I just couldn't help but respond to this video blog and resultant poll from Medscape. Dr. Henry Black talks about the "Demand Side of Healthcare" or when a patient sees an ad on TV or magazine, read on the internet, etc about a new test or treatment. They then come to their health professional with this information and "demand" to have this treatment, test or what have you. Since most physicians do not have the time or resources to continually explain why they do not need that test, they cave in and order it. Dr. Black believes this is another aspect that has contributed to increased healthcare costs. He further states that he had not heard this aspect addressed in the reform "talk". The subsequnt Medscape poll did demonstrate by and large the majority of healthcare professionals either strongly agree or somewhat agree that this is the case.
What was most interesting to me was that the physician group of voters had a higher percent of votes in the "Somewhat Agree" while other professionals had the highest percentage in the "Strongly Agree" voting pool. Is it a difference of those of us who are not physicians having a false perception of reality or the physicians unwilling to admit that they succumb to the pressure? Which case is correct is probably irrelevant since most all professionals agree this to be the case. From my perspective...I certainly believe that to be the case and have seen it happen for years. I do believe it has contributed to rising costs and could be included in part to the practice of defensive medicine.
I first recall this being an issue many years ago with the debate over doing a csection vs a vaginal delivery. It was thought at the time (and still today) that the increasing frequency of csection deliveries was due to consumer demand AND convenience for the physician and consumer. Afterall, when you can schedule the delivery of your baby there is much less interruption in your life...you can plan around it. The physician can also plan it at a more convenient time than in the middle of the night...why not? Of course, having a csection is a greater expense on resources (thus increased cost) and carries a greater risk of complications.
I could go on and on about the continuing debate related to "birthing a baby" but the point is greater than this one example. Throughout the years we have seen higher prescription orders for new drugs or newly "advertised" drugs...thought to be directly attributable to consumer demand after seeing the advertisements or before that, directly attributable to physician's responses to pharmaceutical reps visiting and gifting. It is a big game and we are all losing.
The point to all this is: until WE the consumer and WE the healthcare professionals agree and follow accepted standards of care, we will always be losing in this game. This has been partially addressed in the here-to-fore presented platforms for reform i.e. The Mayo Clinic Experience. For conditions in which we do not have evidence of the most cost effective and highest quality of care, we need to establish that evidence. For conditions in which we do have sufficient evidence for determining the best quality of care (and therefore most cost effective) we should use them. Staying informed and even questioning our physicians is our right and perhaps a responsibility. However, our relationship with our healthcare provider should be a partnership in which we discuss and agree upon the best treatment plan...we should not have to "demand" it...it should be a given. And just because we see it on TV, does not make it so.
This area should be elevated in scope as a major spoke in the healthcare reform wheel. It has been mentioned but not emphasized enough. I invite your comments, agreements and disagreements.
Wednesday, September 30, 2009
Sunday, September 27, 2009
Medication: Get 2 for the Price of 1
The following tip may be useful for some people with a portion of your medications. Let me first put out a disclaimer that to use this method, the individual must be mentally, physically and emotionally capable of carrying out the task correctly. Always use your physician's advice in the use of any of your medications. Having said this, let me describe this potential option. It may be applicable with some of the more expensive medications that are very limited in the amount that can be received in a month time. This is the case whether you have insurance or pay out of pocket for your meds.
Many medications can safely be cut in half. These medications are generally in a pill form rather than a capsule. Never try to half a capsule or a coated tablet...these pills are designed so that the effectiveness of the drug is dependent upon the particular coating of form. Ask your doctor if any of your medications are appropriate to try this method. Never reduce your prescribed medication dose without the advice of your physician, especially in order to save money.
To explain what I am trying to convey, I will use an example...Imitrex (a common pill used to abort migraine headaches). This medication comes in packets of 9 pills...you cannot get more in one month whether it is your insurance limiting it or the pharmacy. There is a reason for this...take too much and it can cause some very serious side effects. However, there may be times when you need to vary your dosage (as prescribed by your doctor).
Lets say that you typically take 50mg Imitrex at the onset of a headache and you need to refill your prescription every month or even 2 months. This drug is expensive (somewhere around $80), especially if you look at it from the point of only getting 9 pills at a time. Imitrex also comes in a 100mg dose (a packet of 9 pills, each one = 100mg). If you must vary your dosage, ask your Dr if it would be appropriate to prescribe the 100mg tablets for you. There are many considerations they may take in making that decision.
1. Are you capable to take the responsibility to divide the pills?
2. Are you capable to know how to take it?
3. Are they willing to take that chance?
This is not an uncommon practice. Some may say that it's fraud or it's just not doing the "right thing". I am not advocating fraudulently prescribing of medication. Based on your individual situation, this may be a very sensible solution. Your doctor will know if this option is appropriate for you. If so, you may not need to fill your prescription as frequently thus spending less money for your required dosing.
Ask your doctor if it is appropriate for your situation. Always follow your doctor's recommendations and never reduce your dosage or half your pills unless directed to do so.
