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Disability Insurance Observer: Whole human basis

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Cigna Corp. (NYSE:CI) has been working with EMD Serono to test how the Rebif brand of interferon beta-1a affects the cost of health care.

The drug is supposed to prevent MS relapses.

EMD Serono has been using Cigna claims data to see how use of the drug affected the likelihood that users of the drug ended up going to the emergency room or being admitted to a hospital.

The drug can cost thousands of dollars per month, but the cost of a typical MS-related hospital stay is about $10,000.

Early returns look good, Cigna representatives say.

A thought: Cigna sells disability insurance, and it promotes efforts to coordinate health insurance with disability coverage, but the study just looked at acute health care costs, not disability insurance claims.

I think it would be great if, once disability insurers get through these horrible, low-interest-rate, weak-job-market days, they could use the jolt of energy they get from the world looking less bleak to promote the idea that medical outcomes studies of all kinds should use work-related indicators, such as days of absence and the likelihood of workers filing short-term disability (STD) claims, as well as acute health care cost and acute health care quality indicators.

One of the dangers of Patient Protection and Affordable Care Act (PPACA) focus on cutting health care costs is that folks might forget that people have lives, and expenses, outside of the hospital and outside of the doctor’s office.

The cost of a checkup and the cost of an emergency room visit matter, but so does the cost of having to miss work.

If Jane Doe had a heart attack, and she had to stay off work for a few weeks, partly to see all of the doctors that she had to see, maybe that would be a necessary evil.

If Jane Doe were a healthy, productive worker, and it took her three days of waiting around in a clinic office just to get a routine checkup, that would be pretty unacceptable. How much the checkup costs Jane Doe and her health insurer would matter, but so would the total cost of the checkup plus the lost work time.

Similarly, if Jane Doe had MS, and one treatment cost $4 per month, but it resulted in her having to give up working, and another treatment cost $500 per month, but she could continue to work at a good job: Maybe health policy analysts and others ought to look hard at those sorts of figures and make sure they understand the full ramifications of whatever decisions Jane Doe, the doctors, insurers and regulators make. 

The point should be to maximize the net economic value and quality of life of Jane Doe as a whole human, not just to minimize her net health care costs.

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