The Slow, Painful Death of the Doctor-Patient Relationship

The Slow, Painful Death of the Doctor-Patient Relationship

Dr. Mark Siegel appears on a weekly FOXNEWS television show.

Marc Siegel is an American doctor and author. He is an associate professor of medicine at NYU Langone Medical Center, a Fox News medical correspondent, and a columnist for several news outlets, including the New York Post and Forbes.Wikipedia

I’ve been taking care of a particular patient for more than 20 years. She first came to see me after suffering a stroke, which severely weakened her right side. She has always arrived in my office in her wheelchair. She has diabetes, which I manage, as well as a heart condition. I’ve treated her through several urinary and skin infections. I also manage her blood pressure, but mostly I hold her hand and smile and look into her eyes. We talk about our families. She has many grown children, and she has always maintained an active interest in my growing children and remembers their birthdays. Re 

Recently, as she has gotten older and sicker—she is now approaching 90—she has required more frequent hospitalizations and her medical problems have grown more complex. Her family expects me to be responsive to their concerns for every decline in her health. Unfortunately, her decline is taking place at a time when much of health care is delivered semi-automatically without a human face attached. The new technology may even keep her alive longer, but her family is not used to the change. They say it was the frequent face-to-face interactions and instructive phone calls with me that always gave her the confidence to follow my recommendations. But these days my time is so consumed with computer management that I find I have less time for direct patient care. Patient expectations haven’t changed, but there is less time available now to seek the undercurrent of illness rather than focusing on the “chief complaint” that rides the surface. Read more at http://observer.com/2015/07/the-slow-painful-death-of-the-doctor-painter-relationship/#ixzz3gliEGgOL  

With Medicare on the verge of approving payment to doctors for end-of-life discussions, I can’t help but wonder exactly when and where these discussions will take place. Don’t get me wrong, it is as crucial as ever for a doctor to know under exactly what circumstances a patient wants to be placed on a respirator or have someone pound on their chest or shock them with electricity if their heart stops. But it is harder and harder to find the time for such a dedicated conversation. The wheels of health are turning ever forward, in constant step with technical progress and the implementation of exciting new discoveries. Medicare is moored in the nostalgic past, in a time when an ineffable rapport with our patients was the most important thing we had. We need to find a better way to preserve that relationship. Simply asserting its importance isn’t enough.  Read more at 

http://observer.com/2015/07/the-slow-painful-death-of-the-doctor-painter-relationship/#ixzz3glidmDaT Follow us: @newyorkobserver on Twitter | newyorkobserver on Facebook Read more at: http://tr.im/jjOJB

VA hospitals in danger of closing unless lawmakers fix newest funding mess | Fox News

VA hospitals in danger of closing unless lawmakers fix newest funding mess | Fox News

VA hospitals in danger of closing unless lawmakers fix newest funding mess

Is the VA FUBAR ?  The Veterans Administration seems to fumble and fall into the next disaster at least once a year.  Despite a new man at the helm who is a proven expert in consumerism, and the leader of a fortune 500 company another fiasco....this time financial.  Perhaps Congress needs to have it's own committee and the IG keep a ready eye on this mega-operation. 

The VA is still managing post Vietnam PTSD and now has a new wave of Desert Storm, Iraqi, and Afghanistan warrriors who have returned home.  

Why can't the VA get it correct......Medical care seems to be up to par, if veterans can get in, and the Congress keeps funds flowing.

Over a Quarter-Million Vietnam War Veterans Still Have PTSD | Science | Smithsonian

Over a Quarter-Million Vietnam War Veterans Still Have PTSD | Science | Smithsonian

The 49 Best Health and Fitness Apps of 2015 | Greatist

The 49 Best Health and Fitness Apps of 2015 | 

Here it is....all you have been looking for health and fitness on your phone, tablet, wearables.

Brought to you by Health Train Express  and Digital Health Space.



This information is not intended as medical device recomendation and we do not endorse any product. It is intended as a reference source.  None of these products have been approved by the FDA, nor is their reliability.

Statistics, Statistics, Lies and More Damn Lies, or is it just Ignorance ?

Health Care     A Tree of Life

It is becoming harder to surf the web looking for health related article without stumbling over another article about  HIT and Data. So here is the latest finding.

