Tag Archives: medical

Managing Your Own Health

DrRich doesn’t want to slip into an “every man for himself” frame of mind, but it’s still true that no one cares about your health more than you do. To become a truly effective patient, you’ve got to be deeply invested in promoting your own health.

By “promoting your own health,” we mean doing four things: become as knowledgeable as possible about your own health conditions; take good care of yourself; make the most of your encounters with your doctor; and keep careful records.

Become as knowledgeable as possible

Learning as much as possible about your heart condition is a simple matter of self-preservation. Even under an ideal health care system (which, most assuredly, we don’t have,) doctors won’t always have the time or the inclination to discuss every important aspect of all your medical conditions. The more you teach yourself about those conditions, the better off you’ll be. You’ll be better able to interpret what your doctor is saying, and you’ll even be able to steer your discussions into the areas that are most pertinent to you. You’ll have a better understanding of what your doctor thinks should be accomplished, and a better grasp of what you can do to help accomplish it. Knowledge allows you to become an active participant, rather that a passive one, in managing your health care.

As an added bonus, by becoming highly educated about your health – and perhaps more importantly, by seeming to be highly educated – you will automatically make yourself ineligible for rationing by omission. Nobody would dare try to withhold information from you if they thought you were probably already aware of all the options. Educating yourself is the best defense you can use in our increasingly hostile health care system.

There are many ways to become more knowledgeable about your health care. Start with this web site, which has hundreds of pages of information on heart conditions, as well as serving as a gateway to other Internet resources. Then check your public library. Your librarian can point you to helpful books and articles about cardiovascular disorders.

Take good care of yourself

It goes without saying that you will enjoy better health if you do all those things you know you should be doing, things like giving up tobacco, maintaining an ideal body weight, cutting down on saturated fats, and getting plenty of exercise. If your doctor has you on a particular medical regimen (such as taking prescription drugs), make sure you follow that regimen religiously.

You gain direct health benefits from doing these things, as you well know. What you may not have realized, however, is the secondary gain you receive. By taking a genuine interest in trying to keep yourself healthy, you also endear yourself to your physician. You enlist him to your cause. Doctors should be engaged in the care of each of their patients, of course. That’s what it is supposed to mean to be a doctor. But, you know by now, they can’t. They’re under steady, unrelenting and overwhelming pressure to make the interests of their patients secondary to the interests of the HMO, of the government, and ultimately, of society at large. They simply cannot go to bat for all their patients. Some (the ones HMOs like the best, and the ones you have tried to avoid) won’t go to bat for any of their patients.

The many doctors who still maintain a strong sense of professional pride (the recalcitrants, the ones you have tried to choose for yourself) will still try to advocate for their patients, at least as circumstances allow. These, however, need to marshal their energies carefully. When they do go out on a limb for their patients, they are much more likely to do so for patients who are assiduously trying to help themselves. If the patient won’t accept responsibility for his own health, it’s not realistic to expect the doctor to jeopardize her career for the patient’s health. Continue reading Managing Your Own Health

How Much Will Your Health Care Cost?

It can be difficult to find out ahead of time how much a medical procedure or test will cost you. Even your physician can be in the dark about this all important consideration.

Costs for health care services vary throughout the country, and different insurance companies may negotiate for different rates for services with providers and health care organizations. Call your insurance company to see if you can get an estimate for a service, and check to see whether your state offers an insurance web site for average pricing information.

Unfortunately, it may be difficult to get a price because medical costs are figured after insurance claims information is submitted to the billing department and processed.

If you want to estimate your costs ahead of time for a procedure or test, these websites are a good starting point:

APCD Council is a federation of government, private, non-profit, and academic organizations working to improve the development and deployment of state-based all payer claims databases (APCD). Pricing is based on claims data collected from insurers, Medicaid, and Medicare. Some states have consumer websites that are up and running like New Hampshire, Maine and Massachusetts.

FAIR Health is a national independent, not-for-profit corporation that uses a database of billions of billed medical and dental services to power a free website that enables consumers to estimate and plan their medical and dental expenditures. The website also offers clear, unbiased educational articles and videos about the healthcare insurance reimbursement system. Call 888-288-1441for more information.

Healthcare Blue Book is a free guide to help determine fair prices in your area for healthcare services. It is especially helpful for people who pay for healthcare out of pocket, have a high deductible or need a service that their insurance does not cover.  Continue reading How Much Will Your Health Care Cost?

