Healthcare Reform: What Will It Mean to You?

Have you been tracking the Patient Protection and Affordable Care Act (PPACA) closely? If you haven’t been, you should be paying attention because you may be affected. If you have been tracking the changes in our healthcare system, you may have noticed that while many changes have gone through as planned, the administration is running into some delays. Some consumers are already seeing basic services included in their current health care such as free immunizations, wellness check-ups, children up to the age of 26 able to remain on their parents insurance plan, free mammograms and cancer screenings, among others. The next big step in the Affordable Care Act (ACA), also called ObamaCare by some, is the requirement that all Americans obtain health insurance coverage.

The U.S. Department of Health and Human Services has given conditional approval to 18 states to run their own Small-Business Health Options Programs (SHOPs) and to another 17 to run their own insurance exchanges for individuals. Unfortunately, while progress has been made, “many activities remain to be completed and some were behind schedule,” a report put out by the US Government Accounting Offices says. This next piece of healthcare reform is scheduled to go into effect starting January 2014. Since individuals need to be able to purchase health insurance beginning October 1, 2013, this delay in getting health insurance exchanges up and running could impact those who need to purchase it.

The health insurance requirement includes a Mandate Tax that individuals would have to pay in 2014 if they don’t have or purchase health insurance. The law requires that individuals have health insurance through their employer, through Medicare or other government program, or individually. Those who would have to spend more than 8% of their household income or are already covered under Medicare or Medicaid will be exempt from the requirement. These individuals may have an opportunity to purchase insurance at discounted prices. The mandate is expected to affect 2% of the population. The number is lower than many would expect because most individuals already have insurance through their employer or a government program.

One of the biggest concerns of those trying to implement the ACA is that young people just starting out may skimp by not purchasing health insurance, assuming that they won’t need it for a long while. Starting in 2014, those who can afford to, but do not purchase health insurance, will pay a tax penalty: For an individual, the tax will start at $95 a year or up to 1 percent of income, whichever is greater, and rises by 2016 to $695 per individual or 2.5 percent of income. For a family, the tax is capped at $285 in 2014 and rises to $2085 or 2.5 percent of income in 2016. The Internal Revenue Service will collect the penalties via tax returns and there are already plans for the new tax form for 2014 to include a space to list your source for health insurance.

In 2014 mandatory basic services that must be included in healthcare plans are:

Emergency Services
Hospitalizations
Laboratory Services
Mental Health and Substance Abuse Treatment
Outpatient or Ambulatory Care
Pediatric Care
Prescription Medications
Preventive Care
Rehabilitative and Habilitative Care
Vision and dental care for children

So, what are your options? If you already have insurance through your employer you don’t need to worry about making a change. For those who are pretty healthy, catastrophic care with higher deductibles may be the right choice. This type of plan would make sense for those who are under 30, those for whom a standard health plan would cost more than 8% of household income, those who only need 3 or fewer primary care visits per year and those who only need the essential health benefits listed above. Catastrophic plans have higher deductibles for anything beyond the basic services, usually $1,500 to $2,000 per year.

Lab testing facilities can easily fill in some of the gaps that catastrophic plans may have. Some cost effective tests and programs to consider include ongoing testing after an initial baseline during a primary care visit, more frequent tracking of cholesterol or diabetes, a Telemedicine program for telephone consults and prescriptions, informational drug testing for teens or before employment tests and additional informational tests that may not be covered under the essential services, like:

Vitamin deficiencies
Testosterone levels
DNA tests

A surprising finding that was documented in Forbes magazine shows that young people may be better off without ObamaCare. The expectation is that many of them will take the easy route and pay the relatively low tax and skip buying healthcare altogether. A study by David Hogberg, PhD., published this month by the National Center for Public Policy Research indicates that, “About 3.7 million of those ages 18-34 will be at least $500 better off if they forgo insurance and pay the penalty and more than 3 million people will be $1,000 better off if they also skip insurance and just pay the mandate tax.”

