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7 costly health insurance mistakes
You’ll pay more to use health care providers who aren’t in your health plan’s network, so check to see if the doctors and other professionals you want are included.
A plan that tightly restricts you to a local network might be sufficient if you need care only in your area, but it won’t benefit a kid away at college or meet all your needs if you spend a lot of time on the road, says Pete Villemain, the president of Employee Benefit Services, which manages employer benefits plans.
Make sure any specialists you need are also covered by the plan, Rosen says. Don’t assume a specialist is in the network just because your primary care doctor gave you the name.
“The mistake I see individuals make so many times is they focus so much on getting a low co-pay and they fail to look at how much extra premium they pay for it,” says Villemain.
He suggests evaluating how you’ll use your plan and comparing the costs accordingly. If you go to the doctor only a couple of times a year, is it worth hundreds of dollars extra on the premium just to get a lower co-pay?
Some states require individual plans to offer prescription drug coverage, but in other states, many individual health insurance plans don’t cover drugs, says benefits consultant Michael Goodheim of Farsighted Strategies in Seattle.
If the plan provides prescription-drug coverage, check to see if your medications are included on its formulary, which lists the preferred drugs for coverage, Goodheim says. Expect to pay more if you take a drug that is not listed.
In addition to comprehensive health plans, many employers offer supplemental insurance policies, such as cancer or critical illness insurance, that pay a lump sum of cash after diagnosis. Such policies can provide valuable protection, but they might be unnecessary if you already have broad coverage under your medical insurance and short-term and long-term disability insurance, Goodheim says.
Low premiums are an attractive feature of high-deductible health plans, but make sure you’re prepared to pay all the out-of-pocket medical expenses, Goodheim says.
Besides the deductible, check the maximum out-of-pocket expenses you pay. After you pay the deductible, many plans pay only a portion, such as 70%, of covered medical expenses. Your 30% share is called co-insurance, which you must fork over until you reach the cap on out-of-pocket expenses.
“Those dollars can really add up,” Goodheim says.
Most employer-sponsored plans cover maternity and prenatal care, thanks to the federal Pregnancy Discrimination Act of 1978 and the Health Insurance Portability and Accountability Act of 1996, as well as many state health insurance mandates for group coverage. Some states also require individual health insurance plans to include maternity coverage, but in states where there is no such mandate, many individual health plans pay only a small portion of the costs or don’t cover maternity at all. Even if the plan includes maternity coverage, read the fine print to know exactly what is covered and whether there’s a monetary cap.
Starting in 2014, individual and small-group plans sold through state health insurance exchanges must include pregnancy and newborn care, along with other essential benefits.
Scrutinize group health plan offerings from employers each year during open enrollment, Rosen says. Don’t assume the plan is still the same. Coverage levels, costs and networks could change from one year to the next, even if the plan is offered by the same insurer.
“If you’re not sure about something and it raises a flag in your mind, then check it out,” Rosen says.Share and Enjoy:
Excessive amounts of radiation from X-rays can cause cancer and many other health issues, like DNA mutations and leukemia. X-rays can be dangerous because the charge of the wavelengths can break a cell’s DNA chains. This cell now has the potential to die or mutate, which can cause the cell to become cancerous. Additionally, it is dangerous for both men and women to get and X-Ray if you are pregnant or looking to become pregnant. Exposure to X-Rays (especially in the reproductive area) can cause mutations of the sperm or egg, causing your child to develop leukemia or birth defects. However, if you get occasional X-rays at doctor’s office visits, you will not be at high risk for cancer. It’s the excessive amounts of exposure that pose a threat. In fact, X-Rays may be more beneficial than problematic.
X-Rays are used to examine broken bones, detect cancer and tumors, and reveal many other medical conditions. Using an X-Ray Machine is much safer than methods used previous to X-Rays. For example, doctors in the past had to perform surgery on their patients to examine broken bones. This more easily posed health threats to the patients, such as putting them at risk of infections. Now, a simple X-ray can help the doctors with these examinations and without the risks of surgery. It is also important to note that since the discovery of X-Rays, researchers have discovered that lead is a key component of X-Rays. Due to its thick density, lead can be used to shield patients from some (but not all) of the electromagnetic wavelengths from an X-Ray. This shield gives us more protection and a lower risk of the rays harming our body. Lead shields can be made for any type of X-Rays, both dental and medical.
If you go for regularly scheduled exams, doctors are aware of the radiation risks. Don’t refuse a single X-Ray because you’re afraid of its health effects. Now you know that the amount of radiation that reaches your body is very minimal, especially with shielding. And the harm on your body will me slim to nothing. This X-Ray can detect a posing health risk that is more threatening to you health than the radiation from an X-Ray. If you go to multiple doctors and are concerned about the X-Rays, let your doctor know about your other experiences with radiation. Your doctor will know the precautions to take regarding radiation and your health.Share and Enjoy:
9 preventative measures to maintaining your health:
Now, new Healthcare regulations require that many preventative tests are covered by your insurance carrier! These new regulations will be applied to insurance plans no later than September 23, 2010. So there is no reason why you should avoid doctor’s office, even when you are healthy. Also, it is important to stay up-to-date on all of your medical tests. This task of managing all of your medical needs may seem daunting at first, but making it more of a routine will help you stay on track. Importantly, routine visits to the doctor’s office will develop your relationship with your doctor. Your relationship is so central to your health because it allows your doctor to become familiar with you and your conditions. This way, he or she will be able to notice changes in your behavior and medical tests that may be indicative of an arising medical condition.Share and Enjoy:
Lyme disease is difficult to diagnose because few people remember even being bitten by a tick, while lab testing has accrued false test results. People with Lyme disease have been misdiagnosed with other neural illnesses, like Parkinson’s disease, arthritis, fibromyalgia, and even Multiple Sclerosis. The Time for Lyme organization is working to fund more research on Lyme disease. Currently, researchers are working to more easily determine Lyme disease from other neurological diseases to avoid wrong diagnoses and improve patient health.
