jueves, 30 de octubre de 2008

"Patient Handbook" Exhibits at Sharjah World Book Fair in UAE

"Patient Handbook to Medical Care: Your Personal Health Guide" by J. L. Richardson, M.D. (Bend of the River Books, Miami, FL), will be on exhibit at the at the Sharjah World Book Fair in the United Arab Emirates October 29th to November 7th. This Writer’s Digest International Self-Published Book Awards winner in the Reference Books category will be on display with The Combined Book Exhibit, a world leader in book shows and expos for seventy-five years. The title was recently on exhibit at the 60th Frankfurt International Book Fair, the largest book fair in the world, for the second consecutive year from October 15th to October 19th in Frankfurt, Germany.

Considered an expert’s guide to personal health care, "Patient Handbook to Medical Care" provides readers with essential information for getting the care they deserve and need. Dr. Richardson, a family medicine physician, offers an overview of health care from an insider’s perspective. This 112-page reader-friendly book covers topics such as complete physical exams, medical tests, medical specialists, preventive screening guidelines, and health coverage.

jueves, 23 de octubre de 2008

Same Health Plan as Yours, Please: Part 2

Many have been waiting to hear details for a health care plan. It is in writing, but has yet to be discussed openly like during the debates and on the campaign trail. Even the mainstream media has yet to pick it up. Obviously, the economy and presidential candidates’ every appearance are more newsworthy.

The Obama-Biden health plan is “to provide affordable, accessible health care to all”. It is presented in nine pages (includes one and a half pages of references) on their campaign website. The new National Health Insurance Exchange is one of the highlights of the plan. The creation of this entity will help everyone, “Americans and businesses”, obtain private health insurance.

Insurance companies will be required to cover pre-existing conditions at affordable prices through the National Health Insurance Exchange, or through private health plans. The Exchange will provide comprehensive care like the health plan that covers Congress.

The FEHBP, Federal Employees Health Benefits Program, is their health plan and that of many federal employees (wonder if that includes the president). Medicare, Medicaid, and SCHIP (children’s health plan) government funded health plans would continue to exist. In fact, Medicaid and SCHIP will be expanded. All children will be required to have health care coverage.

It is unclear to me (as I pointed out in my previous blog), why the Exchange is necessary if it is to be like the FEHBP. It seems highly logical to expand the FEHBP. Medicare, Medicaid, and SCHIP are being expanded. Will they be expanded to be as inclusive and comprehensive as the FEHBP? Furthermore, will the disparities implicated by being a Medicaid recipient be dismissed?

It sounds doubtful as mention of private insurance is still part of the plan. It would seem even more logical to make the National Health Insurance Exchange the FEHBP, or vice-versa. Members of Congress have been talking about making the FEHBP, their health plan, the health plan for the American people for many years.

“So close, yet so far away.”


Dr. J.L. Richardson is the author of the research paper, Building an American Health System, and the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

miércoles, 15 de octubre de 2008

Presidential Health Plans - Same As Yours, Please

Health Care Plan Talk: Show Me the Plan
By J.L. Richardson, M.D.

Why are the candidates continuing to talk about health care plans? They along with their colleagues in Congress have repeatedly proposed the insurance they have is what the American public should have. So why are they failing to move in that direction. Congress has been talking about it for years. Is this another political re-election tactic?

Senator Obama reiterated this in the debate - again. He explained in more detail the cost savings from being in a purchasing pool such as Congress. I applaud his vigor in this matter. I feel like he really wants us to have the best affordable health care like the lawmakers of the land. I want to see a plan, some details. I believe it will work.

He also wants us to be able to keep our same doctors and health plans no matter who we work for if we are working. That was part of HIPPA law passed some years ago. Okay, let's reinforce that. Somehow the pre-existing condition part got overlooked. It would be nice for our insurance companies to do the same. Medicare does. So that must become effective immediately. If not, in spite of the patient privacy part of HIPPA, one may be asked - actually "grilled" - about your current health problems and unhealthy habits by a total stranger over the phone. Ten, more like twenty, years ago you could get insurance without telling your pre-existing health conditions.

