Health Care Uncovered

Fighting Breast Cancer With Kryptonite

2011-03-10T16:12:09-08:00

I'm beside myself.

My aunt has breast cancer and there is no surgery, drug, cocktail, vaccine, or doctor that
can promise to cure her.

Nope. She will have to fight her cancer with kryptonite and hope for the best.

After a double mastectomy, her only options for treatment are 5 weeks of radiation and/or chemotherapy, which will make her nauseous, cause her hair to fall out, weaken her immune system, drain her energy, damage her heart, lungs, & kidneys and put her at risk for other cancers in the future.

Sounds like what kryptonite did to Superman.

Despite big advances in genomic medicine and research, these are the same treatment modality used for breast cancer since the early 20th century with no significant decline in deaths from breast cancer in 50 years.

In fact, research shows that an older, most toxic chemotherapy drug commonly used for breast cancer, Adriamycin, is only effective in 8% of women with breast cancer.

Now, if I'm going to put myself through this kind of hell and mortgage my home to pay for it, it better work, or "cure" my cancer, damn it. Yet, shockingly, oncologists don't make such promises. They don't have reliable statistics for "survival" rates for each individual case and they certainly don't use the word "cure."

So, as we pour record amounts of money - $4 billion to date - into breast cancer research, we have to ask ourselves where it's getting us. Frankly, I'm tired of the all the talk and "walks for a cure" that have not produced better, effective, and affordable treatments, let alone a cure.

No more empty promises. It's time to demand results in exchange for our money and efforts.

If the money is going to the pharmaceutical companies, hold them accountable to make better, more targeted drugs that work. Hold the FDA accountable when they approve expensive cancer drugs based on preliminary evidence that later prove to have little or no benefit, a practice that has continued since the early 1990's.

Just yesterday, federal officials questioned companies that make six cancer drugs about their failure to complete follow-up studies they promised to conduct in exchange for accelerated approval. Full story.

Do you want to put your and your loved one's fate in their hands? I don't.

Before making any treatment decisions, I recommended that my aunt get a chemotherapy sensitivity test through OncotypeDX which will tell her how her cancer will respond to specific chemotherapy drugs and how likely her cancer is to return. This way, she will know if the chemo and all the side effects will be worth it in the end.

As for me, I will give my time & money to those like The Dr. Susan Love Research Foundation who is working hard to prevent, cure and eradicate breast cancer.

I love you, aunt Mina. God will see you through. You are a superhero to me.

Healthy Resolution for a Health Care Revolution

2011-01-07T13:52:09-08:00

Welcome to 2011! Fasten your seatbelts for the healthcare ride.

The 2011 healthcare headlines read like a suspense novel. My pulse is bounding.

There's a quiet panic in Washington as empowered Republicans step up their game to repeal the health law next week. Perfect timing for Blue Shield of California to announce premium hikes of as much as 59% for tens of thousands of customers March 1, 2011.

Who's going to stop them? After all, it's our poor health that's forcing them to do it, right?

If your new year's resolution isn't to get healthy once and for all, I urge you to reconsider.

With "skies the limit" on insurance premiums and deductibles, soon, none of us will have the luxury of having or using health insurance.

Something has to change. We have to change. Now!

2011 is the year for each of us to start a movement toward health & prevention, the number one way to gain control of health care costs.

Here's the good news; We don't have to do it alone. There are many health coaches, fitness trainers & programs to help.

According to Christopher Fey, chairman and CEO of U.S. Preventive Medicine, "America is moving from the reactive treatment of illness to the proactive preservation of health." They have teamed up with Sam's Club to provide members a deep discount on their Prevention Plan, the same plan offered to employees of major corporations. The Prevention Plan, is a personalized, step-by-step health management program designed to help people take control of their individual health, but it's so much more. Watch this video for more details.

I am so impressed with this program, priced at a low $99/year, I have signed up.

It's time for us to make healthy resolutions to start a health care revolution; to take control of our health and make health care affordable.

Will you join me?

Other online health & fitness programs:

http://www.transformation.com

http://www.thebestlife.com

http://www.sharecare.com/topic/dr-oz-move-to-lose-it-challenge

http://www.mywellchoiceplus.com

http://www.sparkpeople.com/

http://www.quitnet.com Quit smoking

Villians, Heroes and Healthcare Reform

2010-11-04T15:31:12-07:00

Ah, Election Day. A day to vote for change and look ahead to better things to come. A day to celebrate victory.

