tag:blogger.com,1999:blog-88750232117295103822024-02-08T11:23:17.073-08:00health caregomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comBlogger19125tag:blogger.com,1999:blog-8875023211729510382.post-53255634366459364002012-09-26T05:25:00.002-07:002012-09-26T05:25:23.786-07:00Cialis Effectively Treats ED <div class="articlecontents">
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 <a href="http://www.edsupertabs.com/">Cialis</a>. There are specific steps you can take to improve the drug's usefulness.<br />
<h2>
Seek Professional Help</h2>
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.<br />
<h2>
Other ED Medications</h2>
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.<br />
<h2>
Why <a href="http://www.edsupertabs.com/articles/cialis-effectively-treats-ed.html">Cialis</a> is More Effective</h2>
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.<br />
<h2>
ED Treatment and Prevention</h2>
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.<br />
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.<br />
</div>
gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-35172644178158200412012-09-26T05:18:00.003-07:002012-09-26T05:18:49.375-07:00Cialis Effectively Treats ED<div class="articlecontents">
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 <a href="http://www.edsupertabs.com/">Cialis</a>. There are specific steps you can take to improve the drug's usefulness.<br />
<h2>
Seek Professional Help</h2>
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.<br />
<h2>
Other ED Medications</h2>
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.<br />
<h2>
Why <a href="http://www.edsupertabs.com/articles/cialis-effectively-treats-ed.html">Cialis</a> is More Effective</h2>
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.<br />
<h2>
ED Treatment and Prevention</h2>
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.<br />
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.<br />
</div>
gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-52345190316568775742012-08-22T19:35:00.000-07:002012-08-22T19:36:12.009-07:00Levitra and the Emotional Effects of Erectile Dysfunction<div class="articlecontents"> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>Emotional discomfort can be immobilizing. However, with the medical advances available today, including <a href="http://www.edphysician.net/">Levitra</a>, 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!</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-66787499084449889292012-05-17T09:11:00.000-07:002012-05-17T09:12:12.223-07:00The Increasing Surge of Health Care<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>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.</p><p>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."</p><p>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.</p><p>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."</p><p>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."</p><p>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."</p><p>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 <i>if</i> <i>more money</i> were spent for people in the health care arena, she says that there is a possibility that the necessary changes would be more evident.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>Regarding the rising tide of health care, Kristin Venderbush<b>, </b>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."</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>Children and Health Care</p><p>Washington's Perspective</p><p>What <i>is</i> driving health care costs?</p><p>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.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-26358972907540096072012-05-17T09:10:00.001-07:002012-05-17T09:10:25.908-07:00Our Health Care System - An Insider's View<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-6753255067234654862012-05-17T09:08:00.002-07:002012-05-17T09:09:08.604-07:00Universal Health Care<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-39418270853759337352012-05-17T09:05:00.003-07:002012-05-17T09:05:57.657-07:00Universal Health Care - The Ideal Health Care<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>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.</p><p>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.</p><p>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.</p><p>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.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-74992406976976247102012-05-17T09:05:00.001-07:002012-05-17T09:05:10.660-07:00Aurora Health Care- The Best Non-Profit Health Care<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>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!</p><p>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.</p><p><b>All Of Your Health Care Needs</b></p><p>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.</p><p><a target="_new" rel="nofollow" href="http://www.tophealthcarehelp.com/Health_Care_Providers/">Aurora Health Care</a> 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.</p><p>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.</p><p>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!</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-68186696504932168592012-05-17T09:04:00.003-07:002012-05-17T09:04:43.792-07:00Health Care Costs Is Rising-What You Need To Know<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>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.</p><p>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.</p><p>Here are some facts that may help explain the high costs of American health care:</p><p>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.</p><p>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!</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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:</p><p>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.</p><p>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).</p><p>Promote preventative care such as smart lifestyle choices, proper nutrition and exercise.</p><p>Examine to ways to control drug advertising to consumers. There is speculation that advertising has led to prescriptions of non-necessary drugs.</p><p>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.</p><p>To view our recommended sources for health insurance, or to read more articles about health insurance, visit: [http://www.insurance-quote-puppy.com]</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-7971944133806466082012-05-17T09:04:00.001-07:002012-05-17T09:04:10.797-07:00Discount Health Cards-Consumer Driven Health Care<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p><strong><u>Discount Health Care Cards-Consumer Driven Healthcare</u></strong></p><p><strong><u>What are discount health cards?</u></strong> 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.</p><p><strong><u>Why Choose a Discount Health Card?</u></strong><strong><u> </u></strong>Discount health cards are NOT insurance.</p><p>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.</p><p>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.</p><p>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.</p><p>In addition, discount health programs typically include the cardholder's entire household.</p><p><strong><u>How You Benefit with a Discount Health Card?</u></strong><strong><u> </u></strong>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:</p><p><strong><u>Access</u></strong>: 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.</p><p><strong><u>Affordability</u></strong>: While insurance rates have increased at double-digit rates over the past 12 years, discount card providers have kept their rates virtually unchanged.</p><p><strong><u>Savings</u></strong>: 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.</p><p><strong><u>Choice</u></strong>: 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.</p><p><strong><u>Convenience</u></strong>: 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:</p><p>* Pearle * LensCrafters * Medicine Shoppe</p><p>* Eckerd's * Safeway * Wal-Mart</p><p>* Sears * Target, and many more!</p><p><strong><u>What types of services are typically included by discount health cards?</u></strong> 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.</p><p><strong><u>Who should use discount health cards?</u></strong> 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.</p><p>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.</p><p>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.</p><p>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.</p><p><strong><u>How do consumers get discount health cards and how do the cards work?</u></strong> 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.</p><p>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.</p><p><strong><u>How do discount healthcare programs offer such benefits?</u></strong> 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.</p><p><strong><u>What is the difference between discount health cards and health insurance?</u></strong> 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.</p><p>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.</p><p>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.</p><p><strong><u>Do I still need insurance if I have a discount health card?</u></strong><strong><u> </u></strong>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.</p><p><strong><u>Why has there been controversy surrounding some discount health card providers?</u></strong> 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.</p><p><strong><u></u></strong>For more information and clarification contact:</p><p>Alan Masters</p><p>800-795-6823 Toll Free</p><p>530-318-6971 Cell</p><p>[http://www.alanmasters.com] Website</p><p><a href="mailto:AlanMasters@Ameriplan.net">AlanMasters@Ameriplan.net</a> email</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-65474299007442982612012-05-17T09:03:00.003-07:002012-05-17T09:03:42.393-07:00Improve your Well-Being through Affordable Health Care Plans<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>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.</p><p>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?</p><p>You will never know what emergency might come up so it is vital for you to have a comprehensive health care plan.</p><p>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.</p><p>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.</p><p>Take a look at some other types of health insurance plans that you can get for you and your family:</p><p>o Health Care Plans for Employees</p><p>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.</p><p>Before signing any pre-employment contracts, ask your Human Resources manager about the health care plans that you will get.</p><p>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.</p><p>o Privately Purchased Insurance Plans</p><p>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.</p><p>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.</p><p>When looking for the best health insurance company to cover your health care needs, remember the following:</p><p>1. Check out the discounted medical benefits included in the health care plan.</p><p>2. Be open about your medical history and pre-existing conditions.