I Need Your Help
Advocate Aaron Supporters:
As you all are aware I fight every single day to help make sure moms can have affordable access to prenatal care. Prenatal care is VERY serious and without it “babies born to mothers who receive no prenatal care are three times more likely to be born at a low birth weight, and five times more likely to die, than those whose mothers received prenatal care.” –US department of Health & Human Services
Three weeks ago I was in Washington, DC lobbying and fighting for this very cause. I had the pleasure of working with Karen Fennell, one of the top lobbyist in the women’s health arena. Karen contacted me today and asked me if I could enlist the Advocate Aaron Army. I responded with an ENTHUSIASTIC “YES”, and told her it would be impossible for our moms, friends, family, relatives, etc. to NOT come through with flying colors. The task is SIMPLE, but, I need you to do it NOW and I need you to forward it to EVERYONE you know. This isn’t about us. It is MUCH bigger. This is literally about life and death for the innocent babies whose mothers CANNOT access affordable prenatal care.
Please see the message from Karen below and then TAKE ACTION NOW!!!!
PRO MOM!!!
AdvocateAaron
A Healthy pregnancy for a Healthy baby
Dear Mothers and Friends:
Pregnant Women’s Access to Care is in danger in many States. Over 43% of women’s pregnancy care is paid for by the Medicaid program; an additional 18% of pregnant women have no health insurance.
Action by the Federal Government has jeopardized the financial stability of our birth centers. I am asking you and your friends to sign on to a letter to the United States Congress to fix this problem. As a Mother and Grandmother of twin girls, I cannot stand back and let pregnant women be left with no care.
We need 10,000 signatures by May 31st to ensure that all pregnant women have access to quality, affordable health care. Stop the Federal Government from excluding pregnant women from receiving the care they deserve.
Go to the American Association of Birth Centers website at www.birthcenters.org/news/breaking-news/?id=82 and sign our consumer letter. You can make a difference!
Sincerely,
Karen S. Fennell, MS, RN
Consultant
Healthcare Advisory Solutions
Childbirth: Can the U.S. improve? C-sections are expensive. Doctors ask if we are doing too many.
Ruby Wales holds her newborn, Carson. Her first doctor worried more about the risks of vaginal delivery than of cesarean, so she found a different one.
After an emergency cesarean with her first baby, Ruby Wales was holding out for a vaginal birth with her second one.
With a toddler underfoot, the 33-year-old Mission Viejo woman wanted a faster recovery. But finding a physician to deliver her second child wasn’t easy. Her first obstetrician turned her down flat. “She said, ‘No — no way,’ ” Wales recalled.
Once reserved for cases in which the life of the baby or mother was in danger, the cesarean is now routine. The most common operation in the U.S., it is performed in 31% of births, up from 4.5% in 1965.
With that surge has come an explosion in medical bills, an increase in complications — and a reconsideration of the cesarean as a sometimes unnecessary risk.
It is a big reason childbirth often is held up in healthcare reform debates as an example of how the intensive and expensive U.S. brand of medicine has failed to deliver better results and may, in fact, be doing more harm than good.
“We’re going in the wrong direction,” said Dr. Roger A. Rosenblatt, a University of Washington professor of family medicine who has written about what he calls the “perinatal paradox,” in which more intervention, such as cesareans, is linked with declining outcomes, such as neonatal intensive care admissions. Maternity care, he said, “is a microcosm of the entire medical enterprise.”
As the No. 1 cause of hospital admissions, childbirth is a huge part of the nation’s $2.4-trillion annual healthcare expenditure, accounting in hospital charges alone for more than $79 billion.
Because spending on the average uncomplicated cesarean for all patients runs about $4,500, nearly twice as much as a comparable vaginal birth, cesareans account for a disproportionate amount (45%) of delivery costs. (Among privately insured patients, uncomplicated cesareans run about $13,000.)
Pregnancy is the most expensive condition for both private insurers and Medicaid, according to a 2008 report by the Childbirth Connection, a New York think tank.
“The financial toll of maternity care on private [insurers]/employers and Medicaid/taxpayers is especially large,” the report said. “Maternity care thus plays a considerable role in escalating healthcare costs, which increasingly threaten the financial stability of families, employers, and federal and state budgets.”