But not this year. No. This year, it was Retribution Day for Washington. Payback for not listening to the American People.

Humble pie, anyone?

Now what?

Now, with the Republicans taking control of the House, it's war in Washington and I'm afraid they're going to do anything but work together to help get the economy back on track, let alone fix our healthcare system.

In a post-election press conference today, a somber President Obama said, "The American people don't want us just standing still...They want us to do the People's business."

Is this really a revelation or an attempt to save face and any hope of re-election?

Honestly, I don't care. All this blame and backlash is a distraction that delays true progress for all Americans.

As this election proved, it's up to us, there are no heroes in Washington, only villians. The real heroes walk among us, willing to take a stand for what is right and provide solutions. Everyday heroes that come together to make their voices heard in order to create the change we desperately need.

Everyday heroes like:

Jason Klein, CEO of Medtipster, who provides the public with a solution to the rising cost of prescription drugs.
Edward Leigh, founder of The Center for Healthcare Communication who works with patients and physicians to reduce medical errors.
Jennifer Jaff, patient rights attorney who advocates for people with chronic illness.
Jeffrey Rice, CEO of The Healthcare Blue Book, established to provide consumers with the knowledge they need to get fair prices for their healthcare.
Kevin Dewalt, creator of ClaimAway, a software program that helps people organize, understand, and manage their healthcare bills.

What do you think? Do YOU know an everyday hero who's making a difference?

Dependence on Prescription Drugs Rise with Costs

2010-09-30T10:16:13-07:00

It looks like government isn't the only thing that Americans are increasingly dependent on.

A new report from the Centers for Disease Control earlier this month shows that prescription drug use in the U.S. is on the rise, with half of all Americans currently on at least one prescription drug.

Who pays for these drugs? In 2009, U.S. prescription drugs sales topped $300 billion .

Sadly, as the number of people without health insurance rise and as more insurance companies get pickier about the drugs they cover, many cannot afford to pay for these drugs.

There is no question that the rising use and cost of prescription drugs is a major cause of rising health care costs in this country so if we want affordable health care and reform, we must start here, looking for alternatives.

According to the Generic Pharmaceutical Association, generic drugs have saved Americans $734 billion in the last 10 years so ask your health care provider if switching your prescription drug to generic is a good alternative for you.

Websites such as Medtipster allow you to search for discounted generic drug programs available at pharmacies throughout the USA.

Many of these drugs are available for as little as $4 or less.

If your medication is available through one of these programs, you will see a list of pharmacies with pricing, in your neighborhood.

If your medication is not on one of the discount generic drug programs they will notify you when it is, or they will suggest a ttherapeutic drug equivalent.

If your medication is not available in generic form, they will search for drug brand coupons you can print and take to your local pharmacy.

Why pay more than you have to?

Other Prescription Drug Assistance Websites

http://www.xubex.com

http://www.needymeds.com

http://www.rxhope.com

http://www.pparx.og

http://www.rxoutreach.com

Healthcare Reform Held Hostage

2010-09-16T12:48:08-07:00

Do you hear crickets?

We're 6 months into the new healthcare reform law and I don't hear anything about the changes that have begun to help Americans.

Even more strange? it's primary election week and candidates have hardly mentioned the healthcare reform bill.

According to Politico, Democratic candidates are spending three times more — nearly $1 million — in advertising against health reform than for it.

Could it be because they know it's not working? That healthcare is still not affordable.

Consider:

High risk pools were expanded in July to help insure those with pre-existing conditions but so far very few uninsured have applied and those who do have found they still don't qualify or can't afford the high premiums.
Starting this month, many insurance companies are asking for 20% premium hikes, blaming the benefit mandates in the law. This means, although they cannot cancel your policy if you become sick, place lifetime limits on coverage, and must cover children up to age 26, they can continue to do what the they've been doing for years - raise premiums until they're unaffordable.

Maybe you don't know this, but Obama, Speaker Pelosi and other key staff made a deal with the insurance companies. In exchange for their support (because they have billions of dollars to fight this bill) every American will be required to buy health insurance. A "deal with the devil," giving insurance companies even more power.

