Health insurance open enrollment time is here again. For something so important, it is quite a quandary instead of a clear, concise issue. First of all, open enrollment implies that you must wait for a certain time once a year for a sixty to ninety day period when you can shop for insurance. This is exactly what it is. Unlike most nonmedical services you need or want, you can only shop for and get it for a limited time. Without it you could get sicker, and pay more for your healthcare. It would be healthier, more convenient, and make more sense to have open enrollment all year long. At one time many years ago, you could shop and get health insurance all year. Time for shopping for your health and insurance should be like shopping for other things you need. If you had to wait to buy a car during a once a year open enrollment period, and you were without a car, what would you do?
Health insurance is too important to have such limited access. Though the cost is high for some, most are able to procure enough to prevent bankruptcy from healthcare costs. Once you have health insurance, you know and feel what is like to have healthcare provisions. This is a major issue if you have been without it. The health insurance experience is a healthy way to learn about your healthcare, and what you can do to make yourself healthier. Many find it to be a security blanket in case of catastrophic illness, but it is also a prevention guide.
If the objective is to insure more people, limited open enrollment time once a year seems to be a contradiction to getting more people insured. This could better serve everyone if it were provided in a timely, sensible manner if open enrollment was ongoing. After all, your health is your most important asset. You should be able to shop, and buy what you need when you need it beyond a limited time. Best health!
Mostrando entradas con la etiqueta health insurance. Mostrar todas las entradas
Mostrando entradas con la etiqueta health insurance. Mostrar todas las entradas
lunes, 31 de octubre de 2016
jueves, 10 de marzo de 2016
HEALTH INSURANCE PRICES RISING
Your health insurance price is going higher. Since July 2015 there have been reports of health insurance premiums rising in 2016. Prices have risen by 25 per cent or more with many health insurance plans. It may actually be cheaper to be uninsured especially if you are healthy and stay that way. Since the Affordable Care Act took effect in 2014, insurance premiums are on the rise again. If deductibles are included, it resembles prices of yesteryear. The premium may be less, but adding the deductible balances out to about the same yearly amount as before the health law was passed.
With premiums likely to rise as much as 25% again next year this could set the stage for more uninsured as patients find they may be able to do better without insurance. The 2016 yearly penalty imposed if one declines to be insured by a health plan is $695 per adult and $347.50 per child but can be no more than $2085 per family or 2.5% of family yearly taxable income. This increased over 50% from $325 and $162.50 respectively in 2015 with total to be no more than $925 or 2% of yearly taxable income. In 2014 when the Affordable Care Act went into effect the penalty started at $95 per adult and $47.50 per child with total to be no more than $285 or 1% of yearly taxable income.
Many are paying between $200 to over $1000/ month for “affordable” health insurance. If health care could be attained at less than $2085 a year, could it be to your advantage to opt of health insurance coverage and pay the health premium penalty? The choice is yours to make for health coverage. With or without it, price increases continue. Though it may appear cheaper and healthier to be uninsured it may be more risky. One unexpected consultant visit or diagnostic test can easily exceed $2085 for the year!
If you are without any major illnesses or chronic disease, and have a healthy genetic predisposition, do you really need health insurance? Should you save your money in a medical fund until you need it instead of having health insurance? There are folks doing this, and they are spending less on their medical care than the price of what health insurance would cost. Many are able to afford their medicines (if they are taking any) and other treatments as well as routine screening tests that may be needed. Their own health savings account is their “insurance”. Saving enough money for your health care is difficult because health changes as unexpected health challenges arise especially with aging.
Should you have health insurance? Do you have enough money in your budget for health insurance and/or a health savings account? It is prudent to have some type of coverage solely because your health is so important. Health insurance is prevention intervention as well as diagnosis and treatment coverage. As more insurance companies focus on wellness and prevention, more services are covered at much less than what you will pay for them yourself. Health insurance benefits do seem to give you more bang for your buck and your body.
The choices for your personal health maintenance are there. Health insurance is important like home and car insurance. You are your most important asset. To keep the car and house while maintaining financial stability, you must stay in good health. Find a plan to fit your needs medically and financially. Even if you have health insurance, unless it's the "gold" plan you will most likely have to pay some out of pocket as well (deductibles, copays, full pays for services not covered). Saving your health can help save your money. Best health!
miércoles, 5 de febrero de 2014
No Insurance or Cash, No Medical Care
Doctors today are faced with so many issues that divert
their attention from their patients. One of these is payment for services. If a patient has no health insurance, cash or
credit card, that patient will go without, or seek medical care at the ER and
pay later. As physicians are faced with so many diversions like increasing
patient visits and "paper work" (computer, phones, etc.) primarily associated with insurance issues, many
are taking cash only. Cash only secures immediate
payment without paper pushing. This
decreases overhead as well because less staff is needed. More doctors are finding this the preferred
way to do business.
Patients with insurance are already finding that some
doctors are not taking any insurance, Medicare, or Medicaid. Why?
Reimbursement rates for their services are getting less each year thereby
decreasing overall income, and profit to run their office. The overwhelming amount of “paper work”
is taking more time and often requires more staff. Without this more time is spent in patient
care. This is what most doctors find
rewarding – more time with patient care and doing what they do best, taking care of their patients.
Yes, you must pay to see your doctor and other health care
providers, but how you pay may determine the availability. Cash allows you to see who you want to see. Health insurance usually has provider
networks of who they want you to see.
Should you want to see an out of network doctor that you know, or feel
would be better for you, you still have to pay for services rendered. Even with health insurance cash/ credit is required for deductibles and co-payments.
The bottom line remains, no cash or health insurance, no medical
care. At least with health insurance,
you are covered especially if a major medical malady occurs like surgery http://bit.ly/1hwqnpX or
chronic disease. If you have the cash
you’re covered. If not, get covered. Great health is true wealth.
Best health! http://amzn.to/13m51UU
Best health! http://amzn.to/13m51UU
jueves, 31 de octubre de 2013
Surge in Surgery
How many surgeries does the average person have in a lifetime? According to the most recent study of its
kind from 2002, it was found that you could need surgery at least 9.2 times if
you live to 85 years of age. It is no surprise that surgeries increase with
age. Surgery is also prevalent in women
during their reproductive years. For
both men and women between ages of 45 to 75 there is also an increase. Three of the top ten most common surgeries
were for women’s gynecological conditions.
C-sections ranked as number one.
For men the top surgery was for cardiac conditions (angioplasty, heart
bypass). Fortunately many surgeries done
today are minimally invasive done as an outpatient instead of in a traditional
hospital stay.
Best health!
These facts indicate that you will have surgeries in your
lifetime. Think about the cost of
this. Would you be able to pay for
it? Rising health care costs and
increase in illness have made this nearly impossible for most on an average
income of today. The sensible and responsible thing to do is have health
insurance. Is your health more
important than that $50,000 car or $200,000 home you insure? Plus these insurances
are usually required. Your health
deserves to be insured as well.
