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.

photo credit: effekt!

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

Japan’s overcrowded, understaffed hospitals are in danger – and so are the people who rely on those hospitals when they need emergency medical care. An elderly Japanese man who sustained head injuries after being struck by a motorcycle waited ninety minutes in an ambulance – while paramedics phoned fourteen different Tokyo hospitals, trying to find a hospital that would accept the man for treatment. All the hospitals refused to admit the injured man, saying they lacked the equipment and staff needed to treat him. The paramedics arrived at the accident site just a few minutes after the 69-year-old man was injured, but ninety minutes and fourteen hospitals later, the man died just a short time after paramedics finally located a hospital that would accept him for treatment. The man died from the shock caused by the loss of a large amount of blood – a condition which the man might have survived if he had received treatment earlier.

Stretching the Health Care System

This incident is only the latest in a list of recent cases occurring in Japan, where the emergency healthcare system is stretched thin due to staff shortages and the medical needs of an aging population. According to Japanese Health Minister Yoichi Masuzoe, the rapidly increasing number of elderly patients is a large part of the problem, with hospitals so full that there just isn’t room for emergency patients. While this particular incident clearly highlights the problems for Japan’s overburdened healthcare system, it is by no means an isolated occurrence. In 2007, more than fourteen thousand emergency patients were rejected three or more times by overcrowded hospitals before finally receiving treatment. The worst case so far was that of a woman who was rejected 49 times before finally receiving emergency treatment for breathing difficulties. Another high profile case, that of a pregnant woman who died eight days after being refused admission by nineteen different hospitals, finally prompted the government to establish a panel to investigate the issue.

What Tokyo is Doing to Change Things

Following the most recent incident, the city of Tokyo issued a directive that requires paramedics to coordinate with emergency call centers so that emergency patients can be accepted to a hospital within fifteen minutes. However, this doesn’t solve the most pressing problem of hospital overcrowding. Health Minister Yoichi Masuzoe has urged that the government develop a community support system to reduce the burden placed on hospitals. The Japanese government has also announced plans to improve coordination between hospitals and the emergency support system, and to increase doctor numbers in understaffed hospitals.

photo credit: udono

After being accused of overcharging millions for health care insurance, one of America’s biggest insurers has agreed to a $50 million settlement pay-out.

Hundreds of people made complaints about charges made by Oxford Insurance, and its parent company UnitedHealth Group. The parent company claims that its reimbursement rates are based on “independent research from across the health care industry,” but an investigation by the New York Attorney General’s office revealed that it’s actually Ingenix, a research firm owned and operated by UnitedHealth Group, that supplies the data.

This isn’t just a case of conflict of interest, however – it gets much worse.

According to New York Attorney General Andrew Cuomo, Ingenix has been manipulating the data, allowing UnitedHealth Group’s Oxford Insurance to pay less for reimbursement of its customers.

Surprising Findings in the Health report

Cuomo’s report says that UnitedHealth Group has been under-reimbursing on an enormous scale, “to the tune of at least hundreds of millions of dollars:” in a “huge scam that affected hundreds of millions of Americans.”

In one example, Yonkers, New York, resident Mary Jerome ended up owing a whopping $46,000 for procedures that Oxford Insurance determined were not “usual, customary, or reasonable.”

So what were these unnecessary procedures – cosmetic surgery? No. Those procedures that the company decided did not require reimbursement were chemotherapy and other medications Mary Jerome needed to fight the ovarian cancer she was diagnosed with in 2006.

So far, only UnitedHealth Group and Oxford Insurance have been investigated. However, several other major insurance companies use data supplied by Ingenix. Among them are Aetna, CIGNA, and WellPoint/Empire BlueCross BlueShield.

UnitedHealth Group Response

UnitedHealth Group continues to deny the charges, saying instead that it agreed to the settlement only to solve the conflict, “We respectfully disagree with the New York Attorney General’s findings that we manipulated data … (or that our ownership of Ingenix was a conflict of interest.) We agreed to his settlement because it was an effective way to address any perceived conflict of interest.”

Ivestigations Continue

Cuomo’s investigations aren’t over. In light of the fact that several other large insurers use Ingenix data to determine patient reimbursement rates, the questions continue to pile up.

UnitedHealth Group’s $50 million settlement will be used in the creation of a non-profit, organization that will help determine reimbursement levels in a genuinely independent fashion.

photo credit: rick

Trees are good for your health – they suck up carbon dioxide and release oxygen, help reduce greenhouse gases and provide welcoming shade during the summer. But those aren’t the trees that have recently been in the news for helping to improve the health of many Americans. This time it’s family trees that are up for discussion – and electronic ones, at that.

