Preventative healthcare saves lives and money.  It is estimated that thousands of lives and millions of dollars can be saved annually if more Americans take preventative measures with their healthcare.  Preventative tests promote early detection of many medical conditions as well as thwart conditions from arising in the first place.  They allow doctors to check for any signs of a threatening condition.  By finding a condition before it is able to develop, you are able to medicate (and hopefully cure) the condition before while it is still tolerable.  These tests will require less advanced technology and therefore will be less expensive.  Depending on your age and gender, it is recommended that you get certain tests and vaccines more often than others.

Vaccinations are just one of the preventative services we all need

9 preventative measures to maintaining your health:

1. Routine Vaccinations: it is important to get routine vaccinations, like the flu, tetanus, and Hepatitis shots.  Protecting yourself from illnesses will keep your immune system healthy and ready to fight off other diseases.
2. Blood Pressure Screenings: these screenings will monitor your blood pressure and advise you on how to maintain a healthy blood pressure level.  Regular screenings will monitor your level to avoid the risk of a cardiac event.
3. Cholesterol tests: your awareness of this level will also help you know if your level risks a cardiac event.  If your cholesterol level is too high, your doctor can give you tips for lowering it.
4. Blood tests: these tests can determine if you have certain conditions that you are unaware of.  Such conditions include diabetes, anemia, and thyroid disorders.
5. Annual check-ups: these will check to make sure you’re maintaining a healthy weight (unhealthy weigh puts you at risk for many medical conditions) and they will check that you are up to date on all your medications.  Check-ups are also another opportunity to get your blood pressure and other tests updated.
6. Bone mass tests: these tests examine you bone density to determine if you are at risk for osteoporosis.
7. Mammograms (for women): women should get an annual mammogram to detect breast cancer.
8. Cervical Cancer Shots (for women): these shots will help protect women against developing cervical cancer.
9. Prostate Cancer check-ups (for men): There is a 1 in 6 chance that men will develop prostate cancer.   Men should get regular examinations to catch any signs of the development of prostate cancer.

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.

When I think of the emergency room, I think of the crowded waiting area, chock full of people who have been waiting a long time to see a doctor.  The Center for Disease Control confirms that image. Studies have shown that the average wait to receive care is around one hour. A 2006 report by Press Ganey Associates found that the average stay in an American emergency room clocks in at around 3.7 hours. Patients filled out satisfaction surveys, and Arizona clocked in with the highest average wait time at 297.3 minutes—close to five hours!  Iowa led the way with a wait time of 138.3 minutes, a little over two hours worth of time spent in the hard plastic waiting room chairs.

Healthcare providers working to reduce Emergency Room waits

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.

Medical residencies are notorious for their excruciatingly long shifts.  Doctors fresh out of medical schools use their residencies to gain on the job experience in their desired specialty. Although residencies allow these young doctors to develop expertise, the long work hours can take a toll on their minds and bodies. Residents practice under the supervision of licensed doctors and continue their training as physicians.

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.

Overworked Medical Residents May Be Catching a Break

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.

Medical experts have developed a new morning after pill that claims to be better than any other emergency contraceptive pill.  It is called ellaOne.  The attraction: it works for 5 days! You can take the pill for up to five days after unprotected sex and it will work as well as if you took it the morning after.  Its leading competitor, Plan B, only works for up to 3 days after unprotected sex.  This could be the answer to many unwanted pregnancies.

Will EllaOne Be Available in the US?

However, as expected, it raises the ongoing abortion debate.  This new pill, ellaOne, delays ovulation and therefore inhibits conception.  It does so by preventing the progesterone hormone, a hormone that causes females to ovulate, from being released in the female body.  Conversely, those who are on the pro-life side of the debate claim that it is an abortion pill.  They believe that the pill does not prevent this hormone from being released.  Rather, the fact that it works for five days leads them to believe that it stops the fertilized egg from being implanted in the female’s uterus; therefore killing the fertilized egg.  This being the case, then they consider it an abortion.  If the pill was used the morning after, fertilization may not have taken place.  But, by the fifth day fertilization has taken place.  Nevertheless, some assert that the pill does both: it delays ovulation and prevents the fertilized egg from implanting in the uterus.  So the question is: how does it really work?

This debate has not stopped the pill from being released.  Medical experts find that there are more benefits to it than drawbacks.  No major side effects of the pill on women’s health have been found.  If you take the EllaOne Pill within this five day window, there is only a 1.8% chance of you becoming pregnant.  Whereas, with Plan B you have a 2.6% chance of becoming pregnant.