</p><p>3. Check out the benefits for your dependents or your immediate family.</p><p>4. Study thoroughly the monthly premiums, deductibles and other costs not included with the health care plan.</p><p>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.</p><p>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.</p><p>When looking for a health insurance provider, it would never hurt to be thorough and ask a lot of questions if you need to.</p><p>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.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-67492939136483420432012-05-17T09:03:00.001-07:002012-05-17T09:03:11.356-07:00Health Care Reform - Why Are People So Worked Up?<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>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?</p><p>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.</p><p>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.</p><p></p><ul> <li>A recent history of American health care - what has driven the costs so high?</li> <li>Key elements of the Obama health care plan</li> <li>The Republican view of health care - free market competition</li> <li>Universal access to state of the art health care - a worthy goal but not easy to achieve</li> <li>what can we do?</li> </ul><p></p><p>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?</p><p>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!</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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?</p><p>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.</p><p></p><ol> <li>Through insurance exchanges and an expansion of Medicaid,the Obama plan dramatically expands the number of Americans that will be covered by health insurance.</li><br /> <li>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.</li><br /> <li>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.</li><br /> <li>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.</li></ol><p></p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-55685206978556416562012-05-17T09:02:00.001-07:002012-05-17T09:02:15.852-07:00Health Care Fraud - The Perfect Storm<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>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.</p><p>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?</p><p>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.</p><p>1. Astronomical Cost Estimates</p><p>What better way to report on fraud then to tout fraud cost estimates, e.g.</p><p>- "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]</p><p>- 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.</p><p>- 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.</p><p>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]</p><p>2. Health Care Standards</p><p>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.</p><p>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.</p><p>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.</p><p>3. Proactively addressing the health care fraud problem</p><p>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.</p><p>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.</p><p>4. Exorcise health care fraud with the creation of new laws</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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:</p><p>- 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.</p><p>- 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...</p><p>- 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.</p><p>- 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.</p><p>- 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.</p><p>5. Insurers are victims of health care fraud</p><p>Insurers, as a regular course of business, offer reports on fraud to present themselves as victims of fraud by deviant providers and suppliers.</p><p>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?</p><p>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.</p><p>6. Increased investigations and prosecutions of health care fraud</p><p>Purportedly, the government (and insurers) have assigned more people to investigate fraud, are conducting more investigations, and are prosecuting more fraud offenders.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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?</p><p>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!</p><p>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.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-1265579173111688872012-05-17T09:01:00.003-07:002012-05-17T09:01:48.744-07:00Hiring a Home Health Care Employee<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p> 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:</p><p></p><ul> <li>General Health Management like administration of medication or other medical treatments</li> <li>Personal care such as bathing, oral hygiene, dressing, and shaving</li> <li>Nutrition help like preparing meals, assisting eating, and grocery shopping</li> <li>Homemaking services including laundry, dishwashing, and light housework</li> <li>Companionship for example reading to the senior or taking them on walks</li> </ul><br /><b>Recruiting and Interviewing Applicants</b><p></p><p>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. </p><p>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.</p><p><b>References</b></p><p>Have applicants fill out an employment form that includes the following information:</p><p></p><ul> <li>Full name</li> <li>Address</li> <li>Phone number</li> <li>Date of birth</li> <li>Social Security number</li> <li>Educational background</li> <li>Work history </li> </ul>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. <p></p><p>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 </p><p><b>Special Points to Consider</b></p><p>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.</p><p>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.</p><p>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.</p><p><b>Job Expectations and Considerations</b></p><p>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.</p><p>Be clear about issues concerning salary, payment schedule, and reimbursement or petty cash funds for out of pocket expenses. </p><p>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. </p><p>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.</p><p><b>Transportation</b></p><p>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.</p><p><b>Insurance and Payroll</b></p><p>Check with an insurance company about the proper coverage for a worker in your home.</p><p>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.</p><p>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.</p><p><b>Ensuring Security</b></p><p>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.</p><p>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.</p><p>You can help to prevent elder abuse to your loved one by: </p><p></p><ul> <li>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.</li> <li>Do not overburden the home health care worker.</li> <li>Encourage openness over potential problems.</li> </ul>The following are possible signs of elder abuse or neglect: <p></p><p></p><ul> <li>Personality changes</li> <li>Crying, whimpering, or refusing to talk</li> <li>Sloppy appearance</li> <li>Poor personal hygiene</li> <li>Disorganized or dirty living conditions</li> <li>Signs of inappropriate sedation, such as confusion, or excessive sleeping</li> <li>Mysterious bruises, pressure sores, fractures, or burns</li> <li>Weight loss</li> </ul>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.<p></p><p>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.</p><p><b>Supervising a Home Health Care Worker</b></p><p>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. </p><p><b>General Eligibility Requirements for Home Care Benefits</b></p><p>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.</p><p><b>Hiring Home Health Care Workers through Home Health Care Agencies versus Independently</b></p><p>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.</p><p>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.</p><p>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. </p><p>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.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-29642554835721615602012-05-17T09:01:00.001-07:002012-05-17T09:01:20.764-07:00A Prescription For the Health Care Crisis<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>With all the shouting going on about America's health care crisis, many are probably finding it difficult to concentrate, much less understand the cause of the problems confronting us. I find myself dismayed at the tone of the discussion (though I understand it---people are scared) as well as bemused that anyone would presume themselves sufficiently qualified to know how to best improve our health care system simply because they've encountered it, when people who've spent entire careers studying it (and I don't mean politicians) aren't sure what to do themselves.</p><p>Albert Einstein is reputed to have said that if he had an hour to save the world he'd spend 55 minutes defining the problem and only 5 minutes solving it. Our health care system is far more complex than most who are offering solutions admit or recognize, and unless we focus most of our efforts on defining its problems and thoroughly understanding their causes, any changes we make are just likely to make them worse as they are better.</p><p>Though I've worked in the American health care system as a physician since 1992 and have seven year's worth of experience as an administrative director of primary care, I don't consider myself qualified to thoroughly evaluate the viability of most of the suggestions I've heard for improving our health care system. I do think, however, I can at least contribute to the discussion by describing some of its troubles, taking reasonable guesses at their causes, and outlining some general principles that should be applied in attempting to solve them.</p><p>THE PROBLEM OF COST</p><p>No one disputes that health care spending in the U.S. has been rising dramatically. According to the Centers for Medicare and Medicaid Services (CMS), health care spending is projected to reach $8,160 per person per year by the end of 2009 compared to the $356 per person per year it was in 1970. This increase occurred roughly 2.4% faster than the increase in GDP over the same period. Though GDP varies from year-to-year and is therefore an imperfect way to assess a rise in health care costs in comparison to other expenditures from one year to the next, we can still conclude from this data that over the last 40 years the percentage of our national income (personal, business, and governmental) we've spent on health care has been rising.</p><p>Despite what most assume, this may or may not be bad. It all depends on two things: the reasons why spending on health care has been increasing relative to our GDP and how much value we've been getting for each dollar we spend.</p><p>WHY HAS HEALTH CARE BECOME SO COSTLY?