Cash Cow For Crooks – Our American Healthcare System

The American Healthcare System is pandemic in fraud and that needs to be taken care of first before we can save real money in the system. We could save multi-billions if the system was revamped and the opportunity for easy money was eliminated. I know what a debacle our healthcare system is in, I spent months preparing my company for Medicaid and Medicare approval. It reminds me of taking a dry towel every 5 minutes to dry off when you’re standing in the rain. There seems to be no end to redundancy and complexity. A system in complete dissaray and bleeding profusely.

I know this as a fact since I spent months getting the necessary requirements for my companies approval for Medicaid and Medicare. Just to get the process started you have to get approved and checked by no less than three clearing-houses. What a nightmare.

Lately there has been a lot of talk about IT and cross operational platforms to help reduce costs and save us from high medical expenses. Our government and most consumers havn’t got a clue how our Healthcare System works and how the system has turned into a “Cash Cow” for the crooks. The system is ‘Bleeding Profusely”, and it will take more than a bandaid to fix it.

The consumer is over charged every step in the process, all the way to bankruptcy. I read an article how in 2007-2008, 61% of bankruptcies were caused by medical bills, this was up from 27% just a few years before.

Yesterday I was having lunch with an elderly man 70 yrs old and he asked what I did. I told him very proudly. Sir I distribute premium medical equipment and supplies and my company carries the best crutches, forearm crutches, bedside commodes and bed tables in the country. He could tell I was passionate in what I did and he told me his story. He retired from General Motors and he that was a diabetic he then mentioned that his co-pay was $11.00 every time he went in for a check-up. The doctor usually rushes him through but recently spent approx 10 minutes with him and he appreciated it, until he checked out. It seems the doctor charged his co-pay $33.00 this time. Well lets do the math, for 10 minutes he charged $20.00. That equates to $120.00 an hour.

Oh now if the co-pay was just 20% of total bill then that leaves a bill of 50 minutes more he can charge for and the Insurance would pay for. We know he charges $33.00 for every 10 minutes. This is a patients portion, so $33.00 times 5 is equal to $165.00. so here is what you have. Whether the man or the insurance company pays for this a total cost that the doctor is billing just for a check-up is $198.00. This is not $198.00 an hour it’s almost $200.00 every ten minutes or $1,200 and hour. I don’t care how you cut this it is wrong!

It gets worse. This doctor hasn’t even started charging for any scripts or extras he can bill for. This happening in my own backyard and I’m sick of it!

In every facet of the healthcare process everyone is overcharging and no one is watching the ship.

Significant savings can occur by supporting preventative care, wellness programs and education. Throw real money at this so people will follow and use recommendations. Unless we have a system that provides monetary incentives for better health, consumers won’t use it.

Health abuse and expense occur with the foods that are recommended and are so-called healthy. My pet peeve is our ludicrous diet with all the non-nutritional foods being marketed and promoted as healthy. It’s causing our society to be obese and psychologically we depend on it, many of the additives and artificial ingredients are causing severe mental and physical problems, they have addictive properties and exacerbate current and future medical conditions. Examples include diabetes, headaches, MS and other neurological conditions.

Healthcare System For Employees – Important Facts

But getting a reliable insurance plan is a must for employers who want to provide good benefits for their employees. So what’s a responsible but financially hard up business owner to do?

What employers must know is that there are health insurance plans designed specifically for small business owners and this is what they should be considering for their employees. There are many insurance companies out there who have ready-made services for small business that have plans that are well within reach of any employer. Some employers think that getting healthcare for their employees is a financial burden. Fact is, business can actually save money in the long run by getting a healthcare system for employees.

The best way to get the most affordable healthcare systems for employees is by performing a through research and survey of all the available insurance plans for small businesses out there. Talk to different insurance agents and ask them about alternatives if the plan that they will present to you is a bit out of your reach. Inquire about how to get tax free insurance policies which will surely be advantageous to you. Many insurance companies offer big discounts when it comes to providing group insurance policies so be sure to ask about it as well. This may seem lot a lot of work for you but the rewards will be tremendous.

You could also benefit from websites that compare different insurance premiums. By logging on to these websites, you will be able to get a quick glance of the available plans to you. It is advisable that you go for the one that provides the most value for money even if it is not necessarily the cheapest.

What Physicians Can Do to Prepare For the New Healthcare System

There has been a great deal of discussion about the new health care reform and whether or not it will affect the business of medical malpractice insurance. Although it has been said that there will be no changes in the business of insurance, there will be many changes in the healthcare industry as a whole. Regardless, now is the time for physicians to prepare for these changes.

It has been estimated that 32,000,000 people will be added to the healthcare system. With such a dramatic increase in people demanding healthcare, there will be an enormous amount of paperwork to process. Likewise, doctors will most likely need to increase their staff because there will be new patients who will have many questions or need help filling out paperwork.