Where does that leave you? It will take some research and soul searching for young people or those working for very small companies (less than 50 employees) or self-employed to determine what the best option is. Many should consider catastrophic care with outside or supplemental lab or testing services to fill in gaps. If you already have insurance through your employer, you’re one of the lucky ones. Let’s just hope that companies don’t have to lay off workers to ensure that they can cover the ones who are left.

Is There a Place For Acupuncture in Healthcare Reform?

No matter what your position on healthcare reform, it should be clear that there’s plenty of room for improvement in our healthcare system.

In my humble opinion, the work we acupuncturists do deserves a seat at the table. It may seem like acupuncture is a “luxury” or an “extra”, since most of us have to pay for it out of our own pockets, but for an increasing number of Americans, acupuncture is a necessary part of getting and staying well. Acupuncture should be considered an integral part of our healthcare future, not only because it is highly effective and extremely safe, but also because I believe it could save us all money in the long run:

o Acupuncture is an excellent, effective substitute for pain-killers. When patients begin to rely more on acupuncture and less on pain-killers, it may not seem like a cost-cutting measure. After all, a typical acupuncture treatment costs about $70 while a bottle of over-the-counter pain medication costs about $10. Consider, though, the health risks of long-term pain medication use: damage to the liver and kidneys, damage to the gastrointestinal tract, altered mental function impairing one’s ability to drive safely, addiction to pain-killers (which affects millions of Americans) and so on. The cost of these risks far outweighs the cost of the 12 to 24 acupuncture sessions needed to significantly relieve chronic pain.

o Acupuncture and Chinese medicine focus on wellness, not just on the control of symptoms. As a provider of holistic medicine, I am interested in improving the overall health of every patient. I see all of your health issues as part of a greater imbalance and I work with you to correct that imbalance, one step at a time. The result? When you are well, you visit your doctor less, take fewer prescription and over-the-counter medications, take fewer sick days from work and are more productive, and the involuntary functions of your body improve: immunity, hormonal balance, digestion, elimination, etc.

o Acupuncture helps seriously ill patients better tolerate their medication and more easily comply with treatment. Patients with cancer, HIV or Hepatitis face grueling, toxic chemotherapies to survive these illnesses. In each of these cases, acupuncture can significantly reduce the side effects of the drugs so that patients need fewer medications to combat side effects, experience fewer serious complications, and report a higher quality of life.

o Acupuncture helps couples set the stage for healthy, natural conception and pregnancy. Infertility treatments are expensive and not always covered by insurance. When acupuncture alone helps couples conceive, thousands of dollars can be saved. Compare the cost of one year of weekly acupuncture $3,640.00 and the typical cost of one in-vitro fertilization $15,000.00. Acupuncture has even been shown to improve the odds of getting pregnant with IVF by 20% (raising a couples chances from 20% to 40% in many cases), reducing the number of $15,000.00-dollar IVF cycles needed to get pregnant. I routinely see pregnant women in their last trimester who need help turning a breech baby (and thus avoiding a cesarean section and all its complications) or want help with natural labor induction (again avoiding medical intervention).

o Acupuncturists get to know their patients well, sometimes better than primary care physicians. I spend about 4 hours with a typical patient over a six-week course of treatment (2 visits per week). We have the opportunity to talk in-depth not just about health issues but also about family and work life, the stresses she is under, what she eats and how she exercises and more. During all that conversation, I may just learn the key to her health problems, a key that would not have come to light without those hours of one-on-one interaction. Also, when a provider knows a patient well it is easier to notice potential problems that he himself may not yet have noticed, like an odd mole or growth on a his back or the slight change in mental status of an elderly patient that may signal dementia. (By the way, I’m not blaming physicians themselves for not having time to get to know their patients. Who can get to know anyone in the 10 to 15 minutes allotted for a typical doctor’s visit? When shrinking insurance reimbursements force doctors to see more patient per hour, we all lose, but that is a topic for another day.)

o Acupuncture excels in its role as a preventive medicine. Why is it that we maintain our cars better than we do our bodies? We can buy new cars, but we can’t buy new bodies, so we need to take good care of them so they’ll last us a lifetime. Along with eating well, exercising regularly and living tobacco free, a monthly acupuncture visit gives you an hour of deep relaxation and improved circulation, allows you the opportunity to ask health-related questions, and allows you to address minor issues before they become major issues.

