health care: 2012

Cialis Effectively Treats ED

Erectile dysfunction (ED) is a common complaint in men, particularly as they age. Millions of men of all ages suffer from the condition on a regular basis. Specific medical conditions and stress can cause ED. Fortunately, there are treatments that help men confidently engage in sexual activity again. One of the most effective is Cialis. There are specific steps you can take to improve the drug's usefulness.

Seek Professional Help

It is a good idea to get a doctor to review your medical record before deciding to take any ED drug. Men who have heart problems or take nitrates are typically warned to avoid this medication. Consult your doctor as soon as you begin experiencing ED symptoms. The sooner you can begin treating ED, the better chance you have of fully recovering from the condition.

Other ED Medications

You may have also considered taking Levitra or Viagra. These are the other two leading drugs marketed for ED treatment. Generally speaking, all ED drugs work the same way. They allow blood flow to enter the penis so that men can achieve and maintain an erection after being sexually stimulated. A hard erection is the only way to obtain successful sexual intercourse.

Why Cialis is More Effective

This particular ED treatment stands out because it has a 36-hour effective period. For this reason, you do not need to take the medication daily. And you can still achieve satisfying erections during that time period. Because of its extended use period, men can be more spontaneous rather than having to plan their intimate encounters.

ED Treatment and Prevention

If you experience ED symptoms, it is important that you learn what is causing your ED. Your doctor can help identify medical problems like high or low blood pressure, heart conditions, or diabetes. But your lifestyle may also be contributing to your ED. Consuming too much alcohol or using illicit drugs can lead to your impotence. So can stress and depression. While ED drugs can help on a short-term basis, you really need to figure out what is causing your condition and address those issues as well.
Cialis can help with your ED while you work to regain a healthy lifestyle. Watch your weight, eat right, and exercise regularly to reduce stress and improve your overall health. Taking these steps will improve the effectiveness of Cialis to treat erectile dysfunction so you can have satisfying sexual encounters.

Cialis Effectively Treats ED

Seek Professional Help

Other ED Medications

Why Cialis is More Effective

ED Treatment and Prevention

Levitra and the Emotional Effects of Erectile Dysfunction

Many people think about the effect of erectile dysfunction on a relationship or marriage and don't stop to consider the emotional effects to the man suffering from this condition. While the treatment for erectile dysfunction might be easy, this doesn't erase the psychological distress caused by erectile dysfunction. Even though most men will experience erectile dysfunction at some point in life, it is still an embarrassing and sensitive topic. If it doesn't go away after one occurrence, anxiety, guilt, depression, frustration, and embarrassment can all be felt.

Although an erection is a physical process, there are many emotional factors that lead to its occurrence. If you do not address these factors, the problem may continue to return. Your best bet is to treat the entire problem. Levitra does a great job of addressing the physical problem of erectile dysfunction, so that you can focus on the emotional.

Many times erectile dysfunction goes untreated because the man is too embarrassed to go to the doctor. However, treatment is important because erectile dysfunction may be a symptom of a bigger problem. Although it is natural to feel embarrassed, ten percent of men older than 40, and forty percent of men older than 50 have experienced erectile dysfunction - so you are certainly not alone. The older one becomes, the more likely you are to experience erectile dysfunction, so even if you think you are "safe" odds are it will happen to you as well. Levitra is taken in pill form, so you could potentially take it any time anywhere, without other people knowing.

Another common emotion felt with erectile dysfunction is depression. This can be a complicated relationship - erectile dysfunction causes depression in some cases, and in others, erectile dysfunction is caused by the depression. Nonetheless, a real connection exists, and this has been backed by research on hormones. Many men do not understand how easy erectile dysfunction is treated and, mixed with the failure to seek treatment, are faced with more emotional turmoil than is necessary. Levitra is highly effective at treating erectile dysfunction, and if you are depressed because of your condition, this treatment can be a tool to overcome the depression.

Emotional discomfort can be immobilizing. However, with the medical advances available today, including Levitra, you do not need to suffer. While everyone can admit that erectile dysfunction is upsetting, it is easily treated and doesn't have to be a big deal. Seek treatment today and improve the quality of your life!

The Increasing Surge of Health Care

While sitting back in her blue jeans and wearing a heavy workout sweater at the Legacy Emanuel Hospital's Emergency room, Angela Jones has her feet prompted up and crossed atop of a small table. When asked about health care issues and how they affect her, Angela explains that there is a portion of people who suffer from not having health care insurance. She makes it clear that some of those who suffer most are young people. Jones, who is a college student, declared her passion for the young because it falls under her own age group.

Says Jones, "The Oregon Health Plan should be open to more people who are under 21 years old. Private insurance shouldn't be so expensive for young people."

According to national surveys, the primary reason people are uninsured is the high cost of health insurance coverage. Notwithstanding, nearly one-quarter (23 percent) of the uninsured reported changing their way of life significantly in order to pay medical bills. Economists have discovered that increasing health care costs correlate to drops in health insurance coverage.

Jones believes that some of the greatest challenges that people face across this nation is obtaining affordable health care. "I would open an Oregon Health Plan to a variety of people who don't have insurance. It is hard to get health insurance."

Terri Heer, a registered nurse at a local hospital, claims that in order to improve America's health care system a key ingredient is to "make sure that everyone (has) access."

This would include cutting out on expenses that are not palpable to so called "health care needs". Heer says, "First, we spend a lot of money servicing people for illnesses that can be prevented. Some of the money spent can go to other things."

Over the long haul, should the nations health care system undergo significant changes, the typical patient may not necessarily see the improvements firsthand. "I would love to say there will be a lot of changes. I am not a pessimist, but I don't think there will be any change," says Heer. Heer does allude to the fact that if more money were spent for people in the health care arena, she says that there is a possibility that the necessary changes would be more evident.

Whether health care is affordable or not is an issue that affects everyone. According to a recent study last year, health care spending in the United States reached $2.3 trillion, and is projected to reach $3 trillion by 2011. By 2016, it is projected to reach $4.2 trillion. Although it is estimated that nearly 47 million Americans are uninsured, the U.S. spends more on health care than any other nation.

The rising tide of health care stems from several factors that has an affect on us all. First, there is an intensity of services in the U.S. health care system that has undergone a dramatic change when you consider that people are living longer coupled with greater chronic illnesses.

Secondly, prescription drugs and technology have gone through significant changes. The fact that major drugs and technological advancement has been a contributing factor for the increase in health care spending. Some analysts suggest that the improvement of state-of-art technologies and drugs increase health care spending. This increase not only attributes to the high-tech inventions, but also because consumer demand for these products has gone through the roof, so to speak.

Thirdly, there is an aging of the population. Since the baby boomers have reached their middle years, there is a tremendous need to take care of them. This trend will continue as baby boomers will qualify for more Medicare in 2011.

Lastly, there is the factor of administrative costs. Some would argue that the private sector plays a critical role in the rise of health care costs and the economic increase they produce in overhead costs. At the same time, 7 percent of health care expenses are a result of administrative costs. This would include aspects of billing and marketing.

Terra Lincoln is a woman who was found waiting in the Emergency room at the Providence Portland Medical Center. When asked about the rising costs of health care, she said, "If you don't have medical coverage, it'll cost you too much money. If I leave the hospital right now and I need to buy two (types) of medicines, I couldn't afford it." Lincoln says that she is a member of the OHP, but she believes that there are still issues that need to be addressed.

Terra recognizes that to reduce medical costs, she would have to start by getting regular checkups. "Sometimes people of color wait till they're in pain before they get a checkup," she said.

A national survey shows that the primary reason why people cannot afford health care is because of soaring costs of health care coverage. In a recent Wall-Street Journal-NBC survey it is reported that 50% of the American public claims that their highest and most significant economic concern is health care. Consequently, the rising cost of health care is the number one concern for Democratic voters.

Regarding the rising tide of health care, Kristin Venderbush, a native Wisconsin, and another patient in emergency at Providence says, "I worry a lot about what happens to the working poor. They don't have OHP. If you can't advocate for yourself, you will not get the health care you need...on every level."

Harvard University researchers conducted a recent study that discovered that the out-of-pocket medical debt for an average consumer who filed bankruptcy was $12,000. This study noted that 68 percent of those who had filed for bankruptcy carried health insurance. Apparently, these bankruptcy's were results from medical expenses. It was also noted in this study that every 30 seconds someone files for bankruptcy after they have had some type of serious health problem.

In spite of all the social and economic bureaucracy in the health care arena, some changes were made in Washington on January 28, 2008. In his State of the Union address, President Bush made inquired Congress to eliminate the unfair bias of the tax code against people who do not get their health care from their employer. Millions would then have more options that were not previously available and health care would be more accessible for people who could not afford it.

