Health Literacy Month Healthy Life Line: Read

 Read what you need. Learn about what you need to maintain good health and well-being.  Health literacy is an important part of your self-care health care.  It helps promote better health and quality of life. During this Health Literacy Month make your health healthier with more medical information.

Medical science progresses so rapidly!  It is impossible for health care providers to keep up with all these new developments. Be aware of treatments your doctors and healthcare team have yet to hear about or are unlikely to ever find out about.  The overwhelming amount of new health information that comes out is far too much for many to stay current on every disease and treatment.  This should not stop you the patient from finding out all you can.  The same goes for wellness.  Participating in your health care is mandatory to maintain good health, achieve wellness, and overcome illness.

There are so many different treatments and modalities that compliment traditional medicine.  As many lack training in these areas they are unable to tell the patient.  Asking your doctor is a good starting place as is telling your doctor about the things you have read about or tried that helped.  In turn this may evoke a response by your physician to find out more,and even share with other patients and colleagues who may in turn share their “new” information which your doctor can share with you.

Reading and learning are vital to good health. Health literacy helps you make healthier, informed choices based on facts that have proven to yield better health outcomes.  Be health literate.  Best health!

Good health maintenance reads: 

Healthy Life Lines Amazon.com: Healthy Life Lines: Simple Tips to Improve Your Health eBook : Richardson M.D., J L: Kindle Store

Patient Handbook to Medical Care Amazon.com: Patient Handbook to Medical Care: Your Personal Health Guide eBook : Richardson M.D., J. L.: Kindle Store

Quality of Medical Care

Quality medical care can be described as the best medical care. The goal is to keep a person well and healthy and to manage acute and chronic illnesses to help a person maintain optimum health. According to a 1996 national survey, “Americans As Health Care Consumers: The Role of Quality Information,” the major concern in choosing a health plan was quality of care (42% of 2,006 adults). This is more important than low cost, choice of doctors, and range of benefits. Employers provide some information on the quality of health plans. Most people choose health providers and health plans based on recommendations from doctors, family,
and friends.

There are independent organizations such as the National Committee for Quality Assurance(NCQA) and the Agency for Healthcare Research and Quality (AHRQ) that monitor and provide information about the quality of healthcare. They develop and report their findings based on research. The AHRQ (www.ahrq.gov) is a government agency that supplies research and guidelines for use by health providers and patients to help determine what care is available and which should be preferred. The NCQA (www.ncqa.org) assesses, monitors, and reports on quality of care. It is a private, nonprofit organization whose diversified board of directors includes employers, health plans, and most importantly, patients, the consumers of managed
healthcare. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) evaluates hospitals, clinics, nursing homes, home health agencies, and laboratories. For community, home health, and hospice programs there is the Community Health Accreditation Program (CHAP). Outpatient healthcare settings like student health services, diagnostic radiology centers, and ambulatory surgical centers are evaluated by the Accreditation Association for Ambulatory Health Care (AAAHC).

In addition, most managed healthcare plans have their own internal quality assurance plans. Once a plan has been reviewed and evaluated by NCQA or other review agencies, the plan is assigned a “grade.” If the plan meets the required standards, it is then given accreditation. This means that the plan met the required guidelines for providing high-quality medical care. The NCQA uses this information to develop a report card on each plan it reviews. The NCQA measures quality using its own Health Plan Employer Data and Information Set (HEDIS) for performance measurement. This data is used for the report card. The report card includes data on the plan’s actual medical services, such as doctor availability, specialist referrals, preventive care, and emergency and hospital coverage. It also reviews charts focusing on the physician’s medical competence and performance. The physician’s licensing, certification, and other credentials are also checked. The physical setting of the office is evaluated to be sure that all quality standards are met.

