Can Doctors and Patients Choose Wisely?

I applaud the society of medical professionals for trying to accomplish cohesion and efficiency within an industry that is having a significant effect on our country’s economy. Health care costs are rising and severely affecting the financial stability of current or prospective seniors aging into Medicare.

The Choosing Wisely Campaign is a project of the ABIM Foundation, medical specialty societies and Consumer Reports. At the heart of the campaign are a series of lists of tests and procedures to question – developed by the societies. Each society came up with a list within their domain of practice.

These ‘lists’ are comprised of overused tests and treatments, that for the beneficiary can be devastatingly expensive and in many cases unnecessary. Do doctors really care and want the best for their patients? I would like to think that they do, and this initiative is doing wonders in restoring my trust. Here’s the problem however…. The medical field’s mantra, if you will, is to provide the best possible care for patients both ethically and professionally. If that’s the case then why are doctors ordering multiple tests or treatments for a patient that when looking at the evidence, doesn’t really help them or provide any new information regarding their illness? I understand they want to do all that they possible can for the patient, but at what cost? It does not cost doctors anything. For the patient however, they are now starring down a barrel made of bills (expenses for providing care) that most cannot afford. So again, I ask, “how does going the extra mile help?”

In a lot of cases, getting a second or third opinion has saved millions of lives. (Not to mention, subsequently either adding or subtracting to the ever increasing cost of providing health care in this country). But many of those second and third opinions have also provided nothing that benefits the patient. The only thing new here is the fact that a patient now has to pay for a procedure or test/treatment they could have done without. The key to solving this conundrum is to find an effective way to develop and execute combined decision making. Doctors and patients must find a better way to communicate their concerns, albeit procedural or financial. This common understanding is truly necessary in order to get past this complication, and increase efficiency without decreasing the quality of care provided.

An interesting point is addressed by this article concerning viewers’ interpretation of this initiative as a means to decrease access to quality health care. For the record IT IS NOT. Choose Wisely’s mission however, is to use communication as a means to determining whether certain or often used tests/treatments are relevant and necessary for the patient. If the medical industry as a whole can reduce health care costs without affecting quality of care provided, it is a win win for both the patient (less medical expenses) and doctors (less paper work and hassle to get insurance companies to cover said treatments provided). Decreasing the cost of health care provided as a nation could potentially save this country billions.

That being said, this potentially new surplus of funds could be used to increase reimbursement rates for social insurances like Medicare or Medicaid, which eventually would increase the quality of care delivered across the country. Doctors would no longer resist the urge to turn away new patients if they have government funded insurance because the reimbursement rates for services rendered would be acceptable. As of right now, they are not, and Medicare beneficiaries are paying the price for it.

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A Decision Worth Waiting For?

For months now health care consumers and leaders in health care reform have awaited the pending decision by the Supreme Court on the Patient Protection and Affordable Care Act. The health care law, socially termed as Obamacare, was passed in March of 2010, and offers clear choices for consumers and provides new ways to hold insurance companies accountable. However, due to some of the provisions the health care law requires of consumers, many have deemed it unconstitutional. Because of this growing concern, the Supreme Court has decided to rule on its validity and whether to uphold all or parts of the law.

That being said, whether the Supreme Court keeps all or part of the health care law, it is unanimous amongst consumers and leaders in health care that a change in current policy must and has to be made. Health care spending is too high and contributing too much to the gross national deficit. Quality care is jeopardized by a lack of efficiency and inability to coordinate health information amongst government programs. This cannot continue, and consumers are paying the price.

Health care reform is inevitable, and necessary. Either through a bipartisan collaboration to correct current policy or a complete overhaul, change is on the horizon. The Supreme Court is scheduled to make their decision on Thursday, June 28th, 2012 and many health care professionals, consumers and insurance companies hold their breath in the mean time hoping the decision favors their social or political interests.

A Country,…..Lost.