Consequently, the President believes that the Federal government can make health care more affordable and available for those who need it most. Some sources suggest that the President not only wants health care to be available for people, but also for patients and their private physicians so that they will be free to make choices as well. One of the main purposes for the health care agenda is to insure that consumers will not only have the freedom to make choices, but to also enable those to make decisions that will best meet their health care needs.

Kerry Weems, Acting Administrator of the Centers for Medicare and Medicaid Services, oversees the State Children's Health Insurance Program, also known as SCHIP. This is a critical program because it pays for the health care of more than six and a half million children who come from homes that cannot afford adequate health insurance. These homes exceed the pay scale for Medicaid programs, therefore are not able to participate.

During SCHIP's ten year span, states have used the program to assist families with low-income and uninsured children for their sense of well-being in the health care arena. The Bush Administration believes that states should do more of an effort to provide for the neediest children and enable them to get insurance immediately. The SCHIP was originally intended to cover children who had family incomes ranging from $20,650. This amount would typically include a family of four. According to sources, all states throughout the U.S. have SCHIP programs in place and just over six million children are served.

Children and Health Care

Washington's Perspective

What is driving health care costs?

The fact that the U.S. faces ever increasing health care woes, has left many to believe that the country's current crisis is on a lock-step path toward insolvability.

Our Health Care System - An Insider's View

Upon completing college back in the early 1970s, I worked for a large department store in NY in the accounting office. Working full time, naturally, I was afforded a company group insurance policy which included health benefits, along with dental, and life insurance. At that time there were no HMOs, nor were there any physicians that did not accept any legitimate health insurance plan. During my childhood, my parents always maintained insurance coverage on both me and my sister through Blue Cross/Blue Shield of NY. The insurance offered by my employer was also through Blue Cross/Blue Shield of NY. It was touted to be the best health insurance plan around at that time, and cost me personally nothing to enroll. The employer paid the entire premium in my behalf, and although it did have a yearly deductible, and then paid 80% up to a specified amount before paying 100%, being relatively healthy it posed no real economic hardship on me, and I was easily able to cover my deductible, and small out of pocket costs for any tests or prescriptions I may have needed.

It wasn't until I relocated to southern California in the mid 1970s, that for the first time, I realized just how much our country needed to revamp its health care system. Perhaps revamp is a poor term for what I observed initially, but eventually it would become a very well suited term for what would be needed. Of course today what is needed is a complete overhaul of our health care system, and a program that will allow everyone affordable and good quality health care. However, intiially, the programs in place were very good, and very affordable to those who worked full time. There obviously weren't as many small businesses out there, and even the ones that were, could at least afford some type of health care coverage for their families. While I was living in southern California I met and married a young woman who had been afflicted with a rare form of Muscular Dystrophy, and was on Social Security Disability and State Supplemental Income. In addition she had Medicare and Medi-Cal to help pay for her medical fees and services which she desperately needed to keep her alive, and functioning.

Even back then, it took almost an act of Congress to qualify for those programs, and you had to have a redetermination every two years to see if your conditions had improved. Every two years my wife was subjected to an independent medical exam with a Medicare approved physician who reviewed all her medical records for the previous two years, and examined her, and then reported his or her findings to the Social Security Administration for review with his or her recommendations. Although my wife's condition was only getting worse, and other than short periods of remission where her disease was in check, she was basically declining, and it was obvious it should would never be cured, still she would continue to be subjected to these exams every two years until her death in 1988. In was during this period of time that I personally became involved in the health care field, and saw first hand just how insurance companies worked, at least when it came to health care.

In 1981, I obtained a position at a very well known Hospital and Health Care center in southern California. My job was that of a Patient Financial Counselor, which entailed the discussion with patients and/or their families either prior to admission, during admission or at discharge, in order to work out arrangements for payment of the unpaid portion of their hospital bills. In most cases the balance owing was anywhere from a few hundred dollars to couple of thousand dollars depending upon the procedure done and the amount of time actually spent in the hospital. If the patient was covered by a good private insurance carrier, it was usually only a few hundred dollars. In the case where they were covered by Medicare of Medi-Cal, they ofter owed nothing. If they were indigent, and had no insurance at all, we had a social worker on staff who would attempt to get them on some form of emergency medical assistance to help pay their debt in full. However, that would soon all change with the cut backs in Medicare, and other social programs during the course of the Regan Administration. By the mid to late 1980s, insurance carriers were demanding second opinions on certain procedures, and PPOs and HMOs began to spring up all over the country. It was the beginning of managed health care, which has its own pros and cons. The biggest advantage to the employers who provided these programs to their employees of course was the costs. Costs for PPOs and HMOs were much less expensive than the traditional health care plans, and saved the employer thousands of dollars per year in costs. It was the biggest selling point for them, but left many employees with less than adequate coverage.

If an employer for example opted for an HMO plan, the employees found themselves in many cases looking for a new doctor as their doctor wasn't a part of the HMO plan. At least with the ones who lucked out with a PPO plan could still see their own doctors of choice. The insurance just didn't pay as much as they would if the physician was enrolled in their plans. With the HMOs, you had to sign up for a primary care physician who had to be a participating physician in their plans, or they would not pay the doctor's fees. In addition if you had to see a specialist, your primary care physician had to get an authorization from the insurance carrier for that visit. The same held true for many procedures you may need to have, and again it was up to the primary care physician to get prior authorization, or the patient was stuck with paying the entire bill. It was during this period that medical groups or clinics began to spring up all over the country, owned and operated by the HMOs. It was their attempt to control health care costs, and manage health care for its patients. Since the inception of HMOs there have been all types of lawsuits filed against the HMOs for wrongful deaths and for lack of necessary treatment for their patients, but still they are going strong.

The question I pose is, when does good health care offset the costs? If a doctor deems it necessary for a patient to undergo a long medical treatment plan to help save their lives, or to give them a better quality of life, costs should be of secondary concern, and the patient's well being should be placed first. Unfortunately, that is not always the case. Yes, I agree that there are people who abuse the system, and run to the nearest emergency room for every little ache and pain when they are covered by a public medical program such as Medicare and Medicaid, but what about the ones who truly do have a need for emergency services, and often have to wait hours to be seen because the emergency room is filled with non emergent cases simply because they know they cannot be turned away just because they have no insurance or public insurance programs. The publicly funded programs such as Medicare and Medicaid need to start to review these non emergent cases, and refuse to pay for those services making the patient liable for any and all costs incurred for those visits.

In the 1990s, during the Clinton administration there was a push on for a complete overhaul of the health care system in this country. The concept behind the idea was to find a feasible way to offer affordable, good quality health care to all Americans, not just those who could easily afford it, or those who were already on publicly funded programs such as Medicare or Medicaid. Additionally, there was a proposal that would allow the insurance companies to receive government subsidies to offset the costs of insuring those who were considered to be high risk, or chronic patients. Several models were investigated, and in an effort to destroy any hope of resolving this issue, lobbyists and special interest groups claimed that it would be a form of socialized medicine and costs taxpayers billions of dollars, and would not necessarily offer better quality health care. In the end the only positive thing that came out of the whole deboggle, was guaranteed health care for children, and the allowing of either parent to take time off from work after a child's birth without fear of losing their job or seniority. Even the bill which affords health care for children needs additional funding and has been lacking due to political pressure and budget restraints over the past several years.

In recent years we have been so concerned about fighting terrorism around the world, and our military and political efforts in Iraq and Afghanistan at the cost of billions of dollars, that the overhaul and reconstruction of America's health care system has been put on the back burner. Even with a Democratically controlled Congress, the health care system has not gained any further support, nor has it been placed on anyone's priority list. Only in recent months with the primary elections has the question of providing affordable health care for all Americans once again resurfaced and been placed on the candidates priority lists. There is no question in this author's mind that something has to be done to protect Americans from the high costs of health care, and the ability to receive good quality health care services no matter what the persons financial situation. I am not proposing a socialized medical system, nor am I in favor of allowing non citizens to have free participation in any such system devised. However, for those hard working Americans who hold down jobs and pay their taxes, and especially those with families, need some type of guarantee, that they can obtain good quality health care when they need it, and at an affordable price.

