Friday, December 28, 2007
Health care has had alot of both. We saw the advent of in-store retail mini-clinics that have taken off with increasing popularity. Most all pharmacy chains, big-box retailers like Wal-Mart and Target, and even some grocery chains have elected to partner with the companies that provide these services--Minute Clinic is an example of one of these clinics. MinuteClinic, which was co-founded by a family physician, is the largest of a growing number of retail clinics, are now in CVS, Targets, Wal-Marts and many other high-traffic retail outlets in metropolitan areas around the country. Patients with acute illnesses can enter these retail clinics without an appointment to see a nurse practitioner or a physician assistant, be diagnosed in a matter of minutes, and head back out the door, stopping by the in-store pharmacy to fill a prescription if needed. If the problem requires a physician, patients are referred to their primary care physicians. If they do not have one, the nurse practitioner refers them to one off the clinic's referral list.
While these clinics lack the personal nature of seeing a family physician who knows your complete medical history, their appeal is their convenience and affordability. The clinics are usually open in the evening and on weekends, and their prices are relatively low - and posted on menu-type boards for all to see.
With other medical news--several pronounced trends: promoting clinical Information Technology being pushed by the government; and the technology of personal health record is being expanded. Additionally, transparency of costs in health care is getting much more attention now as Consumer Directed Health Care is making more headway, especially in the employer market. HSAs are getting much more traction as individuals realize their value as not only a way to save money in the health care space, but also as a great tool for investing for the future. Millions of Americans will sign up for that type of plan this year, and an HSA is a very good tool to save money on out of pocket health care costs when combined with a high deductible health plan. More of those will be sold in 2008 as consumers wake up to the realization that they need to take charge of personal health care decisions.
New trends in health care will continue to develop, and our job as consumers is to make sure that they make sense, are affordable, and have enough available information to make informed and intelligent decisions on personal health matters. Looking ahead in 2008 will be a critical job that every American will need to do in order to save money and maintain a healthy lifestyle.
Until next time. Let me know what you think.
Wednesday, December 19, 2007
With the advent of the internet, we are considerably more savvy now than 10 years ago when it comes to researching the best deals in the market place including health care options. There are websites that show various options for not only insurance, but also other medical needs and information. Transparency is the key factor when it comes to finding the best deal in health care.
Companies that provide information online are more likely to find consumers ready to make a purchase versus those businesses who make it more difficult to find out how to use their products and services. The Commonwealth Fund has recently stated that U.S. health care costs are projected to double in the next ten years. We need greater efficiency in the health care system in order to allow people the ability options for consumer-friendly choices.
A lot of variations on the current theme are being proposed now by politicians, government agencies, and private industry. The real issue is that Americans must make wise choices when it comes to making health care decisions, especially when it comes to purchasing health related products and services, choosing medical providers, and taking preventive measures to maintain a healthy lifestyle. We need to be disciplined and creative in our approach.
Free websites like HealthPricer.com are good to search for multiple options for health products including prescription medications, contact lens, over-the-counter drugs and supplements, and more. Using the Internet's power of information to shop for the best price on expensive procedures and tests is gathering speed. Health insurance is getting more and more expensive all the time.
Insurance websites like Insurance.com, eHealthInsurance.com, and even DentalPlans.com are portals for consumers to shop for coverage without committing to a specific agent for information. Medicineonline.com has valuable information on it, and a site called BidforSurgery.com allow you to list the plastic or dental surgery procedure you need and then wait for doctors to bid to perform the procedure; and even more bizarre is Healthbase.com and other sites like it that promote "medical tourism."
In August, 2006, President Bush signed an Executive Order requiring transparency in pricing and quality of health care with the intent of encouraging private insurance companies to follow his example. The four agencies that were included are:
The Department of Health and Human Services (oversight of Medicaid and Medicare),
the Veteran Affairs Department and the Department of Defense (oversight of military health care programs, i.e. TriCare), and the Office of Personnel Management (oversight of the Federal Employees Health Benefit Program) .
When it comes to making savvy purchases for health care, the true test is whether it makes sense for not only the short term, but also long term benefits. Is it practical and affordable, and can I use the service with nominal restrictions? Where can I use it, and how does it work? How long do I need to wait before I can use what I purchased or get a satisfactory response from the vendor, provider, or company? Is there an easy way to seek restitution if something goes wrong, or I feel that I have been mislead? These and more detailed questions should be considered before entering into an agreement for any health care purchase.