Most people develop a red “bull’s eye” shaped rash, also known as erythema migrans, generally located around the legs or buttocks. The rash is very distinctive, with pale skin surrounded by a red circular rash. Even this can cause problems with diagnosis, because around 20 percent of people with Lyme disease don’t even get the rash. Other Lyme disease sufferers can experience flulike symptoms—especially fever, chill, and fatigue. Others suffer from joint pain, stiff neck, facial paralysis, heart problems, and other physical problems.
Early stage Lyme disease is often treatable by a regimen of antibiotics. In June, Massachusetts passed a law allowing physicians to treat Lyme disease with extended aggressive treatment, protecting them from regulatory bodies and allowing patients to get the treatment they need. Many Lyme disease patients feel that long term, aggressive treatment is more effective in combating the illness. Opponents, including some physicians’ groups, argue that such prolonged use of strong antibiotics may be detrimental to patients’ health in the long run. Connecticut passed a similar law back in 2009.
Unfortunately, there is no vaccine for Lyme disease. Deer ticks are most visible from May to July, so take extra precautions during this time period.. There are several simple steps you can take to avoid both ticks and infection. Remember, not every tick carries Lyme disease, although it is important to remain vigilant. If you can, try to avoid grassy areas where deer ticks may lurk. If you have to enter woody, grassy areas, wear long pants and tuck them into your shoes to protect skin from ticks. Plus, make sure you utilize tick repellent (with 20 to 30 percent DEET) to maximize your protection. You should not use tick repellent on young children.
Check your body after going outside, and if you do find a tick on your body, remember that it takes 24 hours for a tick to infect you with the Borrelia burgdorferi bacteria, so you can safely remove it with tweezers. Still, if you have been bitten by a tick, make sure to consult a doctor.Share and Enjoy:
You’ve always been reminded to “eat your fruits and veggies”, but what is the big attraction to these two food groups? Eating your fruits and veggies can reduce your risk of chronic diseases. The news frequently gives us new stories divulging the latest research about foods you need to eat more of or foods you should avoid. Some claim to lower your cholesterol, help you lose weight, or make you live longer. These boundless stories and choices make it difficult to decipher which foods are actually the best choices to eat. Well, we have narrowed down the list for you. The following are foods that you should make sure to eat every day. Chronic diseases are the cause of 59% of deaths around the world yearly. By eating these foods each day, you can reduce your risk of chronic diseases, such as cancer, heart disease, and diabetes.
1-2. Blueberries and Tomatoes
Fruit, in general, is known to reduce your risk of many cancers, such as mouth, lung, and digestive cancer. Blueberries are known as the “miracle fruit” due to all of the health benefits of blueberries. They have tons of antioxidants that prevent the damaging of cells. All these antioxidants and vitamins help keep your immune system running in good order and it helps with vision and healthy skin, among many others. The nutrients in tomatoes have similar health benefits and, yes, a tomato is considered a fruit. The bright red color of a tomato is given by a carotene called lycopene which protects against many other cancers.
3-4. Carrots and Spinach
Vegetables are important in your daily food intake because they are known to help prevent Cardiovascular Disease (CVD), a chronic heart disease. Carrots in particular have a high content of Vitamin A and fat-solutes. These sources reduce your risk for cancer by promoting good cell communication.
For spinach and leafy foods, a darker leaves have more nutrition. These nutrients reduce muscle degeneration, which protect your bones at risk for osteoporosis. Spinach contains folate. This vitamin reduces your risk of Coronary Heart Disease (CHD). These vitamins, minerals, and nutrients in vegetables reduce your risk for many cancers.
Yogurt contains several vitamins and nutrients. These help boost your immune system to reduce your risk of chronic disease. Calcium and Vitamin D found in yogurt will protect your bones from osteoporosis. You can also find “probiotic” bacteria in yogurt, which is active in your digestive track to help reduce digestive cancers. Calcium also prevents tooth decay; and good mouth health can increase your immune system and reduce your risk of bacterial infections.
6-7. Salmon and Nuts
Salmon and walnuts are loaded with omega-3 fatty acids. The high content of omega-3s is great for heart protection. They lower your blood pressure and raise circulation, both of which reduce your risks for chronic heart diseases such as CHD.
8. Whole grains
The fiber found in whole grains help to lower your cholesterol, which reduces our risk of heart diseases. They also have low concentrations of glycemic. This reduces your chance of becoming diabetic.
