Australians already know that health coverage can provide security for individuals and families when a medical need arises. Many, however, do not know how to find the best value when comparing health insurance policies.
Below are 10 tips everyone should read before shopping for private health coverage.
1. Choose coverage that concentrates on your specific health needs, or potential health needs.
The first thing you should do before comparing your health plan options is determine which policy features best fit your needs. A 30-year-old accountant, for instance, is going to need very different coverage than a 55year-old pro golfer, or a 75-year-old retired veterinarian. By understanding the health needs that most often correspond to people in your age and activity level group – your life stage – you can save money by purchasing only the coverage you need and avoid unnecessary services that aren’t relevant. For instance, a young family with two small children isn’t going to need coverage for joint replacement or cataract surgery. A 60-year-old school teacher isn’t going to need pregnancy and birth control-related services.
Whether it’s high level comprehensive care you’re after, or the least expensive option to exempt you from the Medical Levy Surcharge while providing basic care coverage, always make sure you’re comparing health insurance policies with only those services that make sense for you and your family.
2. Consider options such as Excess or Co-payment to reduce your premium costs.
When you agree to pay for a specified out-of-pocket amount in the event you are hospitalized, you sign an Excess or Co-payment option that will reduce your health insurance premium.
If you choose the Excess option, you agree to pay a predetermined, specific amount when you go to hospital, no matter how long your stay lasts. With a Co-payment option, you agree to pay a daily sum up to a pre-agreed amount. For example, if Joanne has an Excess of $250 on her medical coverage policy and is admitted to hospital, regardless of how long her stay turns out to be, she will pay $250 of the final bill. If Andrew has signed a $75×4 Co-payment with his provider, he will pay $75 per day for just the first the first four days of his hospitalization.
For younger individuals who are healthy and fit with no reason to expect to land in hospital any time soon, either of these options are great ways to reduce the monthly cost of your medical insurance premiums.
Keep in mind that different private insurers have their own rules when it comes to Excess and Co-payments, including how many payments you will need to make annually on either option. It is important to read the policy thoroughly and ask questions in advance in order to have a clear understanding of what you are paying for, and what you can expect coverage-wise in the event that you are hospitalized. Also, make sure you choose an Excess option greater than $500 if you’re purchasing an individual policy, or $1,000 for family coverage, in order to be exempted from the Medicare Levy Surcharge.
3. Pay your health insurance premium in advance before the cost increases.
Each year insurance providers increase their premiums by approximately five percent sometime around the first of April, a practice approved by the Minister of Health. By instituting these annual increases, your health insurance provider retains the ability to fulfill their obligations to policyholders despite increasing medical costs.
Most private medical policy providers allow policy holders to pay for one year’s premium in advance, which locks them into the previous year’s rate for an additional 12 months – a great way to save money. In order to take advantage of the savings offered, most insurers require payment in full be made within the first quarter of the year, between January and March.
4. Lock in to low cost health insurance at an early age.
The most obvious advantage any Australian can take when it comes to saving money on your insurance premiums is to buy in early to the least expensive rate available. And by early, we mean before age 31. Everyone who is eligible for Medicare will receive at least a 30 percent rebate from the government on the price of their health care premium, no matter what age you are. However, by purchasing hospital coverage before the July first following your 31st birthday, you can be ensured the lowest premium rate available.
After age 31, your health insurance rate is subjected to a two percent penalty rate increase for every year after age 30 that you did not have health insurance. Therefore, if you wait to purchase private health coverage until you’re age 35, you will pay 10 percent more annually than you would have if you had purchased it at age 30.
There are exemptions for some people who were overseas when they turned 30, or for new immigrants, and certain others under special exception status. However, if you purchased private insurance after age 30 and are paying an age loading penalty on your health coverage, you will be relieved of the excess penalty after 10 years of continual coverage.
The earlier in life that you lock in to a private health plan, the more money you will save both immediately and over your lifetime.
5. Choose a health care provider who already works with your health fund.
Determine which hospital you prefer if and when the need for treatment does arise, and seek out those health insurance providers that have an agreement with your hospital of choice before making a decision on your health insurance purchase.
It’s a good idea to also find out if your insurer has a list of “preferred providers,” which would include those physicians and practitioners who also have made arrangements with the health funds regarding their charges for services. Request this information from every provider when comparing health insurance policies. This way you can be sure you’ll receive the full gamut of benefits available at the lowest possible cost. These preferred providers often have “no gap” cover – special rates that reduce or eliminate out-of-pocket expenses to policyholders.
6. Double check your health insurance policy before you schedule any treatment or procedures to make sure you have coverage.
Any time you are headed to a private hospital for treatment, first check to see if the hospital and your health insurance provider have an agreement to be absolutely sure you have adequate coverage. At the same time, check with your insurance provider, physician and the hospital to see if there is a Gap between their fees and the government’s Medicare Benefits. This is extremely important because if your physician charges more than Medicare covers and you do not have a “no Gap” plan set up, you could find yourself responsible for a considerable bill. Simply contact your doctor and your insurance company to double check on these items, and avoid being saddled with an out-of-pocket expense your weren’t expecting.
7. File your expense claims promptly.
When you have a health insurance membership card, you can file a claim against your benefits at the time of treatment with no additional paperwork or filing to worry about, at least in most cases. Sometimes, you may still need to file a claim with your insurance provider. When that happens, make sure to file your claim promptly. The typical cut off for insurers to pay health care claims is two years. You can file your health insurance claim directly with your provider or at your area Medicare office, which has a reciprocal agreement in place with most insurance providers.