Generic Prescriptions Help Savvy Consumers Save Money on Healthcare Costs

Prescription drugs have long been the fastest growing cost component of our healthcare system, which likely means they have also been a fast-growing component of a family or individual’s personal budget. With a few consumer-friendly developments in recent years, patients are in a better position to take control of their prescription drug expenses, even if they have recurring or chronic conditions which require long-term drug therapy.

Using generics instead of brand name drugs has long been an option for many, but with steadily increasing prices of insurance premiums and medical care, finding ways to shave money off of prescription costs is becoming more important as people review their budget situations. The typical generic costs anywhere from 25% to 60% of its brand name equivalent, and with the trend for discounted generics at large chains, such as the $4 drug program offered by Target, Costco, Walmart, and others, most consumers have realistic options to save money on pharmaceuticals by researching the generic market. While the ability to substitute generics for brand name drugs once a prescription exists varies from state-to-state – pharmacists have more latitude in some states than in others to determine how they fill a prescription – the best thing to do is talk with a doctor about the possible prescription options. Most physicians are well aware of the common generic substitutes, and for the less common ones can easily find if there are generic options through online or reference tools. To take advantage of the hundreds of prescription drugs offered for discounted prices by major chains, make these three steps habit when evaluating and purchasing prescriptions:

Talk to your doctor about low-cost alternatives. Many physicians assume that their patients want the lowest-cost alternative medications, but some do not. Make sure that it is clear to your physician that cost is a factor in your ability to be compliant with his or her medical orders. Knowing that you are interested in less-expensive drug therapy will help them think in a more cost-conscious manner on your behalf.
Research prescription options. In cases where you or a family member takes medication for a chronic condition, or has recently been given a prescription for a brand-name drug, doing some digging can ensure that the best drug option is being used. The official Food and Drug Administration (FDA) prescription drug crosswalk is called the Orange Book, and lists all approved generic alternatives for any brand name drug.
Find discounted generic prescription drug offerings. Most major pharmacy and many grocery chains are offering a consumer-friendly discount generic drug list, often selling common generic medications for $4 per month. As generics often save you significantly off of brand-name drug prices, this can be an area of significant medical cost savings for individuals who regularly take medications. The great news is that 2008 and 2009 have been banner years for patent expirations on drugs, making more medications available in generic form than ever before. Other vendors fill prescriptions directly online for pricing that may be comparable to some local pharmacies, and may be worth considering as well.

By being a savvy prescription drug shopper, you may be able to save 50% or more from your family’s monthly prescription drug bill. For those with routine sickness or chronic conditions, that kind of savings month-after-month can add up and is worth making a personal financial planning and budgeting priority.

Personal Power, Profit And Influence – Doctors Who Will Save Healthcare

Without these, in your own life and practice, you are unlikely to learn from the past, deal with the present and plan as accurately as possible for the future. But just why are these so important?

One of my fascinations as a consultant comes from dealing the vast differences in how people view the world, as well as their own professions.

Even more fascinating, is how they respond to the wide variety of situations we are all presented with every day. Now this is something I’ve written on extensively, during the last three years, and continue to research on almost daily basis.

Of course, there are many reasons for these vast differences, even amongst similar groups of people (like DCs MDS, DMDs JDs etc.). No doubt, some are biologic and likely even genetic responses. Some are cultural. Some are environmental. And lets not forget education and professional training.

No doubt, the largest factor accounting for all these differences is personal beliefs about the world we live in and then how we should act upon incoming information and react or not to the situations we are faced with on almost a moment-to-moment basis.

Our personal beliefs are what comprise our self-image. Many years ago, Dr. Maxwell Maltz, a plastic surgeon observed this in his patients, and then went on to write about it extensively in his landmark work, “Psychocybernetics”.

