Even for the insured, the cost of copays and other out-of-pocket expenses add up quickly, whether you’re single or have a family. If you’re feeling the pinch, you’re not alone – according to a recent Kaiser Family Foundation poll, 53% of respondents said they had cut back on their health care to try and save money.

Many respondents reported an increased use of over-the-counter medications or home remedies, rather than scheduling a visit to their doctor. Others said they didn’t fill prescriptions to save money; some even skipped treatment or tests that their doctor recommended.

Ignoring your doctor’s instructions could prove risky if you have a serious medical condition. But no matter health status, you can cut down on some of the costs of healthcare without having to neglect your health. What can you do?

• When you visit a doctor, make sure you’re prepared. Take along all the information the doctor might need, including paperwork and medical records if necessary. Take note of whether your health has changed recently, including energy or weight fluctuations. If you have any questions you want to ask, make a note so you don’t forget them. Being prepared for a doctor’s visit cuts down on the need for repeat visits, and helps save on copays.
• Get your test results over the phone. Most of the time you won’t need to return to your doctor to get test results, so there’s no reason to spend money on the copayment when it’s not necessary.
• Consider setting up a flexible spending account when open enrollment comes around. Flexible spending accounts let you put pre-tax dollars aside to fund certain types of medical expenses.
• Call an organization such as the Patient Advocate Foundation (800- 532-5274) if you have a chronic disease and want some help with getting the most out of your insurance plan.
• If you’re uninsured, then consider visiting a store clinic. In some locations, retailers such as Target and Wal-Mart now run clinics where you can receive routine medical care for about half the price of a doctor’s visit.
• Try and track down locations where you can receive free medical screening. Organizations such as the American Cancer Society and the Centers for Disease Control and Prevention can help you locate such programs.
• Request a quote for affordable health insurance here. Our system is able to connect you with leading health insurance carriers from across the country, and it could save you a lot of money on premiums or health care costs.

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According to the results of a new national survey, less than 2% of American hospitals have completely switched to an electronic medical record-keeping system.

Between 8% and 11% of hospitals have partial electronic systems in place, with at least one department in those hospitals having converted to a digital record-keeping system.

Dr. David Blumenthal, head of the Institute for Health Policy at Massachusetts General Hospital, says that American hospitals are at a “very low stage” of adoption of digital technology as compared to other countries. But with less than 2% of American hospitals completely digital, this seems to be a massive understatement.

American hospitals – and doctor’s offices, for that matter, with just 17% of American physicians using digital record-keeping technology – have a very long way to go.

Health Records, Health Insurance, and Saving Money

Previously, the Bush administration set a goal of 2014, by which time the entire country would (theoretically) have transferred to an electronic medical record-keeping system. This goal got a much-needed boost earlier this year when President Obama signed the economic stimulus package which includes $19 billion for converting physicians and hospitals to an electronic system. (Interestingly enough, the majority of the money is earmarked for incentives to encourage doctors and hospitals to use electronic systems.)

The money is certainly needed. A small hospital to convert to an electronic medical record-keeping system, around $20 million in capital is required. For a large academic hospital, that figure can range up to $200 million. For around 75% of hospitals, lack of funding is the main barrio towards updating their record-keeping systems. Approximately 44% also cited maintenance costs as a significant barrier.

Given the enormous cost, the survey results that show 98% of hospitals, and 83% of doctors are in need of an electronic updage, are somewhat sobering. Will $19 billion be enough to update the country’s antiquated medical record-keeping systems?

Photo credit: David Boyle in DC

How many prescription medications are you taking? How many over-the-counter herbal medications or other nutritional supplements? The alarming results of a new study on the combinations of medications taken by American seniors indicate that it’s best to be cautious about taking certain prescription and over-the-counter medications in tandem.

According to the report—which reviewed the medications taken by 3,000 men and women aged between 57 and 85—at least two million older Americans might be taking a potentially dangerous combination of prescription or over-the-counter medications. And up to one in ten older men might be taking a combination of drugs which could be potentially harmful.