The cesarean rate in the U.S. is higher than in most other developed nations. And in spite of a standing government goal of reducing such deliveries, the U.S. has set a new record every year for more than a decade.
The problem, experts say, is that the cesarean — delivery via uterine incision — exposes a woman to the risk of infection, blood clots and other serious problems. Cesareans also have been shown to increase premature births and the need for intensive care for newborns. Even without such complications, cesareans result in longer hospital stays.
Inducing childbirth — bringing on or hastening labor with the drug oxytocin — also is on the rise and is another source of growing concern. Experts say miscalculations often result in the delivery of infants who are too young to breathe on their own. Induction, studies show, also raises the risk of complications that lead to cesareans.
Despite all this intervention — and, many believe, because of it — childbirth in the U.S. doesn’t measure up. The U.S. lags behind other developed nations on key performance indicators including infant mortality and birth weight.
And in at least two areas, the U.S. has lost ground after decades of improvement: The maternal death rate began to rise in 2002, and the typical American newborn is delivered at 39 weeks, down from the full 40. Public health experts view the trends with alarm.
At a recent conference held by Childbirth Connection, physicians, employers, insurers and hospital operators wrestled with the disappointing data and discussed thorny questions, such as whether insurers should stop paying more for cesareans than for vaginal births.
“Cesarean birth ends up being a profit center in hospitals, so there’s not a lot of incentive to reduce them,” said Dr. Elliot Main, chief of obstetrics for Sutter Health, a Northern California hospital chain.
But there is a lot that hospitals can do to reduce them, as illustrated by the wide variation in cesarean rates. Among California hospitals, cesareans range from 16% to 62% of births.
Such variation means a lot of women are getting unnecessary cesareans, Main said. “There’s no justification for that kind of variation.”
The surge in cesareans may owe more to celebrity magazines than medical journals. After word got out that Victoria “Posh Spice” Beckham had three, physicians reported a surge in requests for such deliveries, dubbed the “too posh to push” bump.
Physicians, too, have been blamed for failing to make women fully aware of the consequences of cesareans, and for promoting them for convenience.
But change is underway. The Institute for Healthcare Improvement’s Strategic Partners program trains hospitals to implement a set of guidelines, such as the careful use of oxytocin, and a ban on elective deliveries before 39 weeks. In four years, 60 hospitals have signed on.
“It’s a culture change,” program director Frank Federico said. “We’re at a tipping point. . . . It used to be that we spent more time defending the 39-week rule. Lately, there’s no question about that. It’s, ‘How can we improve the process to support that?’ ”
WellPoint Inc. and UnitedHealthcare Services Inc., the nation’s largest health insurers, also are trying to curb cesareans.
In an analysis of its claims, United found that 48% of newborns admitted to neonatal intensive care units were from scheduled deliveries, many of them before 39 weeks.
Cesarean deliveries by country
United targeted a group of Texas obstetricians with particularly high rates of deliveries before 39 weeks.
An analysis showed that the babies these doctors delivered were admitted to neonatal ICUs twice as often as the national average.
After being notified of the correlation, the physicians changed their practices and reduced neonatal ICU admissions by 46% in three months.
The rise in avoidable first-birth cesareans has had a multiplier effect. Most U.S. physicians discourage vaginal deliveries after a cesarean because of some widely publicized cases several years ago in which the uterus split disastrously along the prior incision.
That’s why Ruby Wales’ first obstetrician refused.
“She said it was because there is a 1% chance of a uterine rupture,” Wales said. “And I thought that was weird because there’s more chance of things going wrong with a cesarean section.”
But some obstetricians believe that new evidence supports allowing some women the option of trying for a vaginal birth.
“If the old incision was a vertical, then a trial of labor is not a good idea,” said Dr. David Lagrew, medical director for the Women’s Hospital at Saddleback Memorial Medical Center in Laguna Hills. “But what happens now in the United States is the low transverse, an incision in the bottom part of the uterus, from side to side. Those heal better. All the studies say, in those types of incisions, the risk is less than 1%, probably a half percent, that it will open during labor.”