8. Whenever you travel overseas, suspend your health coverage.
Anytime you travel overseas for more than a few weeks but less than 24 months, certain medical insurance providers allow policyholders to suspend their memberships for the time they’re out of the country, freeing the policyholders from paying premiums during that time period. While your insurance policy is suspended, your Lifetime Health Cover status remains intact, so you do not have to worry about age loading added when you return home. Contact your health insurance provider to make sure of their policy and rules regarding waiting periods and re-activation.
Remember too that Australia has reciprocal arrangements in certain countries, including New Zealand, Finland, Ireland, Italy, Malta, the Netherlands, Sweden and the U.K. For more information, visit http://www.smartraveller.gov.au.
9. Review your policy benefits annually.
Lifestyles change, individuals get married, have children, age – children grow up and move out on their own, couples separate. A lot can happen in the span of 12 months, which is why the Private Health Insurance Ombudsman recommends that everyone review their policy benefits once every year to make sure your coverage still fits your needs.
Regardless of your life changes, your Lifetime Health Cover status remains protected, and waiting periods for benefits that equal your current coverage are waived in compliance with the Private Health Insurance Act of 2007. This means you will be able to file claims related to features you had before you made any changes without interruption in benefits.
10. Compare policies to get the best price and the coverage you need.
To make sure that you are getting the best possible price on your health insurance premium, you must compare policies from different insurers, Make sure you are comparing policies that reflect the treatment plan and coverage you need, without filler services that you won’t need. The more you know about private health coverage and government sponsored Medicare, the more likely you will find the best value for your money when it comes time to purchasing or renewing your health coverage.
Author Liz Ernst writes on health insurance matters in Australia and the U.S.
Private health insurance is a cost Australians should at least consider factoring into their budget. Different funds have products that better suit different groups of people. Visit the Your Health Insurance website (http://www.yourhealthinsurance.com.au) to compare pricing and policies, and learn more about buying health insurance in Australia.
It really does pay to shop for health insurance.
With all the shouting going on about America’s health care crisis, many are probably finding it difficult to concentrate, much less understand the cause of the problems confronting us. I find myself dismayed at the tone of the discussion (though I understand it—people are scared) as well as bemused that anyone would presume themselves sufficiently qualified to know how to best improve our health care system simply because they’ve encountered it, when people who’ve spent entire careers studying it (and I don’t mean politicians) aren’t sure what to do themselves.
Albert Einstein is reputed to have said that if he had an hour to save the world he’d spend 55 minutes defining the problem and only 5 minutes solving it. Our health care system is far more complex than most who are offering solutions admit or recognize, and unless we focus most of our efforts on defining its problems and thoroughly understanding their causes, any changes we make are just likely to make them worse as they are better.
Though I’ve worked in the American health care system as a physician since 1992 and have seven year’s worth of experience as an administrative director of primary care, I don’t consider myself qualified to thoroughly evaluate the viability of most of the suggestions I’ve heard for improving our health care system. I do think, however, I can at least contribute to the discussion by describing some of its troubles, taking reasonable guesses at their causes, and outlining some general principles that should be applied in attempting to solve them.
THE PROBLEM OF COST
No one disputes that health care spending in the U.S. has been rising dramatically. According to the Centers for Medicare and Medicaid Services (CMS), health care spending is projected to reach $8,160 per person per year by the end of 2009 compared to the $356 per person per year it was in 1970. This increase occurred roughly 2.4% faster than the increase in GDP over the same period. Though GDP varies from year-to-year and is therefore an imperfect way to assess a rise in health care costs in comparison to other expenditures from one year to the next, we can still conclude from this data that over the last 40 years the percentage of our national income (personal, business, and governmental) we’ve spent on health care has been rising.
Despite what most assume, this may or may not be bad. It all depends on two things: the reasons why spending on health care has been increasing relative to our GDP and how much value we’ve been getting for each dollar we spend.
WHY HAS HEALTH CARE BECOME SO COSTLY?
This is a harder question to answer than many would believe. The rise in the cost of health care (on average 8.1% per year from 1970 to 2009, calculated from the data above) has exceeded the rise in inflation (4.4% on average over that same period), so we can’t attribute the increased cost to inflation alone. Health care expenditures are known to be closely associated with a country’s GDP (the wealthier the nation, the more it spends on health care), yet even in this the United States remains an outlier (figure 3).
Is it because of spending on health care for people over the age of 75 (five times what we spend on people between the ages of 25 and 34)? In a word, no. Studies show this demographic trend explains only a small percentage of health expenditure growth.
Is it because of monstrous profits the health insurance companies are raking in? Probably not. It’s admittedly difficult to know for certain as not all insurance companies are publicly traded and therefore have balance sheets available for public review. But Aetna, one of the largest publicly traded health insurance companies in North America, reported a 2009 second quarter profit of $346.7 million, which, if projected out, predicts a yearly profit of around $1.3 billion from the approximately 19 million people they insure. If we assume their profit margin is average for their industry (even if untrue, it’s unlikely to be orders of magnitude different from the average), the total profit for all private health insurance companies in America, which insured 202 million people (2nd bullet point) in 2007, would come to approximately $13 billion per year. Total health care expenditures in 2007 were $2.2 trillion (see Table 1, page 3), which yields a private health care industry profit approximately 0.6% of total health care costs (though this analysis mixes data from different years, it can perhaps be permitted as the numbers aren’t likely different by any order of magnitude).
Is it because of health care fraud? Estimates of losses due to fraud range as high as 10% of all health care expenditures, but it’s hard to find hard data to back this up. Though some percentage of fraud almost certainly goes undetected, perhaps the best way to estimate how much money is lost due to fraud is by looking at how much the government actually recovers. In 2006, this was $2.2 billion, only 0.1% of $2.1 trillion (see Table 1, page 3) in total health care expenditures for that year.