In evaluating healthcare quality NCQA accreditation and HEDIS provide a comprehensive, standardized, and uniform method that is used for the HMOs it reviews.
About 75% of the nation’s HMOs are accredited by NCQA or are in the process of becoming accredited. The following areas are the primary focus of the health plan review, weighted according to the percentages indicated:
• Access and service (patient satisfaction and
easy, timely access to providers and
treatments), 40%
• Qualified providers (trained, licensed,
credentialed), 20%
• Staying healthy (wellness and prevention),
15%
• Living with illness (proper diagnosis and
treatment of acute and chronic medical
problems), 15%
• Getting better (quality of care), 10%
Meeting the accreditation standards in each
area accounts for 75% of the grade.

The HEDIS (Health Plan Employer Data and Information Set) results make up the remaining 25%. Overall, HEDIS results look primarily at quality in the clinic and patient satisfaction. The results from each plan review are then compared to certain target goals for each category reviewed, and the plan is graded. These grades are compiled and compared to other health plan report cards. The collected information is then reported in a comprehensible format for patient use in selecting a quality health plan.

Information like this is becoming more readily available. It will become, increasingly, one of the ways patients look for and find quality health plans. The Accreditation Status List (ASL) is available to anyone by calling (1-888-275-7585), by writing , or by going to the NCQA website, which provides a list of the accreditation status of participating health plans. Accreditation Summary Reports (ASR) are also available and contain more detailed information than the ASL.
Individual private doctors and group practices that use these managed healthcare plans are usually under contract with the health plan to allow for periodic quality assurance checkups and monitoring.

Health insurance that is not part of a managed healthcare plan and private fee-forservice healthcare are also being included in assessments of quality. Uniformity of quality assessment and reporting among all healthcare providers is a major issue being addressed by the government and other independent agencies that specialize in quality measurement. Soon all providers of all types of health services will have routine quality assessment and reviews, and even more information will be available for the patient to review.

Even with the researched, scientific-quality databases provided by independent organizations, patients usually select a health plan and providers recommended by family or friends rather than one that rates much higher based on a formal quality assessment and review. This trend is also reflected in the choice of doctors. Patients are more concerned about the way a doctor communicates with and cares about them than about whether the doctor has been given a high rating by a quality assurance organization. If the doctor has board certification in her or his specialty, this is also given a higher ranking by patients than quality accreditation from an independent organization.

Many people are beginning to see that quality is important, since one of the goals of managed care is to contain costs, sometimes at the patient’s expense. In order to see that this does not become an issue, quality monitoring, assessment, and reporting are vital to the healthcare system. Making it available to the patient is also important. Information is a powerful tool. It allows patients to learn and to make decisions that are best for them. Looking for quality healthcare in today’s healthcare maze can be a challenging experience. Reading information from the medical provider is a good place to start. Many managed health plans provide patient
manuals and patient representatives that are available to talk with you in person or by phone.

For more detailed information you can contact your state’s insurance commission. Health insurance plans are regulated by state insurance commissions. The AHRQ is a federal government agency under the Department of Health and Human Services (DHHS). It does research on the quality and costs of healthcare. Some of the specific areas it covers are patient safety, quality improvement, clinical outcomes, assessment of medical practices, preventive and primary care services, and funding for medical research.

AHRQ states, "Health services research examines how people get access to health care, how much health care costs,and what happens to patients as a result of this care". The main goals of health services research are to identify the most effective ways to organize, finance, and deliver high quality care; reduce medical errors; and improve patient safety. The AHRQ has maintained a database of medical care guidelines based on medical research. The research is “translated into practices and policies that have been proven to provide the best care, diagnosis, treatment, and follow-up for specific conditions. The guidelines are available free of
charge at The National Guideline Clearing House (www.guidelines.gov ).

More information on choosing the right health plan for your medical needs can be found in the following patient information brochures available on the Internet or by contacting the agency via phone or mail:
• “Choosing and Using a Health Plan” and “Checkup on Health Insurances” from AHRQ www.AHRQ.gov
• “Choosing Quality: Finding the Health Plan That’s Right for You” from NCQA
• “Which Plan Is Right for Me?” from NCQA www.NCQA.org
• http://www.healthchoices.org/ website by NCQA
• “It’s Your Health—How to Get the Most Out of Your HMO” from Consumer Action,
http://www.consumer-action.org/ a consumer advocacy group

Best health!

Medicare & You: Will It Be There When You Need It

If you are in your near retirement years, I am sure you are getting ready for Medicare to take over your health care. Will it be there? By 2030 there will be about 100 million persons receiving Medicare. This is twice as many as 2008. This comes at a time when the growing demand for doctors is at a critical point. Their numbers are dwindling, especially those that accept Medicare payments for services.

Medicare is a health program that is publicly funded by the government to care for persons over 65 who have been legal residents for five years.It is a single payor program. Medicare eligibility starts at 65 years of age. If you are a person with disability, end stage kidney disease (i.e. requiring dialysis or kidney transplant), or Lou Gehrig's disease you will get benefits before age 65.

For the past few years Medicare payments to doctors have been cut by as much as 21% in 2010, while Medicare premium payments by patients have risen (along with the cost of health care!)an average of 10% per year. In addition, Medicare taxes are being prepaid through every working persons' paycheck - 2.9% of your wages to be exact (more if you make over $200,000). It would make sense that doctors and health care providers would receive increases instead of sharp cuts (pun intended). Instead doctors are quitting and looking for second careers unrelated to clinical medicine. Hospitals are closing (the small reserves for hospitals may exhausted by 2017). Clinics are downsizing and closing.

Predictions abound that Medicare will be bankrupt by 2020 to 2030, . "The latest report on the solvency of the Social Security and Medicare trust funds reveals that these entitlement programs will likely run out of money sooner than expected." (reference: Brookings Institute, 2009) Medicare alone was 13% of the federal budget (almost $400 billion) in 2009. It is projected to be near the same in 2010 with a higher cost near $500 billion! The amount spent on Medicare is likely to exceed the payroll taxes collected from your hard earned wages. Astounding data! In spite of the fact that doctors must now accept what Medicare pays them versus what they charge (traditional from 1960 to 1980), this program will be in the red.

Health care rationing may become part of the plan to cut costs and be sure all get health care. Those over 60 and those with multiple chronic conditions many of which occur just because you get old like arthritis, high blood pressure, decreased vision with cataracts, decreased hearing will be put in the long line near the end. As we live longer more health care is needed especially if we inherited the family genes for certain things like diabetes, cancer, and heart disease. Add this to the "old age" diseases and you have the equation of a Medicare patient. Of course old age is much kinder to some than others, but it happens to everyone.

Where will you go for health and medical needs when you reach 65? Medicare was supposed to be there. You worked and paid for it. So you must look after it. First and foremost, you must realize that your health is everything. Loss of function of an arm or leg, your speech or vision almost renders you dependent until you "overcome" it, if you do.

Health maintenance and wellness are vital. You must be your best health advocate by taking the time to prevent as much as possible. Routine checkups by you and your healthcare providers are very important. Early detection will prove a lifesaver if some illness is discovered. This will help you get through the Medicare years. You will be able to see your premium payments and hard work pay off, just with less Medicare and more of your money out of your pocket.

Bottom line: cut Medicare benefits or increase payroll taxes? This is truly a "beast and burden" that needs taming.

by J. L. Richardson, M.D.

Dr. Richardson is a family medicine physician, independent medical record reviewer, and author of Patient Handbook to Medical Care: Your Personal Health Guide. This book provides 112 pages (large print) of health information that will tell you what your doctor should be asking you, telling you, and doing for you - as taught in medical school and used since Hippocrates.  

Health Insurance Update

Health insurance companies are overcharging again! Treatment for medical illness that helps patients is consistently ignored and unapproved. Paying an additional $360 per month to get what you need in addition to your $1000 monthly premium is obtusely extreme. Many drugs used have potential for serious life threatening complications, yet health care providers continue to be pill pushers ignoring reports of better results with alternative treatments. The cost of the medicine may be one-fourth the price in dollars and more deadly, but it is the approved standard of care.

Earnings for the health insurers poured in recently revealing huge profits, earnings, and executive compensation packages. A good chunk of patients' health insurance premiums surely helped this cause as well as that of the lobbyists and uninsured. Health care reform measures that may help patients insurance costs will not kick in for who knows how long - anywhere from one year to four years or more. The patient will be unable to dodge the bullet shooting another increase because it was a fact before health care reform was more than radar blip on the national agenda.

How much longer will patients be ignored and treated so casually by the very people who are supposed to be helping them, healing them, taking them from cradle to grave in a dignified manner?

How much longer will patients be forced to suffer in silence and pain from their diseases while drug companies and health insurance entities continue to prosper in such an adverse environment?

How much longer will patients have to choose between a meal or a pill?

by J.L. Richardson, M.D

Author of Patient Handbook to Medical Care: Your Personal Health Guide
www.mypatienthandbook.com/

Read excerpts on google Books www.bit.ly/aTBrEN

Doctor Search On Internet

Have you looked your doctors up on the Internet? When you do, you may find incomplete inconsistencies. Many web sites had no listing for several doctors I was looking up. So I looked at some others.

I went to the state medical board pages. I found that some doctors listed on the other web pages were not listed on the state board pages. Another doctor is listed with an active and an inactive license (several are listed like this). This doctor’s medical education and training have been done overseas. Some doctors have no residency training listed. This doctor has been in practice for 45 years, and is licensed in two countries and two other states. The doctor’s address is listed as a PO Box.

The type of information listed was different amongst the states. For instance, one state listed one line of information – license number, status of license, present location, disciplinary action (yes or no, not what), date of issue and expiration. Another state gives this plus the doctor’s education and training information, details of disciplinary legal action, other states/ countries where licensed, and board certification status. There were inactive licenses that were listed as active in another state’s information.

These incomplete inconsistencies are rather consistent. Do you know about your doctor’s background? Is your doctor properly trained and licensed? Which information is correct?

The American Medical Association (AMA) has a page with links to the state boards for licensing. Check your doctor at  http://www.ama-assn.org/ama/pub/category/2645.html. Compare it to the information at “doctor finder” sites. Incomplete inconsistency.

J.L. Richardson, MD is a family medicine doctor and author of "Patient Handbook to Medical Care: Your Personal Health Guide".

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

Healthcare Reform Changes Due Date?

When will the health care changes occur? Why have we ceased hearing about everyone having access to the same health plan as the President and Congress as promised during their campaigns?

My insurance premium has risen over $100 per year in the past 5 years and is now almost $900 per month! I have COBRA. The President says those with COBRA will get lower premiums. Will this be retroactive as well?

Should I consider dropping my insurance vs. seeking a new insurance? Unavoidable pre-existing conditions pose a problem no matter what. The President says this will cease.

By the time a health care bill is approved, I fear my insurance premium will have skyrocketed beyond my ability to pay. Mind you this does not include any other medical costs like prescriptions, treatments prescribed by my doctor that the insurance company does not cover, co payments, over the counter medication/ supplies, etc.

P.S. As a doctor, please let me dispel the myth that we (and nurses) are "paid too much". Today doctors finishing medical school entering residency are in debt at least $50,000 to $100,000 or more. Residency training barely pays enough to cover monthly living expenses.

by J.L. Richardson, MD, family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide, the book that helps you take care of your most important asset - YOU!

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

Health Insurers Sell Funeral Plans

"You may have already planned ahead for funeral expenses." This is the opening line in a brochure found in a doctor's waiting room. The brochure from Emphesys, further states "call me today for a free quote or a personal consultation in the convenience of your home your home" (so they can assess how to get you to the grave sooner?).

Does this sound like the type of reading material you want to see when you go to your doctor's office? This is absolutely appalling! Insurance companies have no shame, and little respect when it comes to advertising and selling their products. It's all about the bottom line, the profits. Life and death. We will give you limited covered health care, as much generic medicine as you need, increase your insurance premiums every year by 25%, and pay for your funeral, too. How thoughtful.

There is a big conflict of interest here - going to doctor's office to stay well and walk out with a brochure on funeral expenses. The biggest conflict is that the company appears to be part of the health insurance group. The Internet search for this company led to this link http://www.manta.com/company/mm8g6r0 listing the web address as http://www.humana.com/ .

Even sadder is the fact that the doctor did not know this brochure was in his office.

President Obama's Health Care Reform Plan

Did the President sell us a health care overhaul today? Or is it more of the same talk phrased differently in a town hall setting set before the media? SSDD - same stuff, different day.

He discussed the National Health Insurance Exchange that helped fuel his campaign. It is nice to hear a promise that if you like your doctor and health care plan, you will be able to keep them. What other choice do you have with pre-existing conditions? A promise for lower cost would be nice, especially since "health insurance premiums have grown three times faster than wages". Actually, it is more like five times.

This "patchwork system" needs tweaking. Big time. The public option gives people a choice especially if they don't have health insurance. Does it really?

"Every plan should have incentives for preventive care." Incentives are attractive, but is it enough? Do incentives work? What types of incentives are you talking about? Will everybody have access to them, or just those with employer-based health insurance?

It will take "a couple of years" to get it all done. That will be a true miracle from the holy waters of Lourdes. Oh, then the President changes that...it may take four or five years or so. Or longer.

"The more tests I perform the more I get paid" is the "business mentality" of physicians. The more tests doctors perform, the better chance you will get an accurate, timely diagnosis. Those tests that aren't done, are a primary reason for malpractice. Doctors sure could use help with malpractice insurance, especially if medical testing is limited by big business "gatekeepers".

Prevention and wellness is key. The example of obesity and weight loss is a good one, but how realistic is this for the low income 70 year old morbidly obese hypertensive diabetic who is in a wheelchair?

The last question on wellness and prevention covered an incentive example. If you stop smoking, you will see your premium drop. Does this apply to the uninsured? Will you get health insurance if you practice wellness and prevention?

Finally, trillions of dollars in Medicare and Medicaid is still not enough. If "we can bend the cost curve down....we're going to be okay". Let's hope so.

Please, "steal my ideas", Mr. President.

See the previous blogs here for a real plan. It is time to act. It is time to stop talking.

by J. L. Richardson, MD, family medicine doctor, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide.
http://www.mypatienthandbook.com/

ABC's of Healthcare Reform

The link below on the ABC's of healthcare reform is from my friend, Kathleen O'Connor. Her organization, CodeBlueNow! (http://www.codebluenow.org/ ), is dedicated to health care reform. Her effort is one of the best around. Ms. O'Connor started this after challenging the American public in a contest to write about their thoughts on how America's health care system could be fixed. Out of the 2003 entrants CodeBlueNow! was born.

Thank you Ms. O'Connor for the opportunity to submit my action plan, Building An American Health System. I was one of the ten finalists.

As we look forward to the President's national health care plan being passed soon, let us all speak up for the best health care we deserve. It is time for successful CPR.

http://www.codebluenow.org/ABCs%20of%20Reform--The%20Alphabet%20of%20Health%20Care.final.4-27.1doc.pdf



by J.L. Richardson, MD, family physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide.
http://www.mypatienthandbook.com/

Building An American Health System

These are the notes from my Power Point presentation of my 2003 research paper, Building an American Health System. The medical budget and financing was based on a federal deficit. This was about $400 billion dollars which was greater than the HHS budget alone. In 6 years the only thing that has changed is the exorbitant price we all pay.

Slide 1 Building an American Health System = the best health care for everyone by bringing
best of all medical systems together.


FOCUS of my paper is to bring best of all medical systems together = government, private, international – much of infrastructure in place especially with government = agencies, IT, monies



Slide 2 Information technology = CIA = Communication Information Automation
Communication = medical record creation, maintenance, transmission
Information = education + wellness, prevention, diagnosis, treatment
Automation = Internet wired wireless medicine


One of the first things to get the BEST is to maximize IT, info tech

uses CIA…which connects patient to doctor to health providers – thus creating uniformity w/ easy accessibility

Communication based on most important document, the medical record = it’s creation, maintenance and transmission

Information primary for health education

Automation brings it all together seamlessly and efficiently




Slide 3 System Update = uniform with continutiy of care; timely and easy acces to health care;
eduation on wellness, prevention. and treatment based on prevalence of disease and
proven preventive measures; provide more information to patient; serve everyone


In view of the rise in elder and chronic medical illness a uniform system allows access anywhere, anytime i.e healthcare obtained from every state, doctors licensed in every state – this allows timely, quality care – the best –

USPTF and Healthy People 2010 exists for prevention – HHS has many programs from community to federal level and its systems which have shown to have the best care - more efficient care and lower cost than the private sector



Slide 4 To DO List - use government + private "bests" = merger; extend IT infrastructure,
data base


This will create uniform and easily accessible system for everyone from patient to doctor and in between

there is a ways to go when look at federal deficit at an all time high! As is health spending at over $1 trillion!

suggestions for financing are outlined in my paper as are resources already in place



Slide 5 GOALS - Uniform continuous qualitymedical care to everyone regardless of cost of
of pre-existing condition; educate and inform; practice wellness and prevention to
have a Healthy America.


the goals are ...

As the cartoon in depicts the doctor telling the patient “your HMO won’t cover any illness contracted in the 20th century” = that was in 2000 – if American health system continues the way it is this is a dilemma we all potentially face and are beginning to experience.

Doctor Search on the Internet - Healthy Thing to Do?

Have you looked your doctors up on the Internet? When you do, you may find incomplete inconsistencies. Many web sites had no listing for several doctors I was looking up. So I looked at some others.

I went to the state medical board pages. I found that some doctors listed on the other web pages were not listed on the state board pages. Another doctor is listed with an active and an inactive license (several are listed like this). This doctor’s medical education and training have been done overseas. Some doctors have no residency training listed. This doctor has been in practice for 45 years, and is licensed in two countries and two other states. The doctor’s address is listed as a PO Box.

The type of information listed was different amongst the states. For instance, one state listed one line of information – license number, status of license, present location, disciplinary action (yes or no, not what), date of issue and expiration. Another state gives this plus the doctor’s education and training information, details of disciplinary legal action, other states/ countries where licensed, and board certification status. There were inactive licenses that were listed as active in another state’s information.

These incomplete inconsistencies are rather consistent. Do you know about your doctor’s background? Is your doctor properly trained and licensed? Which information is correct?

The American Medical Association (AMA) has a page with links to the state boards for licensing. Check your doctor at http://www.ama-assn.org/ama/pub/category/2645.html. Compare it to the information at “doctor finder” sites. Incomplete inconsistency.

J.L. Richardson, MD is a family medicine doctor and author of "Patient Handbook to Medical Care: Your Personal Health Guide".
http://www.mypatienthandbook.com

Ideal Health System

This is the summary from Building An American Health System, a 2003 award-winning proposal by J.L. Richardson, M.D. Now in 2009 few things have changed.

For the ideal American health system, the goal must be provision of health care to everyone. This is a national priority. This system must be uniform and easily accessible for everyone. National (e.g. Medicare, Medicaid) and international (e.g. Britain's National Health Service) government programs in combination with the commercial sector of health service leaders are appropriate models. Using the systems and components that are successful in these entities will be the foundation.

The system will be managed through the government and insurance companies. The government seems most experienced and prepared for the task as an infrastructure already exists through the Social Security Administration and other government agencies. In addition, the information technology infrastructure is already in place. This provides the most extensive database of the nation's health care recipients that would be accessible to physicians and hospitals. This should ensure that all have access to the best comprehensive quality health care.

In order to attain the above, the employer-based model would be phased out. Purchasing health insurance from the government will subsequently be available to everyone. Each person will pay directly for services at prices comparable to Medicare and Medicaid fees. Through the Public Health Service all preventive screening will be done without charge. This will lead to a healthier people and a health system that takes care of everyone.

Prevention and intervention in a timely manner to all must be the ultimate goal in rebuilding the American health system as "...one nation under God...".

Great health is true wealth!



Thanks to Kathleen O'Connor, founder and CEO of Code Blue Now, the American public was invited to share their ideas on building a decent health care system in America by sponsoring a contest in 2003. Out of this health care reform effort, Code Blue Now was born. For details, visit http://codebluenow.org.

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. Mmm…mmm…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