Wiser Fitness and Health BlogWiser Fitness and Health Blog will update you . . . . . . to let you know about news that could affect your health or wellness affairs and to help you consider your options; . . . to give you in-depth information on fitness and health issues that you may not have seen in other publications; . . . whenever new pages appear on the Fitness- Culture-Health-Insurance.com webpage; . . . when we publish a fitness or health ezine, magazine or news article that might be of interest to you; . . . whenever we discover or offer related products or services that may be of benefit to you.
__________________________________________________________
Would you like to contribute to the Wiser Fitness and Health Blog? Simply give us your reaction or comment by clicking here. If you've had an experience that relates to our discussion, tell us your story. What you have to say may help others. If you think we've missed a vital point or that we're wrong, set us straight. You can disagree, just do it agreeably. Contributing is like riding a bicycle. Once you start, it's easy and a lot of fun. In fact, it's easier. You won't fall. Totally painless.
__________________________________________________________
You can subscribe to our blog, ezine and updates via email. Sign up on our Contact Us Form (See Button to left). Or, go through RSS (see the left margin), in case you don't like giving out your email address or in the event your ISP has filter challenges that make you miss email. To subscribe with RSS, RIGHT-click on the orange RSS button, then copy-and-paste the URL of this site's RSS feed into your RSS reader . . . or . . . if you keep a personalized home page on Google, or My Yahoo, or My MSN, or Bloglines, left click on the appropriate button on this page, then follow their instructions . . . If you are not sure what RSS and blogging are all about, click on the question mark above RSS for an explanation . . . What is RSS? It's simple, and once you start, you'll be surprised how easy it works. Group Quote GuideHow To Get The Best Group Health Plan Quotes Permalink -- click for full blog post "Group Quote Guide" Medicare Dilemma . . . . Painted Into A Corner
Obama Administration officials in the Department of Health and Human Services have extended the projected financial viability of Medicare from 2017 to 2029. A miracle? Not quite. HHS officials just revised their cost projections based on the assumption that Medicare will cut payments to physicians.
Medicare payment rates for doctor services are scheduled to be reduced by 23 percent on the first of December, 2010. Existing law also requires a second cut of 6.5 percent on January 1, 2011. Despite the scheduled cuts in physician fees, HHS is blindly forecasting that healthcare service providers will increase their productivity so that Medicare will save billions more over the twelve year extension.
HHS projections ignore the dissenting opinion of the Medicare Actuary office that says the projected savings might not be realistic. The assumed increased productivity could be difficult to achieve and sustain in view of the lower fees and higher service requirements being forced on participating service providers. Nowhere in the Medicare assumptions do the Obama officials account for the substantial resistance they are generating from medical professionals. Some surveys of physicians have indicated that more than half of doctors serving Medicare patients threaten to discontinue Medicare services if the scheduled fee cuts become effective.
The administration passed Obamacare by promising that Medicare recipients would be able to keep their physicians and by promising to reduce the costs of Medicare services to make the program feasible. These two conflicting positions are clearly pulling against each other.
HHS has painted itself into a corner. It can not deliver on both promises. In fact, it is unlikely to deliver on either promise. What is likely? Higher costs. Reduced and delayed service. And, Medicare patients scrambling for another doctor. Permalink -- click for full blog post "Medicare Dilemma . . . . Painted Into A Corner" Deja Vu . . . What's The Point?
In my last blog contribution, I described the healthcare experience of an old friend and school mate. I knew his condition through a daily journal written by his children. His almost four month ordeal in the hospital was a testament to his faith and strength of character. He suffered due to mistakes in care. It did not end well because of a major misstep.
The experience of my friend brought back vivid memories my family experienced almost thirty years ago when we lost my father due in large part to errors in medical care. So, what's my point?
I guess I have several. First, by no means do I indict the medical system. I believe America has the best medical system in the world. If you have a serious illness, this is the place to be. But, our healthcare system is not infallible. It makes mistakes. Too many mistakes.
US healthcare studies reveal that each year more than 100,000 patients die and more than one million patients have their hospital stays extended due to mistakes in medical care. Mistakes that should not happen, but do.
If you think that is a reason to advocate government controlled healthcare, you need to understand that the government systems - the VA, the Armed Services system, Medicare and Medicaid - are worse in mistakes, in poor care and in poor access to service.