Make sure that you get all questions answered before buying the product or service, and read the fine print before signing on the dotted line. Know what you are buying and what recourse you have if it doesn't work out.
Bargain shopping may work well at the local discount retailer, but not too great for medical needs. Remember, in most cases, you get what you pay for. And, if it sounds way too good to be true, it probably isn't. Like I tell my kids in elementary school.."Do your homework." It will pay off in the long run, and you may well end up saving money in the short run, too.
Until next time.
Monday, December 17, 2007
Yet with all the numerous options for health care available in the market place, the bottom line issues related to choice come down to cost and availability. How much will I pay when I purchase the health plan, and where can I use it? This is especially true when small business owners and companies are considering health insurance coverage for employees. With the cost of insurance premiums almost 75% higher than in 2000, many employers are starting to offer high deductible health plans combined with health savings accounts in order to keep costs lower. The Nashville Business Journal this month has reported that the current number of Americans who have this type of plan are at 4.5 million. The consensus is that the number of people who may purchase this consumer directed health plan will double in 2008 as they become more popular.
This type of plan reduces the cost of health care over traditional insurance. There are a number of plan administrators in the insurance world that provide the option to purchase the HDHP, but often the HSA is the missing component. Bank of America is one institution that has developed a consumer friendly product that will allow their HSA to be used with any high deductible health plan. Through their Benefit Solutions platform, both companies and individuals can purchase an HSA to work along with their HDHP. Additionally, the plan design is very consumer friendly and allows members to manage their account with relative ease. Often, employers will incentivize employees by contributing funds to the HSA for specific health services, needs, and goals. Employees are empowered to be more responsible for making health care choices and being more preventive with medical issues.
The concept of Consumer Directed Health Care was designed to encourage consumers to spend health care dollars wisely by requiring them to spend more of their own money for medical services before insurance kicks in. The theory is that consumers will not seek unnecessary care if they have to spend their own money, so the rate of health care inflation will slow down. According to Health Affairs, total health care spending is reduced when consumers have more responsibility for their health care expenses. The consumer is given a greater role in making decisions with their health care and paying for expenses. The consumer is more informed and has more choices with the aid of more information and available tools at their disposal.
According to the US Treasury website, Health Savings Accounts will change the way millions meet their health care needs because they are designed to help individuals save for qualified medical and retiree health expenses on a tax-advantaged basis. To encourage saving for health expenses after retirement, individuals age 55 and older are allowed to make additional catch-up contributions to their HSAs. Once an individual enrolls in Medicare they are no longer eligible to contribute to their HSA. Amounts contributed to an HSA belong to the account holder and are completely portable. Funds in the account can grow tax-free through investment earnings, just like an IRA. Also, funds distributed from the HSA are not taxed if they are used to pay qualified medical expenses. Unlike amounts in Flexible Spending Arrangements that are forfeited if not used by the end of the year, unused funds remain available for use in later years.
Consumer Directed Health Care is the wave of the future for those who want to take control of their health care issues. Ask your employer to check it out if that is not a current option, and do some research on what plan works best for you. After all, it's your money. Make the best of it.
Until next time. Let me know what you think.
Wednesday, December 12, 2007
But with all this merriment, the Holiday Season is when the highest rate of suicides occur, and depression is at its worst for many people. The physical and mental stress at this time of year sends some people into a frenzy and others into a fit of despair. These feelings are the result of stress and anxiety brought on by many reasons. Good physical health is important. It helps us with our mental wellbeing and health; but during the Holidays many Americans abuse themselves with overeating and indulgence in other areas including alcohol, caffeine, and exotic foods. On About.com a good overview of how to take care of your health during the Holidays by Cathleen Fenton is available. It talks about how to cope with stress and panic disorder. Medical News Today online even has a name for this called SAD--Seasonal Affective Disorder, and it can be destructive to our work and personal life.