How to Get Health Care While Uninsured

A couple of years ago, I had a cold for about four months. I thought I had somehow caught five colds in a row, which I thought was no big deal, because they were just colds after all.

But then I started dropping a lot of weight while eating a lot of chocolate cake. My hair started falling out, and I had the shakes so bad that my handwriting—which I used to be proud of—became illegible. My short-term memory stopped working. It was difficult to have a conversation, because by the time I neared the end of a sentence, I had already forgotten what I was talking about.

Things were bad, but I had no health insurance, which I thought meant that the only thing to do was try to ignore it, and hope that whatever was wrong with me would go away on its own. Each new symptom added another few hundred dollars to the imaginary doctor’s bill in my head, which meant that as things got worse, I had more incentive to pretend that I had some sort of temporary bug that would eventually go away.

Then one day, I got up to go to work— at the time, I had a part-time job copyediting product labels and PowerPoint presentations—but I couldn’t make it out the door. About halfway through my morning shower, I started panting, and my heart was beating out of my chest. It was as if I had just run a mile, when I had actually just walked 20 feet from my bed to the bathroom. There had been signs before this incident: The day before, I found myself so nauseous and out of breath during my four-block walk to work, that I turned around and went straight back home.

It took near-complete incapacitation for me to bite the bullet and go to the doctor. It turned out that I have Graves disease, a congenital, autoimmune hyperthyroid condition that I’ll have for the rest of my life. Missy Elliot, George H.W. Bush and Barbara Bush also have it. Graves disease affects every cell in your body, so it gets bad if it goes untreated. But it’s very manageable as long as I take my pills, see my endocrinologist and get a blood test every six weeks.

As a freelancer, I still don’t have health insurance. But at this point, I’ve gone to a bunch of doctors, and have learned some things along the way about getting health care without health insurance. The more I know about the health care system, the less I do stupid things like get so sick I can’t function anymore.

1. Doctors aren’t just for the insured.

If you don’t have health insurance, the immediate reaction is not to go, and to chew on a couple of echinacea pills and hope for the best. I thought of health insurance as some kind of entry card to the entire health care system, but it doesn’t work that way. Plain old cash can get you through the door too. A trip to a doctor costs around $150–$200, or about the price of a nice dinner.

If you’re too broke to go for nice dinners, then look for community health clinics, like Ryan-NENA in New York City, which has a sliding scale for people without health insurance. I used to go there for routine check-ups when I was a student, and they were very nice. I don’t remember getting a bill for more than $5. If you’re skirting the poverty line, which is an annual income of $10,890 for a single person, then you might qualify for Medicaid, and you should definitely apply.

The other thing to keep in mind is that unless it’s a true emergency (severed limbs, heart attacks), don’t go to the emergency room. Go to an urgent care clinic for things like broken bones, pink eye, and other non-life threatening illnesses, or a private walk-in clinic. They’re more pleasant, faster, and much, much cheaper. Call ahead to ask how much, but they usually fall in the $150–$200 range to see a doctor. I went to one in San Francisco, and they were the ones who ended up diagnosing my illness. Last time I had a tear in my cornea, I went to this place in Manhattan.

Sometimes specialists don’t cost much more than a generalist, depending on what you need. The endocrinologist I go to in New York charged $300 for the initial consultation, then $175 for each visit afterwards. While general practitioners are accessible and great, it’s nice to have a specialist who knows a lot about my disease. If you’ve had insurance before, you may have heard that you need a “referral” before going to a specialist. That’s insurance provider bureaucracy, and you don’t need one if you don’t have a health insurance company to answer to. Continue reading How to Get Health Care While Uninsured

How to reduce your health care costs

Five ways to control expenses while protecting your health

Getting affordable medical care is a challenge for many people. Fortunately, you may be able to reduce your health care costs by taking a more active role in your medical care and maintaining healthy habits. Here are five tips to get you started.

1. Compare costs of several medical providers. The costs of procedures, treatments and medications can vary widely by provider. When your doctor recommends a treatment, ask how much it will cost you, and feel free to shop around or negotiate for a discount. Sites such as Healthcare Blue Book compare prices charged by hospitals, physicians and labs.

If you’re paying some or all of a bill out of your own pocket, you’re likely to be charged much more than an insurer or Medicare would pay, so consider asking for the insurer’s discount. Other simple strategies for reducing health care costs include carefully scrutinizing your hospital bills for costly errors, avoiding emergency room visits unless you are facing a true emergency and asking your doctor or pharmacist about generic versions of your current medications. Continue reading How to reduce your health care costs