What can a patient do? Two things. First, understand that when you go into the healthcare system, you are in harm's way and there are no guarantees. The practice of medicine is both science and art. The science side is more predictable, the art side is less. Maybe that's why they call it practicing.
Second, there is no substitute to minding your healthcare affairs. Pay attention. Do your homework. Have an advocate with you at all times to watch your back, especially when in the hospital. Ask questions, even uncomfortable questions, and demand good answers that make sense to you.
Of course, if you have spent much time on this website, you knew all of this already. Permalink -- click for full blog post "Deja Vu . . . What's The Point?" Healthcare Deja Vu All Over Again
Almost thirty years ago, my father entered the hospital for what the cardiac surgeons called "routine bypass surgery". It was at a prominent Atlanta hospital that had an excellent reputation for heart surgery. The surgical team was both qualified and experienced. The surgery went well.
However, the recovery kept running into small issues, nagging issues. Recovery lasted a week longer than expected, but finally the day of my father's release from the hospital arrived. I was scheduled to pick him up at 2:00 PM. About noon, the hospital called and said I better get there as soon as possible. That did not sound good.
I made the trip in record time, only to discover I was too late. I was too late before I started. While getting dressed to go home, Dad had suffered a blood clot going to his lungs. He died instantly. I was not prepared for that.
I remember it vividly because that was absolutely the toughest day of my life, so far. I have lost close family and friends, but no one closer than Dad.
A childhood friend and high school classmate recently had heart surgery. The surgery went ok, but the recovery was bothersome. Then came some infection issues and some additional surgery. To me, it just didn't feel right, but finally his condition improved and he was scheduled for release.
My high school class, which has always been very close-knit, kept informed about our ailing member through a daily email diary written by his daughter and son. Throughout their ordeal, the kids remained optimistic and upbeat. Last week, our class member was set to get out of the hospital on Tuesday. Finally, the end was in sight.
But, an emotional bomb dropped on Monday. The hospital staff discovered that some medication our patient had been given had destroyed his bone marrow, rendering his immunity system helpless. The medical staff offered no hope.
After a day, he was gone. Joy had turned to deepest despair. The family was not prepared for that. For the kids, I'll bet it was the toughest day of their lives. I remember that feeling. Permalink -- click for full blog post "Healthcare Deja Vu All Over Again" What If . . . You Are Self-Insured Or Have A High Deductible And Need Affordable Care Options?
The premise of this webpage is that no one will mind your healthcare business better than you will . . . if you know how. A key element of the pursuit of such consumer-driven healthcare is the high-deductible health insurance plan with which the insured essentially self-insures the basic but affordable risk in return for reduced premium for covering the catastrophic, unaffordable risk.
This is a reflection of the underlying principle of insurance and is the most cost-effective approach to buying health insurance.
Studies have shown that consumers who direct their own healthcare effectively manage their affairs with lower costs and without reducing quality once they learn to be informed and savvy shoppers. This should come as no surprise, because Americans have been astute shoppers in every other retail venue. We just got out of the habit with healthcare.
If you have insurance, even though you have not satisfied deductible requirements, you may qualify for reduced fees and rates negotiated between your insurer and the service provider. In any event, negotiate for cash discounts. Healthcare providers that do not have to file for insurance and deal with the bureaucratic hassle are often very receptive to a quick but lesser cash payment.
If time and need are not critical factors, shop around for lower prices and better terms. You would do that to buy a car. Why not do it to get medical services or products. Even if you need a treatment or procedure that only a handful of physicians can provide, become an informed and savvy shopper before you leap.
The premise of minding your own business is most important in the hospital and healthcare facility sector. Expect hospital overcharges and phantom charges. Have the mindset that bills are confusing on purpose. Demand itemized bills that are clear and understandable. Keep you own records and compare them meticulously with invoices. Check our Medical Self Care Management section. What If . . . You Are Between Jobs And Need Health Insurance Now?
If you have lost a job with which you had health insurance through your employer, you may be entitled to extended coverage for up to 18 months under the federal Consolidated Omnibus Budget Reconciliation Act, or COBRA. However, you have to pay the entire premium for such extended coverage. The cost is far more than most people have experienced as employees and is often beyond reach.
Because COBRA is usually so expensive, it can be a fickle remedy. Unless you, or a covered family member, have a preexisting health condition for which COBRA offers the only coverage, there are often better alternatives.
If you have are no pre-existing condition issues, a high-deductible medical benefits plan may be a more affordable permanent option. An even less expensive choice would a short term health plan. Short term plans can cover terms of 30 days up to one year.