No one wants to see people dying or not enjoying a good quality of life just simply because they cannot afford to see a physician when they really need to, or afford their medication that keeps them alive or in good health. However, we cannot afford to keep going the way we are just because we are a free enterprise system and allow for competition between businesses. While the health care industry is a business, just as with public utilities, the government does put controls on prices and price increases, and perhaps a similar program with the health care industry would work the same way. I just have a hard time swallowing the fact that we have billions of tax dollars to spend overseas on wars we can't win, or have no reason to be involved in, other than the stuffing of someone's pocket, yet we cannot provide affordable quality health care for our own citizens here at home. While this may be just my opinion, I think that there are many Americans out there who feel the same way, but believe that we are in the minority, and that no one in Washington, is really listening to us. Perhaps this next national election will show the bureaucrats in Washington that this is not the case, and really send a message to our political leaders that it is time for a real change.

Universal Health Care

Universal Health care is a type of government created system in which every citizen of a country is given access to various forms of medical care, even if they don't have the resources to pay out of pocket. While the citizens may be able to pay for some services out of pocket, much of the money for Universal Health care will come through taxation or insurance. One of the first countries to institute this form of medical care successfully was Germany under Otto Von Bismarck. However, the very first Universal Healthcare program was created in Great Britain.

Some of the other countries which offer Universal Health care include Australia, France, and Italy. Virtually every industrialized nation currently offers some type of Universal Health care except for the United States. While the definition of Universal Health care largely remains the same, the actual structure of this system will vary from one country to another. The system also varies in terms of how much the government is involved. For example, while some nations allow private doctors to offer their services, other countries do not. In the United Kingdon, doctors can choose to offer services which are outside the government system, but Canada has more restrictions on their medical services.

It is important for readers to realize that Universal Health care is a very wide concept. There are a number of ways in which such a system can be utilized. However, the most basic factor in implementation involves the process of allowing all the citizens within a nation to be given access to health care for an affordable rate. Because implementing such a system requires a large amount of money, many governments tax their citizens in order to fund it. The government also decides how the care must be administered, and who is allowed to receive certain types of care. While many countries use taxation to fund this health care system, the patient may still be required to pay a relatively small fee as well.

Because the Universal Health care system has worked so well in many countries, some citizens and politicians in the United States have proposed the introduction of such a system in their own country. American proponents of Universal Health care are quick to point at the rising cost of commercial insurance as evidence that Universal Healthcare would work. Indeed, the cost of health insurance in the United States has become so high that millions of Americans go without health insurance each year, and should they become sick or injured, the cost of medical care could cause them to go into bankruptcy.

Proponents of Universal Health care argue that the utilization of their system would make it more affordable for all Americans to afford healthcare, and millions would not need to go without medical insurance. While the United States does not currently have a Universal Health care system, the government does provide health care for certain segments of the population, such as veterans, the disabled, senior citizens, or those currently serving in the military.

However, it is important to note that Universal Health care is not without its opponents. Those who oppose Univeral Health care often raise questions as to who would pay the most in taxes for such a system. These people argue that depending on the rate of taxes to be charged, many of the same people who currently can't afford medical insurance would be hard pressed to pay taxes for a Universal Healthcare system. If the taxes are too high, they argue, then the rich would suffer the largest tax burden, but this is the very same group that is the least likely to need Universal Health care in the first place, since they can afford to pay for private health care.

Many high income American citizens are opposed to Universal Healthcare because they feel they will be forced to pay for something they personally don't need. In addition to paying for their private medical insurance, they would then have to pay taxes for Universal Health care, a service they would not likely use. Opponents of Universal Health care also argue that there are Constitutional issues that come into play. They argue that the 10th Amendment of the U.S. Constitution makes it clear that any powers not granted to the American government in the Constitution must be decided by the states.

Opponents therefore argue that the 10th Amendment demonstrates that only the U.S. states have the power to decide on the issue of Universal Health care, not the Federal government. However, proponents of Universal Health care counter this by saying that the system has worked successfully in other industrialized nations, and if it works there, it can work in the United States as well. One thing that is certain is that there are strong arguments on both sides of the fence, and only time will tell which side is correct. It should also be noted that about 15% of U.S. GDP goes toward health care payments, and this is the highest of any country on the planet.

It should also be noted that over 80% of the U.S. population already has some form of medical care, whether through their job, the government, or a private company. This has led some opponents of Universal Health care to claim that such a system isn't needed, since only a small percentage of the U.S. population doesn't have health insurance. However, proponents argue that while 80% of Americans may have some form of coverage, the 20% who don't is too much. When you consider the fact that 20% of the U.S. population would be around 60 million people who don't have coverage, it becomes hard to argue with this point.

It should also be noted that the cost of health care in the U.S. is one of the fastest growing phenomenons in recent history. In fact, the rising cost of healthcare is even rising faster than the general rate of inflation. From 2001 through 2007, the rate for family health insurance premiums rose by more than 70%, which is unprecedented. Aside from a government based program for Universal Health care, many cities and states in the U.S. are already in the process of implementing their own Universal Health care plans.

Universal Health Care - The Ideal Health Care

There are various theories floating around about health care at the moment. Each and every single one has an ideal attached to it, in which every single individual gets accessible health care whenever they need it at an affordable rate. However, very few of them actually put a plan into action that dictates how the ideal would be achieved. One of those that does is universal health care. It does imply that every person in the world should have access to basic health care, which would raise the health level of the world. Universal health care also refuses to take factors like age, location and status into account. However, it is slightly optimistic considering the third world does not even have access to basic utilities yet.

However, the idea of universal health care is backed by several ideas as to how it can be carried out. Universal health care should in fact be administered via a series of insurance policies that are controlled by the government of any given time. In this way, universal health care will give everyone access to health care whenever they need it at very little personal cost, thus ensuring that every single person can actually call a doctor out whenever necessary. Universal health care may also be administered through a series of clinics and other medical establishments to ensure that lower class individuals that cannot afford private health care can just drop by.

Universal health care could actually be administered by any number of schemes in effect, but at least there are ideas in place to ensure that it could work if governments in power at the moment changed their policies. The ideal behind universal health care are valid as preventative as well as remedial because it would actually encourage everyone to have regular health checks to ensure that they stay in the best of health. This would include testing g younger people for STIs and monitoring their progress as they grow up via a series of vaccinations against diseases that may cut their lives short. Similarly, under universal health care would actually allow older people to be tested for ailments like diabetes on a regular basis too.

Universal health care could provide treatment for every individual, whether they could afford it on paper or not. This would provide great positives for all of humanity and make for a much better world. There is so much more resting on universal health care than just health care alone. If we want a better world, we have to take the chance whenever we can. Universal is one of the chances we should take.

Aurora Health Care- The Best Non-Profit Health Care

Aurora Health Care offers a variety of services for an individual to tap into. Aurora Health Care is a health care provider with some prestige and a great reputation to live up to, and also doubles up as a one-stop shop for jobs in the healthcare sector. Aurora Health Care also offers classes and advice on all aspects of health care. In truth, it actually provides a far better level of care and information than any of its competitors do, and that can only be a positive thing!

Aurora Health Care provides a service for both registered patients and those that are no registered as well. If you do register with them then you can request emergency and same day appointments as well as simply asking for advice from time to time. However, non-registered patients have to wait for appointments, although they can still make them as and when necessary. They cannot ask for emergency service, and so should actually call an ambulance if needed.

All Of Your Health Care Needs

Aurora Health Care does not stop at simply providing appointments. It can in fact take care of all of your needs, including providing convenient pharmacies. There are many Aurora Health Care pharmacies located around the country, thus making it easier to request a prescription or a refill as and when you like. You may find one on a high street, in a clinic or hospital, or even at your local supermarket if it is big enough to include several independent stores.

Aurora Health Care may host women's services at a clinic or pharmacy too. Obviously women have more specialist problems than men do as a result of reproduction and so Aurora Health Care has quite rightly provided a specialist service that is dedicated to the health care of women as a result. Alongside that is a specialist service for seniors too. In old age, everybody's health will dramatically decline over a period of time. This service deals with cancer, arthritis, mental degeneration and a whole host of other ailments that a senior may need from time to time or as a part of ongoing care.

Aurora Health Care also specializes in cancer care because the care for individuals with cancer is often neglected by health insurance companies. It can be so expensive and so draining on a family's income that it is better to invest in health insurance that does cater for that eventuality.

Of course, Aurora Health Care is not just limited to the elements set out above but they are often the tings that individuals look for in a service. It is definitely worth considering Aurora Health Care because they cater for so many needs, including any that you may have right now!

Health Care Costs Is Rising-What You Need To Know

Americans pay more than one and a half trillion dollars for medical care each year and costs related to all manner of health care, such as prescription drugs, continue to skyrocket. While some of reasons behind this booming bill are understandable, Americans caught in a cash crunch might be surprised to find out some of the lesser-known causes of high health care costs.