If you want to see how this deal went down, watch Obama's Deal, a CBS Frontline film. You will be enlightened and incensed.

Did Obama make a good deal? Look at the evidence and you decide.

Last week, Health and Human Services Secretary Kathleen Sebelius warned insurers who blame their rate increases on the new health overhaul that they could be excluded from health insurance exchanges.

I'd like to know how they could do that. A deal is a deal, right?

Not backing down, chief insurance lobbyist Karen Ignagni responded by saying that the new law was a factor for the premium hikes.

It appears she and the insurance industry have Washington and the rest of us in a head lock, holding healthcare reform hostage.

Sadly, it's up to us, the American people, to break free. Maybe former president Jimmy Carter or Bill Clinton can do the negotiating.

Choosing the Right Plan - Health Insurance 101

2010-08-24T08:30:00-07:00

I got a call from a friend and entrepreneur today.

The last time she called she said, "I stayed up all night reading your book and now I'm freaking out! I haven't had health insurance in 3 years and now I'm afraid I'll lose my home if something happens to me."

After telling her that the book is supposed to keep her from freaking out, we discussed her options, including finding an affordable health insurance plan, and questions she needed to ask before deciding on one.

Today, she called with the results.

"I have two plans from einsurance.com. One is $165/month with a $5,000 deductible and a 40% co-insurance (what she has to pay out of pocket) after the deductible is met. The other is $187/month with a $3,000 deductible and a 80% co-insurance. Which one is better?"

I reach for a pen, pad of paper and more caffeine. Ok, let's see...

What's the lifetime maximum coverage amount? $3 million. Good.

Do they both cover inpatient and outpatient treatment? Yes. Good.

What about exclusions and limitations in coverage? Not sure? Find out.

Is your doctor and local hospital contracted? Yes. Good.

She's close to making a decision but calls the NASE for more options.

They present one of the same health insurance plans but when she asks if it covers inpatient and outpatient care, they tell her, "NO." Not only that, the plan doesn't cover doctors other than at a one time, yearly exam.

What? You don't have to be an insurance expert to know this is a bad deal.

My friend calls einsurance back to inform them of their misinformation and surprise! they find another, superior, PPO health plan for $184/month, a $2,500 deductible with 100% coverage after paying $5,000 out-of-pocket and a $5 million coverage maximum for inpatient AND outpatient treatment.

She's one smart cookie who got an excellent, affordable health care plan because she had the right information and knew what questions to ask.

Health Insurance 101

If you're in need of a quality health insurance plan, compare plans in your state through the NASE, NAHU, and coverageforall.com and save yourself from a "junk" plan that will leave you underinsured by following this checklist of questions:

How much will premiums increase each year? What's the grace period for payments?
What's the lifetime maximum for coverage? Will it cover your chronic illness & supplies?
Does the plan cover preventive healthcare?
Does it cover inpatient and outpatient treatment?
Do you need a referral to access your doctors?
What are your out of pocket costs (deductibles, co-insurance, co-pays)?
What is the maximum prescription drug coverage amount? Are your Rx meds covered?
What are the exclusions and limitations of the plan?
How are claims paid? Will you have to pay out of pocket and then submit a claim?

Remember, an affordable plan must be a quality plan.

The doctor will see you now.

Is Dental Care a Luxury?

2010-07-27T15:23:38-07:00

Has dental care in America become a luxury?

Lately, I've been talking to a lot of people who don't have dental insurance and who haven't been to the dentist in who knows how long.

These are some of the same people who wouldn't miss a mammogram or other important health screening.

Why is this?

Maybe they don't know that neglecting your teeth can lead to heart disease and other serious health problems, complications in pregnancy and even death.

Last January, I was shocked to learn that a California woman's gum disease was the cause of her baby's death, after scientists linked bacteria from her gums to an infection in her baby that was full-term but stillborn.

And it's not just teeth we should worry about. How many oral cancers are not being diagnosed by not regularly visiting a dentist?

No, dental care is not a luxury. It is a life-saving necessity that demands our attention.

Find a dentist in your area today at http://www.ada.org.

Search the National Association of Dental Plans for a directory of dental insurance and discount plans in your state.

See if you and your children qualify for Medicaid in your state at http://www.cms.hhs.gov.