EllaOne is not yet available in the US.  There was a recent assembly in the US where the Federal advisory panel of medical experts met to discuss the potential sale of ellaOne in the US.  These 11 experts unanimously voted in approval of the emergency contraceptive pill.  Now, the FDA will take this vote into consideration as they decide whether or not to allow the sale of ellaOne in the US.  If the FDA approves the pill, it will be available in the US by prescription only; not over the counter.  However, you will need to check with your health insurance provider to see if this contraceptive pill is covered by your insurance plan.  This final decision by the FDA could take up to several months.  EllaOne is currently sold in France (where it originated) and Great Britain.

This morning, President Obama spoke to the press about the Gulf Oil Spill. The BP Oil Spill in the Gulf Coast has given us little predictability as to what the future holds for this catastrophic event.  This is the worst oil spill in US history; therefore raising many questions that have never been answered before.  With tar balls now showing up on the beaches in Galveston County Texas (some 400 miles away from the source of the spill) the consequences of this spill are very much unknown.  The health of the people in the Gulf Coast area is obviously an immediate concern.

Little research has been carried out on the long-term effects of oil spills on people’s health.  Those who are currently doing research on the potential health risks of oil presume that most of the health concerns will be short term.  However, they do fear potential long-term damage to the liver, lungs, and kidneys.  These short-term and long-term health concerns would be resultant of the oil fumes that workers are subject to while cleaning up the spill.  Other research has found that those working to clean up the oil may experience temporary DNA damage that the body will repair itself over time.

On a more positive note, physical contact with the oil does not pose many health threats.  The oil itself is potentially harmless. Although some people may experience a rash from skin contact with oil, this is only temporary skin irritation.  Health officials announce that you are not in notable danger if you touch or swallow small amounts of oil, but it is not advised to do so.

What consequences will the Gulf Oil Spill have for human health?

How we choose to manage the present circumstances of the BP Oil Spill can be controlled.  Hence, BP has organized clean-up crews in a particular manner.  Complaints have been recorded of an irrational amount of volunteers “standing around” at clean-up sights.  What they don’t realize is that this particular strategy has been arranged to prevent potential health risks to the volunteers.  The volunteers at the spill clean-up spill sites are working in near 100 degree temperatures.  Extended water breaks and shorter working periods reduces the potential of heat-related health risks, such as heatstroke and dehydration.  It also increases the clean-up efficiency of the volunteers

One health concern that has been deemed inevitable is the mental health of residents in the area of the BP Oil Spill.  Mental health issues are bound to arise because it has happened in every past oil spill.  Residents in the areas affected by the oil spill have higher rates of depression and other mental health issues as a result of the spill.  This ensues as a direct result of damages to the resident’s homes, beaches, and jobs.  People lose their jobs because tourism in the area decreases as a direct result of the damages to tourist attractions (especially beaches).  Also, those in the fishing industry lose their jobs because the oil contaminates many fish and people are more concerned with consuming fish.

While working to clean up the most disastrous Oil Spill in US history, all those involved with the Spill must take precaution.  With so much unknown about the potential health threat of oil, research could potentially find that it is toxic.  It is best to take safety measures.  The oil itself contains organic compounds, which can be carcinogenic.  Those working with oil or around oil fumes have a high risk of exposure to these carcinogens in the oil, such as benzene.

In 2006, Massachusetts established a broader health care system to provide universal health insurance coverage to its residents while also cutting down costs. The Massachusetts health care reform features several crucial components that expanded coverage to more than 100,000 uninsured.  The reform requires all Massachusetts adults to enroll in a health insurance plan or risk penalty, while all employers must also provide health insurance to employees or pay a penalty. Low-income adults have the opportunity to join one of the state-run Commonwealth Care plans.

Massachusetts Must Control It's Health Insurance Costs

While Massachusetts has succeeded in expanding health insurance coverage, it has not succeeded in slashing costs. As of June 2010, Massachusetts has the lowest uninsured rate in the United States at 4.8 percent, having slashed the uninsured rate by 60 percent. Compare that to the United States as a whole, where 15.4% of citizens are not covered.  Massachusetts’ efforts in expanding covered should be classified as successful.

However, the successes of broader coverage cannot hide the plan’s inability to cut costs.  The wide coverage, coupled with state subsidies and reduced rivalry between health providers, has caused costs to rise. The Massachusetts Department of Insurance has denied insurers’ demands for rate hikes in an attempt to keep expenses low for consumers. Meanwhile, insurers argue that reducing rates without slashing health provider costs places undue stress on them. Premiums have increased substantially for individuals and families, while the use of the emergency room for non-emergencies did not markedly decrease, perhaps indicating a deeper issue: the primary care physician shortage.

