Moderate Drinkers Use Medicare Less, Study Finds
A comparison of alcohol consumption habits found that wine drinkers spent less on health care
Buying Bordeaux futures may cost an arm and a leg, but drinking a glass or two of wine a night might save the Unites States a lot of money. According to a recent study in the Health Care Financing Review, a journal published by the United States Department of Health and Human Services, light and moderate wine drinkers on Medicare each saved about $400 in health care costs each year.
Many studies in the past have looked at the costs of dangerous levels of alcohol consumption, focusing on issues such as property damage, societal problems and loss of work hours. Alcohol abuse cost the United States government, health care providers and private employers $184 billion in 1998, for example. However, no studies have examined if the moderate consumption of alcohol has the opposite effect, saving money, especially on the cost of care, according to the lead author of the study, Kenneth Mukamal, M.D., of Beth Israel Deaconess Medical Center in Boston.
"For us, the bigger question was whether Medicare ought to be discouraging alcohol use more actively," said Mukamal, "and it appears probably not." Mukamal, a noted researcher whose previous studies focused on alcohol and heart conditions, said that the study results caught him a little by surprise, since the research was meant to see if alcohol use was costing, not saving, Medicare money.
By drawing data from the larger ongoing Cardiovascular Heath Study (which began in 1989 to study risk factors associated with cardiovascular disease in those 65 years or older, and will conclude in May 2009), the researchers looked at the costs of caring for 4,392 participants drawn from four Medicare rolls in the following communities: Forsyth County, N.C.; Sacramento County, Calif.; Washington County, Md.; and Allegheny County, Pa.
Chosen participants were relatively healthy at the beginning of the study; none used a wheelchair, for example, or were undergoing cancer treatment. Volunteers were also given a wide range of examinations at the onset, including a full physical and heart tests. The daily amount of alcohol intake was also recorded, with one unit equal to a 6-ounce glass of wine, 12 ounces of beer or a shot of liquor. The amount of times they required hospitalization or medical treatment between 1989 and 1995 was also taken down, as was the length and cost of their stay.
"Given the apparent association of moderate alcohol use with the lower risk of cardiovascular heart disease, the major cause of death in the United States, moderate alcohol drinkers might be expected to have lower health care expenditures," the authors wrote, explaining why they conducted the study.
According to the study, during the five years, Medicare costs were $2,000 less for moderate wine drinkers--those who drank six to 13 glasses of wine per week--than for nondrinkers. The costs were even less for beer drinkers, with an average savings of $2,500. Moderate liquor drinkers also saved money, but only $1,200.
Light drinkers--those who consumed less than six units a week--also used Medicare less, with wine drinkers saving the government $300 per year more than nondrinkers. Light liquor and beer drinkers performed better, spending $800 and $1,800 less, respectively.
Heavier drinkers--those who consumed more than 13 units a week--had similar Medicare costs as nondrinkers, however, the study added that heavy drinking is not common among this group, thus diminishing its statistical power. Furthermore, the study pointed out that the results cannot be extrapolated to younger age groups in terms of savings to both the health industry and the public in general, since the typical 65-year-old is less likely to call in sick because of a hangover, or operate a motor vehicle while under the influence.
Unfortunately, Mukamal explained that the study is likely to be of little value to the government-sponsored health care provider. "Medicare provides medical coverage, but has a relatively limited role in health promotion or prevention," he said. "Even if this evidence was stronger, and it is obviously not any sort of proof that alcohol consumption directly lowers costs in some cases, I do not think Medicare would be all that interested in promoting it."
While the study may prove to be of little use to Medicare, however, the study does suggest that physicians may wish to extrapolate further their individual patients' drinking habits and the potential long-term health benefits.