</p><p>This is a harder question to answer than many would believe. The rise in the cost of health care (on average 8.1% per year from 1970 to 2009, calculated from the data above) has exceeded the rise in inflation (4.4% on average over that same period), so we can't attribute the increased cost to inflation alone. Health care expenditures are known to be closely associated with a country's GDP (the wealthier the nation, the more it spends on health care), yet even in this the United States remains an outlier (figure 3).</p><p>Is it because of spending on health care for people over the age of 75 (five times what we spend on people between the ages of 25 and 34)? In a word, no. Studies show this demographic trend explains only a small percentage of health expenditure growth.</p><p>Is it because of monstrous profits the health insurance companies are raking in? Probably not. It's admittedly difficult to know for certain as not all insurance companies are publicly traded and therefore have balance sheets available for public review. But Aetna, one of the largest publicly traded health insurance companies in North America, reported a 2009 second quarter profit of $346.7 million, which, if projected out, predicts a yearly profit of around $1.3 billion from the approximately 19 million people they insure. If we assume their profit margin is average for their industry (even if untrue, it's unlikely to be orders of magnitude different from the average), the total profit for all private health insurance companies in America, which insured 202 million people (2nd bullet point) in 2007, would come to approximately $13 billion per year. Total health care expenditures in 2007 were $2.2 trillion (see Table 1, page 3), which yields a private health care industry profit approximately 0.6% of total health care costs (though this analysis mixes data from different years, it can perhaps be permitted as the numbers aren't likely different by any order of magnitude).</p><p>Is it because of health care fraud? Estimates of losses due to fraud range as high as 10% of all health care expenditures, but it's hard to find hard data to back this up. Though some percentage of fraud almost certainly goes undetected, perhaps the best way to estimate how much money is lost due to fraud is by looking at how much the government actually recovers. In 2006, this was $2.2 billion, only 0.1% of $2.1 trillion (see Table 1, page 3) in total health care expenditures for that year.</p><p>Is it due to pharmaceutical costs? In 2006, total expenditures on prescription drugs was approximately $216 billion (see Table 2, page 4). Though this amounted to 10% of the $2.1 trillion (see Table 1, page 3) in total health care expenditures for that year and must therefore be considered significant, it still remains only a small percentage of total health care costs.</p><p>Is it from administrative costs? In 1999, total administrative costs were estimated to be $294 billion, a full 25% of the $1.2 trillion (Table 1) in total health care expenditures that year. This was a significant percentage in 1999 and it's hard to imagine it's shrunk to any significant degree since then.</p><p>In the end, though, what probably has contributed the greatest amount to the increase in health care spending in the U.S. are two things:</p><p>1. Technological innovation.</p><p>2. Overutilization of health care resources by both patients and health care providers themselves.</p><p>Technological innovation. Data that proves increasing health care costs are due mostly to technological innovation is surprisingly difficult to obtain, but estimates of the contribution to the rise in health care costs due to technological innovation range anywhere from 40% to 65% (Table 2, page 8). Though we mostly only have empirical data for this, several examples illustrate the principle. Heart attacks used to be treated with aspirin and prayer. Now they're treated with drugs to control shock, pulmonary edema, and arrhythmias as well as thrombolytic therapy, cardiac catheterization with angioplasty or stenting, and coronary artery bypass grafting. You don't have to be an economist to figure out which scenario ends up being more expensive. We may learn to perform these same procedures more cheaply over time (the same way we've figured out how to make computers cheaper) but as the cost per procedure decreases, the total amount spent on each procedure goes up because the number of procedures performed goes up. Laparoscopic cholecystectomy is 25% less than the price of an open cholecystectomy, but the rates of both have increased by 60%. As technological advances become more widely available they become more widely used, and one thing we're great at doing in the United States is making technology available.</p><p>Overutilization of health care resources by both patients and health care providers themselves. We can easily define overutilization as the unnecessary consumption of health care resources. What's not so easy is recognizing it. Every year from October through February the majority of patients who come into the Urgent Care Clinic at my hospital are, in my view, doing so unnecessarily. What are they coming in for? Colds. I can offer support, reassurance that nothing is seriously wrong, and advice about over-the-counter remedies---but none of these things will make them better faster (though I often am able to reduce their level of concern). Further, patients have a hard time believing the key to arriving at a correct diagnosis lies in history gathering and careful physical examination rather than technologically-based testing (not that the latter isn't important---just less so than most patients believe). Just how much patient-driven overutilization costs the health care system is hard to pin down as we have mostly only anecdotal evidence as above.</p><p>Further, doctors often disagree among themselves about what constitutes unnecessary health care consumption. In his excellent article, "The Cost Conundrum," Atul Gawande argues that regional variation in overutilization of health care resources by doctors best accounts for the regional variation in Medicare spending per person. He goes on to argue that if doctors could be motivated to rein in their overutilization in high-cost areas of the country, it would save Medicare enough money to keep it solvent for 50 years.</p><p>A reasonable approach. To get that to happen, however, we need to understand why doctors are overutilizing health care resources in the first place:</p><p>1. Judgment varies in cases where the medical literature is vague or unhelpful. When faced with diagnostic dilemmas or diseases for which standard treatments haven't been established, a variation in practice invariably occurs. If a primary care doctor suspects her patient has an ulcer, does she treat herself empirically or refer to a gastroenterologist for an endoscopy? If certain "red flag" symptoms are present, most doctors would refer. If not, some would and some wouldn't depending on their training and the intangible exercise of judgment.</p><p>2. Inexperience or poor judgment. More experienced physicians tend to rely on histories and physicals more than less experienced physicians and consequently order fewer and less expensive tests. Studies suggest primary care physicians spend less money on tests and procedures than their sub-specialty colleagues but obtain similar and sometimes even better outcomes.</p><p>3. Fear of being sued. This is especially common in Emergency Room settings, but extends to almost every area of medicine.</p><p>4. Patients tend to demand more testing rather than less. As noted above. And physicians often have difficulty refusing patient requests for many reasons (eg, wanting to please them, fear of missing a diagnosis and being sued, etc).</p><p>5. In many settings, overutilization makes doctors more money. There exists no reliable incentive for doctors to limit their spending unless their pay is capitated or they're receiving a straight salary.</p><p>Gawande's article implies there exists some level of utilization of health care resources that's optimal: use too little and you get mistakes and missed diagnoses; use too much and excess money gets spent without improving outcomes, paradoxically sometimes resulting in outcomes that are actually worse (likely as a result of complications from all the extra testing and treatments).</p><p>How then can we get doctors to employ uniformly good judgment to order the right number of tests and treatments for each patient---the "sweet spot"---in order to yield the best outcomes with the lowest risk of complications? Not easily. There is, fortunately or unfortunately, an art to good health care resource utilization. Some doctors are more gifted at it than others. Some are more diligent about keeping current. Some care more about their patients. An explosion of studies of medical tests and treatments has occurred in the last several decades to help guide doctors in choosing the most effective, safest, and even cheapest ways to practice medicine, but the diffusion of this evidence-based medicine is a tricky business. Just because beta blockers, for example, have been shown to improve survival after heart attacks doesn't mean every physician knows it or provides them. Data clearly show many don't. How information spreads from the medical literature into medical practice is a subject worthy of an entire post unto itself. Getting it to happen uniformly has proven extremely difficult.</p><p>In summary, then, most of the increase in spending on health care seems to have come from technological innovation coupled with its overuse by doctors working in systems that motivate them to practice more medicine rather than better medicine, as well as patients who demand the former thinking it yields the latter.</p><p>But even if we could snap our fingers and magically eliminate all overutilization today, health care in the U.S. would still remain among the most expensive in the world, requiring us to ask next---</p><p>WHAT VALUE ARE WE GETTING FOR THE DOLLARS WE SPEND?</p><p>According to an article in the New England Journal of Medicine titled The Burden of Health Care Costs for Working Families---Implications for Reform, growth in health care spending "can be defined as affordable as long as the rising percentage of income devoted to health care does not reduce standards of living. When absolute increases in income cannot keep up with absolute increases in health care spending, health care growth can be paid for only by sacrificing consumption of goods and services not related to health care." When would this ever be an acceptable state of affairs? Only when the incremental cost of health care buys equal or greater incremental value. If, for example, you were told that in the near future you'd be spending 60% of your income on health care but that as a result you'd enjoy, say, a 30% chance of living to the age of 250, perhaps you'd judge that 60% a small price to pay.</p><p>This, it seems to me, is what the debate on health care spending really needs to be about. Certainly we should work on ways to eliminate overutilization. But the real question isn't what absolute amount of money is too much to spend on health care. The real question is what are we getting for the money we spend and is it worth what we have to give up?