Eat right and stay healthy! Exercise is also important to maintaining your health and reducing your risk of chronic diseases. You should have 20 minutes of vigorous cardio activity 3-4 times per week. To reduce your risk of many chronic diseases you should also avoid high alcohol consumption, lower or avoid tobacco use, and reduce the amount of salt in your diet.Share and Enjoy:
Believe it or not, drinking too much water in a short period of time can be fatal. This occurrence has been diagnosed as “water intoxication”. People who have water intoxication show similar symptoms of alcohol intoxication, such as disorientation and nausea. An excess amount of water in your system will cause your brain cells to swell (sometimes sending you into a coma) and then burst, which disrupts normal brain functions. It can cause your brain and kidney to become dysfunctional and it can provoke heart failure.
However, water intoxication is not something you should worry about every time you go to drink another glass of water. You should consume 8-10 glasses (about 2-2.5 liters) of water daily. Water intoxication is only triggered when this turns into a situation like 4 liters in less than 4 hours. We should all know from common sense that this not a smart idea. Also, if you’re exercising it is true that you’re going to need to consume more water. Just know your body’s limits and spread out the drinks over time.
There are other substances that people consume daily in minimal amounts that can be toxic in large amounts. Take caffeine for example. The average American drinks about 3 cups of coffee a day (Coffee Fun Facts)! Meaning that many Americans drink even more than that. Does this mean that those people who drink more coffee are putting their life at risk for a caffeine overdose? Not at all. The average cup of coffee contains no more than 200 mg of caffeine. Toxic levels way surpass this amount. Consuming 10g or more of caffeine could be fatal (that would be over 50 cups of coffee in one day!).
A well balanced diet will keep you healthy. Continuing on the theme of “too much of anything isn’t good for you”, too much of any one food can be seen as a health hazard. If you eat too much of one particular food, this means you’re going to eat less of other varieties of foods containing additional vitamins and minerals. These other nutrients are essential to your health and well-being. Also, over-indulgence of one particular food can pose long-term health risks. For example, if you consume too much sugar with not enough exercise you put yourself at risk for diabetes. The human body is such a well-designed complex that it well let you know when enough is enough. It sends out warning signals, such as nausea, indicating that it has reached its limit. You risk unhealthy conditions when you push this limit. Listen to your body.Share and Enjoy:
Many Americans find that glasses are a more appropriate choice for their lifestyle, while others find them more inconvenient. On the down side, many find glasses to be a bit of an annoyance. The frames can obstruct your vision and the lenses do not cover your peripheral vision. The distance from the lens to your eye may distort your perception, too. Also, you have to take your glasses on and off throughout the day when necessary, which can be irritation for some people. And the more you have to touch your glasses for adjustments, the more you’re going to have to clean them off. They also require cleaning or wiping according to the weather (wiping off rain drops) and sudden temperature changes.
On the plus side, many people love their glasses. They enjoy being able to take their glasses on and off as they please and not worry about falling asleep while wearing contacts. When you wake up in the morning, your glasses can be immediately available, instead of stumbling to the bathroom for your contacts. Also, you don’t have to be anal about cleaning your glasses daily to prevent the risk of infection. Importantly, a pair of glasses could last you a lifetime! This makes them a more affordable option over contacts and not to mention they can be quite stylish.
Although there are millions of glasses wearers in the US, many people are aficionados to their contacts. 12% of those who need vision correction wear contacts; more women wear them than men. Contacts are popular because they are suitable for any type of lifestyle. Even those who don’t need vision may choose to wear colored contacts to make a fashion statement. Since they’re directly on your eye, there is no vision distortion or obstructions. Contrary to popular belief, contacts do not make your vision worse more quickly than glasses. However, people find that the maintenance of contacts is not worth the convenience. They can be dry and uncomfortable. Contact wearers risk the possibility of a bacterial infection as well as a contact tear and damage to the eye. Those who wear contacts must be very cautious because your eyes are delicate organs.
The decision between glasses and contacts can be simple – get both! Many people choose to wear both since both options are relatively affordable. With both glasses and contacts, you have flexibility to wear either whenever you would like. Or if you’re really courageous, Lasik is now an option. During this procedure a laser is used to correct your vision so you will no longer need glasses or contacts. In the end, we all make the decision that best suits our need and lifestyle.Share and Enjoy:
When summer comes along, many people just can’t resist lying out in the sun to develop a deep, golden tan. Now, the summer tan is no longer limited to the summertime. The rise of the tanning bed, coupled with the idealization of tanned bodies from shows like the Jersey Shore, has led people—mostly women—to tan year round. Tanning, whether out in the sun or in an indoor tanning bed, can have harmful consequences. Here are the top seven reasons for you to quit tanning once and for all.
1. Tanning—especially in tanning beds—can actually be habit forming and at worst, addictive. Research has shown that tanning is often habit forming, and some people show behaviors similar to drug and alcohol addicts. In a study reported by ABC News back in April, researchers found that between 30 and 40 percent of individuals who used tanning beds demonstrated the psychiatric diagnostic indicators for addiction. Some “tanorexics” just can’t stop tanning no matter what they try, while others miss social opportunities just to tan.
3. Ultraviolet rays also cause premature aging of the skin. Yes, that means wrinkles. UV rays break down the collagen in your skin. Collagen keeps your face smooth and wrinkle-free. Do you really want to risk turning your skin into leather just to keep up a Snooki-esque tan?
4. Proponents of tanning have argued that exposure to sunlight and tanning bed light generates Vitamin D, which may be able to reduce the risk of certain cancers. However, a recent study showed that high levels of vitamin D weren’t necessarily linked to reduced risk in cancer.
5. Overexposure to the sun can also damage the DNA in your skin, leading to increased risk of skin cancer. Tanning bulbs also prevent your body from repairing the damaged DNA, another factor that may increase cancer risks.