One of the things that physicians can do to prepare is to do a thorough review of their policies and procedures to make sure that there is an established system in place to take care of administrative tasks. The more organized an office is, the easier it will be to process patients’ billing and paperwork.

Another way that physicians can prepare for changes is to make sure every person on their team is properly trained. Everyone has to be on the same page when it comes to caring for patients. This has always been the case, but now more than ever physicians have to be more mindful and conscious of how they are treating people. Providing quality health care will be the determining factor on whether or not a person continues to seek care from a particular physician.

Under the new healthcare reform bill, physicians will be rewarded for high quality, efficient care. There will be increased payments to Medicare Advantage plans that demonstrate care and significantly improve quality.

The bottom line is that physicians need to be flexible and adapt to the inevitable changes in healthcare that will take place in the following years. Keep an open mind and always be on the lookout for ways to improve patient care.

Offshoring U.S. Patients No Cure for Ailing Healthcare System

For several years now, American healthcare consumers, including many from other western industrialized nations, have heard about elective surgeries being performed in lesser-developed nations and due to cost and denial of coverage by health insurance providers have opted to go there. However, surgeries in the past were truly elective and not medically necessary procedures that largely consisted of face-lifts, tummy tucks and gastric bypasses for cosmetic purposes.

But just in the past two years, American patients are being wooed to make decisions on serious medically necessary surgeries due to their fears of excessive healthcare costs. And the decision involves traveling abroad primarily to India and Thailand in order to receive such hospital care which they require.

For those self-insured, underinsured, or not insured at all, the desperation of receiving medical care without sacrificing homes or assets in the process is plausible, since costs of similar procedures in South Asia range from 75% – 80% less than in the United States. But now U.S. based corporations have entered the arena as well by encouraging employees to go to India and Thailand via cash incentives, free airfare and hotel stays with no co-pays due on the final bill.

Yet, just as with any large purchase consumers must look beyond the fancy advertisements and read the fine print with a Buyer Beware mentality. Americans have become quite adept at learning what to look for when dealing with car dealerships when purchasing an automobile and with computer retailers when purchasing a new computer. But it has taken many years to educate consumers as to their rights and protections under the law and what to do when something does go wrong.

The term “medical tourism” has been inaccurately applied to what is essentially the offshoring of patients of the U.S. healthcare system to foreign countries, in order to appeal to potential customers who are really medical patients. The term was invented by the media and it stuck and is now being used as a marketing tool. Deceptive in its concept, it is an implication that a patient can go sightseeing before or after a serious hospital procedure in that foreign country. But for those who are more scrupulous it remains difficult to get the necessary information needed to make a reasoned decision on whether to have surgery performed, let alone halfway around the world.

There are now organizations being touted as medical tourism agencies that have cropped up throughout the U.S. in order to facilitate such care overseas for individual patients as well as to serve as a clearinghouse for corporations wishing to outsource their employees’ healthcare with them in tow. These groups include MedSolution, GlobalChoice Healthcare, IndUShealth, Planet Healthcare and Med Retreat, to name just a few.

And with more and more corporations adding select foreign hospitals as Preferred Providers to their employees’ health insurance plans, medical tourism companies handle the paperwork and travel arrangements for their employees. Other countries of destination include Costa Rica, the Dominican Republic, the Philippines, Panama, Mexico, China, Malaysia, Singapore, Turkey and South Africa.

However, it is at this point that the patient needs to start their own due diligence. There is usually a requirement by most U.S. healthcare insurance providers for patients to get second opinions for most complicated surgeries in the U.S., but not so for offshore surgeries. And the list of surgeries which are being sent offshore are indeed medically necessary but confusingly being reported to the media as elective. But you can determine for yourself whether or not the following are elective procedures: cardiac bypass, cardiac stent implantation, cardiac angioplasty, knee replacement, hip replacement, mastectomy, hysterectomy, chemotherapy, eye surgery, vascular surgery, among others.

And as the medical tourism agency is only an intermediary between the client and the hospital as well as between hotels and airlines they do not provide any liability in the event that there is a medical complication or there is a mishap at the destination hospital. Furthermore, there are fees which could arise not documented by an employer nor agency which could require additional expenses upon the patient’s arrival. And as a conduit between patient and hospital, the medical tourism business remains an unregulated industry in the U.S., without licensing requirements and with most managed by non-medical personnel.