</p><p>People alarmed by the notion that as health care costs increase policymakers may decide to ration health care don't realize that we're already rationing at least some of it. It just doesn't appear as if we are because we're rationing it on a first-come-first-serve basis---leaving it at least partially up to chance rather than to policy, which we're uncomfortable defining and enforcing. Thus we don't realize the reason our 90 year-old father in Illinois can't have the liver he needs is because a 14 year-old girl in Alaska got in line first (or maybe our father was in line first and gets it while the 14 year-old girl doesn't). Given that most of us remain uncomfortable with the notion of rationing health care based on criteria like age or utility to society, as technological innovation continues to drive up health care spending, we very well may at some point have to make critical judgments about which medical innovations are worth our entire society sacrificing access to other goods and services (unless we're so foolish as to repeat the critical mistake of believing we can keep borrowing money forever without ever having to pay it back).</p><p>So what value are we getting? It varies. The risk of dying from a heart attack has declined by 66% since 1950 as a result of technological innovation. Because cardiovascular disease ranks as the number one cause of death in the U.S. this would seem to rank high on the scale of value as it benefits a huge proportion of the population in an important way. As a result of advances in pharmacology, we can now treat depression, anxiety, and even psychosis far better than anyone could have imagined even as recently as the mid-1980's (when Prozac was first released). Clearly, then, some increases in health care costs have yielded enormous value we wouldn't want to give up.</p><p>But how do we decide whether we're getting good value from new innovations? Scientific studies must prove the innovation (whether a new test or treatment) actually provides clinically significant benefit (Aricept is a good example of a drug that works but doesn't provide great clinical benefit---demented patients score higher on tests of cognitive ability while on it but probably aren't significantly more functional or significantly better able to remember their children compared to when they're not). But comparative effectiveness studies are extremely costly, take a long time to complete, and can never be perfectly applied to every individual patient, all of which means some health care provider always has to apply good medical judgment to every patient problem.</p><p>Who's best positioned to judge the value to society of the benefit of an innovation---that is, to decide if an innovation's benefit justifies its cost? I would argue the group that ultimately pays for it: the American public. How the public's views could be reconciled and then effectively communicated to policy makers efficiently enough to affect actual policy, however, lies far beyond the scope of this post (and perhaps anyone's imagination).</p><p>THE PROBLEM OF ACCESS</p><p>A significant proportion of the population is uninsured or underinsured, limiting or eliminating their access to health care. As a result, this group finds the path of least (and cheapest) resistance---emergency rooms---which has significantly impaired the ability of our nation's ER physicians to actually render timely emergency care. In addition, surveys suggest a looming primary care physician shortage relative to the demand for their services. In my view, this imbalance between supply and demand explains most of the poor customer service patients face in our system every day: long wait times for doctors' appointments, long wait times in doctors' offices once their appointment day arrives, then short times spent with doctors inside exam rooms, followed by difficulty reaching their doctors in between office visits, and finally delays in getting test results. This imbalance would likely only partially be alleviated by less health care overutilization by patients.</p><p>GUIDELINES FOR SOLUTIONS</p><p>As Freaknomics authors Steven Levitt and Stephen Dubner state, "If morality represents how people would like the world to work, then economics represents how it actually does work." Capitalism is based on the principle of enlightened self-interest, a system that creates incentives to yield behavior that benefits both suppliers and consumers and thus society as a whole. But when incentives get out of whack, people begin to behave in ways that continue to benefit them often at the expense of others or even at their own expense down the road. Whatever changes we make to our health care system (and there's always more than one way to skin a cat), we must be sure to align incentives so that the behavior that results in each part of the system contributes to its sustainability rather than its ruin.</p><p>Here then is a summary of what I consider the best recommendations I've come across to address the problems I've outlined above:</p><p>1. Change the way insurance companies think about doing business. Insurance companies have the same goal as all other businesses: maximize profits. And if a health insurance company is publicly traded and in your 401k portfolio, you want them to maximize profits, too. Unfortunately, the best way for them to do this is to deny their services to the very customers who pay for them. It's harder for them to spread risk (the function of any insurance company) relative to say, a car insurance company, because far more people make health insurance claims than car insurance claims. It would seem, therefore, from a consumer perspective, the private health insurance model is fundamentally flawed. We need to create a disincentive for health insurance companies to deny claims (or, conversely, an extra incentive for them to pay them). Allowing and encouraging aross-state insurance competition would at least partially engage free market forces to drive down insurance premiums as well as open up new markets to local insurance companies, benefiting both insurance consumers and providers. With their customers now armed with the all-important power to go elsewhere, health insurance companies might come to view the quality with which they actually provide service to their customers (ie, the paying out of claims) as a way to retain and grow their business. For this to work, monopolies or near-monopolies must be disbanded or at the very least discouraged. Even if it does work, however, government will probably still have to tighten regulation of the health insurance industry to ensure some of the heinous abuses that are going on now stop (for example, insurance companies shouldn't be allowed to stratify consumers into sub-groups based on age and increase premiums based on an older group's higher average risk of illness because healthy older consumers then end up being penalized for their age rather than their behaviors). Karl Denninger suggests some intriguing ideas in a post on his blog about requiring insurance companies to offer identical rates to businesses and individuals as well as creating a mandatory "open enrollment" period in which participants could only opt in or out of a plan on a yearly basis. This would prevent individuals from only buying insurance when they got sick, eliminating the adverse selection problem that's driven insurance companies to deny payment for pre-existing conditions. I would add that, however reimbursement rates to health care providers are determined in the future (again, an entire post unto itself), all health insurance plans, whether private or public, must reimburse health care providers by an equal percentage to eliminate the existence of "good" and "bad" insurance that's currently responsible for motivating hospitals and doctors to limit or even deny service to the poor and which may be responsible for the same thing occurring to the elderly in the future (Medicare reimburses only slightly better than Medicaid). Finally, regarding the idea of a "public option" insurance plan open to all, I worry that if it's significantly cheaper than private options while providing near-equal benefits the entire country will rush to it en masse, driving private insurance companies out of business and forcing us all to subsidize one another's health care with higher taxes and fewer choices; yet at the same time if the cost to the consumer of a "public option" remains comparable to private options, the very people it's meant to help won't be able to afford it.</p><p>2. Motivate the population to engage in healthier lifestyles that have been proven to prevent disease. Prevention of disease probably saves money, though some have argued that living longer increases the likelihood of developing diseases that wouldn't have otherwise occurred, leading to the overall consumption of more health care dollars (though even if that's true, those extra years of life would be judged by most valuable enough to justify the extra cost. After all, the whole purpose of health care is to improve the quality and quantity of life, not save society money. Let's not put the cart before the horse). However, the idea of preventing a potentially bad outcome sometime in the future is only weakly motivating psychologically, explaining why so many people have so much trouble getting themselves to exercise, eat right, lose weight, stop smoking, etc. The idea of financially rewarding desirable behavior and/or financially punishing undesirable behavior is highly controversial. Though I worry this kind of strategy risks the enacting of policies that may impinge on basic freedoms if taken too far, I'm not against thinking creatively about how we could leverage stronger motivational forces to help people achieve health goals they themselves want to achieve. After all, most obese people want to lose weight. Most smokers want to quit. They might be more successful if they could find more powerful motivation.</p><p>3. Decrease overutilization of health care resources by doctors. I'm in agreement with Gawande that finding ways to get doctors to stop overutilizing health care resources is a worthy goal that will significantly rein in costs, that it will require a willingness to experiment, and that it will take time. Further, I agree that focusing only on who pays for our health care (whether the public or private sectors) will fail to address the issue adequately. But how exactly can we motivate doctors, whose pens are responsible for most of the money spent on health care in this country, to focus on what's truly best for their patients? The idea that external bodies---whether insurance companies or government panels---could be used to set standards of care doctors must follow in order to control costs strikes me as ludicrous. Such bodies have neither the training nor overriding concern for patients' welfare to be trusted to make those judgments. Why else do we have doctors if not to employ their expertise to apply nuanced approaches to complex situations? As long as they work in a system free of incentives that compete with their duty to their patients, they remain in the best position to make decisions about what tests and treatments are worth a given patient's consideration, as long as they're careful to avoid overconfident paternalism (refusing to obtain a head CT for a headache might be overconfidently paternalistic; refusing to offer chemotherapy for a cold isn't). So perhaps we should eliminate any financial incentive doctors have to care about anything but their patients' welfare, meaning doctors' salaries should be disconnected from the number of surgeries they perform and the number of tests they order, and should instead be set by market forces. This model already exists in academic health care centers and hasn't seemed to promote shoddy care when doctors feel they're being paid fairly. Doctors need to earn a good living to compensate for the years of training and massive amounts of debt they amass, but no financial incentive for practicing more medicine should be allowed to attach itself to that good living.