Health and Medical News and Resources

General interest items edited by Janice Flahiff

Is the Fact that I Am a Woman Considered a Pre-Existing Condition?

 

By MAGGIE MAHAR at the 8 August post at The Health Care Blog

The male body has long been considered the “standard” for health care coverage. Having a woman’s body is seen as an expensive anomaly, and women pay dearly for being different.

When they buy their own health insurance in the individual market, women must lay out an extra $1 billion a year, simply because they are women. Some argue that this is fair: after all, a woman could become pregnant, and labor and delivery are costly.

But the truth is that, even when maternity benefits are excluded, one-third of all health plans charge women at least 30 percent more, according to a report released just last month by the National Women’s Law Center.

In 36 states, “92 percent of best-selling plans charge 40-year-old women more than 40-year-old men,” the Center reports, and “only 3 percent of these plans cover maternity services … One plan in South Dakota charges a woman $1252.80 more a year than a 40-year-old man for the same coverage.”

Today, less than half of American women can obtain affordable insurance through a job, which explains why millions buy their own insurance in the individual market. In that market, just 14 states ban gender rating:  California, Colorado, Maine, Massachusetts, Minnesota, Montana, New Hampshire, New Mexico, New Jersey, New York, North Dakota, Oregon, Vermont, and Washington….

 

Insurers explain that women cost them more, even if policies don’t cover maternity, because “they are more likely to visit doctors, get regular check-ups, take prescription drugs, and have certain chronic illnesses.”

In other words, women are penalized for taking care of themselves, As for those “female chronic ailments,” men also are more vulnerable to certain diseases – including many caused by smoking (23 percent percent smoke vs. 17 percent of women)…

If a woman is raped she, too, risks being shunned. When Christina Turner was attacked by strangers, doctors advised that she take HIV medication “just in case.” Insurers then refused to cover her because the HIV drugs “raise too many health questions.” They told her they would reconsider her in three years if she could prove she did not have AIDS.

Turner went without insurance for three years. Other rape victims report being denied because they suffered from post-traumatic stress syndrome.

These are the most shocking cases. Other rules discriminate against millions of women for a long list of commonplace reasons:

  • If a woman has survived breast cancer, this is a pre-existing condition.
  • If she is pregnant when she applies, this also is considered a pre-existing condition, just like cancer. Most likely, she will be turned down.
  • If she is of child-bearing age and has children, this may well viewed as a pre-existing condition, leading to higher premiums.
  • On the other hand, if she is infertile, this too, can be labeled a pre-existing condition.

Not long ago, House Minority Speaker Nancy Pelosi summed up the hurdles: “If you’re a woman, it’s a pre-existing condition.”

“In most markets if you are a non-smoking female you will pay more than a smoking male of the same age because you possess ovaries and not testes.”..

 

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August 9, 2012 Posted by | Public Health | , , , | Leave a comment

The Most Powerful Health Care Group You’ve Never Heard Of

 

By BRIAN KLEPPER AND PAUL FISCHER in their 9 August 2012 post at The Health Care Blog

Excessive health care spending is overwhelming America’s economy, but the subtler truth is that this excess has been largely facilitated by subjugating primary care. A wealth of evidence shows that empowered primary care results in better outcomes at lower cost. Other developed nations have heeded this truth. But US payment policy has undervalued primary care while favoring specialists. The result has been spotty health quality, with costs that are double those in other industrialized countries. How did this happen, and what can we do about it.

American primary care physicians make about half what the average specialist takes home, so only the most idealistic medical students now choose primary care. Over a 30 year career, the average specialist will earn about $3.5 million more. Orthopedic surgeons will make $10 million more. Despite this pay difference, the volume, complexity and risk of primary care work has increased over time. Primary care office visits have, on average, shrunk from 20 minutes to 10 or less, and the next patient could have any disease, presenting in any way.