• Percent of adults who had contact with a health care professional in the past year: 82.1%
• Percent of children who had contact with a health care professional in the past year: 92.8%
• Number of visits (to physician offices, hospital outpatient and emergency departments): 1.2 billion

Source: Selected patient and provider characteristics for ambulatory care visits to physician offices and hospital outpatient and emergency departments: United States, 2009-2010[PDF - 127 KB]

• Number of visits (to physician offices, hospital outpatient and emergency departments) per 100 persons: 408.2

Source: National Ambulatory Medical Care Survey: 2010 Summary Tables, table 1[PDF - 382 KB]
National Hospital Ambulatory Medical Care Survey: 2010 Outpatient Department Summary Tables, table 1[PDF - 330 KB]
National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary Tables, table 1[PDF - 481 KB]

E pluribis Unum

Freedom is one of the features of a nation known for  "exceptionalism" . The term we all have heard is used as a global adjective to describe the United States.  In truth we do not excel in many areas.

In health we do excel in research and development and technology as applied to medicine. We fail miserably in access to health care and the bureaucracy surrounding it. We probably earn a C- in regard to social programs, not that we don't invest billions of dollars into helping certain segments of society to survive with basic necessities of life, food, shelter (inadequate) and a safety net for health-care.

Fee-for-Service is not Dead.......It is not even Wounded

Most industry leaders believe that, in the near future, fee-for-service payment will be replaced by “population-based payment,” intended to reduce incentives to over-treat patients and to encourage prevention. However laudable these goals, we believe the expected shift to population-based payment is unlikely to materialize.

We take population-based payment to mean time-limited fixed per-capita payment for a defined population of covered lives. Much of the inevitability of the trend toward population health is attributed to the Medicare ACO/Shared Savings programs created by the Affordable Care Act. The accountable care organization has been touted as the eventual successor to DRG and Part B payments in regular Medicare. Medicare's ACO programs now cover about 8 million of its beneficiaries (compared to 17 million in Medicare Advantage).

While advocates in the CMS claim hundreds of millions in savings (in an overall program spending more than $600 billion a year), the Pioneer ACO program and its much larger younger sister, the Medicare Shared Savings program, have struggled to gain industry acceptance. Medicare ACOs have so far had minimal impact in reducing costs. (PDF)Managed-care veterans (hospital- and physician-based) that have succeeded in Medicare Advantage or commercial HMO markets have largely failed with ACOs.

After a decade of experimentation, the pattern in these ACO programs is that a small fraction of ACOs generate most of the bonuses, and that excessively high prior Medicare spending, rather than excellent infrastructure and clinical discipline, may be the real reason for those successes. For the majority of ACOs, the return on investment for setting up and operating them is negative and likely to remain so. The recently issued ACO regulations did not materially improve the ROI calculus. In our view, it is extremely unlikely that ACOs will evolve into a “total replacement” for regular Medicare's current payment model.

Kaufman

On the commercial side, about 15 million patients participate in ACO-like commercial insurance contracts. More than 90% are so-called “one-sided” contracts, where there is no downside risk for providers who miss their spending targets. Yet some providers are giving up 30% discounts upfront to enter commercial ACOs that are really narrow-network PPOs. The discounts function as withholds with an earn-back if providers can meet spending and quality targets.

The commercial ACO deals we've looked at are one-sided in more than one sense: they frequently limit future rate increases, so nearly all inflation risk is borne by providers. As structured, they are a no-lose proposition for insurers that deliver real benefits to providers only if their competitors are excluded from the networks. Shifting more insurance risk to providers is unnecessary since insurers have already shifted a large amount of the first-dollar risk to patients (and therefore providers) through deductibles and copayments.

Moreover, with commercial medical-cost growth trends continuing in the mid-single digits, there is no cost emergency requiring a major change in insurers' contracting strategy; the present hybrid discounted fee-for-service model is doing its job. Deeply discounted fee-for-service with a small fraction of payments tied to “performance'” is not population health.

While many healthcare executives have embraced population health in concept, it is our experience that many of their physicians are not participating in a meaningful way. A recent RAND study of clinician acceptance of these models concluded that they have not substantially changed how physicians deliver face-to-face care, and that the additional nonclinical work required (mostly documentation) is perceived to be irrelevant to patient care.

Economists remind us that pursuing a given strategy means sacrificing gains from pursuing alternatives—the concept of “opportunity costs.” Not only are the potential gains from public or private ACO models limited, but the opportunity costs are steep. For hospitals and systems, they include recruiting and retaining physicians; improving hospital operations and profitability; reducing patient risk and improving their clinical experience; and commitment of clinician time to actual practice. Squandering scarce resources on a low-payoff strategy could prove costly for many health systems.