Importance of Knowing Your Health History

The importance of knowing your family medical history can’t be emphasized strongly enough, according to Acting Surgeon General Steven Galson, whose office has been in charge of a new initiative to promote the use of a website where users can grow an electronic family tree to find out where their health risks lie.

The government’s new free service is hoping that people will compile their own family tree at home, and share the information with their families. Compiling an extensive and accurate family tree is even more useful than genetic testing to predict what your medical requirements might be in the future, experts say. It’s a highly useful tool for doctors, too, since it saves time and also provides lots of useful information about potential health risks. You can even use it as you’re applying, or looking into various family health insurance plans.

Significant Benefits of an Online Family Health Tree

The most significant benefit, perhaps, is that it’s likely to be more accurate than anything you remember off-the-cuff in a doctor’s waiting room. And by sharing the information with relatives from both sides of the family, it’s easier to compile an accurate family health tree that includes all the information that’s important.

The family health tree site at https://familyhistory.hhs.gov makes it easy to compile this information. The electronic tree you create can be easily mailed to relatives, who can add their own information into the tree. The information is entirely private, too. Information is downloaded to the user’s own computer, rather than being held on the web site.

Even more useful is the fact that a single click can “re-index” the tree to concentrate on showing the health risks of any relative on the tree – so it’s useful for everyone, not just the person who creates it.

Another benefit is the fact that environmental and lifestyle factors can be added to the tree – factors that are often forgotten during doctor’s visits. The family tree can be printed out or even emailed directly to your doctor, ensuring that none of that valuable information is lost.

photo credit: Wolfiewolf

The Consolidated Omnibus Budget Reconciliation Act (COBRA) was approved by the federal government in 1985, but in the intervening 23 years thousands of Americans have found that the scheme isn’t as useful as it seems. Now, with the economic crisis putting millions out of work, the failings of COBRA are beginning to be revealed, in all their dubious glory.

Under COBRA, workers who lose their jobs can still retain the employer healthcare that job provided. They can retain the healthcare for up to eighteen months, but they must pay for the full price of upkeep once their employment terminates. While employed, they pay only a portion of the premium, with their employer footing the bill for the remainder. But after their employment is terminated, they’ll pay both shares.

It sounds like a great idea – and it works in theory – but the reality is that to maintain their healthcare after losing their jobs, the average worker must pay as much as 30% of their unemployment check. When a family, rather than a single person is involved, that figure can rise to an astonishing 84%.

Real Affects Felt By Real People

One case, cited by healthcare advocacy group Families USA, involved a Minnesota woman forced to rely on COBRA to maintain healthcare coverage for herself and her husband after she lost her job. Her monthly unemployment check amounted to $1,612, while the COBRA coverage bill was $1,200. In Arizona, the situation is even more dire – the monthly COBRA bill for a family is $1,084, and the average monthly unemployment check is just $937.

So clearly, there’s a big problem here, in that maintaining healthcare coverage after losing employment places an enormous financial burden, particularly for families. It’s no wonder that the ranks of the uninsured have swelled at such a staggering rate over the last year, just as the unemployment figures have been increasing.

COBRA’s Last Leg?

According to the Kaiser Family Foundation and Health Research and Educational Trust, a full 80% of workers who are eligible for COBRA don’t use it if their employment is terminated. Given the cost, it’s no surprise that more people aren’t using it. Many advocacy groups are hopeful that the new administration will address COBRA’s inherent failings, but in the meantime, increasing numbers of Americans are finding out first hand that the protection that COBRA was supposed to provide just isn’t there.

photo credit: Obama-Biden Transition Project

Universal healthcare could be useful in more ways than one. With more than half a million jobs lost in America in November (the biggest decline in a single month in more than thirty years), the country is in dire straights. Nearly 7% of the nation is wholly unemployed, and a total of 12.5% are either unemployed or barely working. That’s 19.3 million Americans who have little or no work.

The incoming administration is preparing a stimulus package to be introduced in the New Year, intended to get the economy ticking over again by investing billions in infrastructure. The package may include upgrading school buildings, upgrading public buildings to improve energy efficiency, building of bridges and roads, extending the reach of broadband internet, and improving electronic record keeping for medical billing.

What About Healthcare?

But what about healthcare reform? The much-touted universal healthcare program doesn’t top the to-do list – but should it? Developing universal healthcare as part of the economic stimulus package could have many beneficial effects. Economic stimulation is only the tip of the iceberg – overall, American citizens would enjoy improved financial security, and just as important, the barriers to that much-needed healthcare reform would finally start coming down.