By contrast, specialists’ work most often has a narrower, repetitive focus, but with richer financial rewards. Ophthalmologists may line up 25 cataract operations at a time, earning 12.5 times a primary care doctor’s hourly rate for what may be less challenging or risky work.

 

These differences in physician worth and payment didn’t just happen. Instead, they have been driven by a 31 doctor – 26 specialists and 5 primary care physicians – American Medical Association panel, the Relative Value Scale Update Committee (RUC), which for 20 years has been Medicare’s sole advisor on the value of physician services. The Centers for Medicare and Medicaid Services (CMS), the federal agency overseeing the program, has historically accepted nearly 90 percent of the RUC’s recommendations with no further due diligence. So the RUC has huge financial impact throughout health care, not only for Medicare but for many commercial health plans that follow Medicare’s lead on payment…

t is clear that it will be impossible to get American health care under control unless we can recapture regulation and reconfigure it to act in the common rather than the special interest. Until that is accomplished, America’s and our children’s diminishing prospects will be directly tied to our failure to stop the health industry’s rapaciousness.

 

August 9, 2012 Posted by | health care | , , , , | Leave a comment

I am a physician and guns are a disease

 

From the 9th August 2012 article at KevinMD.com

I feel guilty about the killings in Colorado.  As a doctor, those horrid events are a personal failure.  I have spent a career fighting illness, often investing hundreds of hours in a single cancer case, yet in minutes, a dozen people vanish and 58 are grievously wounded.  Another 32,000 will die this year from gunshots, over 76,000 will be crippled and I cannot keep up with this slaughter.  Why is this my fault?  Because, I am a physician and guns are a disease.

The great plagues of history killed hundreds of millions: Polio, Small Pox, Rabies, Yellow Fever, Influenza, Measles, Dengue and now AIDS.  These diseases are all caused by viral infections.  What is a virus? It is a perfect submicroscopic machine with only one purpose.  It does not create beauty like a flower, nourishment like a fruit tree, nor knowledge like man.  Its sole purpose is to create more viruses and at this it is the ideal mechanism.

A virus recreates itself by infecting the cells of the host on which it preys.  It destroys those cells, turning them into virus factories until overwhelmed by billions of virus particles the host, often a human, becomes ill.  As virus numbers explode the host gradually dies, the whole body becoming a massive sick infected virus-shedding machine and as a last act the virus spreads to the next person.  Then the cycle begins again, making new viruses.  That is all viruses do, reproduce themselves….

 

Related article

As a doctor, I’m going to keep asking about guns (KevinMD.com)

August 9, 2012 Posted by | Public Health | , | Leave a comment

You’re seeing the wrong gynecologist: 6 red flags

 

From the 9 August 2012 article at KevinMD.com

As a doctor, I appreciate that I am at an advantage when I seek medical care. Knowing terminology and basic medical principles helps a lot. In addition, when you’ve been practicing medicine for a while you get a feeling from how a doctor discusses options if the care seems valid or if a second opinion is in order. Other things I look for are board certification and a doctor who explains their treatment plan in the context of recommended guidelines.

 

Summarizing everything that combines to make good medical care is very hard. However, from time to time I take unfortunate histories from patients or hear stories of medical misadventures from friends and I just cringe. Actually, they make me want to shout, “Your doctor did/said what?!” These are red flags, because not only are these recommendations potentially harmful, but if your doctor recommends one thing that is so flagrantly bad, well, uh, um, how can you trust the rest of their care?

So, these are six red flags that would make me stop and not pass go. They would make me get up, get dressed, and say, “Thanks but no thanks,” and walk out the door looking for a second opinion:

1. A prescription for estrogen containing birth control (pills, patch, or ring) with no inquiry about migraines. Why? Migraines with aura are an absolute contraindication to estrogen containing birth control (do to an increased risk of stroke) and if your doctor were up to date on the WHO/CDC guidelines he/she would know that. I want my doctor to be up to date on guidelines, you know?

2. B….

Click here to read the entire article

 

 

August 9, 2012 Posted by | health care | , , , | 1 Comment

   

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