Another factor affecting seniors is the fact that older people tend to take more medications overall, including both prescription and over-the-counter preparations. In the 57 to 85 age group, 91% of people take at least one medication, and more than half use five or more medications, including prescription and over-the-counter drugs.

The consequences of drug combinations aren’t always dangerous, but for older people, the side effects and interactions of drugs and over-the-counter medications are often more hazardous, due to the way metabolism changes as we age.

An example of a potentially serious drug interaction is that between warfarin, which is used to dissolve blood clots, and aspirin, which has a similar blood-thinning effect. The risk of internal bleeding can become dangerously high when both drugs are taken together. The combination of warfarin and garlic can also have a similar effect.

Other potentially dangerous combinations include:

• Aspirin and gingko biloba, taken together, can increase the risk of excessive bleeding.
• Taking Lisinopril (prescribed for blood pressure), along with potassium supplements (which may be prescribed because some blood pressure drugs reduce potassium levels), can cause abnormal heart rhythms.
• Over-the-counter niacin supplements can be dangerous when taken with statins (prescribed for managing cholesterol levels), due to an increased potential for muscle damage.

Experts say it’s best to be cautious when it comes to over-the-counter medications – don’t take them without the ok from your doctor, and make sure you ask about side effects and drug interactions every time your doctor prescribes a new medication.

photo credit: Nils Geylen

Many of us are predisposed towards a mistrust of drug companies. The fact is, they make billions of dollars every year, and it seems like most would do anything for a buck. Recent news that AstraZeneca allegedly suppressed negative information about Seroquel, an anti-psychotic drug, is not helping the tarnished image that the pharmaceutical industry has earned.

A Washington Post article published recently outlines the study, known as “Study 15,” and reported that AstraZeneca had suppressed the study’s negative results, and at the same time promoted more positive results from other studies with less stringent protocols.

Also reported by the Washington Post: The shocking fact that one employee of AstraZeneca praised a colleague’s “smoke and mirrors job” in reference to the suppression of the negative results. Those suppressed results include a possible link between Seroquel and the development of diabetes. In addition, the study showed that Seroquel was no better than other anti-psychotic drugs at preventing psychotic relapses.

Who To Trust With Your Health And Prescription Drugs

Sometimes, it’s hard to know who to trust. And unfortunately, some doctors can’t be trusted when it comes to clinical trials either.

Dr. Scott Reuben, an anesthesiologist currently on leave from Springfield’s Baystate Medical Center in Massachusetts, has been accused of faking data in clinical trials for a staggering twelve years. According to the accusations, Dr. Reuben is responsible for faked data in no less than 21 published medical papers.

• According to news released by the Baystate Medical Center, a routine hospital review carried out in 2008 revealed that some of the doctor’s research had not been approved by the hospital’s review board.
• An investigation into the issue found that Reuben had made up some or all of the data in 21 papers published over the last twelve years.
• The data involves several drugs, including Celebrex, Lyrica, and Effexor, and Reuben attests to their effectiveness as painkillers in the published studies.

On the basis of the studies, Reuben had received numerous research grants from several sources, including drug company Pfizer, which makes and markets Celebrex.

As if the monetary rewards weren’t bad enough, the doctor has become widely respected in the field of anesthesiology on the basis of his fraudulent research, and many doctors have been basing their own use of pain relievers on Reuben’s results.

And even worse for patients, some of the drugs Reuben “studied” have been shown to delay bone healing – but Reuben’s work didn’t show up any of those problems. It’s now likely that many of the clinical trials Reuben published will be redone to ensure that accurate results are achieved.

photo credit: HA! Designs – Artbyheather

One of the great ironies of the insurance system is that when you’re sick and need the protection of health insurance the most, you can expect to pay a lot more for your premiums. It’s practically one of the certainties of life, like death and taxes, that are invariably true for everyone. But is that about to change?

