PhotoWhether you're living or dying, it's costing you more. A report from consulting and actuarial firm Milliman, Inc., shows health care costs for families are up nearly seven percent in one year.

At the same time, Nursing Economic$, a medical journal, examines the escalating expenses incurred in the process of dying in a special May/June 2012 issue.

Healthcare costs -- mostly insurance premiums paid through employer-sponsored programs -- rose for the typical family to an average of $20,728 this year, according to Milliman. While the 6.9 percent increase over 2011 is the lowest rate of increase in the ten years of this study, the $1,335 increase surpasses last year's record of $1,319.

Illustrates the challenge

"The average rate of increase this year dips below seven percent for the first time since we began analyzing these costs, but the total dollar increase is still the highest we have seen," said Lorraine Mayne, principal and consulting actuary with the Salt Lake City office of Milliman. "This helps illustrate the challenge of controlling healthcare costs. When the total cost is already so high, even a slower rate of growth has a serious impact on family budgets."

Families may be surprised to learn their health care costs have reached $20,000 since most only pay part of it. Their employers pick up the rest.

The study notes the future of healthcare remains uncertain, as the constitutionality of the Affordable Care Act is being decided by the U.S. Supreme Court. However, the report notes that, to date, the Act has had only a limited effect on healthcare costs for families covered by an employer-sponsored PPO plan. Longer term, the implications may be more pronounced, researchers say, and will depend on a number of changing and interrelated factors.

"We face a number of different potential scenarios depending on the future of reform," said Chris Girod, principal and consulting actuary with the San Diego office of Milliman. "We have tried to map out what those different scenarios may mean for consumers, employers, care providers, and the government."

High cost of dying

The special issue Nursing Economic$ examines the skyrocketing costs, the discomfort people experience in talking about death, and the emotional strain of end-of-life care. Six research reports are also presented. The authors outline alternatives to the care individuals usually receive at the end of life.

For example, in an article entitled "How Can We Afford To Die," the authors maintain that the U.S. cannot sustain society’s proportional cost commitment to end-of-life care as the baby-boomer generation ages.

"These crises beg the question: How does the United States deal with the substantial costs incurred in the last 6 months of life?" the authors ask.

The issues will get a thorough airing at the 5th Nursing Economic$ Summit, "June 6, 2012, in Washington, DC.

"Now is the time to bury past demons and discussions surrounding 'death panels' and replace them with conversations on progressive approaches to expanding hospice and palliative care, and the use of advanced directives, like living wills, in the United States," said Donna Nickitas, Nursing Economic$ editor.

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