If your health insurance policy has been cancelled, your
health insurance provider has other plans that will fit your need with
comprehensive, affordable coverage that covers more and includes your same
providers. Look at the cancelled product
as new and improved health benefits at a much lower price. Basically your
policy has not been “cancelled”, but upgraded with many more options.
There is also the option of looking at the National
Healthcare Insurance Exchange by phone, paper application, online, or in person at designated places. This offers more choices from other health
insurance providers with different “levels” of coverage. Each level offers basic and free preventive
care from less than 60% to 90% coverage. The
cost is now actually less than what you may have paid
previously under the “cancelled” policy!
Now that health insurance is more affordable and chances are you will
need surgery, it makes sense to have it.
Plus you get the chance to maintain your health with prevention and
proper treatment in hopes of preventing surgery.
The yearly cost of your health insurance premium is much
less than the cost of one major surgery and recuperation (equals 5-10 years worth). Even if you have
enough cash to pay, you will save more than your money by being insured. Get covered for good health!Best health!
domingo, 23 de diciembre de 2012
Tips for Effective Communication
- Listen a lot.
- Be specific.
- Ask for a reasonable change that will relieve the gripe.
- Make sure your patient/healthcare provider understands what you want and you understand what she or he wants.
- Deal with only ONE issue at a time.
- ALWAYS consider compromise.
- Never assume you know what the other is thinking. Check it out. Don't assume or predict reactions, rejections, or acceptance.
- Accept what the other feels. Don't tell your patient/healthcare provider what he or she should or should not be feeling.
- Don't name call or label.
- Sarcasm is dirty fighting - call each other on it.
- Stay in the present. Grievances should be dealt with at the earliest possible moment. Don't save them up to use as weapons.
Great health relies on effective communication by everyone - YOU the patient, your family, and your health care team. Best health!
domingo, 21 de octubre de 2012
Healthcare Deja Vu Come True?
As health care access decreases and costs increase, we must look ahead to improving it for everyone. In 2011 employers paid an average of $11,000 for employees and their families, while yearly insurance premiums rose from $13,000 to $15,000. The following is an excerpt from "Building an American Healthcare System" released in 2002 when the average premium paid by employers was $6500. While proposing ways to decrease cost and access, one is able to see that good healthcare can be deja vu come true.
One stop shopping for medical care is in order. By having more clinics, easy access to care will help people to get what they need in a timely manner. Waiting to see the doctor is one of the reasons our health care is out of control. The Public Health facilities will be a setting in which health care providers will employed and compensated as in the private sector. It will be just as prestigious to work for the Public Health as the private sector. In addition, permanent protection of physician incomes can be guaranteed by the government much like the recent ruling in Britain (British Medical Journal, April 5, 2003). The concept of second rate, low paying health care for the low income associated with Public Health Service must be changed and amplified. We must be proud to work for our country’s health system, and to obtain top notch health services! In this set up, the uninsured are insured and objectives of the Fair Care to the Uninsured Act of 2003 will be met. This is very important. Those without insurance are sicker, die younger and receive less care for many conditions. The risk of illness increases the longer one is without insurance.
More emphasis from the USPHS for education, prevention and screening, eldercare, disabled care, chronic condition care/ chronic multisystem illness (CMI), health awareness, and education is needed. The Public Health clinic will evolve from the barely visible building or little trailer in the field to highly visible, easily accessible structures. Vacant malls and warehouse buildings can be bought and transformed to mini-medical facilities that provide it all. Pre-existing clinics in the area can be merged, or remain as satellite facilities. The goal is to have health care at every corner much like the neighborhood convenience store. The era for traveling 100 miles to your doctor, waiting half a day or more only to spend the average 5 minutes with your health care provider must cease.
Minnesota has set up a system that covered about 95% of its residents under 65 in 2001 (86% in 2000). It uses government and private insurance together to achieve insurability. "Approaching Universal Coverage: Minnesota’s Health Insurance Plans" by Debra Chollet & Lori Achman of Mathematica Research Policy, Inc.states that it has been successful at serving "all populations in need at all levels of income". Coverage is included for the "medically uninsurable" like the person with chronic multisytem disease, or pre-existing conditions. Its GAMC and MA plans includes coverage for expenses that occurred in the 3 months prior to application, and do not have premiums or co-pays. Minnesota's programs have been, or are currently used in other states, and can be used to help lay the foundation for health care uniformity. The Commonwealth Fund has several publications that look at other states' health systems, and universal health coverage.
The effort to consolidate the American health system is a priority. Karen Davis' summary, "Time to Change: The Hidden Cost of a Fragmented Health Insurance System", states that the present system "is not up to the challenge of ensuring a healthy and productive nation because it is 'fragmented' ". The focus of her summary exemplifies how lack of uniform health services costs more with less results.
Attention must also be placed on employer health provisions. In 2002 companies spent an average of $6500 per person for health care. This does not include the patients' out of pocket payment for services. The pages of uncovered services listed in many insurance handbooks grows longer. About 41 million employed by small business pay directly for services at prices compatible with the Medicare and Medicaid models. Through the leadership of the Public Health Service all businesses are uninsured primarily because it is unaffordable. Congress is presently looking at a concept called an Association Health Plan (AHP) as part of the Small Business Health Fairness Act. This would allow small business owners to offer large corporation health discounts. It would also be uniform nationwide. The AHP is in use in some states, and has come and gone in some. Last year 16 states closed down 48 AHP plans. This would be a great opportunity to "phase in" national coverage. As employer health programs are phased out, patients should be offered the option to obtain national insurance. Each person preventive and screening will be done without charge. Eventually this will lead to a healthier people, and health system at a much lower cost.
One stop shopping for medical care is in order. By having more clinics, easy access to care will help people to get what they need in a timely manner. Waiting to see the doctor is one of the reasons our health care is out of control. The Public Health facilities will be a setting in which health care providers will employed and compensated as in the private sector. It will be just as prestigious to work for the Public Health as the private sector. In addition, permanent protection of physician incomes can be guaranteed by the government much like the recent ruling in Britain (British Medical Journal, April 5, 2003). The concept of second rate, low paying health care for the low income associated with Public Health Service must be changed and amplified. We must be proud to work for our country’s health system, and to obtain top notch health services! In this set up, the uninsured are insured and objectives of the Fair Care to the Uninsured Act of 2003 will be met. This is very important. Those without insurance are sicker, die younger and receive less care for many conditions. The risk of illness increases the longer one is without insurance.