The words health care might invoke images of doctors, nurses and hospitals, but the reality is that the medical field is a business and a ruthless one at that. Individual practitioners, researchers and participants may have wonderful intentions and a true desire to help people, but the structure of the American health care system ensures profit is the number one issue of importance.

Here are some facts that may help explain the high costs of American health care:

Pharmaceutical research and development companies spend roughly $20 billion each year on R&D, and about the same amount on advertising and self-promotional marketing activities.

There is sure to be a grin on your face once you get to read this article on health insurance. This is because you are sure to realize that all this matter is so obvious, you wonder how come you never got to know about it!

Additionally, drug companies have as many sales people as there are doctors in the United States. One of the responsibilities of this sales force is to convince doctors to attend pharmaceutical company-sponsored seminars where drugs are showcased.

According to some economists, the purchase of new technology is responsible for more than 50 percent of new health care spending over the last three years.

Much of the money Americans pay for health care finds its way into the rising profits on health care-related products and services such as the provision of medical insurance. Even higher costs have been forecasted for the future, especially for prescription drugs.

For many Americans who are unable to afford the health care they need, rising costs represent an ever-increasing barrier to medical services and products. The financial burden is also felt on the larger national scale with about 15 percent of gross domestic product going toward health care costs. That is equal to about one quarter of the annual federal budget.

Comparatively, Canada invests around 10 percent of its GDP on its public health care program. Unlike the United States, Canada’s health care program is universally available to all citizens and permanent residents without cost. Other countries, such as Germany, where there is a public/private delivery system model for health care, manage to serve their populations for even less while still having better longevity than Americans. This proves that the quality of health care does not rise proportionally with the amount of money spent to attain it.

While many Canadians supplement their universal health care with added insurance to cover the cost of medication and perks such as semi-private or private hospital rooms, health care insurance is much more essential in the United States. Unfortunately, costs have been rising dramatically, making health care insurance out of reach for many Americans. Currently, more than forty million Americans do not receive any kind of health care benefit.

Developing a vision on health insurance, we saw the need of providing some enlightenment in health insurance for others to learn more about health insurance.

For employers, providing health care insurance for employees is also becoming more expensive, with increases dramatically outpacing inflation rates. Some years, the difference is four or six fold. Even if premiums were to remain static, offering health care insurance to employees still costs several thousand dollars per worker. For smaller companies, or for those who employ a large number of people, these costs can be prohibitive.

Measures to reduce health care costs are always under consideration, though many are not popular choices. Suggestions that have been put forward by various sources have included:

Increased drug awareness and education. Millions could be saved if health care insurance covered only generic versions of drugs that have been proven just as effective as their more expensive brand name counterparts.

Terminate expensive treatment options will only add a short amount of time to a patient’s life, particularly if it will not be quality time (i.e. patient is in a coma).

Promote preventative care such as smart lifestyle choices, proper nutrition and exercise.

Examine to ways to control drug advertising to consumers. There is speculation that advertising has led to prescriptions of non-necessary drugs.

Limit malpractice liability so doctors and medical professionals do not feel pressured to cover themselves by ordering unnecessary tests to substantiate conditions they already know to be present.

To view our recommended sources for health insurance, or to read more articles about health insurance, visit: [http://www.insurance-quote-puppy.com]

Discount Health Cards-Consumer Driven Health Care

Discount Health Care Cards-Consumer Driven Healthcare

What are discount health cards? Discount health cards provide one part of the solution to the nation's healthcare crisis by enabling consumers to purchase healthcare products and services at discounted retail rates. Discount health cards are not insurance and are not intended to replace insurance. In fact, many consumers choose a discount card to complement their health insurance program, filling in gaps such as prescription drug benefits or vision care.

Why Choose a Discount Health Card? Discount health cards are NOT insurance.

Discount health cards enable consumers to purchase healthcare products and services from providers at discounted prices, similar to the rates that healthcare providers charge wholesale customers such as preferred provider networks (PPOs) or large insurance plans.

Many consumers choose a discount card to complement their health insurance program, filling in gaps, such as prescription drug benefits, chiropractic care, dental or vision care.

Discount health cards have gained popularity because they provide consumers access to the healthcare they need without the limitations, exclusions and paperwork associated with insurance plans.

In addition, discount health programs typically include the cardholder's entire household.

How You Benefit with a Discount Health Card? Discount health programs, or discount benefits cards as they are sometimes called, were created to help bridge the gap for consumers burdened by the increasing cost of healthcare by providing opportunities to directly purchase healthcare services and products at discounted retail rates. Discount cards offer:

Access: Individuals and families without insurance can use discount programs to receive access to and substantial savings on health care services such as doctor visits, hospitalization, prescription drugs, eyeglasses and dental care that they might otherwise not afford.

Affordability: While insurance rates have increased at double-digit rates over the past 12 years, discount card providers have kept their rates virtually unchanged.

Savings: Those with limited insurance, the under-insured, and insured individuals with high deductibles can reduce out-of-pocket expenses and receive discounts for services not normally covered by insurance such as chiropractic care.

Choice: In some cases, consumers with discount health cards pay less for services such as dental and vision care than those covered by traditional insurance plans.

Convenience: Discount programs are accepted at some of the nation's largest healthcare retailers including national pharmacy and optical chains. While each program varies, many companies offer programs with providers that include:

* Pearle * LensCrafters * Medicine Shoppe

* Eckerd's * Safeway * Wal-Mart

* Sears * Target, and many more!

What types of services are typically included by discount health cards? Discount health cards include a wide range of services and products including dental services, prescription drugs, vision care, chiropractic procedures, hearing care, physician/hospital & ancillary services, nurse medical information lines, vitamins and emergency care for travelers. Choose a program that offers discounts on services that you need and that you will use.

Who should use discount health cards? The wide array of choices in the discount health card industry and the many discounts available make it possible for everyone to enjoy the benefits of discount health cards. Discount health cards are designed to provide benefits for a wide-range of consumers. For individuals and families without insurance, discount health cards offer substantial savings on healthcare services such as doctor visits and on everyday health related expenses including prescription drugs, eyeglasses and dental care that they might otherwise not afford.

For those with limited insurance, the under-insured, and insured individuals with high deductibles, discount health cards can reduce out-of-pocket expenses and offer discounts for services that may not be covered by insurance such as chiropractic care.

In some instances, discount health cards for ancillary health services and products such as vision, dental and chiropractic care offer services at overall out-of-pocket costs lower than insurance co-payments.

For these reasons, many of the country's Fortune 500 companies now offer discount health cards to their employees as part of their benefits packages.

How do consumers get discount health cards and how do the cards work? You can obtain discount health cards either through your employer, an association, union, or another entity with which you are connected or you can go directly through a reputable discount healthcare program.

Signing up for a card is easy. Complete an application and pay a nominal monthly fee. In some instances, your employer will pay the fee. To access care and receive savings, a cardholder must simply provide the card to a participating provider at the time health services are rendered and pay the discounted fee.

How do discount healthcare programs offer such benefits? Discount healthcare programs enable members to access similar rates that healthcare providers charge wholesale customers such as preferred provider networks (PPO) or large insurance plans. The difference is that instead of financing the medical expenses of members by charging high monthly rates, consumers agree to pay a discounted fee to the provider directly at the time of service.

What is the difference between discount health cards and health insurance? Discount health cards are not insurance. Card companies who indicate otherwise are not being truthful. Unlike health insurance, there is no sharing of risk by the consumer and the discount healthcare company.

Discount health cards afford consumers the opportunity to directly purchase health care services and products from providers at amounts discounted below their retail rates. Cardholders are required to pay the provider's discounted fees in full at the time healthcare services are rendered or as dictated by the provider's agreement. Consumers are free to make their own choices about which services to purchase and from whom to make those purchases.

Insurance plans, on the other hand, define specific benefits available to the consumer at rates determined by the plan purchaser. Insurance plans also pay health care providers on behalf of the consumer.

Do I still need insurance if I have a discount health card? That's a decision each consumer must make. Discount cards and insurance plans frequently provide complementary benefits. That is why many of the nation's leading companies offer their employees both insurance plans and discount cards. Each individual should evaluate his or her own health needs and the various benefits offered by each type of program.

Why has there been controversy surrounding some discount health card providers? Millions of consumers have embraced discount health cards because of their value and simplicity. This popularity has led a number of companies to enter the discount health card business. Unfortunately, not all of them are reputable. Some card providers charge steep up-front fees or promise dramatic savings they can't deliver, while others bombard consumers with misleading and confusing sale pitches.