As industry veterans well know, our field is prone to periodic spasms of groupthink. The inevitability of population health is one of them. Though some may succeed in mastering population-health models, fee-for-service is likely to remain the core of the U.S. healthcare payment system for some time to come.

Jeff Goldsmith is president of Health Futures and an associate professor of public health sciences at the University of Virginia. Nathan Kaufman is managing director of Kaufman Strategic Advisors.

FDA Approves First-of-Kind Leg Prosthesis

The US Food and Drug Administration (FDA) today approved the first prosthesis for above-the-knee amputations that does not rely on a conventional, cup-like socket fitting over the stump of a patient's leg.

FDA Approves First-of-Kind Leg Prosthesis

With the new device, called Osseoanchored Prostheses for the Rehabilitation of Amputees (OPRA), an external prosthetic limb attaches to a fixture implanted in the patient's remaining thigh bone.

 There is a need for OPRA because not everyone with an above-the-knee amputation is a candidate for a prosthetic limb that connects to a customized stump socket, the FDA said in a news release. "Some patients may not have a long enough residual limb to properly fit a socket prosthesis or may have other conditions, such as scarring, pain, recurrent skin infections, or fluctuations in the shape of the residual limb that prevent them from being able to use a prosthesis with a socket," the agency said.

It takes two surgical procedures to install the OPRA device. First, a cylinder-shaped fixture is implanted in the remaining thigh bone. Six months later, a rod is inserted in the fixture. It extends through the skin at the bottom of the stump and connects to the prosthetic leg.

The FDA approved the new prosthesis through its humanitarian device exemption pathway, which dispenses with the effectiveness requirements found in its normal approval process. Devices can be designated a humanitarian device if they treat or diagnose a condition or disease affecting fewer than 4000 individuals in the United States each year.

FDA News Release

Regina Holliday's Medical Advocacy Blog: Dark Willow and "73 Cents"

Pain and suffering are common to being human. It often seems to be the great catalyst that produces brilliance and genius in music, writing, painting and creative endeavour.


This is certainly true of Regina Holladay, a woman I have followed for many years. No, I am not a lurker, but a great admirer of this gifted lady who took lemons and made lemonade.


I hope you will feel what I feel every time I read her blog or see her paintings in The Walking Gallery. Every physician should see her exhibits.  Every physician should have one of her paintings on his back of his white coat, or in his office.


Regina Holliday's Medical Advocacy Blog: Dark Willow and "73 Cents"

My Most Popular Blog (As told to me by Blogger)

Every once in awhile (like every day) I look back over my shoulder to see who is following me. (No, I am not paranoid, just narcissistic). I don't rank very high in social media or the blogosphere, and I have been at blogging since 2005. Many bloggers have fallen by the way in these ten years...some of them very good. Why am I still here ? I am a creature of habit...bad ones as well as good.  After ten years of dedication, discipline, good will, offending some,  and encouraging a few I am somehow pleased that I have had a forum to collate and be creative at times.

I average about 75-110 'hits' each day. The numbers are less than what I would expect or desire. However the interesing data that sticks out on Feedjit is the global impact of my blogs, U.S.,Canada and the highest and Romania, Thailand, India, Russian Federation, Phillipines, and our friends in the U.K.

Yesterday my count was over 230. It doubled and I had to know why. It was not the content. I looked at the title "revolutionary","healthy, #wellness". I have used those terms before, but never had this kind of response. I use buffer, newsana, digg, reddit, Google + and Facebook at times. (all the SEOs and experts on social media marketing advise that avenue.

Then it struck me. I use many hashtags, my most popular ones are #hcsm #hitsm #mhealth #cms #medicare #doctors and a few others I cannot remember. Yesterday I looked at the trending hashtags of twitter. I used the highest hashtags in my buffer.

Voila!

#espy

Go look it up.....who wuda known?

Revolutionary Way to Be Healthy #10: See the Bigger Picture | Pilar Gerasimo

There are an overwhelming number of ways to maintain good health. The variations for maintaining good health  are as abundant as the number of people.

Your health effects those all around you. Good health and vitality influence your friends,family and co-workers.

Typically, when we want to check our health and fitness progress, we step on the scaleor look in the mirror. But when it comes to well-being, what you see isn't always what you get -- or at least, not all that you get.