Most short term plans are limited benefit plans, which means they are not as benefit rich as comprehensive major medical plans. That is a primary reason they are not nearly as expensive as comprehensive plans. In addition, a medical condition that develops during the short term plan period would be covered during that term but might be excluded or conditionally covered under a succeeding short term plan.
A combination of a short term plan and a supplemental plan that covers accidental injury and / or critical illness benefits can make for a very effect lower cost alternative while you search for a more permanent solution to your employment and health insurance dilemma.
Check out our information page on short term health plan considerations to see if a short term plan is a good option for you. One thing you will usually discover is that it will be better than COBRA. What If . . . You Are Uninsurable Due To A Pre-Existing Condition?
People who have a pre-existing health condition may be rated up with a premium surcharge for some period, or may have the specific pre-existing condition excluded for a defined period, or may be declined outright for coverage. The coverage determination can vary with different companies, so it is best to apply to more than one insurer. Impaired risk applicants who are denied private insurance coverage due to a serious medical condition have been forced to self insure or to seek relief through Medicaid, if they qualify, or through state-guaranteed high risk pools if that is available in their state of residence. All but eighteen states have such high risk pools. With the passage of Obamacare in March, 2010, the Federal government is now offering another alternative called the Pre-existing Condition Insurance Plan, or PCIP. We have mentioned the PCIP in earlier blog articles before it even had a name. The PCIP is a four year program that will cover qualified uninsurable patients until the full implementation of Obamacare in 2014. PCIP is a federally-funded program that calls for states to administer the fund in a manner similar to Medicaid. States are required to agree to partner with the federal government to implement the program. However, there are two major problems with the PCIP program. First, the plan was under-funded in the federal legislation. Second, any funding deficit in the plan must be borne by the partner states. The funding issue was not accidental. It was done purposely to reduce the official cost of Obamacare in order to get it passed. The result of passing costs along to state taxpayers has kept some states from signing on to PCIP. As far as an individual patient is concerned, this does not matter. Residents of states that did not participate can apply through federal officials rather than state offices. To qualify for the PCIP program, you must be a US citizen or lawfully present in the US. You must have been uninsured for at least six months. And, you must have been denied insurance due to a pre-existing condition. To learn more about PCIP and to apply, go to http://www.healthcare.gov/ and click on Pre-Existing Condition Insurance Plan.
Healthcare consumers who pursue the PCIP coverage should keep in mind that this is a government controlled program. As such, expect it to have all of the characteristics of a government program. Heavy on rules and regulations, but light on friendly service and responsiveness.
We have mentioned that the Obamacare plan was patterned after state insurance programs, such as Massachusetts and Tennessee. The state programs have encountered problems of funding and service shortfalls. PCIP already admits to a shortage of funding. And, anyone who expects the government to deliver good or prompt service simply lives a fantasy. Be prepared to wait. Minding Your Healthcare Affairs - Longevity Guide: Summary
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know.
You can’t change who you are, the fixed factors of your life. But, you can change the variable, fitness, dietary and life quality factors of how you live your life.
The Longevity Guide advisories can show you how to embrace good habits and healthy conduct that might extend your lifespan up to an additional thirteen to fifteen years. More importantly, these advisories can help you avoid or minimize harmful conduct and bad health habits that could penalize you by thirty years . That could be a potential swing of more than forty years. A lifetime of enjoyment.
Take charge of your health and your life. Nobody has more invested in it than you, and no one will do it better. Permalink -- click for full blog post "Minding Your Healthcare Affairs - Longevity Guide: Summary" Minding Your Healthcare Affairs - Longevity Guide: Harmony
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know.
The Longevity Guide is an advisory to make you aware of the of the small things that you can do or avoid to improve your life experience and your lifespan.
Harmony in your daily life is vitally important to the quality and length of your life. A happy and harmonious relationship can add years to a woman's life, even more years to a man's. Compatibility and friendship are important, but so is an active and healthy sexual relationship.
For guidelines and tips that do not involve some little blue pill, check out our Life Quality Factors section. Permalink -- click for full blog post "Minding Your Healthcare Affairs - Longevity Guide: Harmony" Minding Your Healthcare Affairs - Longevity Guide: Life Quality
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know.
The Longevity Guide is an advisory to make you aware of the of the small things that you can do or avoid to improve your life experience and your lifespan.