Similarly, and unbeknownst to most U.S. patients is that the healthcare industry in India is highly unregulated. It was only in 2006 that regulations regarding the medical device industry, which includes surgical devices such as cardiac stents and orthopedic implants for use in hip and knee replacements, was mandated. Such call for regulation from the Drug Controller General of India (DCGI) only came about as the result of discovered defective drug eluting cardiac stents in 2004. And although hospitals have the option of applying for accreditation through the Joint International Commission established in 1999, a subsidiary of the Joint Commission on Accreditation of Healthcare Organizations, used for hospitals in the U.S., there is no such requirement to do so.

As of 2006 there are five hospitals in India which have JCI accreditation, renewable every three years. They include the three facilities of the Apollo Hospital group, the Shruff Eye Hospital and the Wockhardt Hospital. The Bumrungrad International in Bangkok is Thailand’s sole JCI hospital. Singapore has over a dozen JCI hospitals however, and the Philippines has one. But the JCI accreditation only applies primarily to hospital management which although includes procedures to reduce risk of infection and disease and to ensure patient safety, it has no jurisdiction over the actual physicians performing surgical procedures.

The patient is provided limited information other than an introductory phone call to the intended physician and having medical records electronically sent to the doctor or hospital via the internet by the medical tourism agency. The patient has a choice of physicians, but unlike in the U.S. where there is easy access to a doctor’s medical status by medical boards and organizations, other than knowing whether the doctor may have practiced medicine in the U.S., there is little information to come by. Without standardized protocols it is difficult for the patient to make a correct assessment.

When decisions on a patient’s health is driven primarily by cost it can impair the decision making process. There is little argument that healthcare costs in the U.S. are bankrupting corporations and labor unions and deceleration of escalation is nary in sight. With the healthcare industry being 15% of the U.S. Gross Domestic Product and having risen in cost 75% for employers and 143% for employees since the year 2000, the system is broken. High malpractice insurance fees required by both employers and physicians, hospital deregulation and class action medical litigations have only exacerbated the problem.

Such high medical costs will only encourage limited access to healthcare for the middle class and ultimately result in less preventative care costing taxpayers more in the long run. The problem is not the medical care in the U.S., still considered the best in the world, but its delivery system. It is when Medicare and the health insurance providers became the decision makers and took that power away from the physicians that the system began to unravel. Added to that is the lack of restraint of costs by the pharmaceutical industry which charges U.S. patients more for its own medications than any other country in the world.

But as expensive as healthcare is in the U.S., there are legal and safety issues which are part of the American fabric which Americans very much take for granted yet expect but are not present in the undeveloped world. For example, there are few regulatory bodies such as the Centers for Disease Control, the Food and Drug Administration, the Federal Trade Commission, various medical boards, consumer protection laws, available legal experts and the court system. All serve as a net of safeguards offering remedies. But unlike a car purchase, medical care is a complicated undertaking in which there are no guarantees, yet there are areas of compliance which must be maintained.

Once the patient is in a foreign country there is little protection for redress and once that patient leaves the country should they need follow-up care such as therapy or if complications arise even during travel, they must seek medical care in the U.S. Secondarily, if the procedure is performed overseas, insurance providers or Medicare may not honor the additional required care in the U.S. Still, patients may decide to take the risks in addition to the inherent risks of any surgery, but should not be coerced into uninformed choices in order for their employer to save costs under the guise that they are helping to reduce the costs of U.S. healthcare in the long run.

In July 2006 the U.S. Senate Committee on Aging held a hearing called “The Globalization of Healthcare: Can Medical Tourism Reduce Healthcare Costs?” Its goal was to address the subject of medical tourism, its growth, safety of patients and possible regulation of the industry itself. Its Committee Chairman, Senator Gordon H. Smith, has asked that several federal agencies such as the Department of Health and Human Services, the Department of Commerce and the Department of State create an interagency task force necessary for lawmakers to reach informed decisions that healthcare consumers themselves cannot accurately make at this juncture regarding offshoring their medical care.

And among the labor unions, the United Steelworkers Union (USW) has publicly weighed in on this issue when it learned one of its union members, employed by Blue Ridge Paper Products, was going to be sent to India for gall bladder surgery simultaneously with shoulder surgery. Leo W. Gerard, USW International President, fired off a complaint dated September 11, 2006 to Congress by contacting the following committees: the House Committee on Education and the Workforce, the House Committee on Energy and Commerce, the House Committee on Ways and Means, the Senate Committee on Finance, and the Senate Committee on Health, Education, Labor and Pensions.

The goal is not necessarily to create more legislation but to establish guidelines. Perhaps Mr. Gerard puts it best when he states, “The right to safe, secure and dependable health care in one’s own country should not be surrendered for any reason-certainly not to fatten the profit margins of corporate investors.” He also contends to the Congress that “We remain steadfast in our commitment to rebuild a domestic healthcare system.”