We've been inclined to believe that pursuing health and fitness is predominantly self-focused, and that we alone stand to profit from the results.

Nothing could be further from the truth. Certainly, whenever we change our lives for the healthier, there's a lot in it for us as individuals: more energy, strength, confidence, vitality, mental clarity, better moods, improved appearance, lower disease risks, and so on.

But there's just as much in it (if not more) for all the people, places, and projects that we touch during the course of our daily lives.

They imply that the central rewards of health and fitness are largely derived from appearing healthy and fit, and by extension, from impressing others (or avoiding their judgment).

And so, within the vast and deep slipstream of positive results created by healthy lifestyle changes, we've tended to focus on only a comparatively narrow and superficial band.

Of course, there's nothing wrong with wanting to achieve appearance-related changes. In fact, the aesthetic rewards that go along with healthy body transformations have some very real superpowers. (I'll get to those in a moment.)

But in many cases, some of the biggest payoffs of our healthy changes have less to do with us than with the people, places, and things that matter most to us.

The reality: When you make even a modest improvement in your health status, or in even a single health habit, a whole bunch of people around you invariably benefit -- regardless of whether they (or you) happen to realize it at the time. And being even marginally aware of this dynamic can serve as a powerful intrinsic motivator.

Psychological research suggests that intrinsic motivators (those connected with our sense of enjoyment, value, or meaning) are dramatically more powerful and long lasting than extrinsic motivators (those connected with our desire to impress others, win material rewards, avoid punishments, or comply with social expectations).

By expanding your awareness of the potential intrinsic rewards embedded in the fabric of your life, you can tap into a new reservoir of motivation. The kind of meaningful motivation that comes in very handy on those days when bikini-body and flat-abs promises seem to have lost their luster, and the appeal of eating caramel corn in front of the television seems especially strong.

Revolutionary Way to Be Healthy #10: See the Bigger Picture | Pilar Gerasimo

Here are just a few bigger-picture factors to keep in view.

• Relationships. Your level of health, vitality, self-esteem, and equanimity all powerfully influence how you show up for other people. Reflect on what you are like to be around when you are healthy versus unhealthy. Think about how your needs, resources, and capacity shift, and the potential support or pressure that shift creates for others (family, friends, kids, coworkers). As you get healthier and happier, the people closest to you are the most likely to benefit -- and to be inspired by your example.
• Professional Chops. We tend to accomplish a great deal more when we are strong, clear-headed, and confident than when we are sick, tired, and "meh." Which is why most employers today are less concerned about absenteeism than"presenteeism" -- an increasingly common dynamic in which people physically show up at work but don't contribute much. The level of drive and focus you have available to bring to your career and creative pursuits depends heavily on your level of physical, mental, and emotional health.
• Community. The healthier you are, the more surplus energy and attention you can contribute to causes and community efforts. It's much harder to get out and volunteer, to be engaged with your neighbors, to focus on communal concerns, when you aren't feeling your best. Which is why health-motivated people are often the ones who start community gardens, launch local walking and yoga groups, advocate for healthier school lunches, and crusade for other healthy causes.
• Storytelling. As you shift your life, and as you share the story of your journey, you create a bread-crumb trail for others to follow. This can have surprising and long-lasting effects -- many you will never know about, and, likely, some that will outlive you.
• Silent Influence. As you go about your healthy business, other people notice and may begin to model their behavior on yours. The visible changes in your body can function as a superpower catalyst for others ("You look amazing! What are you doing differently these days?"), but ultimately it's learning what you know, and seeing what you do, that winds up having the biggest impact. And don't forget about your healthy diaspora: All the people you inspire will ultimately go out and inspire a whole bunch more people.

I had a neat experience recently that illustrated this last point for me. A woman I helped many years ago -- an overstressed nurse practitioner who was then going through a health and life crisis of her own -- wound up getting some coaching that I recommended based on my own experience.  She shifted her daily priorities and choices, started taking better care of herself, got trained in functional medicine, and, to my surprise, wound up becoming one of the first members of the medical team at Life Time's new LT Proactive Care Clinic. (For more of her story, see "The Nurse Who Learned to Heal Herself First".)

Nurses, care givers go the extra mile to help others, and they forget the most important person who requires nourishing. THEMSELVES. 

So go ahead: Look in the mirror -- and see the bigger picture. When you change your life for the better, everyone around you changes for the better too, even if only by having witnessed the changes you've made and realizing they are possible.

