The Health "Blogosphere"

I had the good fortune Tuesday to attend an on line "HealthCast" (webinar) sponsored by the Kaiser Family Foundation entitled "The Health Blogosphere: What It Means for Policy Debates and Journalism". Jeepers! Did I really think the RauserHealthReview was ahead of the curve . . . . . . . . ?!

I was surprised to learn HHS Secretary Michael Leavitt is a blogger. Given his enormous influence over health care policy, those with a serious interest should connect to the Secretary through an RSS feed. Ditto a Wall Street Journal Blog on health care. In fact, there are dozens of really good health care sites with a wealth of information. The Kaiser Network and WSJ blog serve as great aggregators of information from many sources while Secretary Leavitt's site - like the RauserHealthReview - is based on more personal experiences from our daily work; he of course at the very pinnacle of the health care industry while I am just a foot soldier.

Secretary Leavitt revealed he has been writing his blog since August of 2007 and now has about 2100 visitors each week; yours truly started late in May. Recent traffic is on pace for about 270 weekly visitors. (I can only imagine how many daily 'hits' the Kaiser Foundation receives at their site.) The appetite for good information on health care can only grow with the aging of America. I would sure welcome any suggestions (comments) for posts.

How To Add Years To Your Life

Wellness, wellness, wellness; everyone is talking about wellness. And with good reason. The best way to reduce your health care costs is quite simply to not get sick! ("Brilliant!")

Do you put off going to the doctor for your annual exam afraid of what he/she may find? Are you wary of how your health insurer or employer may misuse the information you provide through their on line Health Risk Assessment. These are natural (most likely unfounded) concerns we can deal with another time. For today, I'd like to make you aware of a wellness 'tool' you can access right now. At no cost. And with no worry about privacy.

Please visit RealAge; a website where you will find a wealth of information on health and wellness. You can enroll as a member and take the RealAge Test. I did. It tells me I am just a few years younger than my chronoligical age thanks in part to some generally good diet choices and regular excercise. It also coaches me in several ways to take easy steps to further cheat father time.

George Carlin used to joke that "life's journey is not to arrive at the grave safely in a well preserved body, but rather to skid in sideways, totally worn out, shouting ....holy sh*t ....what a ride!" George did have a great ride but I sure wish it could have been a little longer?

Good luck on your RealAge Test. I'd enjoy hearing how you did and if it motivates you to make changes.

After All, We're 'Only' Talking About Two Trillion Dollars!

I have written about this before elsewhere but think it bears repetition here as the fall election cycle begins to heat up. I wonder how it is every candidate for office is "selling" ideas for health care reform without abiding by the same principals of ethics that are required for licensed professionals such as myself.

Of course, one might argue that an insurance consultant really ought to stay out of the world of politics and believe me, I would happily do so if 'they' would just stay out of my business!!

Here's all I ask. Under insurance regulations, when I make a sales presentation I am required to give a full analysis of both the pros and cons of the product or service being sold - not just one side of the story. You know: "The Truth. The Whole Truth. And Nothing but the Truth." When candidates for office "sell" their vision for health care reform, they should be held to the same standards of full disclosure and honesty. (And it might also be noted, it is illegal for me to talk negatively about the competition!)

Whether it is through market based strategies or a Single Payer solution, we need to know all the features, benefits and costs - with realistic projections for the future - of health care reform. (At this link, a Cato Institute article helps make my point.)

No one buys from me without all this information. Why do we allow candidates for office to "sell" us a bill of goods with only half truths and soundbites? One can only conclude selling insurance requires a level of ethics we do not expect from most of our candidates for office! Now that is truly amazing.

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Where Is The Outrage - Part II

Here is a true story about an "elderly lady" living very independently and alone until recently, in a city with no other family members anywhere close. She falls and breaks a hip, often a sure sign of decline for this age group. Taken unconscious by ambulance to the nearest hospital, she has very successful orthopaedic surgery. The break is easily fixed and the surgeon predicts a full recovery after extensive physical therapy.