America’s healthcare problems are impossible to ignore. The country spends 16% of gross domestic products on healthcare – more than any other in the world. But despite this, America lags far behind in life expectancy (#48) and infant mortality (#29). Nearly 40 million Americans lacked health insurance in 2007, and that figure is likely to be very much higher now.

Given all these problems, it’s easy to see why universal healthcare could be just what the doctor ordered. With a universal healthcare program in place, every citizen under the age of 65 would be insured, either through a qualified company, or via a government-sponsored insurance program (over-65s are already covered by Medicare).

The Uninsured in America

In the short term, universal coverage would provide an excellent and much-needed boost to the country’s economy. Increasing numbers of people are having trouble paying their medical bills (or accrued medical debts), and in 2007, some 116 million were either uninsured, had problems paying medical bills, or had to forgo medical treatment due to the cost.

And these are average, ordinary Americans – Main Street, not Wall Street. Targeting healthcare as an economic stimulus measure would benefit ordinary, average workers and help relieve one of the most pressing problems for people who lost their jobs during the past year.

There are problems, of course, not the least of which is the cost – an estimated $160 billion a year, and an additional $100 to $200 billion just to set the program up. And this might not turn out to be a long-term solution. But as far as solutions go, it’s hard to see that new bridges and roads are any better – and perhaps the most significant benefit of using healthcare reforms is that the people who benefit the most are this country’s citizens.

photo credit: yosoynuts

Case in Point: Health Insurance in Germany

Take Germany for example; there you will find all working individuals pitching in 8% of their earnings to the health care system. Everyone is given equal access to medical care and procedures with no long waiting periods or prejudice – even those who have chronic illnesses. Many people have the perspective that universal health care doesn’t give quick access, but results have shown otherwise; getting seen by the doctor isn’t difficult and sometimes house calls are even made. Unlike in America, Germany has a 24-hour number you can call to talk to an actual doctor – in the U.S. individuals can hardly get in touch with one. Ten percent have access to special care because they spend more for the coverage – these are entrepreneurs and those that can afford it ($72,000+ annual salary). They are also treated first and they receive extra services.

Raw Numbers: German Health Care

America has approximately 302 million people, a life expectancy of 78 and 15.3% GDP spent annually on health care. In Germany, there are approximately 82.3 million people with a life expectancy of 79 and a 10.7% GDP health care spending rate each year. The health care in Germany is universal – 88% being employer-employee based. In America, it’s 54% employee-employer based and 46% governmental funded (Medicare and Medicaid). The individuals that are covered make up 82% of the adults under 65 and 100% of the individuals who are over 65. In Germany the coverage is 99.8% of all the citizens and legal residents.

The health care spending average per person in America is $6,402 — $2,884 of it from the government, $4,676 paid to private insurance (52% of costs paid by employer and the rest by the employee) and $842 in out-of-pocket costs. In Germany the annual per person costs for health care is $3,673 — $2,518 of it is required from the employment-based coverage or non-for-profit agencies, $259 paid to for-profit agencies, $349 from the government and $547 in out-of-pocket costs.

Germans pay 8% of their gross income towards health care and those who make over $75,000 can and have to get for-profit insurance. In America, financing is from the bigger companies are self-insured, government programs like Medicaid/Medicaid and co-payments and deductibles from plans. Included in the coverage in Germany are comprehensive care, basic dental, full prescription coverage and long-term care. America is known for having leading edge advanced medical technology, drugs and medical centers. Most can choose their own doctor.

Problems faced in the German health care system include large and growing population, high rate of specialist visits and high costs. In America, health care problems are the access to health insurance for those working and still in poverty, rich and poor discrepancies and overuse of tests and procedures. There is a low international ranking in America when it comes to basic health measures – this includes preventable deaths and infant mortality.

So what will it take to develop a better health care system in America? Should we transfer to universal health care or should it be left up to the people? How can our government ensure better coverage for everyone?

Imagine constructing a human being synthesized completely through science—a seemingly supernatural fabrication of life. You may think Frankenstein. You may visualize Iron Man. But it’s called bionics.

The field of bionics doesn’t necessarily create entire human beings, but rather constructs body parts for better human functionality. People have been losing body parts and use of body parts since the beginning of time. Non-functioning limbs have been replaced with plastic, wood and even steel.

photo credit: Walraven

Enter Eileen Brown from London, who has been suffering from rheumatoid arthritis since her late 20s. It took a while for doctors to figure out her condition – first diagnosing her with growing pains and depression. Over the past 20 years, she has undergone countless surgeries to replace her joints with metal.

In the 80s, she had the knuckles on her left hand replaced with plastic joints. Then in the 90s, her wrists had fused together and she was required to have her knee replaced with metal – this is after alternative treatments had failed. Shortly after, she had to have her left shoulder replaced with a metal joint. Right before the new millennium, she began having pain in her right shoulder – another metal joint needed.