Saddleback delivers about 3,000 babies a year. In March, it joined a few hospitals nationwide that are pioneering the “hospitalist” approach to maternity care, which adds a measure of safety to attempted vaginal births after cesareans. A hospitalist is a doctor who cares only for hospitalized patients.
Hospitalist obstetricians staff the maternity ward 24 hours a day, seven days a week. They are there to deliver babies when an attending obstetrician gets stuck in traffic, to monitor lengthy labors and to assist in emergencies.
Saddleback supported Wales’ desire for a vaginal birth. Nine days after her due date and after 30 hours of labor, she gave birth — the way she wanted — to an 8-pound, 11-ounce boy.
“I was so glad nothing happened at the last minute to have an emergency C-section because I’d gone through all this work,” said Wales, resting in her hospital bed with baby Carson in her arms. “I’m so relieved that I don’t have to deal with a [cesarean] recovery because I have a 2 1/2-year-old at home who is very active.”
Maternity Healthcare is in Crisis
The Prenatal Pandemic
While the world scrambles to understand and combat the swine flu, declared an imminent pandemic by the World Health Organization, another pandemic rages on in the United States – and this one is far deadlier.
The growing inaccessibility to proper prenatal care has caused a pandemic of enormous proportions in the United States. Consider that:
- A lack of prenatal care means a baby is three times more likely to be born premature, and five times more likely to die;
- The number of Americans without health insurance that would cover prenatal care has grown by nine million in the last 13 years;
- The March of Dimes gave America a “D” on its recent Prenatal Care Report Card – because a full 12.7% of the 4.3 million babies born in the U.S. annually are premature;
- Over 19,000 babies die within the first 28 days of birth each year in the U.S.;
- Of those deaths, a full 30% are directly caused by premature birth…
- Meaning that premature birth accounts for over 6,000 infant deaths in the United States annually.
A lack of prenatal care leads to premature birth. Premature birth leads to death. A lot of it. The bell sadly tolls for over 6,000 babies each year. That’s more than the death count from the World Trade Center attacks, and this wound is self-inflicted.
Many of these deaths could be prevented with proper prenatal care, yet the U.S. government is more concerned with the swine flu which, as of this writing, has killed one person on U.S. soil. In fact, President Barack Obama has even requested a whopping $1.5 BILLION from Congress to combat the spread of the swine flu.
That kind of money could cover prenatal care for nearly every uninsured pregnant woman for a year. It seems as those who can think for themselves are more interested in protecting themselves from a relatively mild flu than protecting the babies who are unable to think – or speak- for themselves.
Even though a pandemic is characterized by the presence of an infectious disease, how can we be more fearful of a relatively mild swine flu than an epidemic that, in a decade’s time, kills more than 60,000 babies? That’s more than the population of Carson City, Nevada.
Human life is too precious to politicize. It’s time to get our priorities straight. Yes, the swine flu needs addressed. But it’s also time to take care of our nation’s babies. http://www.youtube.com/watch?v=5P_dFD0J47I
Women And Children First?
“Women and children first!” That’s the stereotypical cry from the chivalrous men of literature and the silver screen. When the ship is sinking, you save the most vulnerable first. Unfortunately, this ideology seems to matter primarily in the annals of fiction – in the real world, the practice of saving the most vulnerable first is rarely implemented. Especially evident in today’s economic climate, women and children are being allowed to drown, while the captains of their fate continue to prosper. No, America does not save women and children first, and captains do not go down with their ships.
When financial institutions are facing hardships due to the decisions the companies have made in the last decade or so, the government gives them hundreds of billions of taxpayer dollars. The captains of these industries then enjoy spa treatments and end-of-year bonuses presumably footed by hard-working Americans, while the citizens they employ are laid off, their positions are terminated, or pay and benefit cuts are sweeping.
And women and their children feel it the most. Take a look at this report from the National Women’s Law Center: http://www.nwlc.org/pdf/WomenEconomicRecoveryJuly2008.pdf. It details how women are in need of targeted assistance, especially during recessionary times, because they’re often the first to be tossed overboard. And because women are often the primary caregivers for American’s children, the youth of America is likewise cast aside.
