Thursday, May 31, 2012

Sugar in Soft Drinks

A picture says it all.  Parents, please stop buying soda and soft drinks for your kids.  Lets break the sugar/obesity epidemic once and for all.

Sunday, May 27, 2012

Current Insurance Policies Fall Short of Health Care Reform

While we await the ruling of the  supposedly non-partisan Supreme Court on the legality of  the Affordable Care Act (aka: Obamacare, health care reform) it is useful to know one thing that would change if it goes through.  More than 11 million Americans are currently covered by private individual insurance plans that would not meet the minimum standards of coverage with ACA.  The big insurance companies would have to improve their plan offerings value if ACA goes into effect.

A study by Health Affairs showed that 51% of current policies had an actuarial value of less than 60% which would put it below the minimum requirements established under the Affordable Care Act for future state-based exchanges.  Those exchanges are scheduled to begin by 2014.

It is exorbitantly costly to be self insured and consumers are often stuck with what they can get.  The idea of "competition" and choice is a myth.  The individual insurance design falls short of what most people think they are buying when they pay premiums.  Five thousand dollar deductibles are common and exclusions for prior conditions like sinusitis or benign breast lumps are standard.  If a woman had a benign lump removed in her 20s, it is likely there would be an exclusion for breast disease that might occur when she is 55.  The more conditions that can be excluded, the better it is for underwriting and it completely negates the benefit of having insurance at all.

The purpose of the Affordable Care Act is to protect more Americans by getting them coverage that is truly a benefit.  It is not perfect.  There are many parts that will be tweaked and changed by Congress as it goes forward, just like any piece of legislation.  But it is a start at rectifying the abuses that millions of Americans have had to swallow.

Lets see what the Supreme Court decides.

Saturday, May 26, 2012

High Health Cost Does Not Guarantee Quality

The new buzzword in Medicine these days is "value based purchasing".  It's not a new concept...everyone wants to get their moneys worth, whether it is a new car, a meal at a fancy restaurant or the best medical care.  Without clear information on quality,  however, many patients assume that more expensive care is better care.

The Agency for Health Care Research and Quality (AHCRQ) has funded a study to look at this.  A team of researchers studied how various presentations of cost and quality influenced the choices of patients.  They found that many people perceived low cost clinicians to be substandard and avoided them.  It didn't matter if they were paying out of pocket for care or if they had insurance that covered the service.  They still associated higher cost with higher quality care.

When patients were given information in the form of easy to understand data about care quality they were more likely to make choices that didn't cost more.  It mattered how the data was presented.

Americans spend more on their health care than citizens of 12 other developed nations, but the quality of that care (as measured in outcomes, accessibility, preventive care) lags far behind.  It is difficult for a patient to know what "quality" care is.  According to Peter Lee, the former chief executive of the Pacific Business Group on Health, "For most consumers, the fact that there is no connection between quality and cost is one of the dirty secrets of medicine."

Most people don't have the time or expertise to delve into finding out if their doctor, hospital or surgeon can deliver "value" for the cost.  There are a number of websites that compare hospital outcomes for surgeries, infections and treatments but they are cumbersome and the data can be 2 or more years old.  Essentially they are useless for the patient.

Until we can:
1.  Define quality
2.  Provide transparent data that is easy to understand and
3.  Provide pricing and costs that are easy to understand

we will never be able to bring the escalating cost of health care under control.  Until that time, patients are flying blind and hoping that their high cost care delivers something in return that they can value.

Tuesday, May 22, 2012

PSA Tests Not Advised

A top panel of health experts, the US Preventive Services Task Force (USPSTF) has issued their ruling that prostate specific antigen (PSA) tests should not be done as a screening test on any man.  This is after several years of controversy about the blood test that many men get routinely at their annual physical exam.  The task force said the test leads to treatments that do more harm than medical terms we say the risks outweigh the benefits.

This ruling sparked an outcry from the American Urologic Association, who said the recommendation was "inappropriate and irresponsible".  Keep in mind that the urologists are the specialty that benefits from biopsies and other imaging tests that are needed to confirm whether a PSA is a "true positive" or a ""false positive".  The Association recommends annual PSA tests for men over the age of 40.

The American Cancer Society's chief medical officer, Dr. Otis Brawley, said he agreed with the Task Force recommendations.  We can expect there to be continued controversy about PSA screening now that this ruling has been issued as the various specialties issue their own response.

Like many tests, the PSA has such a high false positive rate, it has proven to be a poor screening test for healthy men.   Unfortunately, like the Ca-125 test  for ovarian cancer, there is not a good alternative screening test.

 It should be noted that there is a difference between a screening test that is done routinely on healthy patients and a diagnostic test that is performed on high-risk people or to follow known disease.  African American men have a much higher rate of aggressive prostate cancer and men in high risk groups may get higher benefit from these tests.

Prostate cancer is the most common non-skin cancer diagnosed in men. The American Cancer Society estimates that 241,740 men will be diagnosed with prostate cancer this year, with 28,170 expected to die from it.

Sunday, May 20, 2012

Stop The Choking Game

A few weeks ago I did a post on "The Choking Game" and I have received a number of comments and emails about it.  Some of the stories are so sad...grieving parents who lost vibrant kids to this crazy game.  Children have no idea of the dangers involved and there is a lack of awareness even among educators and parents.

I was contacted by a woman who is raising money to attend and exhibit at the National PTA Convention, which will be held in San Jose in June.  The goal is to raise awareness about the Choking Game.  I hope readers will see how important this cause is.

Please go to this link and donate a little if you can so these parents can help educators know that knowledge is power and kids need to be informed.   The video on the site is too shocking to put on EverythingHealth.  I could hardly watch it to the end.  A light needs to be shined on this practice and hopefully parents, teachers and principals will understand that informing kids about the game will not increase its may save lives.

Thursday, May 10, 2012

Sharing Blog Posts

EverythingHealth gets many requests from other publications and blogs around the world to write health articles for them.  When it is an established site, I allow them to re-print some of my past posts to better educate the public and spread the word about health.  If you missed the post on Oseoarthritis, one of the most common conditions of mankind, please check out here:

Consultant 360

And thanks again to MR for the great photo of her hands.

When to Use Urgent Care

We all know that Emergency Departments are over-crowded with long waits and exorbitant fees.  Free standing Urgent Care is a great solu...