Is it due to pharmaceutical costs? In 2006, total expenditures on prescription drugs was approximately $216 billion (see Table 2, page 4). Though this amounted to 10% of the $2.1 trillion (see Table 1, page 3) in total health care expenditures for that year and must therefore be considered significant, it still remains only a small percentage of total health care costs.
Is it from administrative costs? In 1999, total administrative costs were estimated to be $294 billion, a full 25% of the $1.2 trillion (Table 1) in total health care expenditures that year. This was a significant percentage in 1999 and it’s hard to imagine it’s shrunk to any significant degree since then.
In the end, though, what probably has contributed the greatest amount to the increase in health care spending in the U.S. are two things:
1. Technological innovation.
2. Overutilization of health care resources by both patients and health care providers themselves.
Technological innovation. Data that proves increasing health care costs are due mostly to technological innovation is surprisingly difficult to obtain, but estimates of the contribution to the rise in health care costs due to technological innovation range anywhere from 40% to 65% (Table 2, page 8). Though we mostly only have empirical data for this, several examples illustrate the principle. Heart attacks used to be treated with aspirin and prayer. Now they’re treated with drugs to control shock, pulmonary edema, and arrhythmias as well as thrombolytic therapy, cardiac catheterization with angioplasty or stenting, and coronary artery bypass grafting. You don’t have to be an economist to figure out which scenario ends up being more expensive. We may learn to perform these same procedures more cheaply over time (the same way we’ve figured out how to make computers cheaper) but as the cost per procedure decreases, the total amount spent on each procedure goes up because the number of procedures performed goes up. Laparoscopic cholecystectomy is 25% less than the price of an open cholecystectomy, but the rates of both have increased by 60%. As technological advances become more widely available they become more widely used, and one thing we’re great at doing in the United States is making technology available.
Overutilization of health care resources by both patients and health care providers themselves. We can easily define overutilization as the unnecessary consumption of health care resources. What’s not so easy is recognizing it. Every year from October through February the majority of patients who come into the Urgent Care Clinic at my hospital are, in my view, doing so unnecessarily. What are they coming in for? Colds. I can offer support, reassurance that nothing is seriously wrong, and advice about over-the-counter remedies—but none of these things will make them better faster (though I often am able to reduce their level of concern). Further, patients have a hard time believing the key to arriving at a correct diagnosis lies in history gathering and careful physical examination rather than technologically-based testing (not that the latter isn’t important—just less so than most patients believe). Just how much patient-driven overutilization costs the health care system is hard to pin down as we have mostly only anecdotal evidence as above.
Further, doctors often disagree among themselves about what constitutes unnecessary health care consumption. In his excellent article, “The Cost Conundrum,” Atul Gawande argues that regional variation in overutilization of health care resources by doctors best accounts for the regional variation in Medicare spending per person. He goes on to argue that if doctors could be motivated to rein in their overutilization in high-cost areas of the country, it would save Medicare enough money to keep it solvent for 50 years.
A reasonable approach. To get that to happen, however, we need to understand why doctors are overutilizing health care resources in the first place:
1. Judgment varies in cases where the medical literature is vague or unhelpful. When faced with diagnostic dilemmas or diseases for which standard treatments haven’t been established, a variation in practice invariably occurs. If a primary care doctor suspects her patient has an ulcer, does she treat herself empirically or refer to a gastroenterologist for an endoscopy? If certain “red flag” symptoms are present, most doctors would refer. If not, some would and some wouldn’t depending on their training and the intangible exercise of judgment.
2. Inexperience or poor judgment. More experienced physicians tend to rely on histories and physicals more than less experienced physicians and consequently order fewer and less expensive tests. Studies suggest primary care physicians spend less money on tests and procedures than their sub-specialty colleagues but obtain similar and sometimes even better outcomes.
3. Fear of being sued. This is especially common in Emergency Room settings, but extends to almost every area of medicine.
4. Patients tend to demand more testing rather than less. As noted above. And physicians often have difficulty refusing patient requests for many reasons (eg, wanting to please them, fear of missing a diagnosis and being sued, etc).
5. In many settings, overutilization makes doctors more money. There exists no reliable incentive for doctors to limit their spending unless their pay is capitated or they’re receiving a straight salary.
Gawande’s article implies there exists some level of utilization of health care resources that’s optimal: use too little and you get mistakes and missed diagnoses; use too much and excess money gets spent without improving outcomes, paradoxically sometimes resulting in outcomes that are actually worse (likely as a result of complications from all the extra testing and treatments).
How then can we get doctors to employ uniformly good judgment to order the right number of tests and treatments for each patient—the “sweet spot”—in order to yield the best outcomes with the lowest risk of complications? Not easily. There is, fortunately or unfortunately, an art to good health care resource utilization. Some doctors are more gifted at it than others. Some are more diligent about keeping current. Some care more about their patients. An explosion of studies of medical tests and treatments has occurred in the last several decades to help guide doctors in choosing the most effective, safest, and even cheapest ways to practice medicine, but the diffusion of this evidence-based medicine is a tricky business. Just because beta blockers, for example, have been shown to improve survival after heart attacks doesn’t mean every physician knows it or provides them. Data clearly show many don’t. How information spreads from the medical literature into medical practice is a subject worthy of an entire post unto itself. Getting it to happen uniformly has proven extremely difficult.
In summary, then, most of the increase in spending on health care seems to have come from technological innovation coupled with its overuse by doctors working in systems that motivate them to practice more medicine rather than better medicine, as well as patients who demand the former thinking it yields the latter.
But even if we could snap our fingers and magically eliminate all overutilization today, health care in the U.S. would still remain among the most expensive in the world, requiring us to ask next—
WHAT VALUE ARE WE GETTING FOR THE DOLLARS WE SPEND?