The similarities between the Massachusetts plan and the 2010 US Affordable Care Act make Massachusetts’ successes and failures ever more glaring on the national stage. According to a report from Fortune Magazine, both the Massachusetts and Obama plans increase health care demands without addressing health care shortages.  Prices have gone through the roof, and according to Fortune, will not decrease until the government stops targeting insurers.  Insurance pools also grow more expensive as younger, healthier members drop out while sicker members stay in.  Subsidizing middle-income plans may also prove expensive, while additional state-mandated benefits have also strained the system.  According to Fortune, Massachusetts residents have begun to manipulate the system to optimize their health insurance benefits and subsidies.

If Massachusetts can successfully manage the costs associated with its health care reform, perhaps this will bode well for the Affordable Health Care Act.  Four years into the Massachusetts plan, costs have continued to skyrocket as more residents are covered. In the current economy, controlling costs is ever more crucial to the health care industry and to the country’s economy as a whole.  Solving the primary care and health provider shortage may prove a good step in shaving down costs.

In the end, it will be the costs, not universal coverage, that determine success for both the Massachusetts and federal reform programs. I hope that both reforms can find a way to cut costs beyond placing limits on insurers, perhaps by streamlining health care overall and improving the pool of preventative

Decided in 1973, the Roe v. Wade case forbade states from establishing laws that banned abortion.  It gave women the right to have an abortion in any US state up until their third trimester.  The ruling of this case has led to an ongoing abortion debate throughout the nation.  Anthony Kennedy, a Justice of the Supreme Court, is known for having a “swing vote” in many Supreme Court decisions.  However, people fear that a Republican President may choose to replace Kennedy.  Kennedy’s vote has always been important in the abortion cases.  If he were replaced, there is fear that Roe v. Wade may be overturned. This would allow states to enact laws against abortion at any point in the pregnancy if they so desire.

Supreme Court Nomination May Overturn on Roe v. Wade

If Roe v. Wade was overturned, the likelihood that we would see any variation in the amount of abortions in the US would be slim.  More problems may arise than would be solved in the event that Roe v. Wade was overturned.  If it was, there are about 20-25 states that would immediately enact laws against abortion.  This would make it more difficult for females to find a doctor offering abortion services.  However, it would not stop them from having abortions.  Females will either go to the states offering abortion services or find other means that are less safe and healthy than finding an available doctor.  Overturning Roe v. Wade would theoretically eliminate 170 doctors providing abortion services, which is less than 10% of all services available in the US.

Overturning Roe v. Wade will pose serious health and financial burdens.  As mentioned before, females will take more risky measures to have an abortion.  Those who decide to keep their baby are immediately faced with the high hospital costs and medical costs associated with having a baby.  Consequently, more women may consider taking contraceptives to prevent pregnancy in the first place.  However, this too can be expensive because many health insurance plans do not cover contraceptives.  If they do offer coverage, there is often a high out-of-pocket charge for the contraceptive prescription.  Also, there are very few health insurance companies that offer abortion coverage (most are private insurance companies).  It is likely that these health insurance companies will establish much higher costs in the states that would choose to allow abortion after overturning Roe v. Wade.

The replacement of Anthony Kennedy is not an immediate concern, but it is a possibility in the near future.  Kennedy’s retirement should not be in question because he is not likely to retire soon.  The only imminent threat to his position would be a Republican president, who may choose to replace Kennedy with a candidate who opposes abortion.  This decision, however, would have many repercussions and may not solve any abortion issues.

Even as federal Medicaid funds through the stimulus package dwindle, experts and state officials are collaborating on ways to identify and enroll eligible children in CHIP and traditional Medicaid this year. They are also working on similar strategies to target the millions of adults who will become eligible for Medicaid in 2014. Kaiser Health Network recently interviewed three health policy analysts for their take on how states can bring the nearly 5 million eligible but unenrolled children into the Children’s Health Insurance Program. The experts from the National Academy for State Health Policy, the Center for Children and Families at Georgetown, the Kaiser Family Foundation, and the Center on Budget and Policy Priorities enumerated several strategies states could adopt.

First, simplify Medicaid enrollment by giving states the option to enroll children automatically based on their records with other government agencies like those that administer food stamps or subsidized school lunch programs. In early 2010, Louisiana identified nearly 10,000 children via its food stamp program who were eligible for CHIP or Medicaid by not enrolled. Express lane eligibility could be expanded by developing a joint Medicaid/CHIP online application which eliminates the now-mandatory in-person interview. This expedited process is currently allowed for enrolling children under a 2009 federal law and 18 states already use it as an option. Federal law could further be changed to allow express lane enrollment for adults, especially those who will become Medicaid eligible in 2014. Creating an express lane process which applies to all Medicaid eligible individuals would encourage enrollment by lowering the barriers to entry. Eligibility terms could also be increased from 6 months to 1 year, and the process for renewing Medicaid coverage could be streamlined.