REVOLUTIONARY READING

"Get Your Groove Back" -- Dr. Frank Lipman on why finding your body's natural sleep cycle and circadian rhythms is the key to strength, vitality and wellness.

"Fearless Health" -- Worrying excessively about our well-being can do us more harm than good. Here's how to keep your health concerns in perspective.

"With Power, Responsibility" -- It's time for us to start taking better care of our amazing bodies -- and for healthcare to start raising its game.

"Fresh Start: A Spring Detox Guide" -- Say goodbye to internal grime and grunge. Your body is begging you to take out the trash!

Pilar Gerasimo is a nationally recognized healthy-living expert, author of A Manifesto for Thriving in a Mixed-Up World, and the creative force behind the 101 Revolutionary Ways to Be Healthy. She serves as senior vice president of Healthy Living for Life Time, the Healthy Way of Life Company, and is currently working on a book about the art of being healthy in an unhealthy world. Learn more about Pilar's work and connect with her via social media at PilarGerasimo.com.

Follow Pilar Gerasimo on Twitter: www.twitter.com/pgerasimo

Telemedicine Puts a Doctor Virtually at Your Bedside

In just the past three months telemedicine has grown exponentially. It has entered the main stream of medicine. Several hospital chains are using Teladoc. Some providers are concerned about remote diagnosis. Telehealth will meet specific guidelines for it's use.  In rural areas where providers are not available, it could make the difference between life and death. In instances where patients present in an emergency department with vascular emergencies, stroke in particular there is a very  narrow time window for treatment with drugs that prevent  clots or dissolve them.

In some situations such as academic medical centers the appropriate physicians are in hospital.   However in most community hospital settings they  are  not.  The video demonstrates availability of a neurologist in less than 6 minutes.  A nurse or  emergency department physician can conduct a physical examination while the consultant observes.  If indicated the treatment can  begin immediately. A history is already available or can be obtained in  real time. Time is then  available for the neurologisit or other specialist to arrive and see the patient face-to-face.  Telehealth will never replace a  physician visit, only augment his arrival at the scene.

Hospital and emergency department studies  reveal that only a few patients are now treated within the recommended time frame. The time difference can mean the difference between successful treatment or serious disability and even death.

The most significant barrier is that each state has it's own medical board, and it will require changes in physician regulations by 50 different state medical boards. It will also require Medicare and private insurers to cover this as a eligible charge.  While Medicare and private insurers have expressed concern about additonal costs during an era of cost containment in  the long run hospitalizations, and periods of rehabilitation as well as a decrease in permanent disability would offset the initial cost.  A 48-72 hour hospitalization is significantly less that a 7-10 admission.

Physicians must insist that their medical boards allow this to proceed without sanctioning physicians and/or hospitals for providing this needed service for patients.  State medical societies, and appropriate specialty societies also need to weight in with this as a standard of care.  The evidence is already present.

References

1: Zerna C, von Kummer R, Gerber J, Engellandt K, Abramyuk A, Wojciechowski C,

Barlinn K, Kepplinger J, Pallesen LP, Siepmann T, Dzialowski I, Reichmann H,

Puetz V, Bodechtel U. Telemedical Brain Computed Tomography Misinterpretation by

Stroke Neurologists Is Not Associated with Thrombolysis-Related Intracranial

Hemorrhage. J Stroke Cerebrovasc Dis. 2015 Jul;24(7):1520-6. doi:

10.1016/j.jstrokecerebrovasdis.2015.03.022. Epub 2015 Apr 11. PubMed PMID:

25873473.

2: Liebeskind DS. Response to letter regarding article, "art of expertise in

stroke telemedicine: imaging and the collaterome". Stroke. 2015 Jun;46(6):e152.

doi: 10.1161/STROKEAHA.115.009327. Epub 2015 Apr 16. PubMed PMID: 25882052;

PubMed Central PMCID: PMC4442038.

3: Uchino K, Rasmussen PA, Hussain MS; Cleveland Pre-Hospital Acute Stroke

Treatment Study Group. Letter by uchino et Al regarding article, "art of

expertise in stroke telemedicine: imaging and the collaterome". Stroke. 2015

Jun;46(6):e151. doi: 10.1161/STROKEAHA.115.009214. Epub 2015 Apr 16. PubMed PMID:

25882054.