According to an article in the New England Journal of Medicine titled The Burden of Health Care Costs for Working Families—Implications for Reform, growth in health care spending “can be defined as affordable as long as the rising percentage of income devoted to health care does not reduce standards of living. When absolute increases in income cannot keep up with absolute increases in health care spending, health care growth can be paid for only by sacrificing consumption of goods and services not related to health care.” When would this ever be an acceptable state of affairs? Only when the incremental cost of health care buys equal or greater incremental value. If, for example, you were told that in the near future you’d be spending 60% of your income on health care but that as a result you’d enjoy, say, a 30% chance of living to the age of 250, perhaps you’d judge that 60% a small price to pay.
This, it seems to me, is what the debate on health care spending really needs to be about. Certainly we should work on ways to eliminate overutilization. But the real question isn’t what absolute amount of money is too much to spend on health care. The real question is what are we getting for the money we spend and is it worth what we have to give up?
People alarmed by the notion that as health care costs increase policymakers may decide to ration health care don’t realize that we’re already rationing at least some of it. It just doesn’t appear as if we are because we’re rationing it on a first-come-first-serve basis—leaving it at least partially up to chance rather than to policy, which we’re uncomfortable defining and enforcing. Thus we don’t realize the reason our 90 year-old father in Illinois can’t have the liver he needs is because a 14 year-old girl in Alaska got in line first (or maybe our father was in line first and gets it while the 14 year-old girl doesn’t). Given that most of us remain uncomfortable with the notion of rationing health care based on criteria like age or utility to society, as technological innovation continues to drive up health care spending, we very well may at some point have to make critical judgments about which medical innovations are worth our entire society sacrificing access to other goods and services (unless we’re so foolish as to repeat the critical mistake of believing we can keep borrowing money forever without ever having to pay it back).
So what value are we getting? It varies. The risk of dying from a heart attack has declined by 66% since 1950 as a result of technological innovation. Because cardiovascular disease ranks as the number one cause of death in the U.S. this would seem to rank high on the scale of value as it benefits a huge proportion of the population in an important way. As a result of advances in pharmacology, we can now treat depression, anxiety, and even psychosis far better than anyone could have imagined even as recently as the mid-1980’s (when Prozac was first released). Clearly, then, some increases in health care costs have yielded enormous value we wouldn’t want to give up.
But how do we decide whether we’re getting good value from new innovations? Scientific studies must prove the innovation (whether a new test or treatment) actually provides clinically significant benefit (Aricept is a good example of a drug that works but doesn’t provide great clinical benefit—demented patients score higher on tests of cognitive ability while on it but probably aren’t significantly more functional or significantly better able to remember their children compared to when they’re not). But comparative effectiveness studies are extremely costly, take a long time to complete, and can never be perfectly applied to every individual patient, all of which means some health care provider always has to apply good medical judgment to every patient problem.
Who’s best positioned to judge the value to society of the benefit of an innovation—that is, to decide if an innovation’s benefit justifies its cost? I would argue the group that ultimately pays for it: the American public. How the public’s views could be reconciled and then effectively communicated to policy makers efficiently enough to affect actual policy, however, lies far beyond the scope of this post (and perhaps anyone’s imagination).
THE PROBLEM OF ACCESS
A significant proportion of the population is uninsured or underinsured, limiting or eliminating their access to health care. As a result, this group finds the path of least (and cheapest) resistance—emergency rooms—which has significantly impaired the ability of our nation’s ER physicians to actually render timely emergency care. In addition, surveys suggest a looming primary care physician shortage relative to the demand for their services. In my view, this imbalance between supply and demand explains most of the poor customer service patients face in our system every day: long wait times for doctors’ appointments, long wait times in doctors’ offices once their appointment day arrives, then short times spent with doctors inside exam rooms, followed by difficulty reaching their doctors in between office visits, and finally delays in getting test results. This imbalance would likely only partially be alleviated by less health care overutilization by patients.
GUIDELINES FOR SOLUTIONS
As Freaknomics authors Steven Levitt and Stephen Dubner state, “If morality represents how people would like the world to work, then economics represents how it actually does work.” Capitalism is based on the principle of enlightened self-interest, a system that creates incentives to yield behavior that benefits both suppliers and consumers and thus society as a whole. But when incentives get out of whack, people begin to behave in ways that continue to benefit them often at the expense of others or even at their own expense down the road. Whatever changes we make to our health care system (and there’s always more than one way to skin a cat), we must be sure to align incentives so that the behavior that results in each part of the system contributes to its sustainability rather than its ruin.