Senator McCain wants to tax insurance premiums, and pay that to the insurance companies. Where is one going to get that extra money when their premium has almost doubled over three years and are currently unemployed? Maybe that will be from the tax cut refund check he is promising. He’s looking out for us, too. Even if is to be paid for by the savings from the continuing health disparities - by age, gender, disability, chronic medical diseases, job and so on. Healthy people would be exempt, that is, until they became sick.

Both senators think health care should be run by the government which already funds almost 50% of the American health system. That must be good. Medicare seems to be working. The premiums have been rising. Payments to doctors are less. Private insurers usually charge more, but get paid the Medicare rate. That must count for something. Medicare is the gold standard for health insurance. Coverage is provided for all over 65. If totally disabled beyond employment at poverty level, you might qualify after the rigorous application and approval process.

They saved the best for last. After months of remaining generically redundant on America’s health care, they finally talked in more generic detail about their health care platforms. This was pretty much what they have already said and put on their websites.

I vote for caps on insurance premiums, retroactive to at least five years ago when insurance premiums started going through the roof. This fits better than a tax credit. There are wage caps in effect. This makes good sense. It is time for shareholders and company executives to put patients on the forefront.

I vote for the omission of pre-existing conditions immediately. Prevention, wellness and health maintenance would be a primary focus. Management of pre-existing conditions and chronic disease are prevention in action. Baseline body scans sound like a good idea for looking into your health (pun intended). Early detection may save your life, and some money. The American health system teaches doctors to treat you after you get sick. Which costs more? Which is better for you? Would you like to know what you have and decide how to manage it?

I vote for and agree with the senators on downsizing the US Department of Health and Human Services. There are agencies that appear to overlap. They could be combined with new initials. Talk about alphabet soup. Put ODPHP with NCCDPHP and USPSTF under OIG monitored by AHRQ and CDC. Mmmmmm…good.

All in all, it appears that the presidential candidates want what they would want for themselves and their families. That remains to be seen instead of heard. After all they have shared their medical history with us through the media – Senator Obama’s one page note from his doctor, and Senator McCain’s thousands of pages in three hours. Senator McCain allowed questions to his doctors for about an hour, while Senator Obama is sticking with his note. Speaking as an expert, both are unacceptable and unrealistic medical record reviews for health assessment. Remember HIPPA.

Actions do speak louder than words. Show me the plan.

Dr. Richardson is author of the award winning reference book, Patient Handbook to Medical Care: Your Personal Health Guide, and Building an American Health System health care proposal.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

jueves, 9 de octubre de 2008

Financial Medical Tips

Here are some financial medical tips to help you during this financial crisis the world is facing.

1) Keep your health insurance coverage. This is as important as your home and food. Cut expenses elsewhere to keep it in your budget. Let your doctor know if you do not have insurance coverage. Many offer discounts to the uninsured as do other health providers like hospitals and diagnostic centers. Pay for what you need instead of relying on insurance.

2) If you lose your job, get COBRA through your employer. You will have at least 18 months of coverage. You will have to pay for it. It is worth it.

3) Be sure you are up to date on your health maintenance. Get in now for your physical and preventive tests (mammogram, blood tests, eye exam, shots, etc.).

4) Check your medication, prescription and non-prescription. Review these with your doctor to discontinue any you really do not need, and/or can't afford. Let your doctor know if you are unable to afford any of your medication, so other options can be discussed such as drug assistance programs. Research them yourself on the Internet, and by calling or writing the drug company that makes your medication. Remember to include your non prescription meds in your budget (like cough medicine, stool enhancers, pain relievers, etc.). Talk with your pharmacist.

5) Discontinue unhealthy habits like smoking and excessive drinking.
These items cost money and your health.

Remember that YOU are your most important asset. Great health is true wealth.

Dr. Richardson is the author of the award winning, Patient Handbook to Medical Care: Your Personal Health Guide, and Building an American Health System.

http://www.mypatienthandbook.com/

martes, 7 de octubre de 2008

Cap Insurance Premiums

Dear Senator Obama and Senator McCain,

As part of your spending cuts, put a scalpel to insurance premiums. Cut and cap. It is preposterous to think that someone on a limited income (like seniors, retirees, disabled folks), or those whose salaries have flat lined can continue to afford increases of 25% or more per year. With the average annual cost of living increase of 3 to 5% it is simply unaffordable. For many this can be as much as 10%or more of their income.