Health Plan Companies Consider Removing Pre-existing Condition Penalties

For the first time, the health insurance industry has been talking about the possibility of ceasing its practice of charging much higher premiums for health insurance applicants with pre-existing medical conditions or a history of medical problems.

The offer comes from America’s Health Insurance Plans and the Blue Cross and Blue Shield Association, and – make no mistake – this is a big deal.

In the wake of the Obama administration’s plans to reform America’s health care system to provide coverage for the estimated 48 million who are currently uninsured, these insurance industry groups have stated their willingness to make a start at charging fair premiums for all Americans.

In their letter to key senators, the two organizations spoke of their willingness to “phase out the practice of varying premiums based on health status in the individual market” if health coverage becomes mandatory for all Americans.

Why is this so important? Because it means these organizations are willing to move away from the risk-assessment factor of insurance premiums – meaning that people who have a history of medical problems won’t be penalized when it comes to getting health insurance.

It’s not all sunshine and roses, however. Insurance companies will still charge different premiums based on other factors such as sex, age, and location. And certain groups, such as small business owners, have been left out in the cold. Small business owners are often hit hard by risk-assessment, because if just one worker becomes seriously ill premiums can sky-rocket the following year.

Financial Motives of Changing the Pre-existing Condition Health Insurance Policy

And, of course, the motive for all of this is purely financial. Insurers are simply trying to gain political support in an attempt to stall the creation of a government insurance plan that would necessarily compete with private insurers.

But whatever the motive, the outcomes could certainly be positive. The insurance industry has already discussed support of a national goal to prevent insurance costs rising, and, in its bid to fend off the competition, has also offered to end its practice of outright denying health coverage to people with pre-existing conditions.

photo credit: SavaTheAggie

President-elect Barack Obama should take note – health reform is about the little things just as much as it is sweeping changes to the system.

Information gathered from a batch of more than 8,500 meetings held around the country in December will be compiled and used to help design the healthcare proposal that has been in the news as of late. Obama’s transition team plans to post some of the material at change.gov.

One particular meeting took place late December 2008, between newly appointed secretary of health and human services, the former Senate Majority Leader Tom Daschle, and more than two dozen seniors During this meeting, seniors told Daschle that they placed more importance on certain things such as waiting times to see their doctor, the increasing cost of prescription drugs, and the narrow range of Medicare coverage for certain medical procedures, equipment, and treatments.

An Example for Health Care Reform: Alzheimer’s

One woman at the meeting cited her family’s history of Alzheimer’s disease for her hope that the new administration will put heavy emphasis on medical research. A man said that helping people live healthier lives should receive more emphasis than it currently does – not only to improve health, but also to reduce medical costs for individuals and the nation as a whole. Another man says he wants medical providers to show more concern for the people they treat than whether or not those people will pay their medical bills.

Daschle says that lawmakers are more likely to get behind a new health care system if voters provide enough incentive pressure. And it seems that the transition team is listening: The Obama administration is encouraging seniors to submit their own stories about health care – and any other issues they think need to be addressed.

The team should also take one final note: The current effort to gather information about the health care system has been compared to the 2005-2006 attempt by the Citizens Health Care Working Group. More than 6,500 people participated in meetings across America, and a further 14,000 participated in online surveys. The Congress-sponsored group eventually recommended guaranteed health coverage for certain doctor’s visits, and some ways to protect people from high health care costs – but none of its recommendations were acted upon.

Let’s hope that this new round of meetings prompts some real change.

photo credit: woodleywonderworks

It’s not just the unemployed facing healthcare insurance problems, according to a new Robert Wood Johnson Foundation report compiling research carried out by the State Health Access Data Assistance Center at the University of Minnesota. Nearly 20% of American workers have no health insurance, up from around 14% in the mid-1990s.

During the mid-1990s, one in seven American workers had no insurance. Just ten years later, that figure has increased to one in five workers uninsured, or around six-million more people over the mid-1990s total.