</p><p>4. Decrease overutilization of health care resources by patients. This, it seems to me, requires at least three interventions:</p><p>* Making available the right resources for the right problems (so that patients aren't going to the ER for colds, for example, but rather to their primary care physicians). This would require hitting the "sweet spot" with respect to the number of primary care physicians, best at front-line gatekeeping, not of health care spending as in the old HMO model, but of triage and treatment. It would also require a recalculating of reimbursement levels for primary care services relative to specialty services to encourage more medical students to go into primary care (the reverse of the alarming trend we've been seeing for the last decade).</p><p>* A massive effort to increase the health literacy of the general public to improve its ability to triage its own complaints (so patients don't actually go anywhere for colds or demand MRIs of their backs when their trusted physicians tells them it's just a strain). This might be best accomplished through a series of educational programs (though given that no one in the private sector has an incentive to fund such programs, it might actually be one of the few things the government should---we'd just need to study and compare different educational programs and methods to see which, if any, reduce unnecessary patient utilization without worsening outcomes and result in more health care savings than they cost).</p><p>* Redesigning insurance plans to make patients in some way more financially liable for their health care choices. We can't have people going bankrupt due to illness, nor do we want people to underutilize health care resources (avoiding the ER when they have chest pain, for example), but neither can we continue to support a system in which patients are actually motivated to overutilize resources, as the current "pre-pay for everything" model does.</p><p>CONCLUSION</p><p>Given the enormous complexity of the health care system, no single post could possibly address every problem that needs to be fixed. Significant issues not raised in this article include the challenges associated with rising drug costs, direct-to-consumer marketing of drugs, end-of-life care, sky-rocketing malpractice insurance costs, the lack of cost transparency that enables hospitals to paradoxically charge the uninsured more than the insured for the same care, extending health care insurance coverage to those who still don't have it, improving administrative efficiency to reduce costs, the implementation of electronic medical records to reduce medical error, the financial burden of businesses being required to provide their employees with health insurance, and tort reform. All are profoundly interdependent, standing together like the proverbial house of cards. To attend to any one is to affect them all, which is why rushing through health care reform without careful contemplation risks unintended and potentially devastating consequences. Change does need to come, but if we don't allow ourselves time to think through the problems clearly and cleverly and to implement solutions in a measured fashion, we risk bringing down that house of cards rather than cementing it.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-8761600611800311482012-04-27T09:23:00.000-07:002012-05-17T09:41:37.128-07:00Union Organizing in the Health Care Industry - New Unions and Alliances Among Rivals<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>Though our nation's economy has recently lost millions of jobs, the health care industry has continued to add them. Not surprisingly, unions are eager to sign up health care workers. In the last 10 years, the rate of union wins in the health care industry has grown faster than the national average. Unions are uniting to lobby for labor-friendly legislation to promote increased union membership in the health care sector.</p><p>In addition to traditional organizing, health care union organizers are using more radical corporate campaigns that target hospital donors, shareholders, community groups, and even patients. The unions push these target groups to put pressure on hospital owners to allow unions to organize their employees. Many critics have argued that some of these agreements with employers have greatly limited workers' power and emphasized the union's cooperation with management.</p><p>The following article provides an overview of the major unions involved in the health care industry, as well as strategies to ensure your organization is prepared and remains successful.</p><p>Service Employees International Union <br />The Service Employees International Union (SEIU) began in 1921 primarily as a janitor's union and branched out to include government, security, and health care workers. By 2000, it was the largest, fastest-growing union in the United States, with much of that growth stemming from a series of strategic mergers with smaller unions. In June 2005, the SEIU and six other unions left the American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) to form the Change to Win coalition. Citing the need for a renewed effort to organize workers, Change to Win purports to be focused on achieving fair wages, health care benefits, and secure retirement for all employees. The coalition also encourages workers to unionize on an industry-wide basis, consolidating smaller unions within larger unions.</p><p>SEIU Healthcare <br />In 2007, the SEIU announced plans to launch a new health care union to serve approximately one million members, such as nurses and service workers at hospitals and nursing homes. SEIU Healthcare combined financial and personnel resources from the 38 local SEIU Healthcare unions. Of the SEIU's 1.9 million members, 900,000 work in health care. In September 2008, the SEIU reported it would begin several high-profile projects to bring business leaders, health care providers, community organizations, and elected officials together to work on the nation's health care system. SEIU leaders were part of a May meeting held by President Obama to discuss a health care overhaul. More recently, SEIU members attended town hall meetings to speak out in support of the proposed health care reform. In August, the SEIU was part of a group-largely funded by the pharmaceutical industry's lobby-that launched $12 million in television advertisements to support Obama's health care proposal. This group, the Americans for Stable Quality Care, could spend tens of millions more this fall.</p><p>SEIU and NUHW <br />The SEIU attempted to consolidate three local units representing home health care workers into one unit last December, taking authority away from the local units. The SEIU accused the local unit officials of financial misconduct, and in response, the leaders of the local units criticized the SEIU's practice of centralizing power at its Washington headquarters and making corrupt deals with employers. In January, a 150,000-member SEIU local unit in Oakland was put under trusteeship by the SEIU, and the local officials of that unit were dismissed. The ousted officials formed a new union, the National Union of Healthcare Workers (NUHW).</p><p>The NUHW announced the first workers had cast votes in favor of representation by the new union in March. A majority of 350 union-represented workers at four nursing homes in northern California managed by North American Health Care wanted to end their labor relationship with SEIU and join the NUHW. The day after this announcement, the SEIU filed unfair labor practice charges against the four nursing homes, charging that administrators of the facilities had illegally withdrawn union recognition and colluded with a competing labor union. In that same month, a National Labor Relations Board regional director ruled against the NUHW, saying that the contract between the SEIU and the hospital chain prevented the effort by a new labor union to represent 14,000 Catholic Healthcare West workers. Despite the ruling, the founding convention to formally launch the NUHW took place in April 2009. According to the NUHW, approximately 91,000 California health care workers have signed petitions filed at the labor board, stating they would like be members of the new union.</p><p>The NUHW also claims that, in response to these decertification drives, the SEIU has resorted to harassment and intimidation and tactics similar to union prevention. The SEIU argues that the new group has unfairly restrained and coerced workers, as well as complained to the National Labor Relations Board. A decisive battle between the two unions will come in 2010, when the SEIU-UHW contract with Kaiser Permanente expires and the opportunity for decertification elections reopens. Kaiser, the largest health care provider in California, has 50,000 workers that could potentially become members of NUHW.</p><p>California Nurses Association/National Nurses Organizing Committee <br />The California Nurses Association (CNA) began as a state chapter of the American Nurses Association (ANA) in 1903. The ANA has a federated structure: Nurses do not typically join the organization directly, but instead join their respective state organization, which has membership in the ANA. After several years of believing the ANA was not providing them adequate financial support to increase collective bargaining activity in California, the CNA broke ties with the ANA in 1995 and formed its own union, becoming the first state organization to secede from the ANA. Since its break from the ANA, the CNA has acquired a reputation as one of the most aggressive labor unions in the country. In 2004, the CNA began establishing itself in other states under the name National Nurses Organizing Committee (NNOC). The CNA voted to seek affiliation in the AFL-CIO in 2007. CNA membership has doubled over the last seven years and represents 80,000 members from all 50 states.</p><p>UAN-NNOC <br />In February, CNA/NNOC, United American Nurses (UAN), and the Massachusetts Nurses Association (MNA) announced the formation of another new union: the United American Nurses-National Nurses Organizing Committee (UAN-NNOC). With a combined membership of more than 150,000 affiliates in 19 states, it is the largest nursing union in the history of the United States.