For more information and clarification contact:

Alan Masters

800-795-6823 Toll Free

530-318-6971 Cell

[http://www.alanmasters.com] Website

AlanMasters@Ameriplan.net email

Improve your Well-Being through Affordable Health Care Plans

You and your family deserve nothing but the best health care services. When you look for a job, one of the first things that you ask for is the employee health benefits that you will be receiving.

When your child or another member of the family gets sick, do you have ample coverage to cover the costs or would you have to get a loan to cover the medical expenses?

You will never know what emergency might come up so it is vital for you to have a comprehensive health care plan.

However, health care costs are soaring each year so it is important to look around for the best health care plans that you can take advantage of. You need to make sure that you are getting ample coverage while getting your money's worth.

There are two basic types of health insurance coverage that you can get: the private health insurance plans that you can purchase as an individual. Second, there are government-sponsored health insurance plans.

Take a look at some other types of health insurance plans that you can get for you and your family:

o Health Care Plans for Employees

One of the benefits that you and your immediate family can get when you have a regular work is the health care plan offered by your employer. Some individuals choose to work for the companies who have the most comprehensive health care plans for their families.

Before signing any pre-employment contracts, ask your Human Resources manager about the health care plans that you will get.

If you are self-employed or if you are a casual employee, make sure that you will still sign-up for a health care benefits plan.

o Privately Purchased Insurance Plans

The health care privileges offered by your company and the ones accessible through the government can be combined. However, if you feel that the coverage that you will get is insufficient, especially if you have a medical history, then you might want to get a separate health care plan for yourself.

This is where you need to do your research. There are a lot of companies which offer discounted health plans and the lowest health insurance quotes. Just ask around or browse the Internet to get the most comprehensive health care plan out of your hard-earned dollars.

When looking for the best health insurance company to cover your health care needs, remember the following:

1. Check out the discounted medical benefits included in the health care plan.

2. Be open about your medical history and pre-existing conditions.

3. Check out the benefits for your dependents or your immediate family.

4. Study thoroughly the monthly premiums, deductibles and other costs not included with the health care plan.

5. Ask about the dental plans, nursing care, hospital facilities, preventive care, elderly care and all the other related services that you might need in the future.

6. When getting a private health insurance plan, do your research and look for members who are satisfied with the services of the company that you will be going for.

When looking for a health insurance provider, it would never hurt to be thorough and ask a lot of questions if you need to.

You should know everything about your health care insurance benefits before signing-up for a particular plan. Make sure that the plan will meet all your medical and health care needs so that you can get your money's worth while taking care of your family's health care needs at the same time.

Health Care Reform - Why Are People So Worked Up?

Why are Americans so worked up about health care reform? Statements such as "don't touch my Medicare" or "everyone should have access to state of the art health care irrespective of cost" are in my opinion uninformed and visceral responses that indicate a poor understanding of our health care system's history, its current and future resources and the funding challenges that America faces going forward. While we all wonder how the health care system has reached what some refer to as a crisis stage. Let's try to take some of the emotion out of the debate by briefly examining how health care in this country emerged and how that has formed our thinking and culture about health care. With that as a foundation let's look at the pros and cons of the Obama administration health care reform proposals and let's look at the concepts put forth by the Republicans?

Access to state of the art health care services is something we can all agree would be a good thing for this country. Experiencing a serious illness is one of life's major challenges and to face it without the means to pay for it is positively frightening. But as we shall see, once we know the facts, we will find that achieving this goal will not be easy without our individual contribution.

These are the themes I will touch on to try to make some sense out of what is happening to American health care and the steps we can personally take to make things better.

A recent history of American health care - what has driven the costs so high?
Key elements of the Obama health care plan
The Republican view of health care - free market competition
Universal access to state of the art health care - a worthy goal but not easy to achieve
what can we do?

First, let's get a little historical perspective on American health care. This is not intended to be an exhausted look into that history but it will give us an appreciation of how the health care system and our expectations for it developed. What drove costs higher and higher?

To begin, let's turn to the American civil war. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail's pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations of the affected limbs and this often resulted in the onset of massive infection. So you might survive a battle wound only to die at the hands of medical care providers who although well-intentioned, their interventions were often quite lethal. High death tolls can also be ascribed to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600,000 deaths occurred from all causes, over 2% of the U.S. population at the time!

Let's skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in American medicine in both the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a "wait and see" approach. Medicine could handle bone fractures and increasingly attempt risky surgeries (now largely performed in sterile surgical environments) but medicines were not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly aware of heart and vascular conditions, and cancer but they had almost nothing with which to treat these conditions.

This very basic review of American medical history helps us to understand that until quite recently (around the 1950's) we had virtually no technologies with which to treat serious or even minor ailments. Here is a critical point we need to understand; "nothing to treat you with means that visits to the doctor if at all were relegated to emergencies so in such a scenario costs are curtailed. The simple fact is that there was little for doctors to offer and therefore virtually nothing to drive health care spending. A second factor holding down costs was that medical treatments that were provided were paid for out-of-pocket, meaning by way of an individuals personal resources. There was no such thing as health insurance and certainly not health insurance paid by an employer. Except for the very destitute who were lucky to find their way into a charity hospital, health care costs were the responsibility of the individual.

What does health care insurance have to do with health care costs? Its impact on health care costs has been, and remains to this day, absolutely enormous. When health insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight a great pool of money became available to pay for health care. Money, as a result of the availability of billions of dollars from health insurance pools, encouraged an innovative America to increase medical research efforts. More Americans became insured not only through private, employer sponsored health insurance but through increased government funding that created Medicare and Medicaid (1965). In addition funding became available for expanded veterans health care benefits. Finding a cure for almost anything has consequently become very lucrative. This is also the primary reason for the vast array of treatments we have available today.

I do not wish to convey that medical innovations are a bad thing. Think of the tens of millions of lives that have been saved, extended, enhanced and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on health care costs are inevitable. Doctor's offer and most of us demand and get access to the latest available health care technology in the form of pharmaceuticals, medical devices, diagnostic tools and surgical procedures. So the result is that there is more health care to spend our money on and until very recently most of us were insured and the costs were largely covered by a third-party (government, employers). Add an insatiable and unrealistic public demand for access and treatment and we have the "perfect storm" for higher and higher health care costs. And by and large the storm is only intensifying.

At this point, let's turn to the key questions that will lead us into a review and hopefully a better understanding of the health care reform proposals in the news today. Is the current trajectory of U.S. health care spending sustainable? Can America maintain its world competitiveness when 16%, heading for 20% of our gross national product is being spent on health care? What are the other industrialized countries spending on health care and is it even close to these numbers? When we add politics and an election year to the debate, information to help us answer these questions become critical. We need to spend some effort in understanding health care and sorting out how we think about it. Properly armed we can more intelligently determine whether certain health care proposals might solve or worsen some of these problems. What can be done about the challenges? How can we as individuals contribute to the solutions?

The Obama health care plan is complex for sure - I have never seen a health care plan that isn't. But through a variety of programs his plan attempts to deal with a) increasing the number of American that are covered by adequate insurance (almost 50 million are not), and b) managing costs in such a manner that quality and our access to health care is not adversely affected. Republicans seek to achieve these same basic and broad goals, but their approach is proposed as being more market driven than government driven. Let's look at what the Obama plan does to accomplish the two objectives above. Remember, by the way, that his plan was passed by congress, and begins to seriously kick-in starting in 2014. So this is the direction we are currently taking as we attempt to reform health care.

Through insurance exchanges and an expansion of Medicaid,the Obama plan dramatically expands the number of Americans that will be covered by health insurance.

To cover the cost of this expansion the plan requires everyone to have health insurance with a penalty to be paid if we don't comply. It will purportedly send money to the states to cover those individuals added to state-based Medicaid programs.

To cover the added costs there were a number of new taxes introduced, one being a 2.5% tax on new medical technologies and another increases taxes on interest and dividend income for wealthier Americans.

The Obama plan also uses concepts such as evidence-based medicine, accountable care organizations, comparative effectiveness research and reduced reimbursement to health care providers (doctors and hospitals) to control costs.

The insurance mandate covered by points 1 and 2 above is a worthy goal and most industrialized countries outside of the U.S. provide "free" (paid for by rather high individual and corporate taxes) health care to most if not all of their citizens. It is important to note, however, that there are a number of restrictions for which many Americans would be culturally unprepared. Here is the primary controversial aspect of the Obama plan, the insurance mandate. The U.S. Supreme Court recently decided to hear arguments as to the constitutionality of the health insurance mandate as a result of a petition by 26 states attorney's general that congress exceeded its authority under the commerce clause of the U.S. constitution by passing this element of the plan. The problem is that if the Supreme Court should rule against the mandate, it is generally believed that the Obama plan as we know it is doomed. This is because its major goal of providing health insurance to all would be severely limited if not terminated altogether by such a decision.