More emphasis from the USPHS for education, prevention and screening, eldercare, disabled care, chronic condition care/ chronic multisystem illness (CMI), health awareness, and education is needed. The Public Health clinic will evolve from the barely visible building or little trailer in the field to highly visible, easily accessible structures. Vacant malls and warehouse buildings can be bought and transformed to mini-medical facilities that provide it all. Pre-existing clinics in the area can be merged, or remain as satellite facilities. The goal is to have health care at every corner much like the neighborhood convenience store. The era for traveling 100 miles to your doctor, waiting half a day or more only to spend the average 5 minutes with your health care provider must cease.
Minnesota has set up a system that covered about 95% of its residents under 65 in 2001 (86% in 2000). It uses government and private insurance together to achieve insurability. "Approaching Universal Coverage: Minnesota’s Health Insurance Plans" by Debra Chollet & Lori Achman of Mathematica Research Policy, Inc.states that it has been successful at serving "all populations in need at all levels of income". Coverage is included for the "medically uninsurable" like the person with chronic multisytem disease, or pre-existing conditions. Its GAMC and MA plans includes coverage for expenses that occurred in the 3 months prior to application, and do not have premiums or co-pays. Minnesota's programs have been, or are currently used in other states, and can be used to help lay the foundation for health care uniformity. The Commonwealth Fund has several publications that look at other states' health systems, and universal health coverage.
The effort to consolidate the American health system is a priority. Karen Davis' summary, "Time to Change: The Hidden Cost of a Fragmented Health Insurance System", states that the present system "is not up to the challenge of ensuring a healthy and productive nation because it is 'fragmented' ". The focus of her summary exemplifies how lack of uniform health services costs more with less results.
Attention must also be placed on employer health provisions. In 2002 companies spent an average of $6500 per person for health care. This does not include the patients' out of pocket payment for services. The pages of uncovered services listed in many insurance handbooks grows longer. About 41 million employed by small business pay directly for services at prices compatible with the Medicare and Medicaid models. Through the leadership of the Public Health Service all businesses are uninsured primarily because it is unaffordable. Congress is presently looking at a concept called an Association Health Plan (AHP) as part of the Small Business Health Fairness Act. This would allow small business owners to offer large corporation health discounts. It would also be uniform nationwide. The AHP is in use in some states, and has come and gone in some. Last year 16 states closed down 48 AHP plans. This would be a great opportunity to "phase in" national coverage. As employer health programs are phased out, patients should be offered the option to obtain national insurance. Each person preventive and screening will be done without charge. Eventually this will lead to a healthier people, and health system at a much lower cost.
miércoles, 22 de agosto de 2012
Health Care Fiscal Physical
Back in 2002 healthcare experts made it apparent that our healthcare system was unable to serve everyone. Analysis of the situation is outlined below.
Fiscal discipline is a must. Every penny should be accounted for. In 2003 health care spending is projected to be about $1.6 trillion. In 2000 it was about $1.3 trillion (13% of GDP) compared to $73 billion (7% of GDP) in 1970. Health spending costs for 2001 were 37% for hospital outpatient, 28% for physician services,21% for prescriptions, and 14% for hospital inpatient. According to the American Hospital Association (AHA), hospitals provided $21.5 billion in uncompensated care in 2001; however, the government pays for most of health care. About 20 -30% is administrative, much being attributed to redundancy and overhead costs ("Government Share of Health Care Expenditures" by Asaf Bitton, James Kahn, M.D., M.P.H. from University of California, San Francisco - March 5, 2003, msJAMA). The CMS
estimate for 1999 government health spending is 45.2% ($548 billion). The elderly, disabled, low-income children, and some low-income adults are covered by government. Medicare and Social Security gets 7% of this amount. This is expected to double in 10 years. The average monthly health insurance premium for an individual is $255 ($3060/yr.), while that of a family is $663 ($7956/yr.) which represents a 12% increase from 2001 to 2002.
The forecast for 2004 federal budget is a record $2.7 trillion. Payroll taxes comprise 38% of the federal revenue. Taxes collected for 2003 are expected to be about $1.9 trillion (Congressional Budget Office, CBO, current budget projection report, March 7, 2003 - (www.cbo.gov). Projected health spending for 2003 is $1.6 trillion. This is over half of the budget! Furthermore, the Office of Management & Budget forecasts that the federal government will run a deficit of about $316 billion for fiscal year 2003 reaching $385 billion for 2004. This is projected to decrease in 2005 with forward projections of a $10 billion surplus by 2012. The
government debt is actually an estimated $6.4 trillion (about
$70,000/ family).
So where does this leave health costs? The HHS expense alone for 2002 is greater than the deficit ($460 billion). The majority of this ($375 billion) is for the CMS. For 2004 the projected expense for HHS is expected to be $500 billion. Other basic government allotment proposals for 2004 are: $400B for Medicare prescription program (over 10 years); $35B for uninsured (federal and state funds); $5 B for SCHIP; $2B for FDA; $60B to Dept of Defense (about $15B for aid to other nations, $21B for military health care); part of estimated $20B to rebuild Iraq (starting with a $2.5B down payment this year). There is $9 billion of “other”. There is an extra $80B approved for war costs ($62.4B to Pentagon, $4B for domestic security, $2.2B for state and local law enforcement and emergency workers; $7.9 foreign aid; $1.1B for Jordan; $1B for Israel; $1B for Turkey; “and money for Afghanistan, the Philippines and Colombia”). This includes $2.9B for airlines (many have filed for bankruptcy or are on the verge in spite of funds given after 9/11), and "for other projects pushed by lawmakers". This is money for use up to the end of the fiscal year ending 9/30/03. What are these "other" projects ($16M for SARS research and $142 M for smallpox vaccine program are $158M of this $2.9B) ? Not included in this is extra 26 weeks of unemployment for employees which was requested by some lawmakers.
So what attention will health care get if a person is unable to get a stipend to live off of while seeking employment? All of this should be itemized and accounted for with more priority given to health and well being. How much can we expect to get for our ailing health system with these other "priorities"? Perhaps much of it can be put on the backburner, while more monies are allotted for remodeling the American health care system to provide health care for all.
Excerpted from "Building An American Health System" (2003) by J. L. Richardson, M.D.
Fiscal discipline is a must. Every penny should be accounted for. In 2003 health care spending is projected to be about $1.6 trillion. In 2000 it was about $1.3 trillion (13% of GDP) compared to $73 billion (7% of GDP) in 1970. Health spending costs for 2001 were 37% for hospital outpatient, 28% for physician services,21% for prescriptions, and 14% for hospital inpatient. According to the American Hospital Association (AHA), hospitals provided $21.5 billion in uncompensated care in 2001; however, the government pays for most of health care. About 20 -30% is administrative, much being attributed to redundancy and overhead costs ("Government Share of Health Care Expenditures" by Asaf Bitton, James Kahn, M.D., M.P.H. from University of California, San Francisco - March 5, 2003, msJAMA). The CMS
estimate for 1999 government health spending is 45.2% ($548 billion). The elderly, disabled, low-income children, and some low-income adults are covered by government. Medicare and Social Security gets 7% of this amount. This is expected to double in 10 years. The average monthly health insurance premium for an individual is $255 ($3060/yr.), while that of a family is $663 ($7956/yr.) which represents a 12% increase from 2001 to 2002.