6. Anyways, soaking up the sun is not the only way to increase Vitamin D intake. Alternative sources include fish, cheese, and fortified foods like milk, as well as vitamin D supplements. Limited exposure to the sun is a good thing, but baking in tanning beds and burning in sunlight is not a good way to obtain Vitamin D.
7. Not only does tanning hurt your health, but it can also hurt your wallet. If you choose to tan in a tanning salon, by default you must pay for services. Add in expensive tanning lotions meant to enhance your tan. By the time you factor in the 10% tanning tax that starts July 1st 2010, you’ve made a sizeable dent in your wallet.
The Situation with tanning does not look promising. “Fake-n-bake” tanning and sunbathing alike can be very harmful to your wallet, and most importantly, your health. If you’re not willing to cut down on your tanning habits, consider at least reducing your time under the heat lamps. If you prefer to brown outside, wear sunscreen to protect your skin. Follow Lindsay Lohan’s lead—this is probably the only time you’ll ever be told to listen to Lohan—and use sunless tanning products. Self-tanners and spray tans can give you that golden glow without harming your health.Share and Enjoy:
Recently, school lunches have been the target of criticism by parents and politicians looking to improve child nutrition and reduce the nation’s childhood obesity epidemic. Plus, remember that many schools and universities are also working to improve conditions for students with food allergies. A large percentage of school-age children consume nearly half of their calories in the school cafeteria. Many poverty-stricken children rely on school lunches for both sustenance and nutrients. On top of that, over 30 million students are enrolled in the National School Lunch program, which provides reduced-cost or free lunches to students in need. Those two factors, coupled with the growing obesity epidemic, make it even more imperative that something be done about school lunches.
One teacher actually went undercover, eating, documenting, and blogging about school lunches every day for an entire school year. A good percentage of students at her school received free or reduced price lunches. However, students tended to pick at their food, which was mostly either packaged or frozen instead of fresh. The teacher noted that when one student consumed 5 sugar cookies (that he’d bartered for at lunch), he bounced off the walls and was unable to focus for the rest of the day. Food truly impacts both the mental and physical well-being of kids, making it imperative to provide them with the healthiest, freshest food possible.
Although schools do have nutritional standards (for reimbursement purposes), often side items like French fries are counted as vegetables. Plus, many a la carte items like French fries, Supporters of the Healthy Hunger Free Kids Act argue that kids should have access to healthy meals, even at school.
On December 13th, President Obama signed the Healthy Hunger Free Kids Act into law, pumping over 4.5 billion dollars into school lunch programs nationwide, subsidizing more meals for students in poverty-stricken areas and improving the overall nutritional quality of food served in school cafeterias.
As a result of this new legislation, over 100,000 more children will be eligible for school lunch programs. The Healthy Hunger Free Kids Act will also add healthier options to school vending machines and increase the meal reimbursement rate by 6 cents per lunch. The bill received bipartisan support in the Senate, although some budget-conscious Republicans are understandably concerned about the 4.5 billion dollar price tag.
These initiatives may not seem like much, but they are a step in the right direction regarding child nutrition. While schools should not bear the entire burden of child nutrition, it is important that schools provide adequate meals for our children. Hopefully the Healthy Hunger Free Kids Act will provide needy kids with the healthful food they need to thrive.Share and Enjoy:
To fund the 2010 Affordable Care act, the federal government will now levy a 10 percent tax on indoor tanning, which started on July 1st. Spray tans and other sunless tanning products will not be taxed under the new legislation. The tanning tax is expected to generate 2.7 billion dollars towards health care reform. Dermatologists and other advocates hope that the tanning tax will dissuade people from baking their skin in indoor tanning beds.
Why tax tanning?
To begin with, countless dermatological studies have shown that tanning has a negative impact on the body. Exposure to UV rays damages the skin’s DNA, leaving people more than three times more likely to develop skin cancers like melanoma. Although many skin cancers can be treatable, melanoma is the most deadly skin cancer—as well as the most common type of skin cancer found in young people. Indoor tanning beds can also contribute to premature aging of the skin, causing younger people to develop wrinkly or leathery looking skin. A young survivor of skin cancer who tanned in his youth even wants to ban tanning for minors because of health risks.
Initially, cosmetic surgery procedures were the victims of the tax—known as the “Botax” for the popular Botox procedure, until dermatologists successfully lobbied Congress to hit indoor tanning beds instead.
Still, tanning businesses fear that the new tax will put a damper on their fun in the sun. Before the 10% tax went into effect, many small businesses expressed their concern over the tax’s impact on business. Although tanning packages purchased at tanning salons will be exposed to the tax, health clubs that also feature tanning beds are exempt from the new legislation. One famous tanning salon patron, the Jersey Shore’s majestically orange Snooki, claimed that she would stop using tanning beds for good because of the tax, and use spray tan services instead. Other tanners said that the tax wouldn’t affect their tanning habits.
Other businesses claim that they have already noticed a drop off in sales. According to an article in the Washington Post, one tanning salon in Arlington, Virginia noticed a 20 to 30 percent drop off in business since the recession, and anticipated worse since the tanning tax went into effect July. Then again, it is July, the height of beach season, when indoor fake n’ bake tanning really isn’t necessary, which could factor into that sales decline.