As you would guess, the taxes covered by point 3 above are rather unpopular with those entities and individuals that have to pay them. Medical device companies, pharmaceutical companies, hospitals, doctors and insurance companies all had to "give up" something that would either create new revenue or would reduce costs within their spheres of control. As an example, Stryker Corporation, a large medical device company, recently announced at least a 1,000 employee reduction in part to cover these new fees. This is being experienced by other medical device companies and pharmaceutical companies as well. The reduction in good paying jobs in these sectors and in the hospital sector may rise as former cost structures will have to be dealt with in order to accommodate the reduced rate of reimbursement to hospitals. Over the next ten years some estimates put the cost reductions to hospitals and physicians at half a trillion dollars and this will flow directly to and affect the companies that supply hospitals and doctors with the latest medical technologies. None of this is to say that efficiencies will not be realized by these changes or that other jobs will in turn be created but this will represent painful change for a while. It helps us to understand that health care reform does have an effect both positive and negative.

Finally, the Obama plan seeks to change the way medical decisions are made. While clinical and basic research underpins almost everything done in medicine today, doctors are creatures of habit like the rest of us and their training and day-to-day experiences dictate to a great extent how they go about diagnosing and treating our conditions. Enter the concept of evidence-based medicine and comparative effectiveness research. Both of these seek to develop and utilize data bases from electronic health records and other sources to give better and more timely information and feedback to physicians as to the outcomes and costs of the treatments they are providing. There is great waste in health care today, estimated at perhaps a third of an over 2 trillion dollar health care spend annually. Imagine the savings that are possible from a reduction in unnecessary test and procedures that do not compare favorably with health care interventions that are better documented as effective. Now the Republicans and others don't generally like these ideas as they tend to characterize them as "big government control" of your and my health care. But to be fair, regardless of their political persuasions, most people who understand health care at all, know that better data for the purposes described above will be crucial to getting health care efficiencies, patient safety and costs headed in the right direction.

A brief review of how Republicans and more conservative individuals think about health care reform. I believe they would agree that costs must come under control and that more, not fewer Americans should have access to health care regardless of their ability to pay. But the main difference is that these folks see market forces and competition as the way to creating the cost reductions and efficiencies we need. There are a number of ideas with regard to driving more competition among health insurance companies and health care providers (doctors and hospitals) so that the consumer would begin to drive cost down by the choices we make. This works in many sectors of our economy but this formula has shown that improvements are illusive when applied to health care. Primarily the problem is that health care choices are difficult even for those who understand it and are connected. The general population, however, is not so informed and besides we have all been brought up to "go to the doctor" when we feel it is necessary and we also have a cultural heritage that has engendered within most of us the feeling that health care is something that is just there and there really isn't any reason not to access it for whatever the reason and worse we all feel that there is nothing we can do to affect its costs to insure its availability to those with serious problems.

OK, this article was not intended to be an exhaustive study as I needed to keep it short in an attempt to hold my audience's attention and to leave some room for discussing what we can do contribute mightily to solving some of the problems. First we must understand that the dollars available for health care are not limitless. Any changes that are put in place to provide better insurance coverage and access to care will cost more. And somehow we have to find the revenues to pay for these changes. At the same time we have to pay less for medical treatments and procedures and do something to restrict the availability of unproven or poorly documented treatments as we are the highest cost health care system in the world and don't necessarily have the best results in terms of longevity or avoiding chronic diseases much earlier than necessary.

I believe that we need a revolutionary change in the way we think about health care, its availability, its costs and who pays for it. And if you think I am about to say we should arbitrarily and drastically reduce spending on health care you would be wrong. Here it is fellow citizens - health care spending needs to be preserved and protected for those who need it. And to free up these dollars those of us who don't need it or can delay it or avoid it need to act. First, we need to convince our politicians that this country needs sustained public education with regard to the value of preventive health strategies. This should be a top priority and it has worked to reduce the number of U.S. smokers for example. If prevention were to take hold, it is reasonable to assume that those needing health care for the myriad of life style engendered chronic diseases would decrease dramatically. Millions of Americans are experiencing these diseases far earlier than in decades past and much of this is due to poor life style choices. This change alone would free up plenty of money to handle the health care costs of those in dire need of treatment, whether due to an acute emergency or chronic condition.

Let's go deeper on the first issue. Most of us refuse do something about implementing basic wellness strategies into our daily lives. We don't exercise but we offer a lot of excuses. We don't eat right but we offer a lot of excuses. We smoke and/or we drink alcohol to excess and we offer a lot of excuses as to why we can't do anything about managing these known to be destructive personal health habits. We don't take advantage of preventive health check-ups that look at blood pressure, cholesterol readings and body weight but we offer a lot of excuses. In short we neglect these things and the result is that we succumb much earlier than necessary to chronic diseases like heart problems, diabetes and high blood pressure. We wind up accessing doctors for these and more routine matters because "health care is there" and somehow we think we have no responsibility for reducing our demand on it.

It is difficult for us to listen to these truths but easy to blame the sick. Maybe they should take better care of themselves! Well, that might be true or maybe they have a genetic condition and they have become among the unfortunate through absolutely no fault of their own. But the point is that you and I can implement personalized preventive disease measures as a way of dramatically improving health care access for others while reducing its costs. It is far better to be productive by doing something we can control then shifting the blame.

There are a huge number of free web sites available that can steer us to a more healthful life style. A soon as you can, "Google" "preventive health care strategies", look up your local hospital's web site and you will find more than enough help to get you started. Finally, there is a lot to think about here and I have tried to outline the challenges but also the very powerful effect we could have on preserving the best of America's health care system now and into the future. I am anxious to hear from you and until then - take charge and increase your chances for good health while making sure that health care is there when we need it.

Health Care Fraud - The Perfect Storm

Today, health care fraud is all over the news. There undoubtedly is fraud in health care. The same is true for every business or endeavor touched by human hands, e.g. banking, credit, insurance, politics, etc. There is no question that health care providers who abuse their position and our trust to steal are a problem. So are those from other professions who do the same.

Why does health care fraud appear to get the 'lions-share' of attention? Could it be that it is the perfect vehicle to drive agendas for divergent groups where taxpayers, health care consumers and health care providers are dupes in a health care fraud shell-game operated with 'sleight-of-hand' precision?

Take a closer look and one finds this is no game-of-chance. Taxpayers, consumers and providers always lose because the problem with health care fraud is not just the fraud, but it is that our government and insurers use the fraud problem to further agendas while at the same time fail to be accountable and take responsibility for a fraud problem they facilitate and allow to flourish.

1. Astronomical Cost Estimates

What better way to report on fraud then to tout fraud cost estimates, e.g.

- "Fraud perpetrated against both public and private health plans costs between $72 and $220 billion annually, increasing the cost of medical care and health insurance and undermining public trust in our health care system... It is no longer a secret that fraud represents one of the fastest growing and most costly forms of crime in America today... We pay these costs as taxpayers and through higher health insurance premiums... We must be proactive in combating health care fraud and abuse... We must also ensure that law enforcement has the tools that it needs to deter, detect, and punish health care fraud." [Senator Ted Kaufman (D-DE), 10/28/09 press release]

- The General Accounting Office (GAO) estimates that fraud in healthcare ranges from $60 billion to $600 billion per year - or anywhere between 3% and 10% of the $2 trillion health care budget. [Health Care Finance News reports, 10/2/09] The GAO is the investigative arm of Congress.

- The National Health Care Anti-Fraud Association (NHCAA) reports over $54 billion is stolen every year in scams designed to stick us and our insurance companies with fraudulent and illegal medical charges. [NHCAA, web-site] NHCAA was created and is funded by health insurance companies.

Unfortunately, the reliability of the purported estimates is dubious at best. Insurers, state and federal agencies, and others may gather fraud data related to their own missions, where the kind, quality and volume of data compiled varies widely. David Hyman, professor of Law, University of Maryland, tells us that the widely-disseminated estimates of the incidence of health care fraud and abuse (assumed to be 10% of total spending) lacks any empirical foundation at all, the little we do know about health care fraud and abuse is dwarfed by what we don't know and what we know that is not so. [The Cato Journal, 3/22/02]

2. Health Care Standards

The laws & rules governing health care - vary from state to state and from payor to payor - are extensive and very confusing for providers and others to understand as they are written in legalese and not plain speak.