4: Moloczij N, Mosley I, Moss K, Bagot K, Bladin C, Cadilhac DA. Is telemedicine

helping or hindering the delivery of stroke thrombolysis in regional areas? A

qualitative analysis. Intern Med J. 2015 Apr 22. doi: 10.1111/imj.12793. [Epub

ahead of print] PubMed PMID: 25904209.

5: Fong WC, Ismail M, Lo JW, Li JT, Wong AH, Ng YW, Chan PY, Chan AL, Chan GH,

Fong KW, Cheung NY, Wong GC, Ho HF, Chan ST, Kwok VW, Yuen BM, Chan JH, Li PC.

Telephone and Teleradiology-Guided Thrombolysis Can Achieve Similar Outcome as

Thrombolysis by Neurologist On-site. J Stroke Cerebrovasc Dis. 2015

Jun;24(6):1223-8. doi: 10.1016/j.jstrokecerebrovasdis.2015.01.022. Epub 2015 Apr

20. PubMed PMID: 25906936.

6: Choi YH, Park HK, Ahn KH, Son YJ, Paik NJ. A Telescreening Tool to Detect

Aphasia in Patients with Stroke. Telemed J E Health. 2015 May 5. [Epub ahead of

print] PubMed PMID: 25942492.

7: Yaghi S, Harik SI, Hinduja A, Bianchi N, Johnson DM, Keyrouz SG. Post t-PA

transfer to hub improves outcome of moderate to severe ischemic stroke patients.

J Telemed Telecare. 2015 May 10. pii: 1357633X15577531. [Epub ahead of print]

PubMed PMID: 25962653.

8: Torres Zenteno AH, Fernández F, Palomino-García A, Moniche F, Escudero I,

Jiménez-Hernández MD, Caballero A, Escobar-Rodriguez G, Parra C. Mobile platform

for treatment of stroke: A case study of tele-assistance. Health Informatics J.

2015 May 14. pii: 1460458215572925. [Epub ahead of print] PubMed PMID: 25975806.

9: Yuan Z, Wang B, Li F, Wang J, Zhi J, Luo E, Liu Z, Zhao G. Intravenous

thrombolysis guided by a telemedicine consultation system for acute ischaemic

stroke patients in China: the protocol of a multicentre historically controlled

study. BMJ Open. 2015 May 15;5(5):e006704. doi: 10.1136/bmjopen-2014-006704.

PubMed PMID: 25979867; PubMed Central PMCID: PMC4442242.

10: Bladin CF, Molocijz N, Ermel S, Bagot KL, Kilkenny M, Vu M, Cadilhac DA; VST

program investigators. Victorian Stroke Telemedicine Project: Implementation of a

new model of translational stroke care for Australia. Intern Med J. 2015 May 26.

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11: Zerna C, Siepmann T, Barlinn K, Kepplinger J, Pallesen LP, Puetz V, Bodechtel

U. Association of time on outcome after intravenous thrombolysis in the elderly

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more:

How Much Money You Can Save on Insurance When You Quit Smoking

Yes, it is true. You will save literally thousands of dollars within one year. The amount rises exponentially for each year thereafter.  Save for your next vacation, buy a gym membership (that will also extend your life, or save it.  You will be able to afford healthier foods, fish, complex carbohydrates and more.

According to NerdWallet, it takes about five years of being smoke-free for rates to be as low as non-smokers’ rates. A few other key findings and takeaways include:

• Switching to a different nicotine product won’t help. Most people who use nicotine gum, patches, lozenges, nasal sprays or e-cigarettes still pay smokers life insurance rates.
• Don’t lie on your life insurance application. Your medical records and your life insurance medical exam, which includes a blood and urine test, will likely reveal your smoking habit. And if you’re an ex-smoker, your insurer might verify the amount of time you’ve been smoke-free by checking past life and health insurance applications you’ve made. Misleading your life insurer is considered fraud and can jeopardize your beneficiaries’ death benefit payment.
• 
  
• You can ask your insurer for a rate review if you quit smoking after buying a policy at smokers rates. The company will re-evaluate your health and smoking status and might grant you a better, nonsmoking rate. There’s no risk to you. Even if you’ve developed other health problems in the meantime, your rate cannot be raised.

In another article on the cost of smoking, NerdWallet points to an eHealth study that foundsmokers pay 14% more for health insurance premiums on average. Bernard Health reports that many companies will lower your rate if you haven’t used tobacco in the last 12 months.

Life Insurance Savings from Quitting Smoking | NerdWallet

How Much Money You Can Save on Insurance When You Quit Smoking