Here then is a summary of what I consider the best recommendations I’ve come across to address the problems I’ve outlined above:
1. Change the way insurance companies think about doing business. Insurance companies have the same goal as all other businesses: maximize profits. And if a health insurance company is publicly traded and in your 401k portfolio, you want them to maximize profits, too. Unfortunately, the best way for them to do this is to deny their services to the very customers who pay for them. It’s harder for them to spread risk (the function of any insurance company) relative to say, a car insurance company, because far more people make health insurance claims than car insurance claims. It would seem, therefore, from a consumer perspective, the private health insurance model is fundamentally flawed. We need to create a disincentive for health insurance companies to deny claims (or, conversely, an extra incentive for them to pay them). Allowing and encouraging aross-state insurance competition would at least partially engage free market forces to drive down insurance premiums as well as open up new markets to local insurance companies, benefiting both insurance consumers and providers. With their customers now armed with the all-important power to go elsewhere, health insurance companies might come to view the quality with which they actually provide service to their customers (ie, the paying out of claims) as a way to retain and grow their business. For this to work, monopolies or near-monopolies must be disbanded or at the very least discouraged. Even if it does work, however, government will probably still have to tighten regulation of the health insurance industry to ensure some of the heinous abuses that are going on now stop (for example, insurance companies shouldn’t be allowed to stratify consumers into sub-groups based on age and increase premiums based on an older group’s higher average risk of illness because healthy older consumers then end up being penalized for their age rather than their behaviors). Karl Denninger suggests some intriguing ideas in a post on his blog about requiring insurance companies to offer identical rates to businesses and individuals as well as creating a mandatory “open enrollment” period in which participants could only opt in or out of a plan on a yearly basis. This would prevent individuals from only buying insurance when they got sick, eliminating the adverse selection problem that’s driven insurance companies to deny payment for pre-existing conditions. I would add that, however reimbursement rates to health care providers are determined in the future (again, an entire post unto itself), all health insurance plans, whether private or public, must reimburse health care providers by an equal percentage to eliminate the existence of “good” and “bad” insurance that’s currently responsible for motivating hospitals and doctors to limit or even deny service to the poor and which may be responsible for the same thing occurring to the elderly in the future (Medicare reimburses only slightly better than Medicaid). Finally, regarding the idea of a “public option” insurance plan open to all, I worry that if it’s significantly cheaper than private options while providing near-equal benefits the entire country will rush to it en masse, driving private insurance companies out of business and forcing us all to subsidize one another’s health care with higher taxes and fewer choices; yet at the same time if the cost to the consumer of a “public option” remains comparable to private options, the very people it’s meant to help won’t be able to afford it.
2. Motivate the population to engage in healthier lifestyles that have been proven to prevent disease. Prevention of disease probably saves money, though some have argued that living longer increases the likelihood of developing diseases that wouldn’t have otherwise occurred, leading to the overall consumption of more health care dollars (though even if that’s true, those extra years of life would be judged by most valuable enough to justify the extra cost. After all, the whole purpose of health care is to improve the quality and quantity of life, not save society money. Let’s not put the cart before the horse). However, the idea of preventing a potentially bad outcome sometime in the future is only weakly motivating psychologically, explaining why so many people have so much trouble getting themselves to exercise, eat right, lose weight, stop smoking, etc. The idea of financially rewarding desirable behavior and/or financially punishing undesirable behavior is highly controversial. Though I worry this kind of strategy risks the enacting of policies that may impinge on basic freedoms if taken too far, I’m not against thinking creatively about how we could leverage stronger motivational forces to help people achieve health goals they themselves want to achieve. After all, most obese people want to lose weight. Most smokers want to quit. They might be more successful if they could find more powerful motivation.
3. Decrease overutilization of health care resources by doctors. I’m in agreement with Gawande that finding ways to get doctors to stop overutilizing health care resources is a worthy goal that will significantly rein in costs, that it will require a willingness to experiment, and that it will take time. Further, I agree that focusing only on who pays for our health care (whether the public or private sectors) will fail to address the issue adequately. But how exactly can we motivate doctors, whose pens are responsible for most of the money spent on health care in this country, to focus on what’s truly best for their patients? The idea that external bodies—whether insurance companies or government panels—could be used to set standards of care doctors must follow in order to control costs strikes me as ludicrous. Such bodies have neither the training nor overriding concern for patients’ welfare to be trusted to make those judgments. Why else do we have doctors if not to employ their expertise to apply nuanced approaches to complex situations? As long as they work in a system free of incentives that compete with their duty to their patients, they remain in the best position to make decisions about what tests and treatments are worth a given patient’s consideration, as long as they’re careful to avoid overconfident paternalism (refusing to obtain a head CT for a headache might be overconfidently paternalistic; refusing to offer chemotherapy for a cold isn’t). So perhaps we should eliminate any financial incentive doctors have to care about anything but their patients’ welfare, meaning doctors’ salaries should be disconnected from the number of surgeries they perform and the number of tests they order, and should instead be set by market forces. This model already exists in academic health care centers and hasn’t seemed to promote shoddy care when doctors feel they’re being paid fairly. Doctors need to earn a good living to compensate for the years of training and massive amounts of debt they amass, but no financial incentive for practicing more medicine should be allowed to attach itself to that good living.
4. Decrease overutilization of health care resources by patients. This, it seems to me, requires at least three interventions:
* Making available the right resources for the right problems (so that patients aren’t going to the ER for colds, for example, but rather to their primary care physicians). This would require hitting the “sweet spot” with respect to the number of primary care physicians, best at front-line gatekeeping, not of health care spending as in the old HMO model, but of triage and treatment. It would also require a recalculating of reimbursement levels for primary care services relative to specialty services to encourage more medical students to go into primary care (the reverse of the alarming trend we’ve been seeing for the last decade).
* A massive effort to increase the health literacy of the general public to improve its ability to triage its own complaints (so patients don’t actually go anywhere for colds or demand MRIs of their backs when their trusted physicians tells them it’s just a strain). This might be best accomplished through a series of educational programs (though given that no one in the private sector has an incentive to fund such programs, it might actually be one of the few things the government should—we’d just need to study and compare different educational programs and methods to see which, if any, reduce unnecessary patient utilization without worsening outcomes and result in more health care savings than they cost).
* Redesigning insurance plans to make patients in some way more financially liable for their health care choices. We can’t have people going bankrupt due to illness, nor do we want people to underutilize health care resources (avoiding the ER when they have chest pain, for example), but neither can we continue to support a system in which patients are actually motivated to overutilize resources, as the current “pre-pay for everything” model does.