Some facts from the report:
Women earn 23% less than men
Women are 40% more likely to live in poverty than men, and one in every eight American women is poor
Women are 10% less likely to receive unemployment benefits after losing a job
Women are 30 to 40% more likely to have subprime mortgage loans, despite comparable credit scores to men
These factors, combined with a lower average compensation, make it more difficult for women to maintain and care for their families and households. Single women with children face the toughest times of all, especially when state legislatures are considering slashing Medicaid budgets (four out of every ten single mothers receives Medicaid assistance).
America, the ship is sinking and women and children are drowning. Our captains, those who have steered us in this direction, are not subject to the consequences of a sinking ship. Instead, the American people are struggling to keep the ship afloat, bucket by bucket, and their collective efforts ensure the livelihood of their captains – who no longer have fear of financial ruin because public funds are readily available to assist them.
Do the heads of industries need assistance more than the heads of households? Of course not. Our women and children need assistance now more than ever, yet these are the last to be attended to. Greed and corruption are in abundance, while millions of women and children nationwide suffer as martyrs for their cause.
Hope is Enough…REALLY!!!!
I woke up at 5am this morning after a rather rough day yesterday. As I was reflecting on what is really going on in this world and in my own life and those around me I thought I need some GOOD news. I want to read about, see, experience people going out of their way to do RIGHT and GOOD. I want to see people NOT think of themselves but instead ask how can I take personal responsibility and make someone else’s life better.
I was frustrated at how much “digging” around I had to do to find “Good”. I know it is out there and all around us just nobody seems to “Promote” it. (Including me) In the coming weeks I am going to change that and I am asking you to join me. Stay tuned for details. In the meantime please take a few minutes and read about what I am talking about.
Now, go out and make a difference for someone else today. I BELIEVE in YOU!!!
By Rick Reilly
ESPN The Magazine
They played the oddest game in high school football history last month down in Grapevine, Texas.It was Grapevine Faith vs. Gainesville State School and everything about it was upside down. For instance, when Gainesville came out to take the field, the Faith fans made a 40-yard spirit line for them to run through. Did you hear that? The other team’s fans? They even made a banner for players to crash through at the end. It said, “Go Tornadoes!” Which is also weird, because Faith is the Lions. It was rivers running uphill and cats petting dogs. More than 200 Faith fans sat on the Gainesville side and kept cheering the Gainesville players on-by name.”I never in my life thought I’d hear people cheering for us to hit their kids,” recalls Gainesville ’s QB and middle linebacker, Isaiah. “I wouldn’t expect another parent to tell somebody to hit their kids. But they wanted us to!”And even though Faith walloped them 33-14, the Gainesville kids were so happy that after the game they gave head coach Mark Williams a sideline squirt-bottle shower like he’d just won state. Gotta be the first Gatorade bath in history for an 0-9 coach. But then you saw the 12 uniformed officers escorting the 14 Gainesville players off the field and two and two started to make four. They lined the players up in groups of five-handcuffs ready in their back pockets-and marched them to the team bus. That’s because Gainesville is a maximum-security correctional facility 75 miles north of Dallas . Every game it plays is on the road. This all started when Faith’s head coach, Kris Hogan, wanted to do something kind for the Gainesville team. Faith had never played Gainesville, but he already knew the score. After all, Faith was 7-2 going into the game, Gainesville 0-8 with 2 TDs all year. Faith has 70 kids, 11 coaches, the latest equipment and involved parents. Gainesville has a lot of kids with convictions for drugs, assault and robbery-many of whose families had disowned them-wearing seven-year-old shoulder pads and ancient helmets. So Hogan had this idea. What if half of our fans-for one night only-cheered for the other team? He sent out an email asking the Faithful to do just that. “Here’s the message I want you to send:” Hogan wrote. “You are just as valuable as any other person on planet Earth.”Some people were naturally confused. One Faith player walked into Hogan’s office and asked, “Coach, why are we doing this?”And Hogan said, “Imagine if you didn’t have a home life. Imagine if everybody had pretty much given up on you. Now imagine what it would mean for hundreds of people to suddenly believe in you.”Next thing you know, the Gainesville Tornadoes were turning around on their bench to see something they never had before. Hundreds of fans. And actual cheerleaders!”I thought maybe they were confused,” said Alex, a Gainesville lineman (only first names are released by the prison). “They started yelling ‘DEE-fense!’ when their team had the ball. I said, ‘What? Why they cheerin’ for us?’”It was a strange experience for boys who most people cross the street to avoid. “We can tell people are a little afraid of us when we come to the games,” says Gerald, a lineman who will wind up doing more than three years. “You can see it in their eyes. They’re lookin’ at us like we’re criminals. But these people, they were yellin’ for us! By our names!”Maybe it figures that Gainesville played better than it had all season, scoring the game’s last two touchdowns. Of course, this might be because Hogan put his third-string nose guard at safety and his third-string corner back at defensive end. Still. After the game, both teams gathered in the middle of the field to pray and that’s when Isaiah surprised everybody by asking to lead. “We had no idea what the kid was going to say,” remembers Coach Hogan. But Isaiah said this: “Lord, I don’t know how this happened, so I don’t know how to say thank You, but I never would’ve known there was so many people in the world that cared about us.”And it was a good thing everybody’s heads were bowed because they might’ve seen Hogan wiping away tears. As the Tornadoes walked back to their bus under guard, they each were handed a bag for the ride home-a burger, some fries, a soda, some candy, a Bible and an encouraging letter from a Faith player. The Gainesville coach saw Hogan, grabbed him hard by the shoulders and said, “You’ll never know what your people did for these kids tonight. You’ll never, ever know.”And as the bus pulled away, all the Gainesville players crammed to one side and pressed their hands to the window, staring at these people they’d never met before, watching their waves and smiles disappearing into the night.
Anyway, with the economy six feet under and Christmas running on about three and a half reindeer, it’s nice to know that one of the best presents you can give is still absolutely free.
HOPE.
Women, Abortion, and Mental Health: Ah, Who Cares?
The American Psychological Association (APA) recently released a report that said there was no reliable evidence that a single abortion affected a woman’s mental health.
I am actually stunned that the American Psychological Association would even make the following statement: “There is no credible evidence that a single elective abortion of an unwanted pregnancy in and of itself causes mental health problems for adult women, according to a draft report released Tuesday by a task force of the American Psychological Association.”
Have they ever talked to a woman who has had an abortion? By reading this report I personally would say NO. What is even driving this kind of nonsense reporting? How much money and resources were spent on this WASTE of a report? I have an idea: I would like the panel that did this report to contact Stacy Massey, President of Abortion Recovery InterNational, Inc. (I haven’t even spoke with her or asked, but I am sure she would love some volunteer help) and volunteer to take calls for one day and THEN tell me that their is no credible evidence that a single elective abortion of an unwanted pregnancy in and of itself causes mental health problems for adult women. (I call BULL!)
The report is really just a literature review. Well, it isn’t really a literature review. A lot of the psychological literature was dismissed as methodologically unsound. So, the report is really based on only a limited number of studies.
If the authors of the APA report decided that a study didn’t first pass a methodological test, it was automatically dismissed as unreliable and thrown out of the sample of studies they looked at. In “science,” you see, there’s nothing to learn from experience, instinct, or insight.
The APA report is somewhat reminiscent of what happened when an Australian doctor discovered that a bacterium (called Helicobacter pylori) caused stomach ulcers. For decades, accepted medical wisdom was that peptic ulcers were caused by stress and lifestyle. Whole chunks of peoples’ stomachs were surgically removed – sometimes repeatedly – in an attempt to cure them of ulcers. Sometimes that worked. All too often, it didn’t.
Doctors Marshall and Warren of Australia discovered the true cause of peptic ulcers and won a Nobel Prize for it in 2005. Their discovery is generally considered one of the ten most significant developments in medical history. Given the suffering and the radical, invasive treatments of the time, you would think doctors jumped at the chance to embrace a new explanation for stomach ulcers. They didn’t. Dr. Marshall was even ridiculed for his claims. Besides, many doctors said, he had not performed proper experiments. Until he did that (which involved great expense that research organizations were hesitant to underwrite given the skepticism), his findings were simply to be ignored. So the suffering needlessly continued for years.