The forecast for 2004 federal budget is a record $2.7 trillion. Payroll taxes comprise 38% of the federal revenue. Taxes collected for 2003 are expected to be about $1.9 trillion (Congressional Budget Office, CBO, current budget projection report, March 7, 2003 - (www.cbo.gov). Projected health spending for 2003 is $1.6 trillion. This is over half of the budget! Furthermore, the Office of Management & Budget forecasts that the federal government will run a deficit of about $316 billion for fiscal year 2003 reaching $385 billion for 2004. This is projected to decrease in 2005 with forward projections of a $10 billion surplus by 2012. The
government debt is actually an estimated $6.4 trillion (about
$70,000/ family).
So where does this leave health costs? The HHS expense alone for 2002 is greater than the deficit ($460 billion). The majority of this ($375 billion) is for the CMS. For 2004 the projected expense for HHS is expected to be $500 billion. Other basic government allotment proposals for 2004 are: $400B for Medicare prescription program (over 10 years); $35B for uninsured (federal and state funds); $5 B for SCHIP; $2B for FDA; $60B to Dept of Defense (about $15B for aid to other nations, $21B for military health care); part of estimated $20B to rebuild Iraq (starting with a $2.5B down payment this year). There is $9 billion of “other”. There is an extra $80B approved for war costs ($62.4B to Pentagon, $4B for domestic security, $2.2B for state and local law enforcement and emergency workers; $7.9 foreign aid; $1.1B for Jordan; $1B for Israel; $1B for Turkey; “and money for Afghanistan, the Philippines and Colombia”). This includes $2.9B for airlines (many have filed for bankruptcy or are on the verge in spite of funds given after 9/11), and "for other projects pushed by lawmakers". This is money for use up to the end of the fiscal year ending 9/30/03. What are these "other" projects ($16M for SARS research and $142 M for smallpox vaccine program are $158M of this $2.9B) ? Not included in this is extra 26 weeks of unemployment for employees which was requested by some lawmakers.
So what attention will health care get if a person is unable to get a stipend to live off of while seeking employment? All of this should be itemized and accounted for with more priority given to health and well being. How much can we expect to get for our ailing health system with these other "priorities"? Perhaps much of it can be put on the backburner, while more monies are allotted for remodeling the American health care system to provide health care for all.
Excerpted from "Building An American Health System" (2003) by J. L. Richardson, M.D.
sábado, 13 de agosto de 2011
Is the Doctor Really "In"?
Dear Patient,
It has indeed been a privilege and wonder to take care of you and your family. Due to unforeseen circumstances, we must vacation indefinitely so we can find the best solutions for cost effective health care. Our budgets are lean as well and get leaner as more patients drop out to do self care or go to emergency rooms, public health clinics, or stand in "lotto" lines to get get health care from traveling clinics.
We must campaign for your healthcare and our salary. Routine sequential cuts for reimbursement by Medicare and Medicaid are taking its toll. Insurance companies demand more time with less pay as well. Now that the healthcare bill requiring each and every one of you to have insurance has been repealed. Self pay is an option, but you must have food and shelter first. Less money in, more money out.
Due to lack of campaign funds and time for raising necessary monies to do so, we are using and pooling our resources. We wish to provide you with continuity of care, but we must also find ways to keep a roof over our heads and food on the table. Many of my fellowess and fellow physicians are supplementing our income as well through other occupations.
Thank you for allowing me to care for you and the family. We are true believers that great health is true wealth; however, you must have money to keep it.
Best health,
Dr. Feelgood
P. S. Check out Patient Handbook to Medical Care: Your Personal Health Guide via links in the right column. Get a heads up and start checking yourself and your family.
It has indeed been a privilege and wonder to take care of you and your family. Due to unforeseen circumstances, we must vacation indefinitely so we can find the best solutions for cost effective health care. Our budgets are lean as well and get leaner as more patients drop out to do self care or go to emergency rooms, public health clinics, or stand in "lotto" lines to get get health care from traveling clinics.
We must campaign for your healthcare and our salary. Routine sequential cuts for reimbursement by Medicare and Medicaid are taking its toll. Insurance companies demand more time with less pay as well. Now that the healthcare bill requiring each and every one of you to have insurance has been repealed. Self pay is an option, but you must have food and shelter first. Less money in, more money out.
Due to lack of campaign funds and time for raising necessary monies to do so, we are using and pooling our resources. We wish to provide you with continuity of care, but we must also find ways to keep a roof over our heads and food on the table. Many of my fellowess and fellow physicians are supplementing our income as well through other occupations.
Thank you for allowing me to care for you and the family. We are true believers that great health is true wealth; however, you must have money to keep it.
Best health,
Dr. Feelgood
P. S. Check out Patient Handbook to Medical Care: Your Personal Health Guide via links in the right column. Get a heads up and start checking yourself and your family.
jueves, 28 de julio de 2011
Letter to the President: Code Blue! Get Crash Cart STAT!
Dear Mr. President,
Please be aware that the doctors of this great nation are finding it near impossible to care for our patients, your people. Our patients are literally dying as the debt crisis looms in limbo for way too long. We are trying to avoid our patients demise, but with almost 1/2 of our population, especially seniors and kids, on Medicare and Medicaid this is already a major problem. Further cuts would be detrimental to us and our patients, your constituents.
Quality of care and proper treatment is near impossible especially with the physician shortage. Medicare and Medicaid should be increases to help us provide, instead of being cut again and again. Payment delays are unacceptable. This statement from the American Academy of Family Practice (Payment Delays Resulting From Debt Ceiling Impasse Are Possible, AAFP Warns http://ow.ly/1dZzY0 ) details the problems as does the letter sent to you and in June by AAFP Board Chair Lori Heim, M.D., who said, "If any budget proposal is to restrain the growth in health care spending, it must also support programs that build the family physician and primary care workforce, pay for quality and outcomes of medical care, and ensure that everyone has access to that care." http://bit.ly/pFjeE7 This is a code blue! Can you imagine not getting paid for your hard work? Or getting sued because you lacked?
The worriation of this debt disease is infecting our people in many obvious ways. I see those on limited incomes with no less than five chronic conditions struggle to keep food on the table and a roof over their heads as their health expenses become obliviously unaffordable. We all know what happens then. Chronic medical care that could have been avoided incurs, and we all pay, especially the patient and doctor.
As we strive for a Healthy People 2020, it is looking bleak. Though Congress has the purse strings, the buck stops with you. Eliminate this unnecessary worriation that has gone too far and too long causing more anxiety, suicide, and worsening of overall health for many.
