Tuesday, May 29, 2012

So Much for Long Week-ends

Memorial Day week-end passed, and I ended up working most of yesterday, but at least I worked at home with Emily on my lap purring.  Today, our summer interns start and I have a school conference.  Tomorrow I have a big insurance appeal hearing.  Thursday, I have two big hearings.  Friday I have a very important (secret) meeting.  So it's going to be a busy week here at Advocacy for Patients.  But first, the news:

What happens to Exchanges -- health insurance marketplaces -- if the Supreme Court strikes down even part of the health reform law?  Some states say they will enact their own individual mandates.  Other states haven't even started setting up Exchanges.  Really, we don't know.  But what we do know is that, if people with pre-existing conditions are going to be covered -- as they must -- then there has to be an individual mandate to help keep premiums level.  If it can't be done at the federal level, expect to see a big push from people like me urging that it be done at the state level, as in Massachusetts.

Congress is beginning to wind down extended unemployment benefits.  Who thought this was a good idea?  What are the unemployed supposed to do?

A staggering 45% of Iraq and Afghanistan vets are seeking compensation for disabilities.  The cost of these wars has not even begun to be felt.  We are better at saving lives on the battlefield, but that means more injuries and trauma, and that means more disability benefits.  Our vets deserve it, but how will be afford it?

The LA Times runs a front-page story on specialty tiers.  I'm telling you, folks. If you are not paying attention to this, you're in for a rude awakening.  One month, your med costs $40.  The next month, it costs $900.  It's incredibly short-sighted of insurers to bump up prices so high that they're unaffordable.  People stop taking their meds and then they get sicker, ending up in the hospital or needing surgery, costing their insurer far more than the cost of these drugs.  What is someone with MS, Crohn's, rheumatoid arthritis to do?  All I can tell you is that this is an issue that you have to pay attention to, talk to your state legislators, urge them to action.

Checklists help increase surgical safety.  A trend started a few years ago by Dr. Atul Gawande is catching on, and it really does help ensure the safety of surgical procedures.  Has your surgeon used a checklist? 

Exercise is good for chronic illness. People with cancer, diabetes, heart disease mistakenly believe exercise is bad for them.  But it's not.  Start slow.  Work up gradually.  And do as I say, not as I do.  Indeed, a push to exercise is occurring among health care workers, as well.  Would you do it if it saved you money?

Colonoscopies are more expensive than they ought to be, some say -- and it's at least partly due to the use of anesthesia.  When the anesthesiologist is out-of-network, look for a big fat bill when you're done.  This is a MAJOR problem.  If you are having a colonoscopy and your doctor uses anesthesia (not the twilight sleep that a nurse administers, but propofol, which requires an anesthesiologist), you must ask in advance if the anesthesiologist is in your insurance network.  If not, you must decline the anesthesia or ask for an in-network anesthesiologist or you will be responsible for the anesthesia bill.  Meanwhile, virtual colonoscopy with virtual cleanse appears to be effective, at least for finding large polyps

Want lower prices?  If you pay cash and don't use your insurance, you may get the cheapest price of all.  Interesting.

MiraLax is a popular therapy for constipation.  It's FDA approved for adults, but not for children, although thousands of pediatricians prescribe it for kids.  This isn't unusual -- most drugs for inflammatory bowel disease, for example, are not FDA approved for kids, but they're used widely.  I suspect this is true of drugs for other diseases, too.  We have to figure out how we're going to treat kids if we have to have FDA approval first.

It's hot all of a sudden.  But it feels hotter than it is because our bodies are not acclimatized to the heat.  Learn all about it here.  The upshot is that it won't bother you as much in a couple of weeks.

And that's it for today.  Keep cool and have a great day!  Jennifer

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