</p><p>National Federation of Nurses <br />The National Federation of Nurses (NFN) was officially launched in April at an event in Portland, Oregon. The NFN represents more than 70,000 nurses in six state nurses' associations, including New York, New Jersey, Ohio, Montana, Oregon, and Washington. Based on a federated model (much like the ANA), the NFN recognizes the independence of each member organization. Membership is open to state nurses' associations and other labor organizations that represent RNs. The NFN is tied to the ANA, which outlines standards for nursing practices, but has historically opposed nurse unionism and includes managers in its leadership. Since nurse union leaders expect many of the 15 unions with nurse memberships to flood hospitals with authorization cards if the Employee Free Choice Act (EFCA) passes, they want to establish their own national union to ensure nurses are organized by nurses.</p><p>SEIU and CNA: From Violent Disputes to Cooperative Agreements <br />The SEIU signed a neutrality agreement in March 2008 with an Ohio Catholic hospital to organize 8,000 workers. The day before voting was scheduled to begin, members of the CNA distributed leaflets to discourage workers from joining the SEIU. After the workers received the leaflets attacking SEIU and its arrangement with management for an election, SEIU called off the vote. Then at an April 2008 conference in Detroit, SEIU staff and members protested at a banquet of CNA members, resulting in violence. The two unions have also launched raids and counter-raids across the country, and both have sent mailings to thousands of nurses (including nurses in other unions, as well as nurses whose unions are currently trying to organize) attacking each other.</p><p>After more than a year of fighting, the SEIU and CNA signed a cooperation agreement in March. They will work together to bring union representation to all non-union RNs and other health care employees, as well as improve patient care standards. The unions have also agreed to refrain from raiding each other's members and will work together toward common goals, including lobbying for congressional passage of the EFCA. SEIU and CNA will coordinate campaigns at the largest health care systems and launch an intensive national organizing campaign. Catholic hospital chains will likely be among the first targets.</p><p>In June, the U.S. Conference of Catholic Bishops and the nation's largest unions (including the SEIU and the AFL-CIO) signed an agreement describing how union organizing will be conducted at Catholic health care facilities. (The document is similar to the one Catholic Healthcare Partners and Community Mercy Health Partners created last year with the SEIU before the CNA protest canceled the vote.) This agreement is significant because Catholic health care providers represent the largest employers and providers of services in many communities. The agreement provides seven guidelines for management at Catholic health care facilities and unions, making it easier organize health care workers at these facilities.</p><p>What This Means for Your Organization <br />Many experts agree that expanded unionization, along with the passage of the EFCA, will negatively impact our health care system. Both health care providers and industry analysts fear that unionization could mean higher costs and more restrictive work rules, adding to the soaring cost of delivering health care. Hospital and health care facilities need to be aware of these issues and how they can educate their supervisors and workers about the threat of unionization.</p><p>Communication with your employees is a critical first step. Many issues are involved in the possible unionization of a health care facility (economic factors, working conditions, quality of patient care, employee satisfaction, etc.). To prepare for possible union activity, identify issues that are relevant to your facility and address those needs publicly. Train leadership and include information about your union-free policy in the employee hiring and orientation procedures. Assess your wage and benefit structure, and be sure to promote what you offer.</p><p>You can use brochures, meetings, video, webinars, e-mail, Web sites, or eLearning tools to reach your employees. The most effective efforts include an employee feedback system that encourages two-way communication.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-49340379727175874262012-04-19T09:27:00.000-07:002012-05-17T09:41:27.227-07:00Making the Choice to Execute a Health Care Power of Attorney and Living Will<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p>Advances in medical technology, recent court rulings and emerging political trends have brought with them a number of life-and-death choices which many have never before considered. The looming prospect of legalized physician-assisted suicide is one such choice which severely erodes the inherent value and dignity of human life. The much-publicized efforts of certain doctors to provide carbon monoxide poisoning or prescribe lethal drugs for their terminally ill patients constitute euthanasia. So may the removal of certain life-sustaining treatments from a patient who is not in a terminal condition. Euthanasia and willful suicide, in any form, are offenses against life; they must be and are rejected by the vast majority of U.S. states.</p><p>However, people faced with these difficult dilemmas should be made aware that there are morally-appropriate, life-affirming legal options available to them. One such option, for Catholics and others, can be a "health care power of attorney" and "living will." South Carolina State law allows you to appoint someone as your agent to make health care decisions for you in the event you lose the ability to decide for yourself. This appointment is executed by means of a "health care power of attorney" form, a model for which can be obtained from your attorney.</p><p>A health care power of attorney can be a morally and legally acceptable means of protecting your wishes, values and religious beliefs when faced with a serious illness or debilitating accident. Accordingly, for persons wishing to execute health care powers of attorney, see the following instructions and guidance from the authoritative teachings and traditions of various religious faiths.</p><p>The intent of the health care power of attorney law is to allow adults to delegate their God-given, legally-recognized right to make health care decisions to a designated and trusted agent. The law does not intend to encourage or discourage any particular health care treatment. Nor does it legalize or promote euthanasia, suicide or assisted suicide. The health care power of attorney law allows you, or any competent adult, to designate an "agent," such as a family member or close friend, to make health care decisions for you if you lose the ability to decide for yourself in the future. This is done by completing a health care power of attorney form.</p><p><b>You... </b></p><p>o Have the right to make all of your own health care decisions while capable of doing so. The health care power of attorney only becomes effective when and if you become incapacitated through illness or accident.</p><p>o Have the right to challenge your doctor's determination that you are not capable of making your own medical decisions.</p><p>o CAN give special instructions about your medical treatment to your agent and can forbid your agent from making certain treatment decisions. To do so, you simply need to communicate your wishes, beliefs and instructions to your agent. Instructions about any specific treatments or procedures which you desire or do not desire under special conditions can also be written in your health care power of attorney and/or provided in a separate living will.</p><p>o Can revoke your health care power of attorney or the appointment of your agent at any time while competent.</p><p>o May not designate as your agent an administrator or employee of the hospital, nursing home or mental hygiene facility to which you are admitted, unless they are related by blood, marriage or adoption. <b>1996 </b></p><p><b>Your agent...</b></p><p>o Can begin making decisions for you only when your doctor determines that you are no longer able to make health care decisions for yourself.</p><p>o May make any and all health care decisions for you, including treatments for physical or mental conditions and decisions regarding life-sustaining procedures, unless you limit the power of your agent.</p><p>o Will <u>not</u> have authority to make decisions about the artificial provision of nutrition and hydration (nourishment and water through feeding tubes) <u>unless</u> he or she clearly knows that these decisions are in accord with your wishes about those measures.</p><p>o Is protected from legal liability when acting in good faith.</p><p>o Must base his or her decisions on your wishes or, if your wishes cannot be reasonably ascertained, in your "best interests." The agent's decisions will take precedence over the decisions of all other persons, regardless of family relationships.</p><p>o May have his or her decision challenged if your family, health care provider or close friend believes the agent is acting in bad faith or is not acting in accord with your wishes, including your religious/moral beliefs, or is not acting in your best interests.</p><p><b>CONSIDERATIONS FOR ALL PEOPLE </b><b>FROM CHRISTIAN/CATHOLIC TEACHING</b></p><p>The following is an attempt to gather information from the doctrines of Christianity, Catholicism, and Judaism to see if there are any commonalities with regard to health care agencies and living wills. We will see that all three religions have placed a value on dying with dignity and the right of the person to direct how <u>their</u> dying process will occur.</p><p>A major tenet of the faith is that it is unethical to take a life. It is not the highest of all values to stay alive, but you cannot affirmatively take steps to kill someone. The church is strongly against euthanasia and suicide. But often if the patient and medical care providers permit nature to take its course without heroic intervention, the person's life may be taken by God.</p><p>This is a narrow path. Taking a life is inappropriate; on the other hand, using heroic medical measures to keep a body biologically functioning would not be appropriate either. Mere biological existence is not considered a value. It is not a sin to allow someone to die peacefully and with dignity. We see death as an evil to be transformed into a victory by faith in God. The difficulty is discussing these issues in abstraction; they must be addressed on a case-by-case basis. The Christian church's view of life-and-death issues should ideally be reflected in the living will and health-care proxy.</p><p>Roman Catholic teaching celebrates life as a gift of a loving God and respects each human life because each is created in the image and likeness of God. It is consistent with Church teaching that each person has a right to make his or her own health care decisions. Further, a person's family or trusted delegate may have to assume that responsibility for someone who has become incapable of making their decisions. Accordingly, it is morally acceptable to appoint a health care agent by executing a health care power of attorney, provided it conforms to the teachings and traditions of the Catholic faith.