For most, life quality issues become more important to us after we pass the mid-life level. Some experience a dramatic mid-life crisis. But, for most, we undergo a subtle, gradual physical deterioration. We probably notice it most in changes of clothing sizes and hair lines or color.
Eventually, we discover that we have new and more frequent aches and pains. And, at some point, we realize that we have don't recover from exertion as quickly. That's the stage at which most of us start to deal with the symptoms of aging and then the health causes that detract from life quality.
A few of our previous longevity topics have dealt with the two primary causes of reduced midlife quality - obesity and smoking. Related conditions can include diabetes and high blood pressure, which start to demand attention in our forties or fifties.
Another condition which takes on greater importance after mid life is sleep and rest. Sufficient quality rest benefits alertness, memory, problem-solving and overall health. Rest requirements that can be pushed beyond limits when you are young become much more necessary after midlife. Our longevity guidelines on these life quality factors can offer some hints. Minding Your Healthcare Affairs - Longevity Guide: Nutritional Factors
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know.
The Longevity Guide is an advisory to make you aware of the of the small things that you can do or avoid to improve your life experience and your lifespan.
Diet management primarily deals with eating the proper amounts of the right kind of foods for weight control. Nutritional management applies to eating and drinking the best food and drink for optimum health and wellness of your body, as well as avoiding intake of food, drink or diet substances that could be harmful.
Nutritional management can step on the toes of some of the popular and most abundant food products of our modern culture. That makes nutritional management even more difficult, because it's often less convenient and/or more expensive.
Check out our longevity nutritional guidelines. Minding Your Healthcare Affairs - Longevity Guide: Diet and Weight
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know.
The Longevity Guide is an advisory to make you aware of the of the small things that you can do or avoid to improve your life experience and your lifespan.
Eating is one of life’s joys, if we control it. Everyone does it, so everyone has an opinion. In fact, there are so many opinions out there, it's confusing and hard to keep up with.
A fact that is not confusing, however, is the high cost of obesity. Obesity has a major negative impact on health quality, on life quality and on longevity.
Abstinence is the best course for avoiding smoking hazards, but it's not practical for avoiding obesity. To apply some common sense to the weight control issue, check out our diet management guidelines. Minding Your Healthcare Affairs - Longevity Guide: Anti-Aging Fitness
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know.
The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you.
As we age, the three primary issues of physical decline are reduced lung capacity, increased body fat and reduced flexibility. The short duration, alternating high intensity exertion with low intensity recovery that benefit body enhancement for younger bodies will offer similar results for older bodies.
It helps maintain higher lung capacity. It stimulates burning fat calories to maintain better body mass index. And, the recommended stretching routines before and after workouts help with the flexibility issues.
What about the longevity benefits? A Harvard study indicated that three or more workouts a week can have significant lifespan benefits. Healthcare Reform Impact - The Coming Trainwreck
In a few previous blog comments, we referenced the Massachusetts state healthcare program which was the template used to write Obama's healthcare reform bill.
To summarize, Massachusetts healthcare officials made it mandatory for health insurers to unconditionally accept all applicants regardless of preexisting condition. Then, to control medical costs and health insurance premiums, Massachusetts political officials invoked insurance premium price controls that have no relationship to real costs.
We predicted that insurers underwriting the Massachusetts healthcare plan would be faced with the dilemma of withdrawal from the program or bankruptcy at the hands of the politicos. In the end, healthcare consumers will be left with limited access and reduced medical services, while taxpayers will face much higher taxes to pay for healthcare cost shortfalls.
On July 7, 2010, The Wall Street Journal reported on the condition of the Massachusetts healthcare plan, describing it as a "trainwreck" that foretells the future of Obamacare.
You can see the Wall Street Journal article by clicking on the following link . . .
Permalink -- click for full blog post "Healthcare Reform Impact - The Coming Trainwreck" Minding Your Healthcare Affairs - Longevity Guide: Body Enhancement Exercise
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know.
The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you.
Recent research has revealed that long-term duration workouts in an endurance pattern often lead to overuse injuries that interrupt program participation. Exercises that alternate high-intensity exertion with short duration lower intensity rest or recovery routines offer greater benefits in burning fat, in building muscle and in developing better cardiopulmonary health.
Such alternating high-intensity, low-intensity routines also offer greater benefits with shorter workout periods as seldom as three times weekly.