Providers use specific codes to report conditions treated (ICD-9) and services rendered (CPT-4 and HCPCS). These codes are used when seeking compensation from payors for services rendered to patients. Although created to universally apply to facilitate accurate reporting to reflect providers' services, many insurers instruct providers to report codes based on what the insurer's computer editing programs recognize - not on what the provider rendered. Further, practice building consultants instruct providers on what codes to report to get paid - in some cases codes that do not accurately reflect the provider's service.

Consumers know what services they receive from their doctor or other provider but may not have a clue as to what those billing codes or service descriptors mean on explanation of benefits received from insurers. This lack of understanding may result in consumers moving on without gaining clarification of what the codes mean, or may result in some believing they were improperly billed. The multitude of insurance plans available today, with varying levels of coverage, ad a wild card to the equation when services are denied for non-coverage - especially if it is Medicare that denotes non-covered services as not medically necessary.

3. Proactively addressing the health care fraud problem

The government and insurers do very little to proactively address the problem with tangible activities that will result in detecting inappropriate claims before they are paid. Indeed, payors of health care claims proclaim to operate a payment system based on trust that providers bill accurately for services rendered, as they can not review every claim before payment is made because the reimbursement system would shut down.

They claim to use sophisticated computer programs to look for errors and patterns in claims, have increased pre- and post-payment audits of selected providers to detect fraud, and have created consortiums and task forces consisting of law enforcers and insurance investigators to study the problem and share fraud information. However, this activity, for the most part, is dealing with activity after the claim is paid and has little bearing on the proactive detection of fraud.

4. Exorcise health care fraud with the creation of new laws

The government's reports on the fraud problem are published in earnest in conjunction with efforts to reform our health care system, and our experience shows us that it ultimately results in the government introducing and enacting new laws - presuming new laws will result in more fraud detected, investigated and prosecuted - without establishing how new laws will accomplish this more effectively than existing laws that were not used to their full potential.

With such efforts in 1996, we got the Health Insurance Portability and Accountability Act (HIPAA). It was enacted by Congress to address insurance portability and accountability for patient privacy and health care fraud and abuse. HIPAA purportedly was to equip federal law enforcers and prosecutors with the tools to attack fraud, and resulted in the creation of a number of new health care fraud statutes, including: Health Care Fraud, Theft or Embezzlement in Health Care, Obstructing Criminal Investigation of Health Care, and False Statements Relating to Health Care Fraud Matters.

In 2009, the Health Care Fraud Enforcement Act appeared on the scene. This act has recently been introduced by Congress with promises that it will build on fraud prevention efforts and strengthen the governments' capacity to investigate and prosecute waste, fraud and abuse in both government and private health insurance by sentencing increases; redefining health care fraud offense; improving whistleblower claims; creating common-sense mental state requirement for health care fraud offenses; and increasing funding in federal antifraud spending.

Undoubtedly, law enforcers and prosecutors MUST have the tools to effectively do their jobs. However, these actions alone, without inclusion of some tangible and significant before-the-claim-is-paid actions, will have little impact on reducing the occurrence of the problem.

What's one person's fraud (insurer alleging medically unnecessary services) is another person's savior (provider administering tests to defend against potential lawsuits from legal sharks). Is tort reform a possibility from those pushing for health care reform? Unfortunately, it is not! Support for legislation placing new and onerous requirements on providers in the name of fighting fraud, however, does not appear to be a problem.

If Congress really wants to use its legislative powers to make a difference on the fraud problem they must think outside-the-box of what has already been done in some form or fashion. Focus on some front-end activity that deals with addressing the fraud before it happens. The following are illustrative of steps that could be taken in an effort to stem-the-tide on fraud and abuse:

- DEMAND all payors and providers, suppliers and others only use approved coding systems, where the codes are clearly defined for ALL to know and understand what the specific code means. Prohibit anyone from deviating from the defined meaning when reporting services rendered (providers, suppliers) and adjudicating claims for payment (payors and others). Make violations a strict liability issue.

- REQUIRE that all submitted claims to public and private insurers be signed or annotated in some fashion by the patient (or appropriate representative) affirming they received the reported and billed services. If such affirmation is not present claim isn't paid. If the claim is later determined to be problematic investigators have the ability to talk with both the provider and the patient...

- REQUIRE that all claims-handlers (especially if they have authority to pay claims), consultants retained by insurers to assist on adjudicating claims, and fraud investigators be certified by a national accrediting company under the purview of the government to exhibit that they have the requisite understanding for recognizing health care fraud, and the knowledge to detect and investigate the fraud in health care claims. If such accreditation is not obtained, then neither the employee nor the consultant would be permitted to touch a health care claim or investigate suspected health care fraud.

- PROHIBIT public and private payors from asserting fraud on claims previously paid where it is established that the payor knew or should have known the claim was improper and should not have been paid. And, in those cases where fraud is established in paid claims any monies collected from providers and suppliers for overpayments be deposited into a national account to fund various fraud and abuse education programs for consumers, insurers, law enforcers, prosecutors, legislators and others; fund front-line investigators for state health care regulatory boards to investigate fraud in their respective jurisdictions; as well as funding other health care related activity.

- PROHIBIT insurers from raising premiums of policyholders based on estimates of the occurrence of fraud. Require insurers to establish a factual basis for purported losses attributed to fraud coupled with showing tangible proof of their efforts to detect and investigate fraud, as well as not paying fraudulent claims.

5. Insurers are victims of health care fraud

Insurers, as a regular course of business, offer reports on fraud to present themselves as victims of fraud by deviant providers and suppliers.

It is disingenuous for insurers to proclaim victim-status when they have the ability to review claims before they are paid, but choose not to because it would impact the flow of the reimbursement system that is under-staffed. Further, for years, insurers have operated within a culture where fraudulent claims were just a part of the cost of doing business. Then, because they were victims of the putative fraud, they pass these losses on to policyholders in the form of higher premiums (despite the duty and ability to review claims before they are paid). Do your premiums continue to rise?

Insurers make a ton of money, and under the cloak of fraud-fighting, are now keeping more of it by alleging fraud in claims to avoid paying legitimate claims, as well as going after monies paid on claims for services performed many years prior from providers too petrified to fight-back. Additionally, many insurers, believing a lack of responsiveness by law enforcers, file civil suits against providers and entities alleging fraud.

6. Increased investigations and prosecutions of health care fraud

Purportedly, the government (and insurers) have assigned more people to investigate fraud, are conducting more investigations, and are prosecuting more fraud offenders.

With the increase in the numbers of investigators, it is not uncommon for law enforcers assigned to work fraud cases to lack the knowledge and understanding for working these types of cases. It is also not uncommon that law enforcers from multiple agencies expend their investigative efforts and numerous man-hours by working on the same fraud case.

Law enforcers, especially at the federal level, may not actively investigate fraud cases unless they have the tacit approval of a prosecutor. Some law enforcers who do not want to work a case, no matter how good it may be, seek out a prosecutor for a declination on cases presented in the most negative light.

Health Care Regulatory Boards are often not seen as a viable member of the investigative team. Boards regularly investigate complaints of inappropriate conduct by licensees under their purview. The major consistency of these boards are licensed providers, typically in active practice, that have the pulse of what is going on in their state.

Insurers, at the insistence of state insurance regulators, created special investigative units to address suspicious claims to facilitate the payment of legitimate claims. Many insurers have recruited ex-law enforcers who have little or no experience on health care matters and/or nurses with no investigative experience to comprise these units.

Reliance is critical for establishing fraud, and often a major hindrance for law enforcers and prosecutors on moving fraud cases forward. Reliance refers to payors relying on information received from providers to be an accurate representation of what was provided in their determination to pay claims. Fraud issues arise when providers misrepresent material facts in submitted claims, e.g. services not rendered, misrepresenting the service provider, etc.

Increased fraud prosecutions and financial recoveries? In the various (federal) prosecutorial jurisdictions in the United States, there are differing loss- thresholds that must be exceeded before the (illegal) activity will be considered for prosecution, e.g. $200,000.00, $1 million. What does this tell fraudsters - steal up to a certain amount, stop and change jurisdictions?

In the end, the health care fraud shell-game is perfect for fringe care-givers and deviant providers and suppliers who jockey for unfettered-access to health care dollars from a payment system incapable or unwilling to employ necessary mechanisms to appropriately address fraud - on the front-end before the claims are paid! These deviant providers and suppliers know that every claim is not looked at before it is paid, and operate knowing that it is then impossible to detect, investigate and prosecute everyone who is committing fraud!

Lucky for us, there are countless experienced and dedicated professionals working in the trenches to combat fraud that persevere in the face of adversity, making a difference one claim/case at a time! These professionals include, but are not limited to: Providers of all disciplines; Regulatory Boards (Insurance and Health Care); Insurance Company Claims Handlers and Special Investigators; Local, State and Federal Law Enforcers; State and Federal Prosecutors; and others.