While time will tell how hard the tax will hit the tanning industry, I feel tanning salons should not be the only establishments subject to the tax. By exempting fitness centers from taxation, the government is really squeezing the tanning industry. Still, the tax may serve as an additional incentive—including health—for people to stop tanning once and for all.Share and Enjoy:
To begin, the amount of SPF protection in sunscreen ranges from SPF 2 to SPF 100+! SPF is an abbreviation for Sun Protection Factor. This measures the length of time the sunscreen will protect you from getting sunburn, compared to not wearing any sunscreen. For example, SPF 15 will protect you from getting sunburn 15 times longer than if you did not use sunscreen. You may think that SPF 30 would give you double protection as SPF 15 from the sun, but it does not work that way. When choosing sun protection, you need to consider the sun’s UV rays.
UVB rays are what cause you to get sunburn. UVA rays have more long terms damage on your skin, like skin cancer and wrinkles. SPF 15 blocks 94% of UVB rays and SPF 30 blocks 97% of UVB rays – now that’s not double the protection! There are many things this information brings you to consider when choosing a sunscreen. First of all, it’s the UVA rays that cause skin cancer, so you want to find a sunscreen with more than just the SPF protection from UVB rays. You want one that protects against both UVA and UVB rays. Generally, theses types of sunscreens are labeled as “broad spectrum”. Look on the label for ingredients such as avobenzone, ecamsule, or zinc oxide. Also, UVB rays allow natural Vitamin D into your body. So, you must be careful not to get Vitamin D deficiency from wearing too much sunscreen and completely blocking this vitamin from getting to your system.
Now that you know what the SPF levels mean, you need to choose a sunscreen that is best for you. If you have lighter skin, you will obviously need an SPF that has stronger and longer protection from the sun’s UV rays. But, Dermatologists do not recommend high SPFs just to people with lighter skin tones. They recommend that everyone uses a higher SPF (check out the most Dermatologist Recommended Brands). The higher the SPF, the greater protection you will have from harmful UV rays. Even if you wear a higher SPF you should still stick to the recommended guidelines for reapplying your sunscreen.
Research shows that you get the best protection from you sunscreen if you apply it 15-30 minutes before going into the sun and then reapply after being in the sun for 15-30 minutes. Then, you should reapply sunscreen every two hours because the ingredients protecting against UVA rays break down rather quickly when exposed to the sun’s rays. If you go in the water or sweat, you will need to reapply the sunscreen. Waterproof sunscreen is available; but, follow the instructions carefully because this too will need reapplication. In addition to sunscreen, there are other things you can wear to protect yourself from the sun’s UV rays, like clothes, hats, and make-up.Share and Enjoy:
Some feel that the health care reforms will put the squeeze on emergency rooms. After Massachusetts implemented universal health care, emergency rooms reported a boost in people. Even though the health insurance would theoretically give them more access to preventative care, the primary care physician shortage may actually make it more difficult to seek preventative services, consequently making ER care ever more critical.
It’s no surprise that hospitals throughout the United States are working to increase patient satisfaction by decreasing hospital wait time. According to the Baltimore Sun, in 2006, 120 million patients went to an emergency room, a sizeable increase from ten years earlier. More and more people are using the ER to receive care. By using innovative, inexpensive new technology, emergency rooms are cutting down unnecessary services. Hospitals in some states use texts and emails to communicate with patients, marketing their services.
A recent article in the Baltimore Sun details the efforts of area emergency rooms. At St. Joseph Medical Center in Towson, the hospital advertises its emergency room wait time online. This initiative has raised patient satisfaction, increasing the likelihood that patients will choose St. Joseph’s. St. Joseph’s cuts out unnecessary, bulky procedures to streamline care. At the University of Maryland Medical Center, staff moves patients in need of urgent care to beds instead of housing them in the ER. Many other Maryland hospitals have added staff to deal with emergencies.
In Arizona, the state that the third longest wait time in 2009, hospitals are also marketing their wares. Gilbert Hospital in Phoenix ran an ad touting its ER services, highlighting the fact that most patients saw a doctor in 31 minutes or less. Other area hospitals used billboards and other media to promote speedy service. By marketing their superior service, hospitals can increase their business, unless their actions don’t back up their words.
All in all, the fact that emergency rooms are working to become more efficient is promising. Ultimately, however, I feel that increased ER waiting times are a symptom of the primary care physician shortage. On top of all the slimming and trimming of ER procedures, emphasizing preventative care is crucial to reducing ER wait times. Building a strong supply of primary care physicians can increase access to preventative care as more and more people are insured.Share and Enjoy:
The O.R. is responsible for so much of the waste because a general “O.R. Pack” is given to doctors for use during each surgery. This pack contains all the tools the doctor may need during the operation. Not surprisingly, all of the tools in this pack are not used during one surgery. However, most doctors discard the entire pack at the end of the surgery, including the tools that have been untouched. Now that is a huge waste of perfectly good medical equipment!
This problem of wasting useful medical equipment arose when disposable medical equipment became available to doctors. Doctors and nurses began throwing things away without the slightest thought of recycling. It was not until recently when doctors and hospitals began seeking ways to cut down on medical costs that they realized their outrageous amount of medical waste. Consciousness of what they were throwing away had doctors realize that they could save a lot of money. Most of the medical equipment that they were throwing away could be reused. The equipment simply needed to be recycled and sterilized before re-use. Even the disposable equipment can be reused a number of times (after sterilization). It’s a two for one deal: doctor’s offices and hospitals can cut down on both medical costs and waste by recycling tools.