Check it out. Minding Your Healthcare Affairs - Longevity Guide: Stress Management
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know. The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you. Some of the information here focuses on fitness and health as continual reminders of how to better manage those aspects of your life. The Longevity Guide is an advisory to make you aware of the of the small things that you can do or avoid to improve your life experience and your lifespan. The Longevity Guide recognizes certain "Variable Factors" that you can embrace, or change or avoid to enhance your life experience. Variable factors can make up for many genetic, gender or age deficiencies and can constitute seventy percent or more of the weighted factor importance in the longevity and life quality equation. Stress and anxiety are hard taskmasters that each of us face. Stress can erode our health. A variable factor is stress management, which determines how well we handle stress. On the longevity scale, those who have a plan to manage stress and who do it well live longer. To discover more, check it out on our Variable Factors page. Minding Your Healthcare Affairs - Longevity Guide: Retiring
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know. The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you. Some of the information here focuses on fitness and health as continual reminders of how to better manage those aspects of your life. The Longevity Guide is an advisory to make you aware of the of the small things that you can do or avoid to improve your life experience and your lifespan. The Longevity Guide recognizes certain "Variable Factors" that you can embrace, or change or avoid to enhance your life experience. Variable factors can make up for many genetic, gender or age deficiencies and can constitute seventy percent or more of the weighted factor importance in the longevity and life quality equation. Another variable factor is retiring. Retirement is a goal long anticipated by many people. Recent economic circumstances have forced many to change their retirement plans. Some, once retired, find that they don't like the reduced pace. They want to be more active, so they un-retire. On the longevity scale, there is no penalty for retiring, but there is a benefit not to retire. Those who stay active, live longer. To discover more, check it out on our Variable Factors page. Permalink -- click for full blog post "Minding Your Healthcare Affairs - Longevity Guide: Retiring" Minding Your Healthcare Affairs - Longevity Guide: Smoking
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know. The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you. Some of the information here focuses on fitness and health as continual reminders of how to better manage those aspects of your life. The Longevity Guide is an advisory to make you aware of the of the small things that you can do or avoid to improve your life experience and your lifespan. The Longevity Guide recognizes certain "Variable Factors" that you can embrace, or change or avoid to enhance your life experience. Variable factors can make up for many genetic, gender or age deficiencies and can constitute seventy percent or more of the weighted factor importance in the longevity and life quality equation. Another prominent variable factor is smoking. Should you smoke or not? Smoking is one of the most harmful habits we inflict on ourselves. It's damage to heart and lung health are well established. In the US, smoking causes over 400,000 deaths per year. If you don't smoke, don't start. If you do smoke, abstention would be the healthiest step you could take. The benefits will begin almost immediately. On the longevity scale, the penalty for smoking is severe. To discover more, check it out on our Variable Factors page. Permalink -- click for full blog post "Minding Your Healthcare Affairs - Longevity Guide: Smoking" Minding Your Healthcare Affairs - Longevity Guide: Alcohol
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know. The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you. Some of the information here focuses on fitness and health as continual reminders of how to better manage those aspects of your life. The Longevity Guide is an advisory to make you aware of the of the small things that you can do or avoid to improve your life experience and your lifespan. The Longevity Guide recognizes certain "Variable Factors" that you can embrace, or change or avoid to enhance your life experience. Variable factors can make up for many genetic, gender or age deficiencies and can constitute seventy percent or more of the weighted factor importance in the longevity and life quality equation. A prominent variable factor is alcohol. Should you drink or not? This is a moral question for some and a physical question for others. If there is history of alcoholism in your family, you should probably avoid drinking. Women with a family history of breast cancer should have reservations about partaking. If it is a moral issue, avoid temptation. For others however, a good case can be made for the health benefits of moderate alcohol consumption. To discover more, check it out on our Variable Factors page. Permalink -- click for full blog post "Minding Your Healthcare Affairs - Longevity Guide: Alcohol" Minding Your Healthcare Affairs - Longevity Guide: Family History
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed to know what you don't know. The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you. Some of the information here focuses on fitness and health as continual reminders of how to better manage those aspects of your life. The Longevity Guide is an advisory to make you aware of the of the small things that you can do to improve your life experience and your lifespan. The Longevity Guide recognizes certain "fixed factors", such as your age, gender and family health history, that are facts you cannot change. They're genetic. You are born with them or have already experienced them. But, you can learn from these factors to improve your life quality and longevity by altering your actions to avoid habits or conduct that were detrimental to the health or well-being of your parents. Taking charge of your healthcare affairs means being proactive. Check it out on our Longevity Fixed Factors. Minding Your Healthcare Affairs - Get Help