What’s causing the high rates of uninsured workers?

What has caused the drop in insurance rates? The study notes that it’s likely due to an increase in the cost of insurance – premium costs for employer-sponsored healthcare have increased up to eight times faster than wages, meaning that fewer employers and fewer workers can afford the coverage.

Another fact the study notes is that many workers are newly uninsured, and the percentage of uninsured workers has risen sharply in the last couple of years. Finally, while up to 20% of workers no longer have insurance, around 90% of children are covered, as well as almost all retirees.

Criticism of the health insurance statistics

Some have criticized the statistics and the healthcare system on the basis of the disparity of insurance rates between workers and retirees – saying that workers are paying the bill for coverage for people who are no longer working. But is this really fair?

Today’s retirees – the people who are now on Medicare – are the taxpayers of the last generation. They’ve already paid for the healthcare they’re now receiving. And the current generation of tax-paying workers is paying now for the Medicare they’ll receive when they hit retirement age.

The real problem is that there just aren’t any insurance safety nets for working adults. SCHIP provides coverage for children and young people, while Medicare provides for seniors. For working adults, however, the options tend to be limited to employer-sponsored care, private insurance, or nothing at all.

More significant in terms of the study’s statistics is the fact that the mid-2000s figures were taken from Census 2007 results – and given current trends it’s likely that the number of uninsured workers is actually much higher than one in five.

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Fibromyalgia is a devastating disease that causes chronic pain and other symptoms for those who are affected – but it’s a disease with no known cause and no standard treatment. Many people haven’t even heard of the condition, but if that’s the case it’s not because the drug industry isn’t trying hard enough.

Drug Companies’ Hundreds of Millions Help Raise Awareness of Fibromyalgia

Last year, drug industry giants Pfizer and Eli Lilly spent hundreds of millions of dollars in advertising to “raise awareness” of fibromyalgia. The companies donated more than six million dollars to non-profit organizations for educational campaigns and medical conferences, too.

That’s more than the companies donated for Alzheimer’s, and diabetes. And only donations made for cancer, depression, and AIDS were higher than the donations made to further the cause of fibromyalgia.

Why all this trouble for a disease nobody’s heard of, that some doctors don’t even believe exists? Simple. Pfizer and Eli Lilly are using their money and influence to “raise awareness” and get doctors prescribing fibromyalgia drugs for people with the disease.

Is Fibromyalgia Real? Why the Sudden Drug Company Interest?

Fibromyalgia is a real disease, especially to those people who are affected by it. But there’s no standard treatment – just a couple of drugs more commonly used to treat other conditions which improve symptoms for some people with fibromyalgia.

Pfizer markets a drug called Lyrica, which originally received FDA approval for the treatment of epileptic seizers. Eli Lilly’s drug, Cymbalta, was originally approved for depression. Both have now been FDA-approved to treat fibromyalgia symptoms and will probably soon be appearing on the formulary lists of prescription drug plans, if they haven’t already.

Sales of the Fibromyalgia Prescriptions since Big-pharma’s Campaign

Since the companies began marketing “awareness” for fibromyalgia, sales increased from $395 million to $702 million for Lyrica, and from $442 million to $721 million for Cymbalta, between 2007 and 2008. Each company spent just over $125 million in advertising its drugs in the first nine months of 2008.

Now this might not necessarily be a bad thing. After all, people with this chronic, painful condition are getting treatment that they need.

The problem, however, is that the underlying purpose for Eli Lilly and Pfizer is simply selling drugs, and some healthcare professionals are concerned that undue influence from the pharmaceutical industry will pressure doctors into diagnosing fibromyalgia more often, even if it might not be appropriate.

In addition, some doctors believe that fibromyalgia, while a real condition, isn’t necessarily physical – that there may also be a psychological or neurological component in the development of the disease. If that’s the case, the drugs that Pfizer and Eli Lilly are pushing may not be the best solution for people with fibromyalgia.