Cathleen says that we can overcome depression by preparing in advance. Don't worry about going to all the parties; just pick a select number of events to attend and try not to "do it all." Feel confident in the decisions you make. Realize that all the activities during the Holidays are designed to give you options, not send you into a tailspin of worry and doubt. Also, remember that during this Season that although you may experience a sense of grief and loss (this can be anything related to death of a close friend or family member, or conflict that happened during the year), you can cope with the loss by reaching out to others who have experienced similar situations. The sense of loneliness often attributed to loss can be overcome by focusing on what really matters to you and not what others perceive as important.
Another reason many individuals have such difficulty during the Holidays is lack of sleep. Going without this important health regimen is a very good way to become fatigued and depressed. Less sleep has been proven by many scientific studies to lead to anxiety and an agitated emotional and mental state. Without adequate amounts of rest, the body is incapable of maintaining both physical strength and mental stability. With all the parties, meetings, events, and other activities that we feel we should attend, our bodies and brains start to wear out quickly if we don't take time out to rest and replenish our personal health bank. It's okay to be tired, but just don't over do it. Take time out when you feel stretched too far, and stop before you reach a point of exhaustion. Learn to recognize the symptoms of fatigue, and slow down to avoid that physical deprivation. Stress related to lack of sleep can cause insomnia, high blood pressure, headaches, and more. Also, statistics prove that more heart attacks occur in December and January than any other time of the year--many brought on by Holiday stress.
Finally, let's remember the Reason for the Season. This time of year is meant to be festive. Enjoy it. This time of year is meant to be reflective. Remember the good times past. This time of year is meant to be loving. Care for those around you whether you know them or not. This time of year is meant for giving. Give to those who are in need, and offer gifts to those who are not. This time of year is meant for looking ahead. Focus on the best opportunities for the year ahead. Stay healthy in mind, body, and spirit. To quote a friend, Lee Truax, who is an insurance executive and also involved in prison ministry reaching out to inmates:
"It is not the lights. It is not the presents. It is not the music. It IS about the coming of the Savior to earth to reach all mankind in the form of a baby in Bethlehem."
Best wishes during the Holiday Season. Until next time.
Friday, December 7, 2007
This post is a short one to propose the following: This a small way to say THANKS to some of the folks in the service that are unable to be with their families and friends this holiday season. (This does not require any of your personal information.)
Something cool that Xerox is doing . If you go to this web site, http://www.letssaythanks.com/ you can pick out a thank you card and Xerox will print it and it will be sent to a soldier that is currently serving in Iraq . You can't pick out who gets it, but it will go to some member of the armed services.
How amazing it would be if we could get everyone we know to send one!!! This is a great site. Please send a card. It is FREE and it only takes a second. Wouldn't it be wonderful if the soldiers received a bunch of these? Whether you are for or against the war, our guys and gals over there need to know we are behind them!
Our military needs to know we are concerned about their health and well-being. Let's show it.
Thursday, December 6, 2007
The most commonly feared new word that has found its way into the American language is "Hillary-care"--a phrase that causes most Americans to shudder because of what it represents. Originally conceived during the early years of the Clinton administration in the early 1990's, a National Task Force on Health Care Reform was established with Hillary Clinton leading the charge for universal health care. For an overview of this campaign and its history since then, Wikipedia has information available online under the heading: "1993 Clinton health care plan." Pushback came from all corners, including Democrats who have over the last several years since then have offered variations on the same them versus going to a single-payor system, similar to socialized health care in countries like the UK and Canada. Most often, the criticism was about having government telling us what doctors to visit and when to go for treatment. In the history of our nation, no one has ever liked the government telling us what to do when individual liberties or matters of personal choice are on the line.
Several states now have a version of universal health care for uninsured residents. Massachusetts under Governor Mitt Romney, now a presidential candidate, passed a plan that has had over 300,000 people sign on. However, this state-mandated health insurance plan has a penalty tied to it if residents don't sign up for enrollment. Help, or penalty? And who is subsidizing those who cannot afford to pay the premium? That's right--the taxpayer, as if residents in that state don't pay enough taxes. And other states are watching the outcome there to see if they want to do their own version of the same trick. The state requires you to participate on a personal choice.. I am wondering about the Constitutionality of forcing state control on individual liberty.