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed. The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you. Some of the information focuses on fitness and health. Some focuses on medical service providers and options. Some focuses on the healthcare and governmental systems. And, some focuses on information that you don't know you don't know. When you're thrown into the healthcare system whirlpool, how can you know who to see, what to say or what questions to ask? How can you know what to do when your claim has been denied or your credit tarnished by unpaid medical bills you thought were covered? How can you find someone to be on your side in our complex healthcare system? You could enlist an experienced and trained family member or friend. Or, you could use professional healthcare advocacy and concierge services. You can learn more about it in our Patent Care Plan section. Permalink -- click for full blog post "Minding Your Healthcare Affairs - Get Help" Minding Your Healthcare Affairs - Next, Be Proactive
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed. The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you. Some of the information focuses on fitness and health. Some focuses on medical service providers and options. Some focuses on the healthcare and governmental systems. And, some focuses on information itself. Another program that offers early and continual benefits is the Medical Self Care Prevention program. This is an optional, low-cost information and advisory program that will help you evaluate and decide about health issues that you may encounter on an any day basis. A lot of money is wasted by uninformed and unmotivated patients who do not understand their symptoms. You don't have to be one of them. You can learn more about becoming an informed healthcare consumer in our Medical Self Care Prevention section. Permalink -- click for full blog post "Minding Your Healthcare Affairs - Next, Be Proactive" Minding Your Healthcare Affairs - First, Get Informed
No one will manage your healthcare affairs as well as you will - if you know how. So, get informed. The Fitness Culture Health Insurance.com website is, at its core, an information resource intended to help you know about, understand and be able to better utilize the healthcare system and health insurance options that are available to you. Some of the information focuses on fitness and health. Some focuses on medical service providers and options. Some focuses on the healthcare and governmental systems. And, some focuses on information itself. A program that offers early and continual benefits is the Medical Self Care Affairs Management program. This is an optional, low-cost information and advisory program that will help you evaluate and decide about medical cost and value issues when you are seeking or using healthcare services. It can help you simplify options and determine the appropriate cost of services commensurate with value. You can learn more about it in our Health Affairs Management section. Permalink -- click for full blog post "Minding Your Healthcare Affairs - First, Get Informed" US Medical Care - What's Right? What Can We Expect?
The World Health Organization (WHO) ranks healthcare systems around the globe based on criteria a bureaucrat can love. Measurements such as average life expectancy, infant mortality, per capita health expenditures, and number of doctors relative to population. WHO also supports government-controlled health systems. Based on WHO standards, the US ranks down the list for quality at 37th out of 191 nations. So, what has US healthcare done really well? It has the quickest, easiest access to care. It offers the greatest choice of healthcare providers. It offers the highest quality of care, especially for high tech and innovative treatment or surgery. It offer the most advanced medical research in the world. WHO may rate American healthcare far down its list, but healthcare consumers here and abroad, who can afford the best, rate US medical care as the best. Affordability has been one valid knock on US healthcare, because we do have the most expensive medical care. As Healthcare Reform Bill provisions take effect in the future, what can we expect? We can expect less access and longer waits for service. We can expect lower quality of care and less technical advancement. Finally, we can expect costs to go even higher, as we pay for all the government benefits and new insureds. In summary, we can expect to be more like everyone else in WHO's world. On the good side, we may rise higher on the WHO list. Permalink -- click for full blog post "US Medical Care - What's Right? What Can We Expect?" Healthcare Reform Impact - Price Controls Arrive
In a previous blog comment, we revealed that the Massachusetts state healthcare program, which Obamacare copied, cost far more than projected, but the state healthcare regulators refused to approve insurer applications for premium increases. Massachusetts officials sought to force insurers to provide insurance coverage at huge losses in order to maintain premium rates at the level state officials arbitrarily thought was reasonable. This is price control, pure and simple. It will have very predictable results. To avoid bankruptcy, the insurance carriers underwriting the Massachusetts healthcare program will withdraw, leaving no insurers and forcing taxpayers to cover the losses state officials have created by their manipulation of the free market. In another blog comment, we mentioned that the Healthcare Reform Bill seeks to pay $136 Billion of Obamacare cost by reducing Federal government support for the Medicare Advantage program that serves more than twenty percent of seniors on Medicare.
