Better Aging Through Practice, Practice, Practice - The New York Times
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Sunday, May 1, 2016
Tuesday, April 26, 2016
Health Reform Troubles and the Affordable Care Act
We are now several years into the Affordable Care Act. There are now facts and figures which reveal troubling tremors in the financial underpinning of health insurance for all patients. No one will be exempt from these market forces.
Some politicians and President Obama (for whom the ACA was renamed "Obamacare") insist on how many millions of Americans are now insured. Yes, they carry a card, either a blue one with a stripe (Medi-caid) or a private plan. What many of these newly insured do not know is the card they carry from the ACA is not the same that fully paying patients have in their wallets. The term "What' in your wallet" may be applied to health insurance cards as it has been to certain credit cards. The similarities are frightening.
These subsidized plans required providers to sign new contracts with less reimbursement eliminating any incentive to be credentialed for the affordable care act. It required providers to re-program their practises management software to bill different amounts for the ACA and to accept a lower reimbursement for each procedure code.
In some Western states the impact of undocumented workers remains largely unknown. However there are those who want to include the segment of our population. I think these immigrants do need to be protected, and not be excluded from the American health system. We have always been a country that welcomes immigrants and usually assimilate them fairly quickly.
Here is what is building.
ACA News
Will Covered California Sell Health Coverage To The Undocumented?
ObamaCare premiums expected to rise sharply amid insurer losses
United’s Departure From Marketplaces Could Impact Consumers’ Costs, Access
Wikinvest lists these UHG mergers and acquisitions and divestitures in the past ten years
This includes former independent health insurers, Oxford, Pacificare,Mid Atlantic Medical Services Inc.,Definity Health Corporation (Definity).Uniprise USS, Exante
United Health Group has several other companies in their sights Humana and Aetna. Anthem also
has eyes on Humana and Aetna is bidding on Cigna. As the old baseball adage goes (So who's on first?)
Readers can see more..........
The changes will impact consumers in different states, according to market share and other factor such as the amount of care to patients with long standing expensive chronic disease, more advanced because of neglect in the group of the uninsurables. The impact of lifestyle becomes a significant issue for some states where poor nutritional habits affect health and the development of chronic illness, diabetes, obesity, hypertension, the effects of depression, unemployment, environmental hazards. Social change and erosion of the middle class will impact health as well.
The longstanding organization of employee based health care is disappearing, and group policies are re-organizing.
Wall Street is ablaze with speculation and the huge increase in share value for many of these companies.
Fortune's headline proclaims,
UnitedHealth-Aetna colossus would overtake Apple on the Fortune 500.
As things develop eventually there may only be several players in the health insurance
market....."too big to fail". Uncle Sam steps in when all is lost.......and there you have it "UNIVERSAL PAYER" Who wudda thot ?
So where do patients and providers fit in?
Parts of this article are from Fortune, and reporting from the California Medical Association.
Some politicians and President Obama (for whom the ACA was renamed "Obamacare") insist on how many millions of Americans are now insured. Yes, they carry a card, either a blue one with a stripe (Medi-caid) or a private plan. What many of these newly insured do not know is the card they carry from the ACA is not the same that fully paying patients have in their wallets. The term "What' in your wallet" may be applied to health insurance cards as it has been to certain credit cards. The similarities are frightening.
These subsidized plans required providers to sign new contracts with less reimbursement eliminating any incentive to be credentialed for the affordable care act. It required providers to re-program their practises management software to bill different amounts for the ACA and to accept a lower reimbursement for each procedure code.
In some Western states the impact of undocumented workers remains largely unknown. However there are those who want to include the segment of our population. I think these immigrants do need to be protected, and not be excluded from the American health system. We have always been a country that welcomes immigrants and usually assimilate them fairly quickly.
Here is what is building.
ACA News
Will Covered California Sell Health Coverage To The Undocumented?