Now let’s put this APA report in the proper context. Five of the six authors were women. Although we’re dealing with women’s mental health and it is certainly proper for women to be on a task force looking at the mental health implications of abortion, is this really the most objective group? You can find all five of them easily on the web and they certainly appear to be a fine group of professionals, but so were the ridiculers of Drs. Marshall and Warren.
One of the reasons those who are anti-abortion have a hard time with “health of the mother exceptions” to proposed laws against such heinous procedures as partial birth abortions is that “mental health” would constitute such an exception. Mental health is a notoriously amorphous notion. Much depends on the beliefs of the person performing a diagnosis, so it’s likely that a mother wanting an abortion will always be able to find a doctor who will sincerely testify that the mother’s (mental) health is in danger.
It might be helpful if each of the task force members who authored the APA report would come clean on whether they think a mother’s mental health would be negatively affected by carrying an unwanted baby to full term. Why? Well, if they think carrying an unwanted baby to term is mentally unhealthy, there would naturally be a tendency to think of abortion as not so unhealthy. Abortion, in fact, might even be therapeutic in their minds.
Actually, they do sort of come clean. Here’s a quote from the study’s conclusion. “[A]mong women who have a single, legal, first-trimester abortion of an unplanned pregnancy for nontherapeutic reasons, the relative risks of mental health problems are no greater than the risks among women who deliver an unplanned pregnancy.” Since women have abortions for nontherapeutic reasons, the authors must think many have them for therapeutic reasons. So the question is relevant. Would the task force’s members sign off on an affidavit to make an exception to a partial birth abortion ban for the sake of a mother’s mental health? If they would, a first trimester abortion would seem trivial to them.
That’s the other important piece of that quote. It is only talking about first trimester abortions. Given the parameters of the studies that are acceptable to the authors of the report, it is highly unlikely that any of the acceptable studies looks at women over a long period of time. So the studies are concerned with women whose only real physical manifestation of their pregnancy has been a few missed periods. And, they’ve not had years to consider their action. If they’ve borne other children, they might even initially feel relief for the lessened responsibility.
What of the day when mothers of first-trimester babies see pictures that look like these? What if these mothers find out that their first-trimester child had fingers and toes, and a discernible nose? What of these mothers’ mental health then? It just doesn’t look like the APA particularly cares.
Fighting Back Against Medical Overcharges
(Here are some tips that a Patient Advocate such as myself uses to help you save money)
It is a fact that the medical system is a mess and if you are uninsured or underinsured and do NOT know your rights or if you do NOT know what to look for chances are VERY high that you will become a VICTIM of the medical establishment. I know, I know, nobody including myself wants to believe that. (But, facts are a stubborn thing) It is now estimated that 90% of all hospital bills contain errors. (Not a misprint, 90%!!!!) So what are you supposed to do to protect yourself? (Follow my tips and tricks below and you could save thousands of dollars) The bad news is the medical establishment knows that you are unlikely to do any of this, which is why Patients Advocates have become VERY popular. I know, because I am one.
There are several strategies to lower your out-of-pocket costs:
First and foremost, if you have any sort of insurance make sure you are aware of exactly what your insurance does cover and any deductibles that must be met before coverage takes affect.(Obvious, but I needed to state it)
Prescriptions:
If you are not insured or not eligible for government assistance be sure to check with Partnership for Prescription Assistance, they provide free or low cost prescriptions. www.PPARx.org or 1-888-4PPA-NOW (1-888-477-2669). (Yes, it requires some paperwork on your part but you really can get FREE Prescriptions. I also recommend you ask your physician or local pharmacist for any coupons or refunds offered by pharmaceutical companies, you would be surprised at what is available just for asking. Also ask them about any local assistance programs that they are aware of in the area.)