According to The Wall street Journal, HHS Secretary Sebelius notified insurance carriers this week that she would not approve new Medicare Advantage plans that sought to increase premiums to offset the reduced Federal support of Medicare Advantage that was redirected to cover Healthcare Reform costs. In fact, Sebelius threatened insurers if they seek to pass on higher costs. This is the same price control game plan that Massachusetts regulators followed. It will have the same result. Insurers will withdraw from the program rather than lose money on it. Higher costs will be borne by taxpayers. And, the only insurer left in the game will be the government. Of course, many opponents of Obamacare always thought this was Obama's objective . . . government-controlled and monopolized healthcare. If this program plays out, taxpayers will be left with higher costs, with reduced access to care and with lower quality of care. Permalink -- click for full blog post "Healthcare Reform Impact - Price Controls Arrive" Healthcare Reform Impact - Insurance Policy Changes
To date, June 7th, we have heard much conversation and speculation about the impact the 2010 Healthcare Reform Bill will have on insurers and insureds. Today, we got the first concrete step of change when we received notice from one of our insurance carriers that they are making an immediate change in underwriting policy, as follows:
"Effective immediately, we have implemented new underwriting guidelines for enrollees under the age of 19. For every offer we extend, we will no longer apply condition-specific deductibles or exclude coverage with special exception riders. Instead, premiums will be adjusted based on pre-existing conditions allowing these enrollees to enjoy full advantage of their policy benefits. "
What does this mean? Well, a provision of the Healthcare Reform Bill prohibits exclusions for dependent children under the age of 19 for pre-existing conditions beginning this month. So, enrollees under age 19 will be covered without special exception or exclusion riders, but premiums may be increased based on condition assessment by underwriters. This will have no effect on other underwriting standards for those up to age19.
Also, it will have no effect on any underwriting standards for individuals over age 19. What about pre existing conditions for those over 19? The Healthcare Reform Bill prohibits pre-existing condition exclusions for everyone else effective January 1, 2014. Even then, it does not prevent insurance companies from charging higher premiums to cover such pre-existing conditions. However, state and Federal regulators will have to approve future rate increases.
What about those with pre-existing conditions who can not secure insurance or who can not get coverage at an affordable premium until 2014? Beginning later this year, they can seek coverage through the Federal-subsidized high-risk pool, provided they have not been insured for at least six months. Permalink -- click for full blog post "Healthcare Reform Impact - Insurance Policy Changes" Health Reform Impact - How Will Restrictions Affect Physicians?
As health insurance companies may be a favorite target for politicians, physicians may be a favorite target for government regulators, for insurance companies and for hospital and health management services.
Present administrative burdens forced on physician practices by government and insurance requirements already eat away more than 60 percent of the annual revenue generated by the average medical practice. Reduced fee rates for Medicare patients, as prescribed by the healthcare reform bill, could force many physicians to discontinue accepting Medicare patients.
The new healthcare reform bill requires that medical practices buy and implement Internet Technology systems to standardize and maintain more records. Such IT systems do not come cheaply and are not inexpensive to operate.
Medical malpractice insurance premiums have risen by ten to twenty percent per year. In the absence of liability reform, this is just another brick, although a large brick, that physicians must carry. Their burden is simply getting too heavy.
As a result, many experienced doctors are considering retirement or selling their practices and either going to a salary basis or just getting out of medicine. Who's buying? Hospital systems, healthcare management systems, maybe some insurance companies who see an opportunity to reduce and better control their costs for medical care services.
Five years ago, only about 25 percent of physician positions were salaried. This year, it is reported to be about 50 percent. By next year, it is forecast that 60 percent will be salaried.
Will salaried physicians, who have no vested interest in their practice, be less dedicated and involved in the care they provide? On the surface, I would say no. However, based on personal experience with government doctors compared to private practice doctors, I would take the private practice doctors every time. If you don't have the choice, you'll have to take what you can get. Healthcare Reform Impact - How Will Restrictions Affect Health Insurers?
Health insurance companies typically need about eight percent of premium to cover administrative costs for group plans, maybe ten percent or more to administer individual and family plans. Insurers may spend another ten to twelve percent on marketing and promotion. The typical allocation for claims expense may be seventy to seventy five percent. Of course, there are taxes and government fees.
On average, health insurers operate on a profit margin of about four percent, give or take a little and depending on market conditions. The healthcare reform bill will squeeze that margin. New regulations and restrictions on health insurance companies will force the smaller and weaker carriers out of business or out of the health insurance market. Whether or not that was the intent of healthcare reform advocates is a topic of debate.