After falling from a ladder in 2003, she was required to have the bones and metal replaced in her left shoulder, due to fractures and an infection that began to spread. Her last operation was on her hips and is looking forward to her 50th birthday and a surgery for her neck and the bottom of her spine.

Imagine how difficult it is explaining why the metal detectors are going off.

Regardless of how bizarre it may appear, cases like Brown are more common than one may think. It’s not rare to see people with one or two bionic legs; even some athletes continue to run track and play sports on their prosthetic limbs. Some industries have argued about the use of “bionic athletes” because of their possible super-human abilities to run faster and jump higher. They believe that bionic athletes should participate in separate events.

Thought Robocop Was Cool?

Law enforcement agencies are upgrading their bulletproof vests with nanotube technology. Although bulletproof vests are great for stopping bullets, it doesn’t protect its human hosts from blunt force trauma, which can cause bruising and organ damage. This technology is currently being studied in Sydney by the Centre for Advanced Materials Technology.

How About Iron Man?

In 2005, there was a release of a ROBOT suit that gives its wearer super strength – don’t get carried away, this suit is far from bulletproof and it doesn’t fly. What it can do is help the elderly or those with disabilities to move about and lift heavy objects. This suit, called HAL (Hybrid Assistive Limb), has been under preparation a decade before its release; Yoshiyuki Sankai created it. It is attached to your legs and hips and operates by a battery pack on the belt. HAL 3 helps you to walk by detecting electrical currents sent to you brain by your nerves attempting to move. The HAL is also available for the arms.

The Ever-watching Eye

You’ve heard of people getting eye surgery and glass eyes, but have you heard of bionic eyes that help you to see? It uses a camera – yes, a camera – and electrodes to help its host to identify simple objects. The surgery is known in London; the first operation was done at Moorfields Eye Hospital, where two men in their 50s had their retinas artificially fitted. You may find these available on the market within the next three years. It costs about £15,000; or $30,000 USD.

It didn’t. She was delirious by the time friends finally took her to the emergency room on New Year’s Eve. The doctors diagnosed pneumonia. Three weeks later, she died of adult respiratory distress syndrome. Would universal healthcare have saved her life? You decide.

Universal Healthcare – The Pros

Under universal health care, access to good medical care would become a right rather than a privilege. Hillary Clinton has referred to universal healthcare as “a core Democratic principle.” Certainly, universal healthcare would help the 40 million uninsured, and the countless under-insured people in the United States.

Universal healthcare would allow doctors to focus on what their patients need, not what their patients can afford. For instance, Julie (not her real name) suffers from bipolar disorder. A mood stabilizer controls her condition, but it costs several hundred dollars per month, and Julie has no insurance. So instead of prescribing the medication that he knows will be most effective, Julie’s psychiatrist has to experiment with the off-label generics that Julie can afford. Julie suffers, and society suffers with her when her condition deteriorates and requires expensive hospitalizations that, ultimately, tax payers end up funding. Perhaps this is why, in a recent survey, 59% of doctors supported universal healthcare.

Universal healthcare would allow for good preventive medicine. Chances are that Sylvia would never have become so sick with a chest infection if her asthma had been properly controlled in the first place. If people have access to healthcare, they can work on controlling chronic conditions and preventing health problems, which is far less expensive than dealing with medical problems that have spiraled out of control due to poor preventive care.

Universal Healthcare – The Cons

Universal healthcare would be difficult to coordinate and administer. Of course, universal healthcare isn’t a walk in the park, a magic cure-all. There are challenges as well, one of the chief challenges being who would administer the program. The government has, to put it kindly, not always shown itself to be a model of efficiency. Working out the kinks in universal healthcare would take time and patience—perhaps more patience than most patients possess.

Increased taxes. In a speech explaining why he opposed universal healthcare, John McCain stated, “I’m certainly not interested in raising people’s taxes.” He has touched on a valid point. Both proponents and opponents of universal healthcare agree that taxes would need to be increased to fund healthcare for everyone.

Hard choices. Countries that practice universal healthcare do not give a carte blanche to every treatment for every condition. Some expensive procedures that have very poor success rates may have to be disallowed in the interests of keeping the system afloat. Americans understand this intellectually, but might have a hard time when it is their care or a loved one’s care that is affected.

Universal healthcare is neither angel nor devil. It has its benefits and its drawbacks. But whatever your feelings on the issue, it’s clear that the American healthcare system is ripe for change. It will be interesting to see where this election year takes us and what the President has up his (or her) sleeve.

photo credit: Heather R.