In California, the argument is raging like the wildfires that have scorched the state. According to the Small Business Review online this year, the current debate in Sacramento over how to cover the uninsured and rein in premium costs could set a pattern for the rest of the nation—and have major ramifications for small business owners. Governor Schwarzenegger is pushing for one variation, and their state legislature wants another. Over 12% of the nation's population are California residents, and the saying "As California goes, so goes the nation" means that this controversy once settled with a mandated insurance plan by the state may very well be the tone set as a template for the rest of the states. I pray for wisdom by those legislators to not bankrupt their state and come up with legislation that makes sense.
Sure..there are plenty of Americans who are uninsured. At last count according to the U.S. Census, about 47 million people don't have insurance of any type. But when the raw numbers are crunched on who can afford it and who can't, the surprising fact is that many Americans have personal income that can support insurance. However, for whatever reason they choose not to purchase coverage. Rather than the government cramming health care down my throat as a way to further intrude on my lifestyle, I would just as soon make that choice myself. Fortunately, I currently have very good health insurance, and it is expensive. But it's still my choice.
In 2007, the conversation about universal health care has heated up to a fever pitch. Current presidential debates are almost comical as all the participants in the contest, both Democrat and Republican, are jostling for position as the "top dog" when it comes to their positions in this category. These are viewable on many sites for everyone to see who wants what for national health care. A snapshot of each player's opinion on this topic is available for you to find out which one of the candidates has the best platform.
Until next time. Let me know what you think.
Tuesday, December 4, 2007
Thursday, November 29, 2007
However, in the past few years we have seen a proliferation of health care cases that are a direct result of unhealthy habits in eating choices and lifestyle issues. Obesity and other medical problems in Americans are now more frequent due to poor choices in diet and lack of physical exercise. Often there are cultural, economic, or demographic reasons for these poor choices. Typically, lower income Americans suffer with shorter life spans due to medical issues brought on by poor nutrition, and the resulting problems are further compounded by lack of preventive care.
Americans need to change their attitude about lifestyle choices. Eating junk food and sustaining a high caloric intake is definitely not good for a healthy body. Never going to the health club or having a personal exercise plan is not a wise way to live. Expect to get fat and unfit, and look forward to health problems such as obesity, diabetes, high blood pressure, and a host of other diseases that will slowly kill you over time. Imagine lying in a hospital bed or an emergency room after you have just had a heart attack because you have been eating burgers and fries every day at your favorite fast food joint. Think about those tubes protruding out of you because your breathing is constricted due to poor circulation and lung capacity from no workouts or walking program. Pleasant thoughts?
Although we are living longer in the U.S., the quality of life for many is not great. This can change and needs to change. Just because your poor or live in a bad neighborhood, or your parents abused you as a child, or your boss is not nice, or any other miriad reasons is no excuse for not taking care of important health needs. Recently, a leading health care professional at John Hopkins University has stated that as Americans get more affluent, we tend to spend more money on health care. However, the problem exists that many people still tend to be lazy. Although income is going up per capita, the rate of health care issues is skyrocketing because people are not using their new economic gains to get and stay healthy. We need to turn that around, and fast.
Until next time. Let me know what you think.
Tuesday, November 27, 2007
Employees are getting more nervous as employers continue to cut benefits and increase premiums. Cost shifting has become more the norm as insurance companies seek ways to recoup more profits and pass those costs on to employers. Small businesses are having more and more difficulty maintaining benefits for employees, and most small companies are forcing employees to pick up the cost of their health plan as a result. The other option is to cut benefits for employees altogether and hope that they can either find their own insurance or take the risk of not getting sick or have an accident. The cost of processing claims should be going down as we see more companies use electronic filing and record keeping.
Unfortunately, as the American population ages with the first waive of Baby Boomers now starting to turn 60, there are more claims being filed; and the cost of health care continues to increase every year. Americans are living longer and are putting a strain on the health care system as they age. Even those seniors who continue to work past the age of retirement are concerned about how they are going to pay for their insurance until Medicare kicks in. With limited income or restricted access to health care options, many people will postpone necessary medical needs simply due to lack of available funds.