Given the enormous complexity of the health care system, no single post could possibly address every problem that needs to be fixed. Significant issues not raised in this article include the challenges associated with rising drug costs, direct-to-consumer marketing of drugs, end-of-life care, sky-rocketing malpractice insurance costs, the lack of cost transparency that enables hospitals to paradoxically charge the uninsured more than the insured for the same care, extending health care insurance coverage to those who still don’t have it, improving administrative efficiency to reduce costs, the implementation of electronic medical records to reduce medical error, the financial burden of businesses being required to provide their employees with health insurance, and tort reform. All are profoundly interdependent, standing together like the proverbial house of cards. To attend to any one is to affect them all, which is why rushing through health care reform without careful contemplation risks unintended and potentially devastating consequences. Change does need to come, but if we don’t allow ourselves time to think through the problems clearly and cleverly and to implement solutions in a measured fashion, we risk bringing down that house of cards rather than cementing it.
Article Source: http://EzineArticles.com/2772660
Two days are never the same in this industry and whatever you fabricate or deliver identified with wellbeing one needs to keep future in sight and keep the items reasonable and in addition result successful. We as a whole know and comprehend that nobody may ever wish to trade off on wellbeing benchmarks and this is something which every individual merits. In spite of the fact that this is a truth that in a nation like India even essential wellbeing offices are not set up so we can’t dream or envision about solaces or appropriate consideration. However individuals who can bear the cost of it and can offer self the best restorative consideration for them there is bounty in accessibility and at the solace of at whatever time and anyplace.
Since this industry has never witnessed recession more and more manufacturers are joining the league and with the population growth in our country one can be rest assured that health industry is there to grow and the demand for health and health related products will multiply with each passing day. Thus to offer a new meaning to health care many companies with innovative and much needed services have been launched in market which are doing pretty well and are redefining health industry and services in a big way. Now health care is not restricted to just hospitals, nursing homes and Government health care centres but one can afford it right at the comfort of his own home. There are companies offering home health care Delhi to individuals who need it and can afford it easily. Earlier this was a distant dream and whether possible or not one had to visit a hospital for a proper check up and medication which is no longer a story now.
This company offering the best of medical services at home in Delhi has meaningful tie-ups with medical equipment suppliers and thus can offer any kind of medical equipment which one needs for patient care at home. Not only individuals but there are few health centres who need medical equipments either on temporary or permanent basis can seek help from this company and procure them at the best market rates. This is only possible with the company’s vision to be the best preferred healthcare partner to set highest standards of quality and comprehensive healthcare to people at their doorsteps. They have the best of sleep diagnostic, respiratory home care Delhi, medical equipments for sale, rent, service and support and Bio resonance therapy support.
So if you are looking for any kind of testing to be done at home or wish to know the CPAP machine price in Delhi all you need to do is get in touch with the concerned person with this health care company and you will get the right help and support just in time. Health is the most important thing for any human being and being in this industry there cannot be a second though on compromising on quality and thus the best service, right equipments and excellent service is something which will pave the way for more success and adding value to human health.
This subject may strike some as offensive, but an attack of hemorrhoids is one of the most common conditions suffered by Americans. Although hemorrhoids are partially hereditary; they can also be caused; and remedied, by things such as diet and toilet habits.
Hemorrhoids, also known as piles, are those inflamed and widened veins that look like purple skin growths around the anus. This condition tends to run in families, either because they acquire similar personal habits that worsen the problem or they inherit delicate veins.
They can also be caused by allergies, constipation, heavy lifting, improper diet, lack of exercise, liver damage, obesity, pregnancy and prolonged sitting. But most often the problem is constipation.
Symptoms include rectal itching, pain and tenderness, and sometimes bleeding. The most alarming sign of hemorrhoids is bright red blood in the stool, caused by pressure during the bowel movement. The bleeding is usually minor; however, dark, tarry blood could indicate a more severe internal bleeding problem that should be brought to the attention of your doctor immediately.
The best way to treat hemorrhoids is to prevent them from getting started. Here are some natural healing remedies, supplements and herbs for soothing, preventing and maintaining hemorrhoids. Here is to you a healthy bottom.
Natural Healing Remedies
Avoid constipation. Stay regular by consuming about 30 grams of dietary fiber and drinking at least 48 ounces of water per day. Regular exercise also helps prevent constipation.
Strive for soft and easy bowel movements. Take a stool softener. Linseed oil helps to soften stools. Use one or two tablespoons daily.
Do not grunt or hold your breath while defecating. This is just the kind of strain needed to engorge and swell the veins in your rectum.
Ointments containing vitamins A and D or E may be helpful for lubrication and relief of pain. Or use a dab of petroleum jelly on a cotton swab, apply about inch into the rectum.
Vitamin E oil, wheat germ oil or liquid lecithin can be applied to external hemorrhoids. For painful internal hemorrhoids, pierced capsules may be used as suppositories, or an ounce of vitamin E oil or wheat germ oil can be injected into the rectum with a baby syringe.
Aloe vera gel is an extremely effective ointment for persistent pain and itching.
To stop anal itching and “cure” chronic hemorrhoids, stir a teaspoon of vinegar in a glass of water to sip with each meal. Use another glass of the same mixture for external applications throughout the day.
To reduce irritation and help stop bleeding, wrap a tablespoon of finely chopped raw cranberries in cheesecloth, insert in the painful area, replace after one hour. Or drench a cotton ball with papaya juice and apply the same way.
To reduce pain and swelling, make a suppository from a raw potato or an unpeeled cucumber slice (coated with vitamin E oil, if desired) and insert it overnight.
It is the New Year now. In the New Year holiday, many people plan to have a travel outside to relax themselves. The weather in this holiday is so cold, so I will introduce some tips people should pay attention to in travelling.