It is very important that you COMMUNICATE openly and honestly with your doctor and let them know that you simply cannot afford expensive prescriptions. Most of the times he/she will have sample packs available, or will be able to prescribe generic or over-the-counter alternatives. If you are on any maintenance prescriptions inquire whether the dosage can be altered to make it more cost effective, or if it can be doubled and split to cut costs. Pill splitters are inexpensive, and you can purchase empty capsules at most apothecaries or formulary pharmacies. They may even split the capsules for you.
Doctor Bills:
Most insurance carriers pay physicians one-half to two-thirds of the billed amount, so if you are uninsured speak with your doctor personally and request a discounted rate. They will most often work with you. (If they won’t QUIT being loyal to a doctor that is NOT willing to offer you the same or better rates that he allows the greedy, self-serving “SYSTEM.”) Instead find a compassionate doctor who cares about YOU. If they request a follow-up visit see if it is possible that any fee may be waived, or at least discounted. And, if it is necessary, a follow up visit with a nurse so you won’t interrupt the doctor’s schedule and pay more. Notify your doctor that you will be paying out-of-pocket, and that you need to keep the costs down. Most respectable doctors will be happy to accommodate your request.
If any tests are suggested, make sure that you ask if they are necessary and what they will do. If you do have to have them request the paperwork so you can have it done at a lab. Or, you can request the physician waive the additional lab fees because you’re already being charged for a visit. And if you have to come in just to have blood work done you will be charged for a visit, a phlebotomist fee, and lab fees. If you go to a lab, you are charged a flat lab fee. (This is typical of MOST but NOT all situations)
If the tests are expensive (and you have insurance) be sure to check with your insurance to verify that they will be covered, or if a second opinion is necessary before payment will be made.
Hospital Bills:
This is one place most people are likely to be overcharged. There are several things you can do to prevent this. You just need to be diligent and observant and always enlist help to catch anything you may miss.
The first thing you want to do is request an itemized bill when you are checking in. They are required by law to provide this. Be sure to specify that you want an itemized list brought to your bed each evening. If they neglect to do this or deny your request, demand to speak with a Patient Advocate. They are there for you, and their job is to protect your rights. (Hospitals don’t like it, but think about it, who wants someone looking over their shoulder?) If you’re being truthful it should be NO BIG DEAL…RIGHT?
Secondly, ask if you will be charged for your final days visit. Hospitals charge a full day’s visit no matter what time you are admitted, and in return, they are not supposed to charge for the final day. But, unless you check your bill you will not know until either you are billed, or the insurance company declines to pay, and then you have to fight with them. Be sure to ask for a specific check out time also. Before the final day arrives let the doctor know that you want to be discharged by the check-out time. If he will not be on call inform him/her that either you want to be discharged the day before when he/she is on call, or, you want to see another doctor. If you still are not accommodated, let your Patient Advocate know that you will refuse to be billed because it is the doctor’s fault that you could not be discharged by the specified time.
The third thing you need to do is double check your itemized list and verify every item on it. If something isn’t clear ask a nurse for a specific description. Make sure you’re not billed for two doctor visits when you only saw a physician once. Verify that any non-essential item isn’t actually included in your room and board. Check operating room times against your charge for the anesthesiologist. Operating rooms are charged by the minute so if the charges are padded even a little it can be a substantial amount. And be sure to verify what exactly is included in operating room costs.
Finally, make sure that you have someone whom you can trust help keep track of all of the costs. Or, if you prefer have them take care of it for you. However, if any problems do arise that you feel are not adequately resolved there are people who will work on your behalf to resolve any issues. Generally speaking, these Patient Advocates will provide their services for a percentage of any savings they facilitate (NO savings, NO fees) or they will work for a flat rate. (Easy to budget for)
So, the question I get a lot. Advocate Aaron why do I need to pay a Patient Advocate? Can’t I just do it myself? The answer is simple. YES, you can do it yourself. If you get a DWI, you can also represent yourself. It is NOT recommended but you can. I only listed a few tips and tricks, the list is LONG.
I do think it is DUMB, UNFAIR, and RIDICULIOUS that you have to hire a Patient Advocate. The system should not be this messed up. The fact is the system is BAD and you DO need the help of a Patient Advocate.