Surveys have shown that one of the leading components of personal bankruptcies over the past few years has been unpaid medical bills. Often, when employees have significant medical needs, their insurance may only pay a portion of the total bill which leaves a large amount due to the medical provider or hospital. Typically, as in any other creditor situation, the billing entity will pursue the payor for the balance. If the issue cannot be resolved favorably, the employee will be sued for what he/she owes. If the illness or accident that caused the medical problem led to long term absence from the job, the employee is most likely terminated. This problem leads to a bigger issue as the employee in most cases no longer has insurance coverage, and there is no income to offset living expenses and payment of outstanding debts.
Most of us complain about our insurance--it's too expensive; it doesn't pay enough; the insurance company takes forever to pay the medical bill, etc. All these complaints may be legitimate gripes. But the alternative is not something that most Americans really want. People want to know that if they have a medical need, that they have a way to help offset the costs. Insurance can be a great asset, but it can also be a problem if the insured has no idea what benefits they have. That's primarily due to the fact that insurance has a stigma attached to it. The explanation of benefits is a challenge for the insured to understand the complex language written in most policies.
As a licensed insurance agent in all 50 states and the District of Columbia, I have talked with many people over the past 9 years who have no clue what their insurance is or how it works. All they know is that they pay alot for it, and sometimes it works and sometimes it doesn't. Insurance companies like to reap huge profits from premiums and investments, and most of them talk about how many lives they insure. They are proud of their ratings from Weiss and other rating companies that promote how great the insurance companies are in all categories including customer care, assets under management, regulatory compliance, and more. But the honest truth is that insurance is expensive. It's expensive to have, and expensive to keep.
When the choice is made by employers to drop benefits or force employees to pay more money from their paycheck for less coverage, or worse--drop coverage completely as an available benefit--the American worker needs to get smart. There is no incentive to shop insurance plans if somebody else is paying for it. Go to your HR Director and talk with them about considering various options. Search the internet and find plan information about products that work for you. Do some research and compare plans. Take the initiative to find a way to help offset catastrophic medical bills so bankruptcy is not an option. If you don't look out for your health care, no one else will.
Until next time. Let me know what you think.
Monday, November 26, 2007
No wonder Wal-Mart, Target, and other retailers have found gold in offering $4 generics. A September 27, 2007 article on CNNMoney.com quoted the Wal-Mart CFO giving a statistic of $613 million in savings over the prior 12 months for their pharmacy customers. This is huge! You would think that the price would be a loss leader, but Wal-Mart claims to be making money even at $4 per perscription. Good for them, and great for the American consumer! While government, the drug industry, and the FDA try to figure out how to make health care more complicated, private industry steps up to the plate and actually reduces costs.
While there is no "silver bullet" to control the cost of health care in the U.S., there are a few ways for Americans to make sure that they maintain a standard of acceptable care without declaring bankruptcy. One way is to shop for good insurance at affordable rates, and make sure that the coverage works the way you want it to at the price you can afford. There are some very good insurance plans in the marketplace. Don't let an insurance agent talk you into a plan that does not meet your needs. Insurance agents are paid healthy commissions to sign you up for insurance coverage, so make them work for their money. Compare prices and benefits and choose what makes sense for your needs.
Also, check out High Deductible insurance plans and HSAs to save even more money. Insurance should be used to offset catastrophic needs, not every sniffle, minor headache or sore throat. When your deductible is high, your premium is low. Americans have been brainwashed to think the opposite way. So we need to change our thinking when it comes to health care and saving money. Why pay for a Mercedes when you only need to drive a Ford? Don't get greedy. HSAs help with the day to day expenses of going to the doctor, getting new glasses, or seeing a dentist. They force you to save money and use your health care dollars wisely so you can get preventive health care without spending a fortune.
Learn about preventive measures to get and stay healthy. Join a health club and go regularly to help lose weight and get fit. Get some decent regular exercise. Start eating a healthier diet. Go for regular check ups to your family doctor. If you are a smoker, STOP SMOKING. How can anyone continue that habit after all the medical news that has been made public in the last few years about cancer and other fatal diseases related to smoking? Don't do drugs. Don't do drugs. Don't do drugs. Do I need to day it again? Don't do drugs! Make sure that you are taking care of your health on a pro-active basis. Don't wait for something to happen that may take a toll on your health. Learn to be responsible for your own well-being.