Drink black tea one week in advance. Study found that drinking 500 ml of black tea every day one week before travel will stimulate the body to secrete 2-4 times of interferon more than usual, which can enhance the immune system and allow you not vulnerable virus caused by the common cold and hepatitis.
Prepare ample anti-hypoxia drugs. Irish researchers found that more than half of the passengers will have hypoxia symptom when they take planes. Hypoxia combined with dehydration, sedentariness and drying and other factors can induce a variety of diseases. So, it is suggested that travelers eat acetazolamide to increase the body’s oxygen metabolism two days before taking planes.
Eat protein before departure. According to the American Academy of Neurology’s theory, when people take vehicles, ear vestibule balance receptors in human body will stimulated and make people feel dizzy, nausea, vomiting and have other symptoms. Pennsylvania State University study shows that eating protein such as eggs and beef before takeoff could reduce nausea and other symptoms by 26%.
Drink bottled water outside. To travel in remote areas or underdeveloped countries, it is better not to the local water. Experts recommend you drink bottled water when traveling to avoid viruses and bacterial infection. Brushing teeth and cleaning contact lenses are better to use boiled water.
Remember to wash hands frequently. Experts think that washing hands frequently during travel is the best way to prevent various infections. If it is not convenient to wash hand, you can take a bottle of alcohol (content of 60% or more). In addition, do not touch poultry and wild birds, for they are highly susceptible to infectious diseases.
In the present times, when computerization is controlling almost all sectors, the health care industry is being influenced equally. With health care automation, there has been a remarkable improvement in the levels of patient care and office functionalities. Among the various aspects involved in health care automation, one is the use of medical billing software.
Medical billing software helps health care providers in maintaining the records of expenses and revenues involved in patient care. Let us discuss some of the benefits of using this system:
Managing paperwork is a time consuming and laborious work. You are required to appoint a large number of staffs and bear the costs of paying for their insurance and social security in order to efficiently maintain the billing records of innumerable patients. You also have to pay for the space required to accommodate large number of employees. Though installing medical billing software can be an expensive affair, it is still more reasonable in comparison to the cost involved in appointing a large number of staffs. In addition, you can save a considerable amount of money by comparing the prices of various medical billing software available in the market and choosing the one thats most affordable. Sometimes there are attractive discounts on these programs that can help you avail them at a very budget-friendly price. All you have to do is to make a thorough research on all the programs available in the market and compare their prices and discounts before purchasing one.
Owing to the details that needs to be taken care of in medical practice and the various complexities involved in the billing process, huge amounts of paperwork builds up in no time. The use of medical billing software helps in maintaining patient medical records and all the billing information in the digital data format, thereby considerably reducing the need for paperwork. Reduction in the use of paperwork helps in saving a great deal of space in your office.
In the process of entering huge amounts of data in the computer, errors can anytime be committed by your staffs. Medical billing software can be pre-programmed to detect such errors and remove them, thereby making it possible to maintain flawless and perfect billing records. This in turn helps in saving a great deal of time and effort while making the process of patient care highly efficient and methodical. Moreover, flawless medical billing also helps in the maintenance of a healthy relationship between patients and health care providers.
One of the significant advantages of using medical billing software is that it enables doctors and staffs to access patient billing records from any of the office locations. This can be immensely helpful in case of emergency or when doctors need to access these reports from outside their office.
Medical billing software helps in making the entire patient billing system extremely methodical and organized. It requires a mere click to know the details of how much each patient owes to a health care provider or center.
Noble men of all ages throughout the centuries have worn mens copper bracelets. As a metal, copper was one of earliest discovered useful materials. Admired for its charm and versatility, copper has been crafted into exceptional mens copper jewelry like bangles, bracelets, rings and necklaces. A lot of men find copper bracelets a fine choice because it is so elegant and manly. It has a red-colored antique sparkle that echoes toughness and leadership.
By and of itself, the mens copper bracelets are fine bracelets that will look good with a variety of clothing, from blue jeans to sportswear. The more fine-crafted ones with sophisticated looks enhances the look of a men in classic business attire. The great thing about wearing a copper bracelet is that at the same time it enhances a man’s looks, it also relieves pains and aches on his body.
Yes, you heard it correct. These mens copper bracelets have therapeutic qualities. And its not new either. This has been recorded in outstanding ancient cultures like the Egytian and Greek cultures. Copper that have been dissolved in water was drank to sterilize wounds and relieve headaches. The anti-inflammatory properties of copper is thought to be what’s driving the restorative healing. Sadly, our usual diet generally won’t contain sufficient copper to promote healing. When a men wears a copper bracelet, some of the copper is dissolved through his skin and absorbed. That dosage of copper is sufficient to relieve the pains and aches, such as aches from arthritis and injuries.
For added results, some mens copper bracelets are magnetic copper bracelets, meaning that they have magnets embedded in them for higher healing strength. Alternative medicine practitioners say that magnetic copper bracelets possess a magnetic field that influences and hastens the flow a persons energy through his body. These help to clear energy blockages. A lot of pains are a result of blocked energy flow, so wearing a copper bracelet will cure the pain.
Most of the evidence about the wellness benefits so far is anecdotal. So far, there has not been any conclusive scientific study supporting these benefits. Before one gets his hopes up too high, it may be much more suitable to put on a bracelet much more for its looks instead of expecting immediate pain relief.
For every fine-crafted mens copper bracelet is truly a unique gift. Every item is individual, as copper is a finish that ages with time. Each piece ages to its personal unique path as time goes on. It is something that will add towards the charisma and personal space of each and every gentlemen.