Recycling tools and materials is a great way for medical facilities to cut back on costs and waste. They can absolutely rely on sterilization to kill the virus. In fact, a doctor and a medical student did research to see if anyone had suffered infections or harm from recycled medical tools. Their results were outstanding: they found none! Devices that have shown even the slightest risk of hazard have been exempt from the “Go Green” process (though these are few). Other devices don’t need as much attention when cleaned for recycling because they have such a low risk. These would include devices that do not penetrate the skin.
If doctors and hospitals choose not to re-use their equipment, there is still no excuse for throwing useful tools away. Many things can be done with this medical equipment. There are non-profit organizations that collect unused medical equipment and redistribute it to places that cannot afford the equipment. This is extremely useful to poorer countries, like Haiti.
In efforts to “Go Green”, medical facilities are also looking to take more environmental measures than just cutting back on waste. They are looking for ways to reduce their energy consumption (especially electricity), as well as improving their indoor air quality. More specifically, the O.R. has considered many other environmentally friendly methods in their campaign for “Greening the O.R.”.Share and Enjoy:
The program links each patient to a non-ER medical home where they can make appointments for non-emergency issues. The program was once led by Michelle Obama and has linked 5600 people to a medical home since it began. The idea behind finding patients a medical home is that redirecting non-emergency needs to a primary care physician or specialist at a clinic will result in higher-quality care for patients than they would receive at hospitals where costs are also much higher than at clinics. Decreasing the number of patients appearing unnecessarily for routine issues in emergency rooms will increase both cost-efficiency and quality of care.
Though these patients are not maintaining a consistent relationship with one doctor after they are referred by the University of Chicago to its directory of primary care providers, they are maintaining a closer relationship with a facility (their medical home) which helps target the national problem of those with chronic conditions not seeking preventive care. Increasing the rate at which these chronic conditions are addressed earlier and more consistently not only helps prevent premature deaths but also saves the healthcare system tens of billions of dollars. Though the problem of not seeking preventive care from a primary care doctor regularly is a national issue that transcends income groups, the problem is most severe in low-income neighborhoods such as those served by the Urban Health Initiative, where doctor’s appointments are low on the list of priorities.
The Urban Health Initiative has grown to include 24 community-based clinics and other providers and has a budget of over $6 million annually. The number of appointments made at clinics through program referrals have jumped nearly 40% to 3649 in the last year, compared to 2006. Critics point out however that in 2005 34% of patients (884 people) who were referred by the program kept their appointments at their medical home clinic. In 2010, that number has grown to 1386 patients – only 39% of all referrals.
Despite this criticism, the success of the program has been lauded nation-wide, to the point that the Urban Health Initiative is now poised to escalate research initiatives and teaching opportunities for physicians hopefully leading to its being a national model for medical care in urban areas.Share and Enjoy:
While there are many guidelines for schools, there is no wide sweeping federal mandate regarding students dealing with food allergies. Many students avoid allergic reactions by sitting at special peanut-free lunch tables or classrooms for severely allergic students. However, many parents protest segregating students because of their food allergies. Another group of parents want to completely ensure their children’s safety, and encourage peanut-free zones in the cafeteria. Other parents want a complete ban on peanut products: unfortunately, it is very difficult to completely ban peanut butter and other related products from schools. Peanut butter and jelly sandwiches are often the centerpiece of a child’s lunch, as they are easy to make, nutritious, and relatively inexpensive.
Still, allergies have grown into a critical issue at many schools throughout the country. More children and adults have food allergies than ever before. According to a study at Children’s Hospital in Boston, Mass., the number of food related allergic reactions in children doubled from 164 cases in 2001 to 391 just five years later in 2006. The study also noted an increase in anaphylaxis, one of the most dangerous types of allergic reactions. When a person goes into anaphylactic shock, they may experience sudden rash, breathing issues, dizziness, vomiting, and a dramatic blood pressure drop. More than 30,000 individuals, children and adults alike, will go to the emergency room for allergic reactions to food every year.
While some children outgrow their allergies, some still suffer from food allergies well into adulthood. Those allergic to peanuts and tree nuts suffer from more severe reactions, and they are also less likely to outgrow their allergies as they grow older. As a result, managing care for food allergies in colleges and universities has grown more important in the 21st century.
Colleges are working hard to give students with food allergies safe food alternatives. Although an estimated 4 percent of the population has a food allergy, only a small percentage of these college students ask staff for help finding alternatives. Still, many colleges offer frozen meals and gluten free bread for such students. At Franklin and Marshall College, dining halls are completely nut free and foods like granola are clearly marked so allergic students can avoid them. Other schools like Tufts provide online menus with clickable ingredient lists, and food cards made for every meal on the menu to ensure safety.
At the College of the Holy Cross, students have access to a wide variety of allergy free meals. Students can pre-order such meals from the campus dining hall, where staff makes meals specifically for the student. In the case that the student forgets to order meals in advance, the dining hall boasts an allergy free kitchen stocked with supplies necessary to make a meal. This approach allows students to eat with friends despite their allergies.