ObamaCare premiums expected to rise sharply amid insurer losses
United’s Departure From Marketplaces Could Impact Consumers’ Costs, Access
United HealthCare has absorbed multiple other companies during the past two years, to insulate itself from competition and have full reign over the market for insurance plans. These mergers include or will include the following competitors.
This includes former independent health insurers, Oxford, Pacificare,Mid Atlantic Medical Services Inc.,Definity Health Corporation (Definity).Uniprise USS, Exante
United Health Group has several other companies in their sights Humana and Aetna. Anthem also
has eyes on Humana and Aetna is bidding on Cigna. As the old baseball adage goes (So who's on first?)
Readers can see more..........
The changes will impact consumers in different states, according to market share and other factor such as the amount of care to patients with long standing expensive chronic disease, more advanced because of neglect in the group of the uninsurables. The impact of lifestyle becomes a significant issue for some states where poor nutritional habits affect health and the development of chronic illness, diabetes, obesity, hypertension, the effects of depression, unemployment, environmental hazards. Social change and erosion of the middle class will impact health as well.
The longstanding organization of employee based health care is disappearing, and group policies are re-organizing.
Wall Street is ablaze with speculation and the huge increase in share value for many of these companies.
Fortune's headline proclaims,
UnitedHealth-Aetna colossus would overtake Apple on the Fortune 500.
As things develop eventually there may only be several players in the health insurance
market....."too big to fail". Uncle Sam steps in when all is lost.......and there you have it "UNIVERSAL PAYER" Who wudda thot ?
So where do patients and providers fit in?
Parts of this article are from Fortune, and reporting from the California Medical Association.
Monday, April 25, 2016
Medical school has killed my soul. What can I do? | Pamela Wible MD
It is not hopeless. the problem and the solution lies within.
Medical school has killed my soul. What can I do? | Pamela Wible MD
Medical school has killed my soul. What can I do? | Pamela Wible MD
Sunday, April 24, 2016
F.A.S.T. Are you at Risk for a Stroke
I have had many illnesses, including heart disease and a mild stroke. I went through open heart surgery and several angioplasties for heart disease.
On a scale of dread, heart disease was about a 2 on a scale of 1 to 5. The idea of a stroke was a 6 in my mind, and when it happened quite suddenly, while I was asleep i had an acute anxiety attack.
When I awoke I realized there was something amiss in my non-dominant right hand, it was numb. In the past I would at times awaken and have one of my hands tingling or numb which I attributed to a cervical disk problem.(one of my cervical disks bulges,and I have had a surgery on my lower back for a ruptured intervertebral disk) However this did not go away even with stretching my neck. Try as I might my right arm and hand refused to obey my commands.
I am fortunate. The symptoms and signs diminished quickly over a period of two weeks. I was left with some residual balance and gait disorder, for which I have learned to compensate.
The best way to treat a stroke is to not have one. I ignored a serious and common factor for stroke risk. Snoring and sleep apnea, both of which are successfully treated. It is listed as a risk factor, but is overshadowed by cholesterol issues, hypertension, and diabetes. I ignored my spouses warnings about my snoring and periods of sleep apnea. Sleep apnea occurs when there is total airway obstruction from snoring. Patients are unaware of these episodes but whoever sleeps with or near them will hear a gasp and see the victim roll over or moan.
Sleep apnea or severe snoring should be characterized as an urgent medical problem. There are tests to easily diagnose the problems, and even an at home testing device, which screens for sleep apnea. A formal sleep apnea test in a sleep lab is still necessary. It's a small price to pay, sleeping away from home for a night, however it is a small price as compared to paralysis
I share this as an admonition for this month' preventive measure as well as weight reduction, a healthy diet, and exercise.
AUT researchers have developed an app to calculate stroke risk factors. Available on both iOS & Android platforms, the Stroke Riskometer App was selected by leading doctors as a top health app for 2014 from 100,000+ apps available. It is available on iTunes and Google Play Store.It is endorsed by the WSO (World Stroke Organization
Remember !
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