Healthcare Reform legislation requires health insurers to spend 80 percent of individual or family plan premium on medical expense claims, 85 percent of group premium on claims. It also requires insurers to broaden coverage to include costs of preventative and other services that may not previously have been covered.
These regulations will force insurers to become more efficient in their administration. They will also force insurers to cut services in other areas, to reduce profits and to eliminate non-required plan features. Some of these restrictive steps will be forced by future regulations built into the healthcare reform bill. If insurers can not spend the money necessary to implement and promote new plans, new plans will not be offered. Insurers will be forced to standardize health plan designs. This will result in narrower and more restrictive options for consumers.
Insurers are already beginning to take steps to reduce their physician networks and to restrict optional services. Expect insurers to offer fewer plans, fewer services that are not required and smaller, more restricted areas of coverage. All of this will mean lower standards of services and reduced access for consumers.
Will the new government exchanges fill the gap? In theory, perhaps, but government programs do not compare well with private programs. Given free choice, consumers almost always choose the non-government option. The problem will be that consumer choice will become limited. The ultimate problem might be the absence of any non-government option. Healthcare Reform Impact - Higher Cost and More Restrictions - Why?
Many analysts of healthcare reform have concluded that this new government program, which had the expressed objectives of reducing medical cost and expanding health insurance coverage will have the opposite effects. Why is that?
The obvious answer to that question is that the healthcare reform bill provides for expanding health insurance coverage to people who have pre-existing medical conditions and/or who can not afford health insurance at normal rates. The law requires that those with health problems must be given insurance and provides for subsidizing premiums for insureds who would normally require higher rates. One effect of these demands is to increase cost of medical care because less healthy patients will be seeking it. A second effect is to spread the existing supply of medical services across a larger number of patients, thus requiring rationing of access to services or rationing of services themselves or both.
The lawmakers anticipated that their new requirements would cost more and that health insurers would offset such higher costs by charging more. So, the politicians sought to cut the insurance companies off at the pass by requiring them to reduce their non-medical expenses and to reduce profit margins while also paying for more medical and preventive services. They also required an additional future layer of governmental regulatory oversight to approve or disapprove future insurance premiums.
Lawmakers correctly assumed that the American public would not sympathize with insurance companies, So, they should have no problem turning the screws on insurers. Of course, the big problem with such a government control strategy is always those unintended consequences that both reduce services and drive up costs.
The insurance companies are certainly having to scramble in order to comply with new or coming government regulations. Their biggest challenge will be to maintain operational feasibility and financial survival. Smaller and weaker insurers will have difficulty. Some will bankrupt. Insurance plans will certainly become more restrictive. Fewer insurance companies will reduce competition, further restricting choice and increasing cost.
In seeking options for relief from restrictions imposed by healthcare reform, many insurers and large medical services providers are buying up medical practices and smaller suppliers of medical products and services. Their intent is both horizontal and vertical consolidation of services they routinely use and that are not cost restricted under healthcare reform. Their objectives are to better control and reduce their medical services costs and to increase permissible profit margins.
The net effects for patients, however, will be higher costs and more restricted services. Healthcare Reform Impact - Individual and Family Plans
Healthcare consumers who buy insurance coverage in the individual or family plan market will see some coverage benefits beginning October 1, 2010, when insurers will be restricted from placing lifetime limits on the value of coverages and from revoking existing coverage.
Individuals who have preexisting conditions and who have been uninsured for at least six months will be eligible to enroll in an interim national high-risk pool which benefits from subsidized premiums through the Federal program. Beginning January 1, 2014, insurers must start accepting all applicants, including those with preexisting medical conditions.
The interim federal-subsidized high-risk pool which will be in effect from 2010 until 2014 will offer premium subsidies capped at $5,950 for individuals and $11,900 for families. It will be administered through states that agree to participate (see previous Blog entry on State High Risk Pools). It may be especially beneficial for residents of the 18 states that do not presently have high risk pools.
However, consumers with preexisting conditions who are now covered under existing state high-risk pool programs will be penalized by the requirement that they not have coverage for at least six months in order to qualify for the federal plan. The subsidy feature of the federal plan could leave those currently covered under high-risk programs trapped in a more expensive plan. Permalink -- click for full blog post "Healthcare Reform Impact - Individual and Family Plans"
|