Many medications can safely be cut in half. These medications are generally in a pill form rather than a capsule. Never try to half a capsule or a coated tablet...these pills are designed so that the effectiveness of the drug is dependent upon the particular coating of form. Ask your doctor if any of your medications are appropriate to try this method. Never reduce your prescribed medication dose without the advice of your physician, especially in order to save money.
To explain what I am trying to convey, I will use an example...Imitrex (a common pill used to abort migraine headaches). This medication comes in packets of 9 pills...you cannot get more in one month whether it is your insurance limiting it or the pharmacy. There is a reason for this...take too much and it can cause some very serious side effects. However, there may be times when you need to vary your dosage (as prescribed by your doctor).
Lets say that you typically take 50mg Imitrex at the onset of a headache and you need to refill your prescription every month or even 2 months. This drug is expensive (somewhere around $80), especially if you look at it from the point of only getting 9 pills at a time. Imitrex also comes in a 100mg dose (a packet of 9 pills, each one = 100mg). If you must vary your dosage, ask your Dr if it would be appropriate to prescribe the 100mg tablets for you. There are many considerations they may take in making that decision.
1. Are you capable to take the responsibility to divide the pills?
2. Are you capable to know how to take it?
3. Are they willing to take that chance?
This is not an uncommon practice. Some may say that it's fraud or it's just not doing the "right thing". I am not advocating fraudulently prescribing of medication. Based on your individual situation, this may be a very sensible solution. Your doctor will know if this option is appropriate for you. If so, you may not need to fill your prescription as frequently thus spending less money for your required dosing.
Ask your doctor if it is appropriate for your situation. Always follow your doctor's recommendations and never reduce your dosage or half your pills unless directed to do so.
Thursday, August 6, 2009
Preventive Maintenance
In a time when so many people are uninsured, partially insured and tightening our budget belts, it is more difficult for many to justify spending money for a physician visit when you are not ill. The problem with this issue is many serious health conditions can be festering inside our bodies only to erupt at a later time. When they do eventually begin to manifest in an outward way, the conditions could already have done damage that may not be reversible. Of course, there will be additional expenses to deal with these abnormalities.
Current patterns of health care utilization indicate a trend of people not using the healthcare system due to the state of financial uncertainty as well as other potential reasons. What are the consequences of this behavior? For the remainder of this discussion, we are going to assume that the previous frequency of health care utilization was for needed services and not just using the system because it was there, someone else was paying or you had a little more confidence in your individual financial situation. This is a rather large assumption and it is just that…an assumption.
What are the potential consequences of not changing the oil in your car or not maintaining the integrity of the roof on your house? The answer is pretty obvious…more serious problems that must be addressed or you may not have a car to drive or a roof over your head. And of course, it will be much more expensive than if you had just had the oil changed. I am talking about simple and inexpensive monitoring of your vital functioning. You can probably obtain the necessary care at no cost or a nominal fee.
The following items should be monitored on a regular basis and if one or more of them starts to change in an unfavorable direction, implement measures to correct or control. You have the power to control your baseline health. At a minimum, you should be monitoring and performing preventive maintenance of the following:
· Blood Pressure
· Cholesterol
· Blood Sugar
· Heart rate
· Breathing patterns
· Skin integrity
Your response in an effort to balance the above measures is an entire discussion for each one. There is a wealth of information at your finger tips to assist you in your effort.
How do you obtain the necessary monitoring and care?
1. If you have health insurance, check your policy for provision of “Preventive Health”. Many policies will cover these services with very little or no out of pocket expenses.
2. If you can’t afford these services, here are some options:
a. Check your blood pressure at the local grocery store or discount department store. Many of these businesses have machines available with no charge for the use. Look for them in the area of the pharmacy section. Check it at regular intervals and keep track of it in a log so you can see if a pattern develops.
b. Seek out community services. Most communities, employers or senior organizations will sponsor a “Health Fair”. Most of the time you can even obtain your cholesterol levels at no or little cost. Check your local newspaper, churches, hospitals, AARP or notices posted at your pharmacy or department store to locate these Health Fairs.
c. Often times in communities, free clinics may be offered. These often are sponsored by a healthcare organization (hospital, physician practice) or church. These clinics usually have physicians, nurses and sometimes dentists available. Search the same sources as mentioned previously.
So, you see there are options where you thought there were none. You might need to put a little effort into a search for these offerings, but it is well worth it. Maintain your physical systems like the well oiled machine that it is.
If anyone knows of additional sources or options, please comment so all the readers can benefit from your information. After all, that is what it is all about. Until next time…stay tuned.
Current patterns of health care utilization indicate a trend of people not using the healthcare system due to the state of financial uncertainty as well as other potential reasons. What are the consequences of this behavior? For the remainder of this discussion, we are going to assume that the previous frequency of health care utilization was for needed services and not just using the system because it was there, someone else was paying or you had a little more confidence in your individual financial situation. This is a rather large assumption and it is just that…an assumption.