A Systemic Problem in Our Healthcare System

Those of you who are old enough to remember the Australian bush nurse Sister Kenny (1880-1952), will no doubt recall the brouhaha she caused within the medical establishment of her time. Elizabeth Kenny had devised a treatment for polio that was universally castigated by doctors of the day. In fact her methods proved time and again to be efficacious and became the forerunner for the practice of physical therapy as we know it today.

The reason Sister Kenny, and her struggles with the established order of medicine, is brought to mind is that licensed medical doctors all too often behave like members of a closed-shop union. In such an environment, no one is allowed to do work that is perceived as encroaching on their specialty, without consequent castigation and sanction. And, they vigorously lobby for laws to protect them from perceived interlopers.

In Sister Kenny’s case, she struggled for years to get her therapeutic methods accepted, even in the face of observable success, and admiring testimonials from patients. The medical profession cast aspersions on her methods and her person, largely because she wasn’t an accredited practitioner (only a nurse), and her methods contradicted generally accepted treatment standards.

In today’s contentious health care environment, alternative treatments are greatly frowned upon, and their practitioners ridiculed. Ask licensed doctors what they think of acupuncture, chiropractic, aroma or muscle activation therapy, and they will almost always turn up their noses. In fact, they have convinced the insurance industry that these methods are nothing more than palliatives bordering on quackery. Thus, patients are channeled into much more expensive surgical and drug treatments that often times provide no relief.

This is not to say that there aren’t quacks hovering around the practice of alternative medicine, just as there are quacks who are licensed to practice the approved variety. It is also not claimed that there alternative methods for all sicknesses or diseases. But it is also true that in most professions, wherever there is a buck to be made, a surfeit of willing hands will extend to accommodate. We see desperately sick people try all sorts of last gasp treatments, especially after traditional medicine has given up on them. And these alternative methods seldom work.

However, in the less well defined areas of pain management, due to a variety of causes, modern medicine has proven to be quite fallible. Countless thousands of people suffer through painful days of agony with only the promise of relief provided by dangerous drugs. Doctors prescribe many unproven medications because their pharmaceutical rep told them this was the cutting edge drug du jour for pain management. Big Pharma and the medical profession work hand and glove to push their latest (and expensive) drug on suffering patients. And since only licensed doctors can dispense them, this conduit is exploited by both parties. Why there might even be a financial incentive for the prescribing doctor. Heavens!

Because of the built-in aversion to examining or even testing alternative therapies, the healthcare system is saddled with more expensive, “accredited” treatments that push the insured patients in that direction.

Even though back surgery has been shown to be less than 50% effective, and much less costly alternative therapies have proven efficacious, they are ignored. Worse, just as in Sister Kenny’s case, they are scoffed at by the establishment. Such are the ironic side-effects of our costly for-profit health care system.

As another example of padding the bottom line is a practice that is becoming more common. Doctors are increasingly insisting on patients coming in for an office visit just to renew a prescription. Admittedly for some drugs it is necessary to monitor side effects (another indication of how dangerous some of them are), but in many cases it is totally unnecessary. As cuts in Medicare go into effect (which will increase, rather than cut costs), doctors will seek more ways to supplement their income. Once a professional is used to a certain level of earnings (no matter the discipline), it’s hard to accept less. Doctors are no exception.

So, the bottom line is that there just might be ways to improve both the costs of health care and the patients’ welfare by researching and approving alternative therapies. Sadly, that’s not even on the table for discussion.

BodyTalk – Complementary Or Standalone Healthcare System

BodyTalk in fact falls into the category of Energy Medicine and is not all invasive or prescriptive. A BodyTalk Practitioner does not do any invasive procedures and neither diagnoses nor prescribes anything. This makes BodyTalk an excellent healthcare system that can be used both on a standalone basis or it works very well as a complementary healthcare system too.

BodyTalk is ideal when used on a standalone basis when one is fundamentally healthy but just wanting to maintain and improve overall health and balance of the various aspects of oneself; physical, mental, emotional and/or spiritual. BodyTalk is great in helping one balance the experience of normal daily stress and discomfort. By using BodyTalk on a regular basis one finds that in general one heals faster and more easily.

BodyTalk is also very helpful in a situation where someone is already receiving other physically based treatments; whether they are alternative or traditional. Because BodyTalk works on an energetic level and is not invasive, there are only two possible outcomes from the treatment.

Most people find that they benefit from a BodyTalk session and usually feel much better for having had one. Because BodyTalk is not at all invasive, if a session is found to be ineffective, then the person simply experiences no change from having had a session.

For many years it seems that one had to make a choice between alternative or traditional medical treatment. More and more, however, people are taking the best treatment from both disciplines and applying those to one individual. One is finding that doctors from both disciplines are working together, and some doctors themselves have studied both disciplines and then they pick an appropriate treatment or combination of treatments from both disciplines.