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When a doctor explains treatment options to a patient, it’s often little understood; frequently glossed over; and delivered in over-technical terms. A new movement in health care is makings strides to change the status quo, and with it the decisions of a whole new group of patients.

Case Examples of Informed Consent Opportunities

Currently, the most effective early warning signal for prostate cancer is an elevated level of prostate-specific antigen in the blood. But that test is nowhere near perfect – many men with prostate cancer test negative for PSA, and men who are overweight and have developed prostate cancer often have reduced PSA levels. Up to 25% of men with prostate cancer test negative for elevated PSA.

The medical world is full of situations like these, where tests and diagnoses are not as clear-cut as patients might think. If you knew that some blood tests were unreliable, would you still choose to take them? What about when the situation is more serious than a simple blood test – what if you had to choose between several rounds of chemotherapy, or the removal of one or both breasts, as a treatment for breast cancer?

The Solution to Improving Patient Decision-making

The fact is, with medical science becoming increasingly sophisticated and more highly technical, it’s harder for patients to keep up. What’s the solution? A growing movement of doctors is pushing for a solution that has become known as informed consent 2.0. The idea is to promote more extensive patient education in the form of decision aids – guidelines written in plain English, rather than overly technical medical language, to help patients fully understand the positives and negatives of their options for medical treatment.

The goal, say the doctors, is for patients to view these guides before they visit their doctor, so that during the appointment more time can be spent on patient decisions rather than explaining their options. At New Hampshire’s Dartmouth-Hitchcock Medical Center, for example, every woman who is diagnosed with early-stage breast cancer views a video decision aid before ever seeing a surgeon. The video includes information about treatment options – tumor removal followed by chemotherapy or full – breast removal and explains that both options produce almost equal survivability results.

Programs such as these are even more important in light of the results of a recent study from the University of Michigan which suggests that many patients making common medical decisions over medication and other treatments are not well informed. Many patients, for example, said their doctors rarely discussed the disadvantages of various treatment options.

photo credit: Lisa Brewster

The $787 billion economic stimulus package that was signed into law last week includes one or two health-related measures that haven’t been widely publicized, but which are no less important for it.

One of these is the $1.1 billion that has been assigned for a study to compare the effectiveness of a large number of medical treatments, drugs, surgeries, and other current standard medical procedures and devices. A council of fifteen federal employees will be set up to coordinate the research and advise the President and Congress on where the money would best be spent.

The program is a response to growing concerns that doctors have little solid evidence on which to base the value of many of the treatments that are currently considered standard.

Questions to Answer with the Stimulus Package Health Care Money

According to Dr. Elliott S. Fisher of Dartmouth Medical School, the study will help answer questions such as these:

• Should severe neck pain be treated with physical therapy, medication, and exercise, or with surgery?
• What is the best combination of prescription medication and therapy for the treatment of depression?
• Is it more effective to treat arterial blockage in the legs with medication or with surgery?
• Is medication alone an effective treatment for chronic heart failure, or are active health intervention measures also necessary?

Second Concern: Rapidly Increasing Health Care Costs

A second concern is the rapidly increasing cost of health care. Healthcare spending hit a total of $2.2 trillion in 2007. That’s 16% of gross domestic product – and it’s been estimated that figure will hit 25% by 2025. It is hoped that the research will save money by discouraging the use of expensive treatments that are largely ineffective and, at the same time, boosting the use of more effective treatments. During her years as a senator, Hilary Rodham Clinton was a firm proponent of such research and President Obama endorsed the concept during his White House campaign.

Not everyone is supportive of the idea of spending millions of taxpayer dollars on health care comparison studies. Critics say it may allow the federal government to be too intrusive when it comes to personal health care choices, and may jeopardize the doctor-patient relationship by put the government squarely between patients and health care professions. Others worry that insurance companies will use the data gained from the study as an excuse to deny coverage of more costly medical treatments.

photo credit: Emily Taliaferro Prince