12 ways to cut healthcare costs. Tell your patients and their families.

March 2009

Economists agree that American health care reform will falter unless health care spending is brought under control. Moreover, even people with good health insurance are paying a larger fraction of their health care bills these days, in the form of co-pays, deductibles, and other out-of-pocket expenses. The editors of the Harvard Health Letter, in consultation with the doctors on its editorial board, propose 12 ways you can help curb health care spending, saving society—and perhaps yourself—some money. The recommendations, published in the March 2009 issue, include these:

Develop a good relationship with a primary care physician. A primary care doctor who knows you, your medical history, and your circumstances stands a better chance than a stranger does of making decisions and giving advice that will keep you healthy. He or she can take care of you in context.

Don’t use the emergency department unless absolutely necessary. Call your doctor and try to get some advice over the phone or in person.

Get and stick with the program. Taking prescribed medications, getting regular check-ups, and adhering to lifestyle changes can keep chronic diseases under control at relatively modest cost.

Don’t go directly to a specialist without checking with your primary care doctor, even if insurance allows it. Whenever possible, let your primary care physician coordinate your care. If he or she doesn’t know what’s going on, it can lead to wasteful—and possibly harmful—overtesting and duplication of treatments.

Go generic. Generic drugs cost less than their brand-name equivalents. Also, most insurers have higher co-pays for brand-name drugs. Check with your doctor about generic options.

Fight inertia. If you’re taking a medication, discuss with your physician how long you’ve been taking it, whether it’s working, and, if it isn’t, not taking it anymore.

Question the need for expensive tests. Don’t push to get new, expensive tests just because you think new is better. If your doctor orders an expensive test like an MRI or CT scan, ask why it’s necessary and how it will make a difference.

Stay healthy. Quit smoking, eat right, exercise, and get enough sleep. You’ll reduce your risk for conditions that require medical care.

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