Hiring a Home Health Care Employee

Providing the primary care for an elder loved one can be difficult. When you cannot deliver all the elder care yourself and support from friends, family, and community organizations is not enough, it may be useful to hire a home health care worker. He or she can offer care from a few hours a week to 24 hours a day, and can provide many other helpful services. Types of in-home health care services include:

General Health Management like administration of medication or other medical treatments
Personal care such as bathing, oral hygiene, dressing, and shaving
Nutrition help like preparing meals, assisting eating, and grocery shopping
Homemaking services including laundry, dishwashing, and light housework
Companionship for example reading to the senior or taking them on walks

Recruiting and Interviewing Applicants

There are many avenues for hiring a home health care employee. Generally, home health care workers can be hired directly or through an agency. Home health care agencies often have a staff that includes social workers and nurses that will manage your care. However hiring an independent home health care worker is generally more cost effective, it will also give you more control over the type of care you receive.

Senior home care workers should be carefully screened for proper training, qualifications, and temperament. Fully discuss the needs of the elder care recipient during an interview with a prospective home health care employee. There should be a written copy the job description and the type of experience you are looking for.

References

Have applicants fill out an employment form that includes the following information:

Full name
Address
Phone number
Date of birth
Social Security number
Educational background
Work history

Before hiring, you should ask to see the senior home care worker's licenses and certificates, if applicable, and personal identification including their social security card, driver's license, or photo ID.

References should be checked out thoroughly. Prospective employees should provide the employer with names, dates of employment, and phone numbers of previous employers and how to contact them. It is best to talk directly to previous employers, rather than just to accept letters of recommendations. Also ask the applicant to provide or sign off on conducting a criminal background check

Special Points to Consider

Make sure the person you are considering hiring knows how to carry out the tasks the elder care recipient requires, such as transferring the senior to and from a wheelchair or bed. Training may be available, but make sure the worker completes the training successfully before hiring him or her.

No one should be hired on a seven-day-a-week basis. Even the most dedicated employee will soon burn out. All employees need some time to take care of their personal needs. No worker should be on call 24-hours a day. If the elder care recipient needs frequent supervision or care during the night, a family member or second home health care worker should be able to help out or fill in.

Live-in assistance may seem to be more convenient and economic than hourly or per-day employees but there can be drawbacks. Food and lodging costs must be calculated into the total cost of care, and it could be difficult to dismiss someone without immediate housing alternatives. If you decide to utilize a live-in arrangement, the employee should have his own living quarters, free time, and ample sleep.

Job Expectations and Considerations

Before hiring a senior home health care worker, you should go over the tasks you expect them to perform and other issues, such as promptness, benefits, pay scale, holidays, vacations, absences, and notification time needed for either employer or employee before employment is terminated. If you work and are heavily dependent on the home health care worker, emphasize the importance of being informed as soon as possible if he or she is going to be late or absent so that you can make alternative arrangements. Be clear about notification needed for time off, or what to do in the case the home health care worker experiences a personal emergency that requires them to abruptly leave work. It is important to have a backup list of friends, family, other home care workers, or a home health care agency you can call on.

Be clear about issues concerning salary, payment schedule, and reimbursement or petty cash funds for out of pocket expenses.

You should spend the day with the home health care worker on his first day to make sure you are both in agreement over how to carry out daily tasks. It would also be helpful to supply the home health care worker with a list of information on the elder care recipient such as: special diets, likes, dislikes, mobility problems, health issues, danger signs to monitor, possible behavior problems and accompanying coping strategies, medication schedule, therapeutic exercises, eye glasses, dentures, and any prosthetics.

You should also provide the following information to your home health care worker: your contact information, emergency contacts, security precautions and access to keys, clothing, and locations of washing/cleaning supplies, medical supplies, light bulbs, flashlights, fuse box, and other important household items.

Transportation

Another big consideration in hiring a senior home care worker is how he or she is going to get to work. If they do not have a reliable car or access to public transit, then you might want to consider hiring someone to drive him or her, which might be more economical than using taxis. Inform your insurance company if the home health care worker is going to drive your car when caring for the senior. Your insurance company will perform the necessary driving background checks. If the home health care worker is using his or her car to drive the elder care recipient, then discuss use of her or his car, and conduct a driving background check.

Insurance and Payroll

Check with an insurance company about the proper coverage for a worker in your home.

Make sure all the proper taxes are being drawn from the employee's check by contacting the Internal Revenue Service, state treasury department, social security, and the labor department. If you do not want to deal with the complexities of the payroll withholdings yourself, than you can hire a payroll company for a fee.

Even if your home health care worker is working as a contractor, you are still obligated to report the earnings to the IRS. Talk to your accountant or financial adviser about making sure you are following IRS rules.

Ensuring Security

You should protect your private papers and valuables in a locked file cabinet, safe deposit box, or safe. If you are unable to pick up your mail on a daily basis, have someone you trust do it, or have it sent to a post box. You should check the phone bill for unusual items or unauthorized calls. You should put a block on your phone for 900 numbers, collect calls, and long-distance calls.

Keep checkbooks and credit cards locked up. Review credit card and bank statements on a monthly basis, and periodically request credit reports from credit reporting agencies. Lock up valuable possessions or keep an inventory of items accessible to people working in the house.

You can help to prevent elder abuse to your loved one by:

Make sure the home health care worker thoroughly understands his or her responsibilities, the elder care recipient's medical problems and limitations, and how to cope with stressful situations.
Do not overburden the home health care worker.
Encourage openness over potential problems.

The following are possible signs of elder abuse or neglect:

Personality changes
Crying, whimpering, or refusing to talk
Sloppy appearance
Poor personal hygiene
Disorganized or dirty living conditions
Signs of inappropriate sedation, such as confusion, or excessive sleeping
Mysterious bruises, pressure sores, fractures, or burns
Weight loss

If you suspect abuse, act immediately. Do not wait until the situation turns tragic. Investigate the situation by talking to the elder care recipient in a safe situation, or install monitoring equipment. Examples of abusive behavior include yelling, threatening, or over controlling behavior that could involve isolating the senior from others. If the situation is serious, you should replace the home health care worker as quickly as possible. If you fear the elder care recipient is in danger, he or she should be separated from the home health care worker as soon as possible. Place the elder care recipient with a trusted relative or in a respite care facility. Make sure your loved one is safe before confronting the home health care worker, especially if there is concern about retaliation.

Report the situation to Adult Protective Services after ensuring the safety of the elder care recipient. The police should be contacted in the case of serious neglect, such as sexual abuse, physical injury, or misuse of funds.

Supervising a Home Health Care Worker

The most important thing to remember after hiring a home health care worker is to keep the lines of communication open. You should explain the job responsibilities clearly, and your responsibilities to the home health care worker. Do not forget that the home health care worker is there for the elder care recipient and not the rest of the family. For live-in arrangements, the maximum amount of privacy should be set up for the home health care worker's living quarters. Meetings should be set up on a regular basis to assure that problems are nipped in the bud. If conflicts cannot be resolved after repeated attempts, than it is best to terminate the employee. In such a case, you may have to either place the elder care recipient in a nursing home temporarily or hire a home health care worker through an agency. Reserve funds should be kept on hand in the case of such an emergency.

General Eligibility Requirements for Home Care Benefits

Hiring a home health care worker directly is usually less expensive than hiring through a home health care agency; but if the elder care recipient is eligible and you wish to use assistance from Medicare, you must hire someone through a certified home health care agency. For the senior patient to be eligible, three or more services must be ordered by a physician. Other factors or eligibility are the required need for skilled nursing assistance, or one of the following therapies: physical, speech or occupational. The elder care recipient's medical needs will determine asset and income requirements.

Hiring Home Health Care Workers through Home Health Care Agencies versus Independently

Different health professionals can assess the elder care recipient's needs. A nurse or social worker can help with design and coordination of a home care plan. Your care manager, doctor, or discharge planner can help with services being covered by Medicare. They generally help make the arrangements with a home care agency.

You should ask the home health care agency how they supervise their employees, and what kind of training their employees receive. Find out the procedures for when an employee does not show up. Also ask about the fee schedule and what it covers, there may be a sliding fee schedule. Furthermore, find out if they have a policy for minimum or maximum hours. Ask the agency if there are any limitations on the types of tasks performed.

Especially if you have to pay for the care services yourself, find out if there are any hidden costs such as transportation. If all the costs for hiring a care worker through an agency become too much, you may want to consider hiring directly.

Hiring independent home health care workers is not only more economical than using an agency, but it also allows more direct control over the elder care.

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