Additionally, you may want to opt for a discount savings plan for ancillary medical needs. In lieu of insurance, these plans can save you alot of money over rack rates charged at the point of service. There are networks involved, so check out who is participating in your area before you sign up and go. Verify, verify, verify. Remember, there are plenty of businesses ready to take your money. Make sure you are dealing with a reputable company that is registered to do business in your state. Also, you will want to get a copy of the Terms and Conditions before you sign up. Check on the refund policy, and talk with a supervisor if you are not happy with the sales rep who sold you the plan. These plans do save money, and they can be a good alternative if you are not insured. They also can work in conjunction with some insurance plans to help save even more health care dollars.
Let me know what you think.
Tuesday, November 20, 2007
Let me know what you think. Until next time, thank you.
Monday, November 19, 2007
Contrary to public opinion, health care in the United States is not a right. It is a privilege. Most working age Americans pay for their health care via employee based health insurance plans. Often, those who are self-employed purchase insurance directly from an agent who represents an insurance company and pays a hefty price for the premium, especially if there are any health issues that may need additional coverage. And the age of the insured is taken into account, as well as a host of other issues that health underwriters must consider. New medical treatments, rising prices and growing demand from aging baby boomers are expected to continue to fuel rapid inflation in healthcare for years. The underlying health care costs are not going down.
Now that health care has become the new political football, there are a variety of proposals in the market that are being propogated. Politicians and legislators are calling for universal coverage, which translates to free health care for those who don't want to or cannot pay for it. However, free health care is not free. Someone has to pay for it--the American taxpayer either directly though higher taxes or indirectly through higher insurance premiums to offset care for the indigent and the uninsured. The Memphis Business Journal reported in August, 2006, that
young adults (19-29) account for a huge percentage of under-65 uninsured—over 10 million healthy adults with no insurance; covering the uninsured is another topic too large to include in this initial blog.
The Average Joe needs a way for relief in health care. We cannot expect to provide free coverage like Canadians and those that live in the U.K. receive. That would bankrupt the government and be horrific for anyone who needs medical attention. Besides, who wants Uncle Sam to tell you what doctor to see and where you can go to get medical attention? The increased spending on health care, combined with the trend by private insurers to pass more costs to consumers, means fewer people, particularly the working poor, will be able to afford health care in the coming years. Americans cannot afford to pay for universal health care.
Health care in the United States is the best in the world, and Americans deserve the best. As a result, our costs are higher. And costs continue to escalate. There are solutions, and we need to think outside the traditional health care box to contain increases in the cost of care without decreasing the quality of care. Let's work on it.
Let me know what you think.
As I mentioned in the previous blog, health care is a privilege, not a right. Many people feel that they deserve to have some form of health care and not have to pay for it, or perhaps are entitled to health care at a radically reduced rate (if not free)--paid for by the government, such as Medicaid. One of the reasons that health care has become so outrageously expensive is because of the entitlement programs that have stressed the American health care system. Another reason is that so many uninsured people that are overburdening the U.S. health care system. The latest U.S. Census report says that over 47 million Americans are uninsured. The topic of why this number is so large will be discussed in a separate blog. The issue of the uninsured deserve its own discussion.
Over the last few decades, our society has been brainwashed to think that we all deserve insurance to take care of us for every little event--from a simple cold to a minor cut. Insurance was originally designed to protect us in the event of catastrophic situations. Insurance helps protect us from total financial loss in case we are unable to work or pay our bills. Instead, we have played the game of having it take care of every little item using a co-pay to reduce our out of pocket expenses, and now the average American pays over $10,000 a year in premiums for a family plan. According to an article published online with the Philadelphia Inquirer in February, 2006, by 2015, one in every $5 spent in the U.S. will go toward medical costs—a reflection of the aging baby boomers, the cost of the Medicare prescription-drug benefit, declining rates of insurance coverage, and rising hospital costs—with health care costs averaging $12,320 per person.
In order for the American health care system to not implode in the next few years, there should be certain ways for costs to be reduced both at the point of service and in the infrastructure of the health care system itself. We can study these over time in additional blogs, and consider various alternative options for additional discussion. In the interim, the most important consideration is for Average Josephine to figure out how to stay well and not abuse the best health care system in the world.
Your thoughts are welcome. Until next time, thank you.