I saw the other day on CBS Channel 3 news a senior resident is facing eviction from her high rise apartment for flying small American flags from her balcony for Memorial Day. The Phillipsburg Housing Authority says that they are not “Anti-American” but that its a hazard issue to have anything hanging off balconies. They are trying to enforce lease adherence due to federal laws and safety rules.
“Really, are you serious right now?”
What has this country come to in this day and age? That a senior citizen who has survived a world war, the great depression and a cold war threat can’t show pride for their country. I’m sad to say but this, to me, validates every reason why seniors ARE and SHOULD BE upset at their country. The significance of law and corporate greed have surpassed patriotism. Our seniors today have seen a country once dedicated to its citizens mutate into an egotistical superpower obsessed with nepotism. Needless to say, this leads me to my point.
Seniors and baby boomers today have experienced a time when our country valued its relationship with its citizens. They were this country’s backbone; our present and future successes have been predicated on their devotion and love for America. Today…..sadly to say, but we are considering cutting the funding for Social Security and Medicare: Two major social insurances established for administering the health of these same seniors. Now, to me, this sort of approach seems a bit callus and cold. Actually, let me re-phrase that…. Really callous and cold. How can we as a nation turn our backs on the same individuals that helped create the land we call “The Home of the Free and the Brave?”
I understand that we as a country are facing a major crisis right now with regards to this country’s economic situation but to reduce health care funding for 80 million seniors turning 65 over the next 20 years is quite drastic; and will it really change anything?… I’m not so sure. That sort of approach is only solving one problem and creating another. We need to find a more systematic approach to addressing the major concerns of this country and I believe the Affordable Care Act is step in the right direction. Don’t get me wrong, it certainly has its flaws but it DOES keep those responsible for this country’s success at the forefront of their solution exploration. That being said, any wrinkles can be ironed out over time. Nothing is ever perfect the first time around, but it is a bit refreshing to now that the current “Powers that Be” have the moral aptitude to keep our seniors in mind.

Are You A Part of the Growing Trend?

Senior health care management is a growing concern among the 80 million baby boomers turning 65 and facing retirement over the next 20 years, and for many is a daunting task to tackle. If you handle your own administration then you may have noticed the developing trend of seniors taking responsibility to understand and educate themselves about Medicare.

“ Do you know what type of Medicare plan you currently have, and how it coordinates benefits?”

For most, it’s like buying a lottery ticket and hoping to win. Seniors have better odds of winning the lottery than they would the chance of NOT having any claims disputes with insurance providers about coverage. “What’s the correlation?” I’m glad you asked. The probability of skating through the world of insurance without any hassles is slim to none. However, if you empower yourself by learning about what your beneficiary rights and entitlements are, you’ll be less likely to be taken advantage of.

You would be surprised to know that many seniors are uninformed, so you shouldn’t feel alone. But one does beg to question, if you were to educate yourself about Medicare and health insurance, what resources do you have? Well…. there’s Medicare, Social Security and CMS. Have you tried contacting these “so-­‐called” resources? If you haven’t, by all means give it a try and let me know how you make out; just be prepared to spend at least 30-­‐45 minutes on hold before a representative will be available to help you. Don’t get me wrong, these resources ARE Valuable and Viable options, but they are incapable of handling the growing volume of seniors seeking assistance to concerns regarding understanding their health care possibilities.

So….. what viable “options” are there for seniors to use as a resource to educate themselves more about Medicare and their health care management? Well, reading this article is a good start, but here are a few more tangible possibilities seniors can take advantage of. Educational resources for seniors include the Internet, (highly recommended but not necessarily user friendly to those unfamiliar with how to navigate a computer), Local Community Senior Centers and Local Corporations for the Aging.

THE INTERNET:

This is probably the best educational resource guide available to seniors. The entire world is at your fingertips. You can access Medicare, CMS and Social Security’s website archives for all the new changes made and the history of social insurance. You could also use the Internet to follow the leaders in health care whether it is through publications, blogs or chat rooms. The Internet has the capability to provide seniors with the ability to educate themselves on their own time and at their own pace.

LOCAL COMMUNITY SENIOR CENTERS:

Community Centers are a great place for seniors to go to educate themselves. You have access to the Center’s resources, for example weekly/monthly lectures by community professionals, but more importantly, it’s a place where people get together to show each other that they are not alone. Everyone can share his or her Medicare experiences with someone who cares and understands. It’s that personal connection that frees them from any inhibition towards embarrassment for not comprehending how a health plan really works. “It’s a struggle we all share,” a prospect once told me.

It shouldn’t have to be.

LOCAL CORPORATIONS FOR THE AGING:

Corporations for the aging are fantastic educational resources for seniors because they can provide information about senior services, programs, and local senior communities in the area. They are the voice for the elderly; their advocate. They want to ensure that the quality of life for future generations of seniors continues to improve.