</p><p>While the health care power of attorney law allows us to designate someone to make health care decisions for us, we must bear in mind that life is a sacred trust over which we have been given stewardship. We have a duty to preserve it, while recognizing that we have no unlimited power over it. Therefore, the Catholic Church encourages us to keep the following considerations in mind if we decide to sign a health care power of attorney.</p><p>1. As Christians, we believe that our physical life is sacred but that our ultimate goal is everlasting life with God. We are called to accept death as a part of the human condition. Death need not be avoided at all costs.</p><p>2. Suffering is "a fact of human life, and has special significance for the Christian as an opportunity to share in Christ's redemptive suffering. Nevertheless there is nothing wrong in trying to relieve someone's suffering as long as this does not interfere with other moral and religious duties. For example, it is permissible in the case of terminal illness to use pain killers which carry the risk of shortening life, so long as the intent is to relieve pain effectively rather than to cause death."</p><p>3. Euthanasia is "an action or omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated." "[Euthanasia] is an attack on human life which no one has a right to make or request."</p><p>4. "Everyone has the duty to care for his or her own health and to seek necessary medical care from others, but this does not mean that all possible remedies must be used in all circumstances. One is not obliged to use 'extraordinary' means - that is, means which offer no reasonable hope of benefit or which involve excessive hardship.</p><p>5. No health care agent may be authorized to deny personal services which every patient can rightfully expect, such as appropriate food, water, bed rest, room temperature and hygiene.</p><p>6. The patient's condition, however, may affect the moral obligation of providing food and water when they are being administered artificially. Factors that must be weighed in making this judgment include: the patient's ability to assimilate the artificially provided nutrition and hydration, the imminence of death and the risks of the procedures for the patient. While medically-administered food and water pose unique questions, especially for patients who are permanently unconscious, decisions about these measures should be guided by a presumption in favor of their use. Food and water must never be withdrawn in order to cause death. They may be withdrawn if they offer no reasonable hope of maintaining life or if they pose excessive risks or burdens.</p><p>7. Life-sustaining treatment must be maintained for a pregnant patient if continued treatment may benefit her unborn child.</p><p>Such principles and guidelines from the Christian heritage may guide Catholics and others as they strive to make responsible health care decisions and execute health care proxies. They may also guide Catholic health care facilities and providers in deciding when to accept and when to refuse to honor an agent's decision.</p><p><b>CONSIDERATIONS FOR ALL PEOPLE </b><b>FROM JEWISH TEACHING</b></p><p>Jewish tradition as understood by Conservative Judaism teaches that life is a blessing and a gift from God. Each human being is valued as created <i>b'tselem elohim, </i>in God's image. Whatever the level of our physical and mental abilities, whatever the extent of our dependence on others, each person has intrinsic dignity and value in God's eyes. Judaism values life and respects our bodies as the creation of God. We have the responsibility to care for ourselves and seek medical treatment needed for our recovery-we owe that to ourselves, to our loved ones, and to God.</p><p>In accordance with our tradition's respect for the life God has given us and its consequent bans on murder and suicide, Judaism rejects any form of active euthanasia ("mercy killing") or assisted suicide. Within these broad guidelines, decisions may be required about which treatment would best promote recovery and would offer the greatest benefit. Accordingly, each patient may face important choices concerning what mode of treatment he or she feels would be both beneficial and tolerable.</p><p>The breadth of the Conservative movement and its intellectual vitality have produced two differing positions put forward by Rabbis Avram Israel Reisner and Elliot N. Dorff, both approved by the Conservative movement's Committee on Jewish Law and Standards. Both positions agree on the value of life and the individual's responsibility to protect his or her life and seek healing. Both agree on a large area of autonomy in which a patient can make decisions about treatment when risk or uncertainty is involved. Both would allow terminally ill patients to rule out certain treatment options (such as those with significant side effects), to forgo mechanical life support, and to choose hospice care as a treatment option.</p><p>Nevertheless, important differences between the two positions may be found regarding both theoretical commitments and practical applications. Rabbi Reisner affirms the supreme value of protecting all life. Even the most difficult life and that of the shortest duration is yet God given, purposeful, and ours to nurture and protect. All nutrition, hydration, and medication should be provided whenever these are understood to be effective measures for sustaining life. Some medical interventions, however, do not sustain life so much as they prolong the dying process. These interventions are not required. The distinction may best be judged by our intent. We may choose to avoid treatments causing us fear or entailing risk or pain, in the interest of the remaining moments of life. We may not avoid treatment in an attempt to speed an escape into death.</p><p>Rabbi Dorff finds basis in Jewish law to grant greater latitude to the patient who wishes to reject life-sustaining measures. He sees a life under the siege of a terminal illness as an impaired life. In such a circumstance, a patient might be justified in deciding that a treatment that extends life without hope for cure would not benefit him or her, and may be forgone.</p><p>Both Rabbis Dorff and Reisner agree that advance directives should only be used to indicate preferences within the range allowed by Jewish law. They disagree as to what those acceptable ranges are. In completing a health care power of attorney and living will, it is recommended that you consult with your rabbi to discuss the values and norms of Jewish ethics and halakhah. You also may wish to talk with your physician to learn about the medical significance of your choices, in particular any decisions your physician feels are likely to be faced in light of your medical circumstances. You may find it helpful to discuss these concerns with family members.</p><p><b>CONCLUSION</b></p><p>In the end, the decision to execute a health care power of attorney and living will is a uniquely individual choice. Every person has their own set of principles by which they will live, and by which they will eventually pass on. When executing these documents, it is wise to examine how these documents assimilate into your worldview and religious beliefs. While the topic of death and dying is an uncomfortable one, you are well advised to discuss this decision with your family members, friends, and members and leaders of your religious community that you respect. Having done this, you can rest easy knowing that you have made a good decision with regard to your health care power of attorney and last will, and that your last wishes will be respected and undertaken.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-34145789990661519292012-03-28T09:16:00.000-07:002012-05-17T09:42:02.036-07:005 Myths in the Health Care Debate<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p><strong>Myth #5: Most Americans like their private health insurance and want to keep it. </strong></p><p>First off, let's start with the fact that in 2007 46 million Americans in this country have NO health care whatsoever. Not Medicare, not Medicaid, nothing. So that's 18% of the population who either cannot afford health care or will not qualify because of preexisting conditions. Then there are the people who've been in the hospital for costly procedures who had to battle the insurance companies in order to get treatment. A retired nurse from Texas testified before Congress that when she was diagnosed with aggressive breast cancer, Blue Cross Blue Shield sent her an email informing her that because of an issue with her with her application(the company had mistaken her dermatologist's notes on acne as a precancerous condition) her policy was being dropped. This was days before she was supposed to undergo a lifesaving hysterectomy. This practice, known as rescission, is often done by health insurance companies after one of their customers with an individual policy submits a claim for an expensive medical treatment. They dig through a patients records hoping to find anything that will disqualify the patient from receiving often much needed medical care. It saves the insurance company millions in medical claims; approximately 300 million was saved WellPoint Inc., UnitedHealth Group and Assurant Inc over a 5 year period. The insurance companies claim they are shielding themselves from fraud, however, during testimony before the House Energy and Commerce Committee committee over the practice of rescission, the CEOs from the nations top insurance companies refused to stop using rescission to cancel the policies of patients who did not intentionally deceive insurance companies on their applications. The key word being intentionally. They all responded by saying that the law allowed them terminating policies for even the most minor mistake. A poll conducted by the Harris Poll found that 75% of all Americans (independent, liberal, conservative) are actually for universal health care.</p><p><strong>Myth #4: America has the best health care in the world and part of that is because our health care is not run by the government. </strong></p><p>Based on the WHO's World Health Report 2000, the US is ranked 37th in the world for health care . The report is based on five factors: life expectancies, inequalities in health, the responsiveness of the system in providing diagnosis and treatment, inequalities in responsiveness, and how fairly systems are financed. As we all know statistics can made to say almost anything, however, the findings in this report cannot be discounted completely. Maybe we're not as low as 37 but we're definitely not #1. France, a country with Universal Health Care, is actually #1. Since it's inception the United States has been a trend setter of sorts. Other countries copy everything from our pop culture to our policies. If our for profit private health care system is so great, why are we the only industrialized nation on the planet doing it? America has never been perfect but one of our strengths has always been our ability to right social ills from slavery to women's suffrage. We're constantly evolving.