/surgery/hospital policy in case we develop a major illness or require hospitalization or surgery.

The average actuarial cost during the tenth decade of life should be approximately $1000 per year–$10,000 for this decade of life.

Health insurance may cost $1000 per month–or $12,000 per year or $120,000 for this decade of life. High deductible insurance to start above the average cost of self-care starting at $1000 per year during this decade will be considerably less expensive than usual complete insurance but remains the individual’s responsibility to decide or obtain.

You may want to take the risk of MEDICARE denials with intermittent lack of care rather than continue this personal care for which you pay but keeps you in charge.

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