As family physicians on the forefront of patient care, the burden rests with us to do our best. The most you and Congress can do is resolve the present debt crisis. If this was was your doctor treating you and your family, such delay would be unacceptable most likely leading to adverse outcomes. Everyone must do their job as if someone's life depended on it. Much too often it does, especially for patients and doctors.
Thank you, Mr. Obama.
Best regards,
Dr. Richardson
Please be aware that the doctors of this great nation are finding it near impossible to care for our patients, your people. Our patients are literally dying as the debt crisis looms in limbo for way too long. We are trying to avoid our patients demise, but with almost 1/2 of our population, especially seniors and kids, on Medicare and Medicaid this is already a major problem. Further cuts would be detrimental to us and our patients, your constituents.
Quality of care and proper treatment is near impossible especially with the physician shortage. Medicare and Medicaid should be increases to help us provide, instead of being cut again and again. Payment delays are unacceptable. This statement from the American Academy of Family Practice (Payment Delays Resulting From Debt Ceiling Impasse Are Possible, AAFP Warns http://ow.ly/1dZzY0 ) details the problems as does the letter sent to you and in June by AAFP Board Chair Lori Heim, M.D., who said, "If any budget proposal is to restrain the growth in health care spending, it must also support programs that build the family physician and primary care workforce, pay for quality and outcomes of medical care, and ensure that everyone has access to that care." http://bit.ly/pFjeE7 This is a code blue! Can you imagine not getting paid for your hard work? Or getting sued because you lacked?
The worriation of this debt disease is infecting our people in many obvious ways. I see those on limited incomes with no less than five chronic conditions struggle to keep food on the table and a roof over their heads as their health expenses become obliviously unaffordable. We all know what happens then. Chronic medical care that could have been avoided incurs, and we all pay, especially the patient and doctor.
As we strive for a Healthy People 2020, it is looking bleak. Though Congress has the purse strings, the buck stops with you. Eliminate this unnecessary worriation that has gone too far and too long causing more anxiety, suicide, and worsening of overall health for many.
As family physicians on the forefront of patient care, the burden rests with us to do our best. The most you and Congress can do is resolve the present debt crisis. If this was was your doctor treating you and your family, such delay would be unacceptable most likely leading to adverse outcomes. Everyone must do their job as if someone's life depended on it. Much too often it does, especially for patients and doctors.
Thank you, Mr. Obama.
Best regards,
Dr. Richardson
jueves, 7 de julio de 2011
Your Physical Exam: Below the Waist
After the physical exam above the waist is completed, the rest of the exam follows. For females, the pelvic exam and rectal exam are done next. The pelvic exam can also be done by a gynecologist, a doctor who specializes in female medicine. This depends on your preference and/or if your primary care doctor chooses to refer you. It is an examination of the female external(outer) genitalia (parts) and internal (inside)reproductive sexual parts. The first female exam should be done at any age if there are any symptoms. Routinely, the first pelvic exam is done once the female is sexually active (having sex) or 18 years of age. It is recommended that a third person or chaperone who is an authorized health professional should be in the room for this exam. Every health care setting should have chaperone policies in place for gynecology exams. This should always be presented as an option, if there is no policy or law. Furthermore, it should be offered to a patient for the full physical examination, especially if the physician is the opposite sex of the patient.
The assistant will help you get in position. Your legs will be placed in stirrups (foot holders) that are at the end of the table. You will then slide your hips down until the buttocks touch the edge of the table. Your legs will then be able to relax
apart. (Some doctors have more comfortable exam chairs.) For those who might not be able to do this, there is the frog-leg position. The heels are brought together while the legs are bent: the heels are, thus, brought as close as possible to the
buttocks, like frog legs. For persons not able to assume either of these positions, referral to a gynecologist is necessary. Please note also that you should not be put in this position until the doctor is ready to examine you. That’s just good manners on the doctor’s part. Once the exam begins, the doctor will instruct you when to lie down. You should also be informed when and where you will be touched during each part of the exam. The doctor will be wearing latex gloves to do this part of the exam. You may also request that a mirror be placed so that you can watch the exam.
There are five basic parts of the pelvic exam. The first part is the exam of the external genital area where the doctor inspects and palpates for any abnormalities. The second part of the exam is done using a tool called a speculum. This is for looking into the vagina and at the cervix. It resembles a fancy pair of tongs (or a pelican beak) and is either plastic or metal. Most doctors
will and should warm the speculum with water before use. This allows for easier passage of the speculum. In the closed position the speculum is then placed gently in the vagina and opened to keep the vagina walls apart. When this is done,the doctor is able to see the cervix. The third part of the exam involves doing a Pap smear, which is a screening test for cancer of the cervix. A thin wooden stick about the size of a popsicle stick(called a spatula) and a stick with a tiny (about quarter-inch) brush on the end are used to do the test. When gently rubbed against the cervix, they are able to pick up cells. The cell samples are then placed on a glass side or in a test tube, which is then sent to the lab. The speculum is then removed.
Part four is the bimanual exam, which includes palpation of the internal female organs. One or two fingers that have been lubricated are placed in the vagina, while the other hand presses
over the pelvic (lower abdomen) area. The uterus(womb) and ovaries (eggs)can be felt for any tenderness or masses. The last part of the exam is the rectovaginal exam. Using a clean lubricated glove, one finger is inserted into the vagina and a
second finger into the rectum. This is an important part of the exam for two reasons: to check the rectum for bleeding and masses, and to further palpate the female organs. A complete
pelvic exam includes a rectal exam. The stool is checked for blood by placing a sample of stool from the gloved finger in the rectum onto a special card (commonly called guaiac or Hemoccult cards). If there is no stool for the specimen, your doctor will give you cards with instructions on how to collect samples at home. Once completed, the cards are returned to the doctor to be checked for blood. This is a very important test. Small amounts of blood in the stool cannot be seen with the naked eye but can
be detected with this test.
The male genital exam is the equivalent of the female pelvic. The doctor inspects first. With gloved hands, the penis glans (tip) and shaft are checked. If the male is not circumcised, the
foreskin (extra skin) should be pulled back. Then each scrotal sac is palpated to check the testicles for any abnormal lumps or bumps. This is a good time for the doctor to show you how to do your own monthly scrotal exam. Next the famous “cough” test is done in standing position. This is to check for hernias and is done with the insertion of the examining finger into the scrotal
and inguinal (groin) area while the patient coughs. It is done on the right and left side. The rectal exam follows and is usually done with the doctor’s lubricated gloved index finger inserted into the rectum. In addition to checking the stool
for blood, the prostate gland (which makes male fluids) is also checked for size, tenderness, and masses. This is an important cancer screening test for men and should be done routinely after age 40.