No more excuses. *Smile*

How Much Will Your Surgery Cost? Hospitals Can't Say

2010-07-21T10:41:23-07:00

How much will your surgery cost?

If you're uninsured or have a high deductible insurance plan, you need to know.

But don't count on the hospital to tell you.

Research from "The Healthcare Blue Book Surgery Pricing Secrets: The Challenges Patients Face," shows that it is almost impossible to get prices ahead of time if a patient plans to have surgery in a hospital.

In a recent Kaiser Health News article, Paul Ginsburg, president of the Center for Studying Health System Change, said published hospital charges are "useless for consumers."

This is why my friend Jan has traveled from the states to Thailand to have several operations over the past five years. Ask her about her experience, quality of care, and the discounted cost and you'll see her smile and say, "I'd do it again in a heartbeat."

While I'm not advocating you fly across the globe, it does make my point. A growing number of Americans can't afford to have surgery in traditional hospitals.

So what should you do?

According to http://www.healthcarebluebook.com, hospitals are 4 times more costly than outpatient ambulatory surgery centers for the same procedure and they are more likely to offer a cash discount and guaranteed pricing.

Something to consider, right?

Regardless of where you have surgery, ask and compare prices.

Go with the one that can give you a competitive price with a price guarantee and take the rest to the bank.

Health Care Reform Reality Check

2010-07-02T08:33:00-07:00

I'm all fired up!

Health care reform has begun America and I hope you're paying attention.

Keeping their promise to insure dependents under age 26 by September 2010 and those with pre-existing conditions through state high-risk insurance pools beginning July 1, 2010, yesterday, the U.S. government launched the new health insurance website, to help you "Take Health Care Into Your Own Hands."

Just choose your state from the drop-down menu, answer a few questions and wa-la, you're given a custom list of private insurance and publicly funded health care coverage options. Sounds easy.

Let's take it for a ride.

Ok. I'm a pregnant woman who lives in Colorado, aged 26-64, looking for insurance that will cover my pregnancy.

Here are my list of options:

Get a job with health insurance. That's out.

Join a high-risk insurance pool - Can't have had insurance in the last 6 months? That's out.

Find a facility that offers free or low cost care. Next.

Private insurance. Let's see what's available.

I click on the last option to find a list of insurance companies. None cover pregnancy.

I am even more outraged after I read the benefit details of insurance plans that will launch in October.

21 plans are listed for Humana Health Insurance Company - which I'm assuming will represent the practices of other major insurers - and here's what I find:

Separate, additional deductibles for medical, prescription drug, mental health, and certain illnesses.
High medical deductibles, as much as $30,000 for out-of-network care.
Average 20% to 50% co-insurance after your deductible is met.
The right to "balance bill" or collect from you what your insurance didn't pay the provider.
Restrictive and outright ridiculous limitations and exclusions including pregnancy, well baby care, non-emergency hospital stays that occur on Friday & Saturdays, hearing & eye exams, foot care, drugs for toenail fungus, vasectomy, tubal ligation, contraceptives...you get the picture.

Premiums will be disclosed in October, but this will be the least of your worries as you "Take Health Care Into Your Own Hands."

What do you think? As always, I welcome your comments.

A Health Insurance Company Invested in Healthcare?

2010-06-23T09:25:00-07:00

It appears the health insurance industry is as hopeless as the BP oil spill.

Massive amounts of dollars are being dumped into a system that does little to improve health outcomes or control costs.

And Americans despise health insurance companies as much as BP.

Just when I thought all health insurance companies were as inept as BP, I read a story in the NY Times about Geisinger Health System, an insurance company in rural Pennsylvania who's primary interest is keeping their patients healthy and physicians happy.

Using innovative research and technology to "strive for perfection," Geisinger is going to extreme lengths to care for their patients. As just one example, they've installed about 1,500 home monitoring devices in patient homes to closely monitor their blood pressure, glucose levels and weight, helping them avoid complications and hospitalization.

And what's really impressive?

Geisinger pays physicians and nurses to keep patients healthy, sharing a large percentage of the savings with them.

As reasearch shows, this close collaboration between patients and providers has "significantly reduced the number of unnecessary hospital admissions and readmissions."

Rewarding physicians for providing quality healthcare while lowering costs? Now there's a healthcare model that makes sense.