New Strategies Employed to Enroll More Children & Adults in Medicaid

States might also consider eliminating the asset test applied when determining adults’ Medicaid eligibility. This test has already been dropped for parents enrolling their children in most states. One big barrier to enrolling more of the Medicaid eligible population is the social stigma associated with being on Medicaid. Unfortunately, this stigma places Medicaid enrollees in the same category as welfare recipients. Though both these programs provide necessary services to families in need, “welfare” has taken on a negative connotation in popular culture, one which Medicaid has also acquired. In order to encourage a culture of coverage, states could rename Medicaid to something more appealing and which sounds less like a welfare entitlement. My home state of Connecticut already made such a change, renaming CHIP the “Husky” Program after our NCAA Champion UConn basketball teams.

Finally, experts suggested paying incentives to nonprofit social service agencies who help enroll children in Medicaid and CHIP. Some states including Oregon, California, Louisiana, New Hampshire, Illinois, and Indiana have had success enrolling thousands of kids via these groups using paid incentives. Any or all of these strategies could prove useful to Medicaid program administrators in the years to come as the pool of eligible individuals is set to swell tremendously.

Thousands of families who took advantage of the federal government subsidy for extending their former employer’s health insurance coverage through COBRA have had to rethink their options in the past few weeks. On June 1, 2010 the federal government’s subsidy of COBRA health plan extensions expired. COBRA is a federal program which allows workers who have been laid off to continue the health insurance benefits their families received through their job after their employment has been terminated. With employer-sponsored coverage, companies contribute a given portion of the cost of their workers’ health insurance premiums and workers pay the rest. When a worker is laid off, COBRA gives that individual the option to remain on the same insurance plan as long as they agree to pay the total cost of monthly premiums themselves. Unfortunately, the full burden of such premiums is often too onerous for unemployed individuals to bear, especially in economic times such as these. That’s why as part of last year’s economic stimulus package, the federal government offered to subsidize the cost of extending one’s old coverage through COBRA at 65%. This subsidy was available beginning March 1, 2009 and offered 15 months of subsidized coverage to those who took advantage of the extension.

According to a study by the Treasury Department up to 1/3 of eligible unemployed workers signed up for the program. Last Tuesday, this benefit expired leaving thousands of families who took advantage of the opportunity to extend their health plan feeling they can no longer afford to continue this coverage without the help of the subsidy.  One exception to the June 1, 2010 expiration date remains for those who did not become unemployed until more recently. Those families who accepted the COBRA subsidized extension after March 1, 2009 but before December 31, 2009 are able to continue COBRA until September 30, 2010 when the subsidy expires completely. These families will be dropped off COBRA on a rolling basis based on when they signed up.

Though Congress has extended the COBRA subsidies four times since February 2009, the most recent proposed subsidy extension failed due to worries on the part of legislators about the federal budget deficit. Some states are offering additional COBRA extensions (called “mini-COBRA” laws) to supplement federal COBRA to extend benefits up to 36 months but again, the cost of these premiums tend to be much higher than those for plans available on the individual market.

Recently we have had many families losing their COBRA coverage visit our website to look into other, less expensive health insurance options offered on the individual and family health insurance market through us at Health Plan One. With individual and family plans, consumers are able to tailor their coverage so they only pay for the benefits which meet their specific needs. If you’re interested in doing your homework on the individual and family plans available to you, call one of our licensed agents at (877) 567-5267 for an expert, personalized consultation. Other public options for individuals with major preexisting conditions dropping their COBRA exist in most states, as do so-called “HIPAA-eligible” plans. Visit your state’s informational page at healthplanone.com to learn more about the publicly funded programs available in your area which benefit groups like pregnant women, children, and low-income families.

According to a recent report, Americans are not only fat, but they are getting fatter. The report, done by the Trust for America’s Health found that adult obesity increased in 23 states and did not decrease in a single state during the past year. Also, the report stated that childhood obesity is now at or above 30% in 30 states.

The highest rate of obesity was found in Mississippi, with a rate of 32.5 percent for adults (and an astounding 44.4 percent rate of child obesity). Three other states join Mississippi as having obesity rates over 30 percent: Alabama at 31.2 percent, West Virginia at 31.1 percent and Tennessee at 30.2 percent. Interestingly, 8 of the 10 top states with highest adult obesity are located in the South; where as the northern state of Colorado has the lowest rate at 18.9 percent. This is the fifth year in a row where Mississippi ranked the highest for adult obesity rates.

The fact that Americans are getting fatter is a concern for the healthcare industry because with obesity comes disease and illness and higher health insurance premiums. Despite the increase in nutritional standards from four to 19 states in public schools within the past five years, it is evident that the obesity epidemic is still flourishing. More has to be done by government, families, parents and individuals in order to promote healthy eating and life-styles, exercise and appropriate nutrition.