Examination of the musculoskeletal system(arms, legs, back), nervous system (including mental health), and skin mark the end of the complete physical. The extremities (arms and legs)are checked for symmetry (the same on both sides, and were being checked as you got on and off the exam table, to see if you required assistance or were using an assistive device such as a wheelchair,walker, or cane. Following instructions and answering the doctor’s questions during the exam allows for an indirect check of the nervous system. The skin can be inspected as each of the previous parts of the physical is done. Be sure to
have the doctor show you how to do your own self skin exam.
The inspection of the extremities continues as the doctor looks for scars, skin color change,edema (swelling), and effusions (joint swelling). The joints of the arms and legs are then tested for range of motion (actual movement) actively (movements done by patient) and passively (extremities are moved by the doctor). They are also checked for any tenderness, swelling, and
warmth or coolness. The strength, reflexes, and sensation(feeling)in the extremities are usually tested at this time or can be included in the neurologic(nervous system) exam. Strength is tested by resisting the doctor’s strength. Pushing the hand against the doctor’s hand, kicking the leg out, and gripping a finger with your hand are all relative tests of strength. The reflexes are checked with a reflex hammer at several places on
the arm (front and back of the elbow, above the wrist) and leg (below front of knee, back of ankle on Achilles’ tendon). Sensation can be checked using different items but is usually checked by light touch on the same parts of the arm or leg at
the same time. A sterile pin touched lightly on the area to be checked can also be used. Different areas of the body are touched while the patient’s eyes are closed and the doctor asks whether the touch feels the same on both sides or if a sharp or
dull feeling is experienced with the pin. Position sense is checked by being able to tell if your finger or toe is being held up or down with eyes closed. Vibration sense is tested on a finger or toe joint with a tool called a tuning fork (a six-inch
or so steel piece that vibrates when tapped lightly). Your job is to tell the doctor if it’s vibrating and when it stops. Finally, the extremities are checked for the pulses(circulation) in the arm and leg and for any vein abnormalities.
The rest of the neurological exam involves checking the way you walk, talk, and answer a few questions designed to check the mental state(such as where you are, the date, ability to identify a simple object). The cranial nerves(nerves involving the face and neck area) can also be checked now, if they were not included in the head and neck exam. During the back exam the doctor first looks at your posture. The shoulders and hips are checked for symmetry and deformities. The muscles of the neck, posterior thorax (chest), and lower back are palpated to check for any tenderness or spasm. Likewise, the bones of the spinal column are also checked. Movement of the neck and lower back is
done actively and passively in all directions of movement.
Please be reminded that the way the physical exam is done may vary from doctor to doctor. This is unimportant as long as a complete physical exam is done. Please note that the above
description of the CPE is quite generalized and does not include every specific detail. Book references for more detail include: "Bates Pocket Guide to Physical Examination and History Taking" by Barbara Bates, M.D., et al. (also available on CDROM
and VHS tape), and "Bedside Diagnostic Examination" by Drs. Elmer and Richard DeGowan. Many medical school curricula use
these references.
Once the physical exam is complete, the doctor and assistant will leave the room so you can get dressed. If an EKG (electrocardiogram — heart tracing) and X-ray are going to be done, you may be asked to get partially dressed (bottoms only) and keep the gown on. If blood has not been taken, that can be done at this time, too. Following these tests you will be able to get fully dressed. The doctor will then sit down with you in the office or exam room and discuss your symptoms,the physical findings (normal vs. abnormal), diagnosis, and whether any further tests or treatments are needed.
This is also the time for obtaining any prescriptions and to be told about any further tests or specialists whose expertise will be required. The doctor may also counsel you with information about your diagnosis and treatment, as well as any number of preventive healthcare topics. You may also be given handouts and booklets. Doctors may refer you to pertinent medical and patient education websites such as www.webmd.com. Email is becoming another way to talk with your doctor, in addition to phone calls, regular mail, and faxes. Prescriptions for medication are usually given to the patient at the end of the visit. Prescriptions are written orders for medicine that the doctor
has chosen for you. The patient should take these to the drugstore as soon as possible to stay well or to hasten recovery. Prescription medication must be dispensed by a licensed pharmacist. Some doctors fax or call the prescription in to your drugstore. Asking the doctor to do this for you will ensure you receive your medication promptly and will save you a trip to the drugstore. Some doctors are now using e-prescriptions
over the computer to send in patient prescriptions. By giving your doctor the number for the druggist you use, you will be able
to get a prescription filled in less time. You may also get prescriptions for medicine that can be bought over the counter—that is, without a pharmacist. Your pharmacist is the best person to help you with obtaining your medicine, discussing side effects and interactions, what the medicine is for, and so on. Be sure to discuss this with your doctor, too.
Best health!
Patient Handbook to Medical Care: Your Personal Health Guide http://amzn.to/13m51UU FREE with Kindle unlimited!
The assistant will help you get in position. Your legs will be placed in stirrups (foot holders) that are at the end of the table. You will then slide your hips down until the buttocks touch the edge of the table. Your legs will then be able to relax
apart. (Some doctors have more comfortable exam chairs.) For those who might not be able to do this, there is the frog-leg position. The heels are brought together while the legs are bent: the heels are, thus, brought as close as possible to the
buttocks, like frog legs. For persons not able to assume either of these positions, referral to a gynecologist is necessary. Please note also that you should not be put in this position until the doctor is ready to examine you. That’s just good manners on the doctor’s part. Once the exam begins, the doctor will instruct you when to lie down. You should also be informed when and where you will be touched during each part of the exam. The doctor will be wearing latex gloves to do this part of the exam. You may also request that a mirror be placed so that you can watch the exam.
There are five basic parts of the pelvic exam. The first part is the exam of the external genital area where the doctor inspects and palpates for any abnormalities. The second part of the exam is done using a tool called a speculum. This is for looking into the vagina and at the cervix. It resembles a fancy pair of tongs (or a pelican beak) and is either plastic or metal. Most doctors
will and should warm the speculum with water before use. This allows for easier passage of the speculum. In the closed position the speculum is then placed gently in the vagina and opened to keep the vagina walls apart. When this is done,the doctor is able to see the cervix. The third part of the exam involves doing a Pap smear, which is a screening test for cancer of the cervix. A thin wooden stick about the size of a popsicle stick(called a spatula) and a stick with a tiny (about quarter-inch) brush on the end are used to do the test. When gently rubbed against the cervix, they are able to pick up cells. The cell samples are then placed on a glass side or in a test tube, which is then sent to the lab. The speculum is then removed.