New Home Exercise Program for Lawyers and Other Busy Professionals
By Trial Lawyer, Jon Mitchell Mitch Jackson
Theres one undeniable fact in life that my father-in-law shared with me long ago. Youve got to take care of No. 1 in life before you do anything else. That is, if you dont take care of yourself and your health, then youre not going to be much good to anyone else. To this day I consider this to be some of the best advice Ive ever been given.
Before I jump in to this topic in detail, Id like to tell you who I am. My name is Mitch Jackson and for the past 24 years Ive been a full time trial attorney. In fact, last year I was named Orange County Trial Lawyer of the Year for my verdict in a difficult and tragic wrongful death case. Ive achieved a top AV rating (top rating in ability and ethics) and my firm is listed in the Bar Register of Preeminent Lawyers, an exclusive listing reserved for the best law firms in the United States. Im a multiple time member of the Million Dollar Advocates Club having obtained numerous settlements, judgments, and verdicts in excess of $1,000,000. My firms web site is www.JacksonWilson.com
As a lawyer Im around many other lawyers and professionals. Ive seen how many of them neglect their health and best interest while spending a majority of their time servicing clients and chasing the mighty dollar. While I believe strongly in the free enterprise system, the problem I observe on almost a daily basis is balance or a lack thereof. Ive watched too many professionals essentially sabotage their long-term health with poor short-term diet choices and a lack of exercise.
What started me thinking about all this was an experience I had at a recent mediation. At the hearing, I ran into an old friend who also happens to be one of the most intelligent and talented lawyers Ive had the pleasure of litigating against over the past two decades. His ability to present an extremely persuasive argumenteven when his client is legally wrongis remarkable and truly amazing to experience. Ive seen this guy win several cases that most other lawyers wouldve lost.
But theres one big problem. And I mean BIG problem. My friend, who is a wonderful human being, is extremely overweight and perspires profusely. Needless to say, the first impression he makes to strangers (like witnesses and jurors) is not anywhere close to being as good as it could be.
Now please dont take this observation the wrong way. I learned at a very young age not to judge a book by its cover. I know how wonderful this person is and also respect his legal abilities. Unfortunately, when it comes to practicing law and also to living life, none of us ever gets a second chance to make a good first impression. Its too bad when you really think about it.
Even more important is that most of us already know that poor health brought on by a lack of exercise and bad diet will probably lead to serious medical problems and a shortened life span. Emotionally, many people dealing with overweight or health issues also find themselves suffering from various levels of anxiety and depression.
Effectively representing a client is extremely demanding. It takes a great deal of skill, intellect, and physical effort. I honestly believe that in order to meet the rigorous demands of practicing law and to be the best person and best lawyer that you are capable of being, good health and exercise is mandatory. After all, without your health, you have nothing.
With respect to my overweight friend, Ive heard people talk about him behind his back. Ive observed jurors become distracted by this lawyers awkward manner of walk and heavy breathing while delivering a closing argument. Hes of course aware of these issues but does not know how to go about taking his first emotional and physical steps down the path to good health.
The problem most lawyers have with staying in shape is that many of us have a very limited amount of free time. And when we have free time, in most instances its not put to the best use. In fact, some of the lawyers Ive met unfortunately use their spare time to partake in unhealthy habits such as eating and drinking too much.
What if I told you that Ive come across a very reasonably priced exercise program that you can do at home and without any expensive equipment? What if I told you that this proven program comes on a set of easy to use DVDs that you can start, play and even pause whenever you want? And what if I told you this home exercise course allows you to get back into shape at your own pace and only takes about an hour a day?
The program Ive discovered and am now hooked on is called P90X. Im loving the program so much that each and every day I cant stop thinking about my evening home workout.
I took my first serious look at P90X when some neighbors became excited about the results they were experiencing and seeing with the program. The excitement part is what really interested me. I dont know about you but if Im not excited or having a good time with something, chances are Ill stop doing it sooner rather than later.
With the P90X program, I was seeing smiles on the faces of my friends and over time, watching their bodies change for the better. After hearing for about the twentieth time, Mitch, you should get started. Youll love it I decided to give P90X a try. Without any hesitation whatsoever I can now report this is one of the best life decisions Ive ever made.
In the P90X DVDs, instructor Tony Horton keeps things fun, interesting, challenging, and safe. He also shows you how to exercise properly and how to pace yourself over the 90 day program. Add to this the easy-to-follow meal plans, nutritional advice, and a support system like no other, and I can see myself doing this for the rest of my life.
How about you?
Look, if youve been thinking about improving your health and getting back in to shape, I believe P90X is where your new healthy lifestyle can easily begin. The good news is that theres no need to recreate the wheel. This program works and it works well. All you need to do is plug into it. Whether you’re looking to lose weight or get fit, P90X can provide a solution.
Is it hard? Yes it is. But if you can press the pause and play buttons on your DVD, then you can take as many breaks as you need to get through the program. Theres good reason why so many professionals, athletes and celebrities who are all on limited time schedules (sound familiar) are benefiting from the P90X program.
Find out for yourself. Watch a really good video overview of P90X by clicking
For more information, really cool success stories or to get started today, go to www.activesuccess.com and click on the Shop Beachbody link on the left side of the screen. Next, click on the Fitness Program link and then click on the P90X link. Place your order and youre good to go!
Not only will P90X make you a better lawyer, it will make you a healthier and happier human being. Im using P90X every day and so can you. It also comes with a money back guarantee so when you think about it, what do you really have to lose?
After you get P90X and get in to the program, give me a call or drop me an email and let me know about all the amazing results youre getting! Also dont be shy about sharing P90X with your family and friends.
While I like to do P90X by myself, others have told me they can get through the routine much easier when doing P90X with friends. Hey, it doesnt matter which approach you use as long as you hit the play button and do it!