Fighting for the uninsured and underinsured pregnant mom and their unborn babies,
What Path Will We Take?
What path will we take to a public health care system? That’s the question posed by Atul Gawande in this New Yorker article (http://www.newyorker.com/reporting/2009/01/26/090126fa_fact_gawande?currentPage=all). Gawande’s poignant piece ponders the transition from private to public health care, or variations thereof, from Britain to France to Massachusetts. In each example, the historical factors that drove a fundamental change in health care were very different. The article begs the question, what path will we take?
The answer is still largely undecided. What can be answered, however, is the question of whether national health care can work. The answer is yes.
During his inauguration speech, President Obama spoke of America’s courage, of America’s values, of America’s prosperity. National health care reform is part of his message of change; and working hard to address social issues that put our nation in danger has already helped to combat inequality. Still, the battle against inequality is waged on many fronts: status, career, wealth, race, religion and health care, among others.
Every day pregnant women are subjected to inequalities, whether it’s unnecessary stress related to ethnicity or a refusal of treatment because of socioeconomic status or a lack of insurance. Health care reform can combat these issues by providing better access to needed services, preserving the lives and livelihoods of women and their children.
The question then becomes: Should health care be 100% government-run or government-subsidized? The answer is a bit trickier. America doesn’t like to be in the business of, well, putting people out of business; particularly large corporations like those who dole out health insurance policies. It could be said that these companies have dug their own graves by making insurance unaffordable for many Americans, thus necessitating government intervention.
On the other side of the fence are those who believe the private health insurance sector would be adequate without government intervention. It is the government’s willingness, they say, to pay whatever health care providers charge that has driven up medical costs, causing insurers to charge more for insurance. Without government bail-outs, both medical practices and insurers would be in a truly competitive marketplace, and would in effect have to institute a bidding war to attract customers.
The problem with that is that, often, when the lowest bidder wins the quality of service is compromised. American health care quality is already suspect, and jeopardizing this any more spells trouble for everyone.
The most likely scenario, and one that current proposals seem to advocate, is one in which private insurance companies continue to operate in that capacity while the government subsidizes specific plans available only through public avenues. At the same time, the government will enact policies that strive to keep health care costs low without sacrificing quality of treatment.
The success of any health care reform will be decided by two measures: can everyone access quality health care, and can the program that allows them to do so be sustained?
In the meantime, many Americans are suffering, putting off cancer treatment, ignoring a chest pain, and skipping prenatal care – causing untold numbers of complications and deaths.
President Obama, the spotlight is on you. You’ve promised change. Now it’s time to make good on that promise. If you’re going to bring proper health care and equal treatment to pregnant women, regardless of socioeconomic status, wealth, race or insurance, you have my support.
This is News?
The recent $50 million settlement by Oxford Insurance and its parent company, UnitedHealth Group, to halt accusations by the New York attorney general’s office that the health insurance providers overcharged millions of Americans hundreds of millions of dollars got a lot of media coverage (http://www.msnbc.msn.com/id/28628880/). But it isn’t news – this is what we’ve been talking about for years!
Undoubtedly, New York isn’t the only state in which this occurred, nor is Oxford/UnitedHealth the only company that should be investigated. The research firm that provided the reimbursement rate figures, Ingenix (also owned by UnitedHealth), serves several other insurers. The article says that other companies will be investigated – but how many? How many other research firms fix the numbers? How many other insurance companies are overcharging?
And what happens to the millions of Americans who are overcharged? Women with newborns, those struggling with diabetes or fighting cancer – how do they also contend with bills totaling tens of thousands of dollars? How many people have died because they could no longer afford treatment after being overcharged?
The health insurance conglomerate denies the allegations, of course, but was willing to pay $50 million to make them go away. That’s a lot of money to pay if you’re innocent.
Some good will come out of the settlement, though. The $50 million is to be used for a nonprofit organization that will determine patient reimbursement rates, and the story did grab the attention of the media (about time!).
Still, it doesn’t seem as though justice was served. If you swindle people out of money, you should not be allowed to use that money to buy your way out of trouble. And now, the company is left with a gaping $50 million void in the budget – whose dollars do you think are going to fill that void?