What are the potential consequences of not changing the oil in your car or not maintaining the integrity of the roof on your house? The answer is pretty obvious…more serious problems that must be addressed or you may not have a car to drive or a roof over your head. And of course, it will be much more expensive than if you had just had the oil changed. I am talking about simple and inexpensive monitoring of your vital functioning. You can probably obtain the necessary care at no cost or a nominal fee.
The following items should be monitored on a regular basis and if one or more of them starts to change in an unfavorable direction, implement measures to correct or control. You have the power to control your baseline health. At a minimum, you should be monitoring and performing preventive maintenance of the following:
· Blood Pressure
· Cholesterol
· Blood Sugar
· Heart rate
· Breathing patterns
· Skin integrity
Your response in an effort to balance the above measures is an entire discussion for each one. There is a wealth of information at your finger tips to assist you in your effort.
How do you obtain the necessary monitoring and care?
1. If you have health insurance, check your policy for provision of “Preventive Health”. Many policies will cover these services with very little or no out of pocket expenses.
2. If you can’t afford these services, here are some options:
a. Check your blood pressure at the local grocery store or discount department store. Many of these businesses have machines available with no charge for the use. Look for them in the area of the pharmacy section. Check it at regular intervals and keep track of it in a log so you can see if a pattern develops.
b. Seek out community services. Most communities, employers or senior organizations will sponsor a “Health Fair”. Most of the time you can even obtain your cholesterol levels at no or little cost. Check your local newspaper, churches, hospitals, AARP or notices posted at your pharmacy or department store to locate these Health Fairs.
c. Often times in communities, free clinics may be offered. These often are sponsored by a healthcare organization (hospital, physician practice) or church. These clinics usually have physicians, nurses and sometimes dentists available. Search the same sources as mentioned previously.
So, you see there are options where you thought there were none. You might need to put a little effort into a search for these offerings, but it is well worth it. Maintain your physical systems like the well oiled machine that it is.
If anyone knows of additional sources or options, please comment so all the readers can benefit from your information. After all, that is what it is all about. Until next time…stay tuned.
Tuesday, July 21, 2009
Covering the Un-insured?
It should be no surprise to anyone that a democratic bill, phased in over several years will reach the point of covering the uninsured in 2013. It will begin with collecting taxes on "the rich", banking the cash for pay-out in 2013. Can you spell Social Security?...Medicare?...bankrupt? Enough of the sarcasm for now. This is really a serious subject. What are people to do between now and 2013?? or longer?? We really can't expect things to change over night...the mess didn't develop over night.
There are some options within the current quagmire of health care. You may need to work around some things, through other things/providers and work WITH providers. I told a friend recently (who is uninsured) that if I could advise on 1 item, it would be to negotiate with healthcare providers (Doctors, hospitals, etc). However, you cannot expect it to be like the good doctor making a house call for a dozen eggs. But...this concept/strategy is worth a try. It will not be easy with negotiations because providers in this healthcare market are generally paid to provide more care (needed or not). The market will move toward an end in which this negotiation is more attractive. Just think...you could arrange with a physician to pay a certain amount (cash or services) for a visit, procedure, etc...at a discount of full price (of which is always over-priced). What is the incentive for the doctor? No paperwork, insurance forms, the time spent for billing, coding, re-billing. This, of course is only useful if you do pay your negotiated part and up-front.
Do you provide a service that could be useful to the provider? Plumbing, electric, drafting, cleaning, yeard work?? Perhaps, you could trade services. Think about other services that may be of potential use for bartering. Please share your thoughts and suggestions about this topic. Kind of an interesting way to approach your healthcare? Think about it...share with us.
Until next time... Simplify Your HealthCare with Alice@ezhealthcareonline.com
There are some options within the current quagmire of health care. You may need to work around some things, through other things/providers and work WITH providers. I told a friend recently (who is uninsured) that if I could advise on 1 item, it would be to negotiate with healthcare providers (Doctors, hospitals, etc). However, you cannot expect it to be like the good doctor making a house call for a dozen eggs. But...this concept/strategy is worth a try. It will not be easy with negotiations because providers in this healthcare market are generally paid to provide more care (needed or not). The market will move toward an end in which this negotiation is more attractive. Just think...you could arrange with a physician to pay a certain amount (cash or services) for a visit, procedure, etc...at a discount of full price (of which is always over-priced). What is the incentive for the doctor? No paperwork, insurance forms, the time spent for billing, coding, re-billing. This, of course is only useful if you do pay your negotiated part and up-front.
Do you provide a service that could be useful to the provider? Plumbing, electric, drafting, cleaning, yeard work?? Perhaps, you could trade services. Think about other services that may be of potential use for bartering. Please share your thoughts and suggestions about this topic. Kind of an interesting way to approach your healthcare? Think about it...share with us.
Until next time... Simplify Your HealthCare with Alice@ezhealthcareonline.com
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