Discharged from the hospital after 6 days to a rehab facility across town, her physical and mental condition deteriorates badly instead of improving. Only after three full weeks does anyone finally contact her primary care physician who reveals she had been on an antidepressant for years. This med had not been administered at the hospital or the rehab facility. The complete loss of appetite (which makes her too weak for the PT critical to her recovery), disorientation and anxiety are consistent with the withdrawal symptoms from the antidepressant.

How could such antediluvian behavior occur in today's modern world of medicine? Is it possible a patient could be so unaware of her own drug regimen (or, incapable of communicating)? Is it possible the patient's family - out of state or not - could so poorly advocate for her care coordination? Is it possible a hospital could be so uninterested in contacting the primary care physician (in this case, from a different "integrated health system"), relying instead on their own "hospitalists" to develop from scratch a treatment plan?

A national database of patient health histories would go a long way toward improving the care of patients like the one in this anecdote. There are innovative initiatives that can make this a reality; Google Health may be one of the best because their on line patient records tool is portable and users can access and control them from anywhere.

People change insurers and doctors. Emergencies obviously do not always happen near our hospital or health system of choice. Some might like the idea of an Orwellian Big Brother owning our health records but personally, my family and I will learn from the story above and take charge of our own records and be better prepared than the "elderly lady" above . . . . . . .. who just happens to be my mother . . . . . . . . and is still teaching her kid, even so late in her life.

I Stand Corrected

In my blog post of June 24th - picked up today by the 'biz times' daily enews blast (Small Business Times) - I wrote about how the high cost of health care could exceed insurance policy lifetime limits. And I mentioned two "drug therapies that can cost up to $24,000 per month". One of the drugs I referenced - Zevalin - is not administered monthly but only one time for certain cancers. Given the efficacy of the drug, the one time cost of approx $24,000 is - to quote the famous commercial - "priceless".

My apologies to Seattle based Cell Therapeutics, Inc. - makers of Zevalin -for this error.

Health Care Independence Day

Would that there might be a time in the future when we might celebrate health care free from the 'tyranny' of government.

The Declaration of Independence and our Constitution are silent as to the role of government in health care. Could that be so because in 1776 life expectancy was only 35 years; that a new born child had only a 60% chance of reaching adulthood; that the cost of medicine then was incidental to daily life.

Today government accounts for nearly 50% of every health care dollar spent, setting the standards of care and reimbursement levels for the other half spent in the private sector. Every day in health care, in decisions that literally involve matters of life and death, we have ceded our "representation" to others.

On this special day when we celebrate our independence as a nation, we might also give thought as to who in the future will govern our health care.

Lessons From Another Health Encounter

At the tail end (an apt choice of words) of my annual exam the other day, my doc asked me if I wanted to have a vaccine for shingles. Then he handed me some information about this condition from the Centers for Disease Control (CDC). I have a friend who suffered from shingles for over two years so this had my attention. My first question: "what does it cost?" The answer: "$300 and your insurance probably won't cover it." I gave him the green light anyway.

That decision puts me in the top 5% of my "class" (finally!); e.g. of the 45 million folks boomer age and older who should be vaccinated for shingles, only 2.3 million have done so. It seems besides the influenza vaccine most of us know about, there are other "adult immunizations" most of us do not hear about; tetanus, pneumonia, even cervical cancer! Perhaps this is largely because our health plans don't cover them. That seems like another of the many confounding financial decisions we allow our insurers to make for us. [Actually, if I were (way) older and covered by Medicare Part D, the shingles vaccine would be covered subject to a copay I found as low as $37 with one carrier.]

I also found that had I simply delayed my decision, I could have had the same injection at a Walgreen's Take Care Clinic for just $219.99. The moral of the story: listen well to your doctors advice but then if conditions allow a little time, shop for the best deal. Of all the people who should have known that, you'd think it would be me. My Health Savings Account will be minus $300 instead of $219. Darn! And, since my risk of getting shingles has now been halved, I'll be asking my insurer for a discount when the renewal premium arrives. Which brings me full circle on this post . . . . . .