</p><p><strong>Myth#3: Our current system is fine, why change it? </strong></p><p>We should question those who say this because they are from three camps: they are severely misinformed, they're in the pockets of the health insurance industry, or they don't want President Obama to accomplish anything significant. Currently Americans spend more money on health care than any other nation PERIOD . Switzerland, a country that requires ALL of it's citizens to have health care, comes in 2nd and we spend 53% more than them. Ask the politicians who are for the status quo but appalled by the current deficit how these contradictory viewpoints. The only people who you will see saying that our current system is fine are those are blessed enough to have and it have never had any fear of losing it. Consider that America is touted as one of the greatest countries in the world and yet 18,000 of our citizens die unnecessarily each year because they have no health care. How can we say that our health care system is not broken?</p><p>Insurance companies lining the pockets of those who have the most influence in this debate may sound like conspiracy theory, but consider this: insurance companies spent approximately 100 million lobbying and producing commercials such as the infamous Congress in 1993 fighting the Clinton Health Care Plan; this time around they are spending millions more to fight it. What are they so afraid of? If the insured are so content with their current coverage, why are they so against a public option?</p><p>The people who represent us in Congress, both Democrat and Republican, have always tried to make everything political. If President Obama were to be successful where Clinton failed in 1993, it would represent a major accomplishment and some conservatives can't have that. Republican Jim DeMint, Republican from South Carolina, famously said "If we're able to stop Obama on this (health care), it will be his Waterloo. It will break him." Why should an issue as important to million of Americans be looked at as an opportunity to "break" the President? As someone who represents the people of South Carolina shouldn't his primary concern be what is best for them, not strategically outmaneuvering the new Democratic President? Bill Kristol, who played a pivotal role in defeating the Clinton push to reform health care, urged conservatives to "kill" Obama's plan for health care reform; however, later he was on the Daily Show even though the public health care the troops receive is "the best" average Americans do not deserve this level of care. These objections to health care reform do not seem rooted in principal and reason but in a game of tic and tac played by both parties.</p><p><strong>Myth#2: Tort Reform would significantly the cost of health care.</strong></p><p>Often times this is the argument made as an alternative to drastically changing our current system. Doctors who fear being sued for malpractice begin practicing defensive medicine, which leads them to order expensive and sometimes unnecessary tests in order to avoid expensive malpractice suits. This inevitably increases the cost of health care. However, in a study done by the Johns Hopkins Bloomberg School of Public Health, defensive medicine accounted for at most 9% of the total cost of health care, and most experts doubt it's that high. Some estimate it's as little as 1%. When our country spends 53% more than anyone on health care, Tort Reform would not represent a significant improvement..</p><p><strong>Myth#1: If we having allow a public option our country will become a bankrupt and socialist. </strong></p><p>Anytime a policy benefits the public by giving them something, it is seen as a hand out that will inevitably destroy this country. The same was said of Social Security when it was introduced by FDR in 1935. Medicare and Medicaid were also called "socialized medicine" when Truman introduced them in 1945. But we enacted all these programs and somehow the United States did not immediately become a socialist country. Today many of the politicians that would've probably been against these programs when they were introduced fight to keep them alive.</p><p>The point is do not believe everything you hear. Whether it comes from the conservative right or the liberal left. Many people have an agenda and at times it maybe not be concern for the American people (buzz word). You shouldn't trust Bill O'Reily anymore than you trust Keith Olbermann. Trust the facts.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.comtag:blogger.com,1999:blog-8875023211729510382.post-35109997991407884852012-03-02T09:18:00.000-08:002012-05-17T09:41:50.768-07:00An American Universal Health Care System<div style="border-color: rgb(0, 0, 255); border-width: 2px; border-style: solid;" id="article-content"> <p><b>Health Care System Needs Reform, Not a Government Takeover </b></p><p>Believe it or not, America boasts some of the world's best doctors, the most advanced health care system, and the most technically superior resources in the world, bar none. Those who travel globally and have gotten sick know that their first choice for treatment would be in the U.S. Though health care in America is, more expensive than any other country, many of the worlds wealthiest come to the U.S for surgical procedures and complex care, because it holds a worldwide reputation for the gold standard in health care.</p><p>To examine the complex health care issue, a small research study was conducted from randomly selected doctors in a best doctors database. We ask 50 top doctors, located in different states and who practice different specialty fields, " Is a universal health care plan good for America?" Forty-eight of these doctors essentially responded that it was a "bad idea" that would have negative impacts on the quality of our nation's health care.</p><p><b>Social Engineering Medicine</b></p><p>One of the greatest mis-conceptions some people have relied on with regard to the health care debate is that, given a universal health care system, every person in the U.S. would receive the highest quality health care - the kind our nation is renowned for and that we currently receive. However, unlike some public amenities, health care is not a collective public service like police and fire protection services, therefore the Government cannot provide the same quality of health care to everyone, because not all physicians are equally good orthopedic surgeons, internists, neurosurgeons, etc, in the same way that not all individuals in need of health care are equally good patients.</p><p>As an analogy - stay with me - when you design a software program, there are many elements that are coded on the back-end, and used to manipulate certain aspects of the software program, that your average "John Doe" who uses the software (the end user) does not understand or utilize, nor do they care about these elements. Certain aspects of the program are coded, so that when one uses that portion of the program, other elements of the program are manipulated and automatically follow the present or next command.</p><p>Likewise, once a universal care plan is implemented in America and its massive infrastructure is shaped, private insurance companies will slowly disappear, and as a result, eventually patients will automatically be forced to utilize the government's universal health care plan. As part of such a system, patients will be known as numbers rather than patients, because such a massive government program would provide compensation incentive based on care provided, patients would become "numbers," rather than "patients." In addition, for cost savings reasons, every bit of health information, including your own, will be analyzed, and stored by the Government. What are the consequences? If you're a senior citizen and need a knee replacement at the age of 70, the government may determine that you're to old and it's not worth the investment cost, therefore instead of surgery, you may be given medication for the rest of your life at a substantial cost savings to the government, and at a high quality of life price to you.</p><p><b>Solutions:</b></p><p>Fixing the current U.S. health care system might require that we;</p><p><b>1.</b> Encourage prevention and early diagnosis of chronic conditions and management. <br /><b>2.</b> Completely reform existing government are programs, including Medicare and Medicaid. <br /><b>3.</b> Forgive medical school debt for those willing to practice primary care in under-served areas. <br /><b>4.</b> Improve access to care, provide small businesses and the self-employed with tax credits, not penalties for providing health care. <br /><b>5.</b> Encourage innovation in medical records management to reduce costs. <br /><b>6.</b> Require tort reform in medical malpractice judgments to lower the cost of providing care. <br /><b>7.</b> Keep what isn't broken-research shows 80% of Americans are happy with their current insurance, therefore, why completely dismantle it? <br /><b>8.</b> Reimburse physicians for their services. <br /><b>9.</b> Innovate a system in which Medicare fraud is dramatically decreased.</p><p><b>Devil In the Details </b></p><p>Socialized medicine means:</p><p><b>1.</b> Loss of private practice options, reduced pay for physicians, overwhelming numbers of patients, and increasing burn-out may reduce the number of doctors pursuing the profession.</p><p><b>2.</b> Patient confidentiality will need to be compromised, since centralized health information will be maintained by the government and it's databases.</p><p><b>3.</b> Healthy people who take care of themselves will pay for the burden of those with unhealthy lifestyles, such as those who smoke, are obese, etc.</p><p><b>4.</b> Patients lose the incentive to stay healthy or aren't likely to take efforts to curb their prescription drug costs because health care is free and the system can easily be abused.</p><p><b>5.</b> The U.S. Government will need to call the shots about important health decisions dictating what procedures are best for you, rather than those decisions being made by your doctor(s), which will result in poor individualized patient care.</p><p><b>6.</b> Tax rates will rise substantially-universal health care is not free since citizens are required to pay for it in the form of taxes.</p><p><b>7.</b> Your freedom of choice will be restricted as to which doctor is best for you and your family.</p><p><b>8.</b> Like all public programs, government bureaucracy, even in the form of health care, does not promote healthy competition that reduces costs based on demand. What's more, accountability is limited to the budgetary resources available to police such a system.</p><p><b>9.</b> Medicare is subsidized by private insurers to the tune of billions of dollars, therefore if you take them out of the equation, add a trillion dollars or more to the current trillion dollar-plus cost estimates.</p><p><b>10.</b> Currently, the government loses an estimated $ 30 billion a year due to Medicare fraud. Therefore, what makes anyone think that this same government will be able to run & operate a universal health care system that is resistant to fraud and save money while doing so?.</p> </div>gomhttp://www.blogger.com/profile/00377737268209738018noreply@blogger.com