Dr. Matltz’s observations at the time were, and still are landmark, in dealing with human behavior and achievement. Matlz observed that humans have the unique capacity to set courses like a missile, and hit targets with precision. He also astutely observed that these missile courses are never over a straight line, and indeed the vast majority of travel time is off course.

Q. So what causes a missile, or you or I to hit our targets?

A. It’s actually continual course correction.

Q. And which is the faster course?

A. It’s always a straight line.

Q. Which combination of characteristics produces a straighter line in professional practice development?

A. It’s Personal Power, Profit and Influence.

Success, happiness and fulfillment in practice and in life are always a combination of accurate assessment and response, over and over again. (This is also why the mechanisms we teach to run and grow a professional practice actually work.)

As keen as Maltz’s observations were, it really wasn’t until 1970 when Alvin Toffler wrote “Future Shock” did we come to understand again, some of the reasons why we have vast differences not only in human behavior, but society as a whole.

Toffler’s work also clearly demonstrates how ignorance of these factors can lead entire groups and organizations to become ineffective, powerless and unprofitable.

Not unlike healthcare professionals (“providers”).
Not because they (we) changed, but rather the world changed.
Seemingly very quickly.

So how can we not only survive, but also prosper and grow as individuals and professionals? How can we stand for solid principles and render the excellence in human services we have been trained to do?

It will be only through Personal Power, Profit, and Influence.

Personal Power comes from building all aspects of our lives on a firm foundation. Personal power in this day and age fully develops only with an eye clearly on the future. Ignorance of either the speed of change or the magnitude of change will lead to failure. Without firm foundations, principles and beliefs, we are like trees without roots.

With a firm foundation however we can weather hurricanes, tornadoes and tsunamis.

And profit. You, and you alone will determine your financial future. Without profit and savings, a strong financial future is impossibility. Without a strong financial position, we actually end up powerless, in so many ways.

Lastly, let’s talk about influence. Many of us ignore the impact of our influence on our patients, our staff, and most especially our communities. Those doctors, who maintain a high degree of influence not only in their offices, but also in their communities, will undoubtedly be those who master personal power and profit.

In “Future Shock- Personal Power, Profit and Influence”, we will together, around the USA be exploring the role all these have not only in our personal and professional lives, but the significant impact our collective efforts have in producing meaningful results and a bright future, not just for a very unique profession, but for our healthcare system. And, most especially our patients.

I hope you will join me on the quest to preserve patient choice, the affordable access to private healthcare, and the highest quality of care possible.

Swine Flu and How UK Healthcare Can Deal With It

With a possible pandemic on the cards and people panicking about what the future will hold for the country and its population, it seems the media has done little to stop the panic. Swine flu has been escalated in to a frenzy status and the national health system and local doctors have had to deal with worried and concerned people with questions about the possibility of infection.

The WHO (World Health Organization) has done the best possible job to address the problem as soon as it came to light. Since the virus has escaped Mexico there have been four reported deaths outside of Mexico itself according to the World Health Organization.

The Mexican population has not been so fortunate though, at this present time there have been a total of 56 deaths and 2,059 confirmed human cases. Scientists have warned that it would be possible for a third of the worlds population to become infected.

So far there have been a total number of 65cases in the UK so far. However it is well worth remembering that people throughout the United Kingdom have become infected and made a full recovery from the infection.

The British government is advising people to be a little more considerate towards their actions to reduce the spread of any possible infection. The campaign ‘catch it, bin it, kill it’ has been set up in order to raise awareness of the germs that people spread about when sneezing. The emphasis being that by sneezing into a tissue any possible virus is caught and contained then disposed of in order to prevent the spread.

If you believe that you may have become infected it is advised that you contact you local doctors surgery by phone and do not attend the practice in person as this may fuel the possibility of infection to others. It seems to be that as long as good standards of hygiene are maintained that this will help reduce that chance of infection.

The UK seems to offer one of the best healthcare systems in the world. It is also apparent that they are pulling out all of the stops to keep the risk to the public is at minimum. This also requires cooperation from the public and if they adopt the ‘catch it, kill it, bin it’ method the spread of this virus should become very limited indeed.