While many universities across the country are working hard to improve food quality for students, there is still much to be done for younger students. It is imperative that we make school cafeterias and mealtimes safe for our children, no matter what their age or allergy.Share and Enjoy:
71% of Missouri voters approved the measure while only 29% voted against it. Though turnout for the vote was low, the vast majority of those who did vote were Republicans. Analysts know this because even though Missouri’s open primaries do not require voters to register their party affiliation, many more voters took Republican ballots than Democratic ones. Republican legislators originally wanted to put Proposition C on Missouri’s November election ballot as a vote on a constitutional amendment, but to avoid a Democratic state senate filibuster they settled for a proposed law on last week’s primary ballot.
The purpose of the federal law’s individual mandate is to widen the pool of healthy individuals covered by insurers to balance out the influx of unhealthy individuals expected to enter the pool as a result of separate provisions which prohibit insurers from denying people with pre-existing medical conditions. Were there not to be an individual mandate in conjunction with eliminating denials based on pre-existing conditions, premiums would rise out of control.
Though this is nothing more than a symbolic gesture of disapproval from voters, several other states have also passed similar statutes not based on referenda, including Arizona, Georgia, Idaho, Louisiana, and Virginia. Arizona and Oklahoma voters are set to vote on state constitutional amendments to the same effect in November. In the same vein, public officials in more than twelve states (including Missouri) have filed lawsuits claiming the individual mandate violates usual federal-state relations. Defenders of the law argue the mandate falls under Congress’s power to levy taxes and regulate interstate commerce. Federal courts are expected to weigh in on the constitutionality of this issue before the individual mandate goes into effect.
A number of high powered interest groups were involved in campaigning for Proposition C. The Missouri Hospital Association was particularly vocal – to the tune of $400,000 – in warning voters that passage of the measure could increase hospital costs for treating the uninsured. The group argues that were there not to be an individual mandate, there is the potential for a massive cost-shift onto the insured to cover those visiting emergency rooms because they lack insurance. There was little opposition from grass-roots organizations or unions and consumer groups who had forcefully supported reform earlier this year.Share and Enjoy:
To encourage workers to use the program, companies waive deductibles, cover travel and hotel costs for patients and their families, and reduce co-insurance payments by as much as half. Even factoring in travel costs on the company tab and in some instances monetary incentives to workers, most large employers who’ve tried “domestic medical travel” say they can reduce their costs 20-40% by directing workers to facilities with higher-quality care and lower negotiated prices. Employers who’ve promoted domestic medical travel include Alpha Coal West, BridgeHealth Medical’s group of small and midsize companies, and the Health Services Coalition of employers and unions in Nevada. Alpha Coal West has reported its medical costs have remained flat even as such spending has risen nationwide in the nine years since it implemented the program.
If domestic medical travel becomes popular amongst large employers, health industry experts argue the shift could improve quality of care overall and help drive down costs by “fostering a truly national competition.” Savings with domestic medical travel programs result not only from lower prices (negotiated between the company and the out-of-state hospital) but from fewer complications with procedures done at high-quality hospitals. Better hospitals perform procedures better, meaning fewer costs incurred after surgery to resolve complications. Any necessary follow-up care (like physical therapy) is usually performed at the local hospital and covered under the company’s normal insurance plan.
The concept of domestic medical travel is really nothing new; employers and insurers have always sent patients to very high-quality facilities for complex procedures like organ transplants. Domestic medical travel is taking this idea to another level, applying the same concept to more types of medical care like back, knee, and heart surgeries.
Some critics argue the movement toward domestic medical travel could backfire if employers and insurers forget about quality and focus only on cost-savings. Also, some workers (even with incentives and paid travel for patients and family members) are reluctant to travel for surgery. Though the programs are now voluntary, critics worry they may become mandatory and force patients to travel for their procedures even when they don’t want to. For these reasons, and because such programs can anger the local provider community, some insurers are reluctant to encourage domestic medical travel.
These considerations do not seem to be hindering the trend toward domestic medical travel, especially since major companies like Alpha Coal West have experienced such success (and savings) with their programs. It appears as rising medical costs continue to increase nationwide, domestic medical travel is the way of the future for major companies to flatten escalating costs while simultaneously providing their employees with the best quality of care.Share and Enjoy:
In the past, a medical resident could expect to work more than 100 hours a week, with minimal rest in between. Things changed in 2003, when the Accreditation Council for Graduate Medical Education (also known as ACGME), cut down the hours to 80 weekly, although this ruling was not strictly enforced. Still, many shifts can last over a day, up to 30 hours with limited time to sleep.
A new proposal set by ACGME will cut down on mistakes and ensure that patients are safe. Maximum shift lengths would be reduced hopefully reduce harmful medical from 24 hours to 16 hours for first year residents and to 24 hours for all other physicians. Additionally, attending physicians would be required to make patients aware that they are under the charge of a resident. The new guidelines will require attending physicians to supervise residents more closely in an effort to improve patient safety. Still, these regulations would only affect first year residents. All other physicians would limited to 24-hour shifts.
Studies have shown that sleep-deprived residents are more prone to making medical mistakes. A Mayo Clinic study revealed that fatigued, distressed medical residents were more likely to make preventable medical mistakes. Yet another study found that residents were three times as likely to say that they’d made an error during months when they worked one 24 hour long shift. In 2004, a report discovered that medical residents who worked all night shifts were ultimately accountable for over half of medical errors.
Ultimately, some medical mistakes prove fatal. One famous medical malpractice case is that of Libby Zion, an 18 year old college student who died when her overworked, fatigued medical residents prescribed her medication that reacted dangerously with her antidepressants.