Part four is the bimanual exam, which includes palpation of the internal female organs. One or two fingers that have been lubricated are placed in the vagina, while the other hand presses
over the pelvic (lower abdomen) area. The uterus(womb) and ovaries (eggs)can be felt for any tenderness or masses. The last part of the exam is the rectovaginal exam. Using a clean lubricated glove, one finger is inserted into the vagina and a
second finger into the rectum. This is an important part of the exam for two reasons: to check the rectum for bleeding and masses, and to further palpate the female organs. A complete
pelvic exam includes a rectal exam. The stool is checked for blood by placing a sample of stool from the gloved finger in the rectum onto a special card (commonly called guaiac or Hemoccult cards). If there is no stool for the specimen, your doctor will give you cards with instructions on how to collect samples at home. Once completed, the cards are returned to the doctor to be checked for blood. This is a very important test. Small amounts of blood in the stool cannot be seen with the naked eye but can
be detected with this test.
The male genital exam is the equivalent of the female pelvic. The doctor inspects first. With gloved hands, the penis glans (tip) and shaft are checked. If the male is not circumcised, the
foreskin (extra skin) should be pulled back. Then each scrotal sac is palpated to check the testicles for any abnormal lumps or bumps. This is a good time for the doctor to show you how to do your own monthly scrotal exam. Next the famous “cough” test is done in standing position. This is to check for hernias and is done with the insertion of the examining finger into the scrotal
and inguinal (groin) area while the patient coughs. It is done on the right and left side. The rectal exam follows and is usually done with the doctor’s lubricated gloved index finger inserted into the rectum. In addition to checking the stool
for blood, the prostate gland (which makes male fluids) is also checked for size, tenderness, and masses. This is an important cancer screening test for men and should be done routinely after age 40.
Examination of the musculoskeletal system(arms, legs, back), nervous system (including mental health), and skin mark the end of the complete physical. The extremities (arms and legs)are checked for symmetry (the same on both sides, and were being checked as you got on and off the exam table, to see if you required assistance or were using an assistive device such as a wheelchair,walker, or cane. Following instructions and answering the doctor’s questions during the exam allows for an indirect check of the nervous system. The skin can be inspected as each of the previous parts of the physical is done. Be sure to
have the doctor show you how to do your own self skin exam.
The inspection of the extremities continues as the doctor looks for scars, skin color change,edema (swelling), and effusions (joint swelling). The joints of the arms and legs are then tested for range of motion (actual movement) actively (movements done by patient) and passively (extremities are moved by the doctor). They are also checked for any tenderness, swelling, and
warmth or coolness. The strength, reflexes, and sensation(feeling)in the extremities are usually tested at this time or can be included in the neurologic(nervous system) exam. Strength is tested by resisting the doctor’s strength. Pushing the hand against the doctor’s hand, kicking the leg out, and gripping a finger with your hand are all relative tests of strength. The reflexes are checked with a reflex hammer at several places on
the arm (front and back of the elbow, above the wrist) and leg (below front of knee, back of ankle on Achilles’ tendon). Sensation can be checked using different items but is usually checked by light touch on the same parts of the arm or leg at
the same time. A sterile pin touched lightly on the area to be checked can also be used. Different areas of the body are touched while the patient’s eyes are closed and the doctor asks whether the touch feels the same on both sides or if a sharp or
dull feeling is experienced with the pin. Position sense is checked by being able to tell if your finger or toe is being held up or down with eyes closed. Vibration sense is tested on a finger or toe joint with a tool called a tuning fork (a six-inch
or so steel piece that vibrates when tapped lightly). Your job is to tell the doctor if it’s vibrating and when it stops. Finally, the extremities are checked for the pulses(circulation) in the arm and leg and for any vein abnormalities.
The rest of the neurological exam involves checking the way you walk, talk, and answer a few questions designed to check the mental state(such as where you are, the date, ability to identify a simple object). The cranial nerves(nerves involving the face and neck area) can also be checked now, if they were not included in the head and neck exam. During the back exam the doctor first looks at your posture. The shoulders and hips are checked for symmetry and deformities. The muscles of the neck, posterior thorax (chest), and lower back are palpated to check for any tenderness or spasm. Likewise, the bones of the spinal column are also checked. Movement of the neck and lower back is
done actively and passively in all directions of movement.
Please be reminded that the way the physical exam is done may vary from doctor to doctor. This is unimportant as long as a complete physical exam is done. Please note that the above
description of the CPE is quite generalized and does not include every specific detail. Book references for more detail include: "Bates Pocket Guide to Physical Examination and History Taking" by Barbara Bates, M.D., et al. (also available on CDROM
and VHS tape), and "Bedside Diagnostic Examination" by Drs. Elmer and Richard DeGowan. Many medical school curricula use
these references.
Once the physical exam is complete, the doctor and assistant will leave the room so you can get dressed. If an EKG (electrocardiogram — heart tracing) and X-ray are going to be done, you may be asked to get partially dressed (bottoms only) and keep the gown on. If blood has not been taken, that can be done at this time, too. Following these tests you will be able to get fully dressed. The doctor will then sit down with you in the office or exam room and discuss your symptoms,the physical findings (normal vs. abnormal), diagnosis, and whether any further tests or treatments are needed.
This is also the time for obtaining any prescriptions and to be told about any further tests or specialists whose expertise will be required. The doctor may also counsel you with information about your diagnosis and treatment, as well as any number of preventive healthcare topics. You may also be given handouts and booklets. Doctors may refer you to pertinent medical and patient education websites such as www.webmd.com. Email is becoming another way to talk with your doctor, in addition to phone calls, regular mail, and faxes. Prescriptions for medication are usually given to the patient at the end of the visit. Prescriptions are written orders for medicine that the doctor
has chosen for you. The patient should take these to the drugstore as soon as possible to stay well or to hasten recovery. Prescription medication must be dispensed by a licensed pharmacist. Some doctors fax or call the prescription in to your drugstore. Asking the doctor to do this for you will ensure you receive your medication promptly and will save you a trip to the drugstore. Some doctors are now using e-prescriptions
over the computer to send in patient prescriptions. By giving your doctor the number for the druggist you use, you will be able
to get a prescription filled in less time. You may also get prescriptions for medicine that can be bought over the counter—that is, without a pharmacist. Your pharmacist is the best person to help you with obtaining your medicine, discussing side effects and interactions, what the medicine is for, and so on. Be sure to discuss this with your doctor, too.
Best health!
Patient Handbook to Medical Care: Your Personal Health Guide http://amzn.to/13m51UU FREE with Kindle unlimited!
lunes, 10 de mayo de 2010
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
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
domingo, 11 de abril de 2010
Disability Insurance & You
Have you thought about what you would do financially if you were were unable to work? If you were disabled short term or long term, where would the money come from? Disability insurance is one of the best lifetime investments you can make. Hopefully you will not have to use it, but you may need it.
It is important because anyone can have a devastating health challenge that could wipe them out physically and financially. Medical costs are one of the top reasons people end up in the poor house. Disability insurance payments allow you to have money for health needs as well as for everyday necessities. This is a very sensible thing to do.
Disability insurance is seldom talked about when it comes to insurance you need. Your house is insured. So is your car. So you should be insured, too. Life insurance is good, but pays off after you die.
Disability coverage is available as "own occupation" coverage. This type covers you for being unable to work at the occupation for which you have been explicitly educated, trained, and employed like doctor, lawyer, broadcast media, president, etc.
It is usually more expensive than basic generic coverage like Social Security, and pays more. The going rate is two-thirds of your salary.
If you pay for your own policy instead of allowing your employer to do so, your money is tax free. If you withdraw IRA monies early and provide proof of disability you are exempt from the penalty.
Protect yourself financially from medical disability and potential financial free fall. Disability insurance like health insurance protects your most important asset - YOU.
by J.L. Richardson, MD, family medicine physician and author of Patient Handbook to Medical Care: Your Personal Health Guide.
http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd
It is important because anyone can have a devastating health challenge that could wipe them out physically and financially. Medical costs are one of the top reasons people end up in the poor house. Disability insurance payments allow you to have money for health needs as well as for everyday necessities. This is a very sensible thing to do.
Disability insurance is seldom talked about when it comes to insurance you need. Your house is insured. So is your car. So you should be insured, too. Life insurance is good, but pays off after you die.
Disability coverage is available as "own occupation" coverage. This type covers you for being unable to work at the occupation for which you have been explicitly educated, trained, and employed like doctor, lawyer, broadcast media, president, etc.
It is usually more expensive than basic generic coverage like Social Security, and pays more. The going rate is two-thirds of your salary.
If you pay for your own policy instead of allowing your employer to do so, your money is tax free. If you withdraw IRA monies early and provide proof of disability you are exempt from the penalty.
Protect yourself financially from medical disability and potential financial free fall. Disability insurance like health insurance protects your most important asset - YOU.
by J.L. Richardson, MD, family medicine physician and author of Patient Handbook to Medical Care: Your Personal Health Guide.
http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd
miércoles, 2 de diciembre de 2009
Some Doctors Miss the Mark
For the past few years I have seen pain management specialists for chronic pain. Seeking relief after many, many years has indeed been a challenge. Each time I was referred to a pain management specialist for the neck and back pain (from arthritis and herniated discs), treatments offered were medicine (especially samples of new stuff), and invasive procedures like epidural spinals and trigger point injections. Alternative treatment was rarely offered, and if so was limited to 20-30 minutes physical therapy sessions for about six weeks every few years, upon my request.
Fortunately, my neurosurgeons saw the light. In efforts to achieve pain control and maintain function without surgery, other treatments such as massage and acupuncture were recommended. Sadly enough, these choices are not covered by my insurance. I am still waiting for over a year now for approval and payment for long term treatment (which works) instead of six weeks.
Even though some doctors miss the mark, there are others who are on the mark. As a savvy patient you must always recognize this. You have choices even if you must pay for medical services you need out of your pocket. It is a tough choice, but the best for your health. If there is something you need that is not covered by your insurance, you have choices. Make the one best for you, especially if your doctor misses the mark.
by J. L. Richardson, MD, family medicine doctor, patient advocate and author of Patient Handbook to Medical Care: Your Personal Health Guide.
Read excerpts at Google Books http://books.google.com/books?id=kPmXiNrg1pYC&printsec=frontcover&dq=patient+handbook+to+medical+care
www.twitter.com/MD4U
Fortunately, my neurosurgeons saw the light. In efforts to achieve pain control and maintain function without surgery, other treatments such as massage and acupuncture were recommended. Sadly enough, these choices are not covered by my insurance. I am still waiting for over a year now for approval and payment for long term treatment (which works) instead of six weeks.
Even though some doctors miss the mark, there are others who are on the mark. As a savvy patient you must always recognize this. You have choices even if you must pay for medical services you need out of your pocket. It is a tough choice, but the best for your health. If there is something you need that is not covered by your insurance, you have choices. Make the one best for you, especially if your doctor misses the mark.
by J. L. Richardson, MD, family medicine doctor, patient advocate and author of Patient Handbook to Medical Care: Your Personal Health Guide.
Read excerpts at Google Books http://books.google.com/books?id=kPmXiNrg1pYC&printsec=frontcover&dq=patient+handbook+to+medical+care
www.twitter.com/MD4U
viernes, 14 de agosto de 2009
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
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
viernes, 3 de julio de 2009
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.
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.
miércoles, 10 de junio de 2009
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/
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/
viernes, 27 de febrero de 2009
Drug Prices Cheaper With Coupons?
This week my doctor gave me samples (about 4 to be exact) of a new medication he thought would benefit me. He also gave me a coupon for up to $30 off with the written prescription he gave me. On this coupon your patient information must be disclosed. There is space for your name, address, and a check box "if payment to pharmacy".
I call it a coupon. The drug company calls it a copay assistance card. If by chance, your pharmacy does not accept the copay card it instructs you to complete the personal information and mail it in with your pharmacy receipt (cost to mail another 43 cents).
There are all sorts of codes listed on the card in a small box. What does this mean? It seems like some secret tagging process.
I have two issues with this - the privacy afforded patients by HIPAA , and the copay card itself. If you get "up to $30 off", that can only mean that the medication is at least $29.99. This is an average amount for any monthly supply of meds as far as I am concerned.
Thank you, but no thank you, doc. Did it ever dawn on you that I may not be able to fit this in my already tight medical budget? I would have appreciated more samples especially if you have prescribed it to help me. Even information about the drug would have been welcome.
I was turned down for more samples even after shouting down the hall that this seemed unaffordable. I was denied the time to even think about asking for written drug information. Makes you go hmmm....
J.L. Richardson, M.D. is author of the award winning (soon to be NY Times bestseller), Patient Handbook to Medical Care: Your Personal Health Guide.
http://mypatienthandbook.com/
I call it a coupon. The drug company calls it a copay assistance card. If by chance, your pharmacy does not accept the copay card it instructs you to complete the personal information and mail it in with your pharmacy receipt (cost to mail another 43 cents).
There are all sorts of codes listed on the card in a small box. What does this mean? It seems like some secret tagging process.
I have two issues with this - the privacy afforded patients by HIPAA , and the copay card itself. If you get "up to $30 off", that can only mean that the medication is at least $29.99. This is an average amount for any monthly supply of meds as far as I am concerned.
Thank you, but no thank you, doc. Did it ever dawn on you that I may not be able to fit this in my already tight medical budget? I would have appreciated more samples especially if you have prescribed it to help me. Even information about the drug would have been welcome.
I was turned down for more samples even after shouting down the hall that this seemed unaffordable. I was denied the time to even think about asking for written drug information. Makes you go hmmm....
J.L. Richardson, M.D. is author of the award winning (soon to be NY Times bestseller), Patient Handbook to Medical Care: Your Personal Health Guide.
http://mypatienthandbook.com/
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. 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
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
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.
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.
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