For the past three years many insurance premiums have risen as much as total of 25% per year for the past few years! Meanwhile your insurance rates in Congress were recently reported as an 8% increase last year to a hefty 12% this year. Give us the same. After all you do work for us. You and your colleagues keep saying we should have the same health insurance opportunities as Congress. Act on it and stop the private insurance sector from hemorrhaging us to code blue.

Start by putting a cap on insurance premiums. Make this retroactive for the unfair cost increases over the past five years. Let the insurance companies apply this instead of a tax credit to our insurance.

It is time that patients instead of shareholders and company executives reap the benefits of decent health care. Shift the focus on preventive care to preserve your health and save your life as opposed to waiting until you get sick and die.

Do the right thing and the best thing for your country. Keep insurance premiums affordable. Keep your country's health from failing. Invest in prevention, health maintenance, wellness, and health preservation. Make the insurance companies accountable for this, too. Disease management is good, but if it is prevented or detected early it's even better.

Information technology such as electronic medical records are great, too. Be realistic. We are behind here and trying to catch up. Take care of patients first and do this as you go. Most doctors' office are still trying to figure out how they are going to afford it.

Consolidate some of the government health agencies that overlap. As I waded through the Health and Human Services department, I drowned in an alphabet soup of agencies that do similar things. It looks like a lot of money being spent for those most in need; however, the disparities in health care continue in despair.

Keep our country's vital signs stable. Resuscitate. Perform CPR STAT. Open the airway, breathe in fresh air, and circulate the proper health care to all Americans. It is our birth right. It is our privilege. Make it our asset.

Best regards,
Dr. Richardson

P.S. On a personal note - my insurance company increased my premium another 25% this year from $700 to $882. Pre-existing conditions have prevented me from getting affordable continuous coverage elsewhere, or from getting into less expensive plans in the company. My years of employment with this company have amounted to nil.

lunes, 6 de octubre de 2008

Patient Grievance

You arrive at your doctor's office for an appointment. You arrive at the scheduled time. You make your co-payment. You wait for 45 minutes before you are taken into the exam room. The doctor enters in a frenzied panic about 15 minutes later. He tells you that you must reschedule because there is not enough time for him to see you. After persistent banter back and forth, your "official" doctor visit begins.

Once the visit starts, there are multiple interruptions from the staff. The doctor does not have the results of your tests. He fumbles persistently through the chart ignoring your presence. You look over your list and move on to the second item while test results are being located. Another interruption puts these results in your doctor's hands. Since you have not heard about these tests done a month ago, you assume all is okay. You assume wrong again.

As the doctor comes to his senses and recoups his professional demeanor, you continue with your list of items to discuss. After 30 minutes you have it all together - copies of test results, prescriptions, and a plan for follow-up on all that is necessary. You are asked to schedule your next appointment in one month at the doctor's convenience. There is no one at the front desk to give you an appointment.

Doctor visits like this are far too common to ignore. In this instance, the patient had an abnormal test that would have been ignored for a longer time. The unprofessional encounter amplified the patient's stress and blood pressure. It may have been easier for the doctor for the patient to reschedule, but would it have been the right thing to do, and the best thing to do?

Doctors would you?
1) keep arguing with the patient until blood pressure reaches 160/120
2) blame the patient for waiting one hour to be seen
3) see the patient
4) see the 2 drug reps and make the patient reschedule
5) apologize for unprofessional rudeness.

Patients would you?
1) reschedule appointment
2) let the doctor know you were on time - deal with it
3) continue talking with doctor instead of wasting time
4) stand up for your rights
5) file patient grievance with insurance company, state medical board.

Filing a patient grievance/complaint is a smart thing to do. A grievance is a request for an investigation of a complaint about a possible risk to the health, safety, or well-being of a patient; or a situation where the patient is unnecessarily at high risk. Check with with your health insurance provider to find out the details for reporting unacceptable medical services that may threaten your life. In addition, it may save other lives as well since about 15% of JCAHO sentinel events reported are from responsible patients who speak up.

by J. L. Richardson, M.D., family physician, patient advocate (specializing in grievenace process and medical record review), patient, and author of Patient Handbook to Medical Care: Your Personal Health Guide, and upcoming Patient Handbook to Surgery: Surviving Your Operation.