Grueling shifts can compromise the health of the doctors themselves. Dr. Shannon Gulliver recently wrote a piece for the New York Times in which she detailed her own weakened immune system, a result of the long hours and high stress of her position. She developed esophagitis, while her colleagues themselves developed shingles, fungal infections, C. difficile diarrhea, and more.
While education is undoubtedly a priority during residency, maintaining the health of both doctors and patients is equally important. As long as these regulations can cut down life threatening mistakes, I feel that cutting back these hours can be a good thing. Medical residents will still be able to gain the experience they need to practice, and after they complete their first year of residency, young doctors will only be restricted to 24 hour shifts. Ultimately, these guidelines will improve quality of care for patients and better health for doctors and patients alike.Share and Enjoy:
However, including one service in the preventative care has been a source of contention for many groups. Namely, that service is free contraception and family planning services for women.
According to Michelle Andrews from Kaiser Health News, American women spend an average of 30 years attempting to prevent pregnancy, and only five years of their lives actively trying to become pregnant. Birth control is one important approach to family planning, and many women’s and employer groups argue that it should be deemed a preventative service.
Still, many more conservative groups oppose including contraceptives in the preventative care mandate, honing in on the support of socially conservative voices. The U.S. Conference of Catholic Bishops argues that pregnancy is not the same as a disease, and therefore contraception should not be placed in the same category as preventative care.
Already, 27 states include birth control as preventative care measures. According to Ms. Andrews, there are over 3 million unplanned pregnancies nationwide every year—a product of the high cost of birth control. Women who use the birth control pill as a contraceptive can expect to spend nearly $75 every month to prevent pregnancy. Not surprisingly, many unexpected births can be attributed to the high cost of birth control options like the pill and IUDs (intrauterine devices). Even when health insurance plans provide birth control, copayments could still be too high for women—ranging from $50 for the birth control pill and hundreds for IUDS. Young women in particular are hit hard by the prices.
And remember—even married women use birth control to prevent unwanted pregnancy. In fact, over 11 million American women use contraceptives. Unplanned pregnancies actually cost the American health care system over 5 billion dollars every year—and 40% of these births are covered by Medicaid. Low-income women on Medicaid are less likely to have access to affordable birth control. Plus, many health plans for individuals do not include maternity coverage.
Some employer groups argue that offering contraceptives as a part of preventative care will decrease the cost of insurance, as prenatal and postnatal care is far more expensive than the cost of birth control.
Still, the issue is a touchy one—pregnancies are not as black and white as diseases. To the millions of American on birth control, hoping to avoid pregnancy, birth control is a crucial part of preventative care. To other Americans, pregnancy is not a disease to be prevented, but the gift of a life. Thus, birth control—like the new morning after pill, Ella One— falls into the health care reform’s gray area of morality.
Despite the tremendous cost benefits that providing contraception would provides—as well as a high demand, the White House took the politically safe route and opted not to include contraception in the preventative care mandate.Share and Enjoy:
Now, HIV positive people depend on HAART to live. Drug therapy for HIV/AIDS is incredibly expensive: one Florida man’s medications cost him over $4,500 monthly, ringing up at around $54,000 every year. Most HIV positive people simply can’t afford the skyrocketing costs of their prescriptions. Many of these people instead rely on the AIDS Drug Assistance Programs (ADAP), where they only have to pay $12,000 for their drugs. Currently, AIDS Drug Assistance Programs serve around 170,000 who are unable to buy these mind-numbingly expensive drugs.
However, because of the recession, AIDS Drug Assistance Programs have been hit hard. In order to balance strained budgets, many states have squeezed their ADAPs, forcing thousands of people nationwide onto waiting lists and off their prescriptions. Many states have either created more strict requirements for enrollments or trimmed their prescription drug formularies in order to keep the programs afloat. At the same time, more and more people are applying for assistance because of the high unemployment levels, squeezing the ADAP’s resources even more.
The effectiveness of HAART has also contributed to the ADAP crunch. Because of drug therapy, HIV positive people are living longer because the drugs more successfully slow the progression from HIV to AIDS. At the same time, the CDC’s HIV testing initiatives has resulted in more people knowing their status sooner, adding even more people to the ADAP pool.
Some people on the waiting list have been able to procure drugs from other resources: some pharmaceutical companies offer free or discounted drugs to qualifying patients on a temporary basis. Still, gaps in HAART can have deadly consequences for patients. HAART most effectively suppresses HIV when used consistently: when patients are off drugs, the HIV viral load increases and can even reduce the effectiveness of those drugs. When patients skip doses, the AIDS virus becomes resistant to that drug.
Ultimately, these programs need more funding. The government made a commitment to HIV/AIDS when it began promoting increased HIV testing and renewed the Ryan White Act, and it should thus help defray the costs of drug assistance. The states are not economically equipped to fund these programs. The National Alliance of State and Territorial AIDS Directors have requested $126 million dollars worth of funding to keep their programs afloat and patients alive, a number which dwarfs President Obama’s proposed $20 million in additional funding. Meanwhile, several Republican senators want the whole amount to be paid for from Department of Health and Human Service stimulus.
For people relying on state AIDS Drug Assistance Programs, enrollment in an ADAP can mean the difference between life and death. It is imperative that the United States continue its commitment in the war against HIV by increasing funding for such crucial programming and in turn, save lives.Share and Enjoy: