Number Yourself a Priority

By Dave Racer

Do you ever feel like a number, not a person?

In order to provide services to you, the healthcare system is likely to link your Social Security Number to several other numbers. Identifying you is, of course, important to your well-being.

Treating you as a number and not a person, however, is a different matter.

A conflict is brewing in the era of healthcare reform. Reformers often focus on creating system-wide efficiencies in an attempt to reduce cost. As a result, there is a balancing act between what is best for the most number of people, and what is best for each individual.

To remain an individual in the era of population health, you must proactively do all that you can to make sure your care is patient-centered.

At worldmeter.info I am told there are 7.4 billion people in the world. The website also says there are 323.1 million Americans. These are huge populations.

Providing and paying for healthcare for 323.1 million people is a huge challenge for the United States. It is the central point of the healthcare reforms we’ve experienced since Congress passed the Affordable Care Act (ACA) of 2010.

One of the relative new buzzwords informing ACA healthcare reformers is “population health.” A definition of population health acceptable to most reformers is hard to find. One definition is “the health outcome of a group of individuals, including the distribution of such outcomes within the group.” The hard part for reformers is knowing who fits into what group or groups, and how it will affect your ability to receive and pay for healthcare services.

Public policymakers apply the population health concept to healthcare budgets, practice guidelines for physicians, medical research, bedside care, clinical services, and just about anything else related to healthcare.

The federal government has invested billions of dollars pursuing effective and useful electronic health records (EHRs), and to build a massive repository of healthcare data at the national level. This healthcare data, it is thought, can be used to guide doctors, hospitals, and other medical professionals concerning the care they provide to patients.

Population health data records do not include the names of individuals, only numbers that are able to be grouped together and analyzed for many different purposes. The data can be reduced to mathematical formulae that guide healthcare professionals, payers, and government planners in the distribution of healthcare.

A potential conflict exists, however, between population health data and individual needs.

This is where you come in.

Regardless of population health trends, each of us wants to be more than a number. Our reality is that we want to stay healthy, and when we are suffering, or our life is threatened, we want to be treated in a welcoming healthcare system as an individual human being. We want the data of our individual life to take precedence over population health data that might conflict with it.

The implications of being a name, not a number, are great. The most obvious implication is self-preservation and individual quality of life. The great news is that in the United States we retain the freedom to manage our own lives.

Making sure we are more than a number in the healthcare data set starts with taking care of ourselves. The Centers for Disease Control (CDC), for instance, asserts that as much as 70 percent of healthcare spending is related to preventable conditions, chief among which is obesity. Just as important, is learning how the healthcare system works so you can partner with medical professionals when you need help.

Knowledge of how our healthcare system delivers individual care to you is a life-changer.

The best way to guard against becoming just a number in a population health system starts with choosing to take ownership of your healthcare. Trig’s mission is to serve as a central resource to help you access healthcare, to become an informed healthcare consumer rather than a number in a system.

Dave Racer is a writer, researcher, publisher, speaker, and teacher. As such, he has written and/or edited 44 books, of which 14 focus on healthcare and health finance issues. Dave has spoken in more than 25 states and all across Minnesota as a keynoter or educator about healthcare, and a broad array of issues and ideas. Since 2005, he has been speaking about healthcare reform, including legislative and congressional actions related to the financing and delivery of health. Dave is also the President of DGRCommunications, Inc., providing research, writing, publishing, and communication services for a diverse group of individual and corporate clients, and is the founder and CEO of Alethos Press, a book publisher.

Medical Error Leads to Infant’s Wrongful Procedure

A Tennessee couple experienced a real-life nightmare when their infant son’s tongue was clipped for a procedure meant for another baby.

“The baby was perfect, healthy and beautiful,” Jennifer Melton said to CBS Nashville affiliate WTVF in this news segment.

These types of medical errors can be avoidable when you have the right information. Trig, the world’s first comprehensive healthcare training program, teaches consumers how to save time, money and hassle on their medical care. This includes help avoiding medical errors.

If you’re not yet a member, click here to learn more about Trig. If you are a member, be sure to log in and finish your training plan.

Do you have a story to share about a healthcare experience? Go to Voices on Care — by clicking here — and share your story today. If you’d rather be interviewed by one of our staff members, we can arrange that as well. E-mail us at info@trigls.com and we will set a time for an interview.

Trig: Healthcare is Hard. We Make it Simple.

Be Transformed by Trig

Lynda was overweight, depressed and in drop-to-her-knees pain, she said.

She had been dealing with issues related to endometriosis since she was 18. Doctor after doctor didn’t know what to do for her, and the suggestions they had didn’t work. She was beyond fed up.

Enter Trig, the world’s first comprehensive healthcare training plan. Trig taught Lynda how to stand her ground, to ask the right questions and push doctors to listen to her. After that training, Lynda found the right treatment plan. She then lost 40 pounds, found her energy and her happiness again. To boot, she also saved $100 per refill for her prescription — a total of $1,200 per year — thanks to Trig’s tips on shopping around for the right medication.

(To learn from our training modules to make progress like Lynda did, see Healthcare AssertivenessSecond OpinionsSelecting a Treatment Plan and Managing Prescriptions.)

Trig teaches consumers just like Lynda to be mindful about going to the doctor. We teach patients healthcare literacy so that they understand how to use the healthcare system in a way that saves time, money and hassle — and possibly even a life.

Do you have a story to share about a healthcare experience? Go to Voices on Care — by clicking here — and share your story today. If you’d rather be interviewed by one of our staff members, we can arrange that as well. E-mail us at info@trigls.com and we will set a time for an interview.

Trig: Healthcare is Hard. We Make it Simple.

Ask the Right Questions, Get the Right Answers

 

By Dave Racer

Are you depressed or do you suffer from anxiety?

Get ready to be tested.

January - Preventive CareOn January 26, 2016 the United States Preventive Services Task Force (USPSTF) stated, “… everyone age 18 or older should be screened for depression with adequate systems in place to ensure accurate diagnosis, effective treatment and appropriate follow-up.”

The USPSTF as the federal agency in charge of deciding which tests and procedures are classified as preventive care. Your insurance payer and medical professionals follow their guidelines.

You can be sure you will eventually encounter this new screening requirement. Why?

Major depressive disorder is the leading cause of disability among adults in high-income countries, according to the USPSTF. The cost of treating depression in the U.S. reached nearly $23 billion in 2009, and lost productivity from the condition likely cost the nation an estimated $23 billion in 2011.

The fact is that if the government says you need to be tested for depression, your doctor will ask you to take the test.

When you are tested, be ready to take charge of your own care to avoid going through a long series of ineffective therapies, as I did.

I had one form of the test in July of 2008, because I suffered a stress attack. It felt like a heart attack.

I had pushed myself extremely hard during 2008 with a goal to finish my master’s thesis by mid-August. I wanted to graduate in September, right after my 61st birthday. Writing a thesis is stressful, but as it turns out, doing it while writing another book is playing Russian roulette with your psyche.

That same summer, my writing partner and I were writing Why healthcare costs so much: The solution – Consumers. Each of the four books he and I wrote together required excruciatingly tough work. “There’s a lot of blood on those pages,” I’d say after each editing session. We labored over and negotiated every idea and word.

On July 30, I suffered radiating pains across my chest. As a result, I rode the ambulance ($1,692) four miles to an Emergency Room. After a bevy of tests, the ER physician said my heart looked strong, and the cause of my pain most likely was stress.

That made me feel less stressed. Sort of.

As soon as my family practice physician saw me in his office the next day, he handed me a single-sided piece of paper. “Here, answer these questions and add up your score. I will be right back.”

He had given me a PHQ9, Patient Health Questionnaire. My total score determined what he prescribed as he followed the practice guidelines by which his practice was managed, and that determined how he gets paid.

If I had this test today, I would have asked, “How much does it cost? Why do you want me to take it? How is it used?” I’m not opposed to the test, but I’ve learned that I want to know the reasons for what my doctor is doing with and to me, and whether it’s necessary or the best option.

My score indicated that I suffered from anxiety, which had seemed perfectly clear to me given that I rode in the ambulance the day before. He ordered a prescription and told me again to cut back on coffee, and try to relax. He made no other suggestions.

Based on the PHQ9 results and according to the practice guidelines, he prescribed two popular Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs ease depression by affecting naturally occurring chemical messengers (neurotransmitters) … SSRIs block the reabsorption (reuptake) of the neurotransmitter serotonin in the brain. Changing the balance of serotonin seems to help brain cells send and receive chemical messages, which in turn boosts mood.

I’m sure he told me the side-effects, but I didn’t listen. Within a few weeks, my wife told me my face drooped, I looked sad, and I felt a loss of energy. Intimacy, too, had become a problem. I saw the doctor again. He gave me the PHQ9 again, and prescribed a different SSRI. Same results. Next we tried a stimulant, which made me manic.

Like many other obedient patients, I had done what the physician recommended without questioning him.

I’ll never do that again.

A new doctor on staff finally weaned me from the drugs and sent me to a psychologist. It turned out I simply needed to talk with someone, and learn a relaxation technique. Within four weeks, I had calmed down and dealt with my stress without the aid of anti-depressants.

In the same situation today, I would ask for an alternative to pharmacology as the beginning point. I would have asked for a referral to a mental health specialist with experience dealing with anxiety. I would have checked out the qualifications of the mental health professional to which I had been referred. Taking charge in this manner is my job. No one has more interest in it than I do.

Since then, I chose an Internist as my primary physician. He’s my consultant, and I trust him. If he doesn’t maintain my trust, I will fire him and hire someone else. I have learned that taking control of my own healthcare reduces my stress, and that keeps me healthier, saves me money, and keeps me smiling.

Dave Racer is a writer, researcher, publisher, speaker, and teacher. As such, he has written and/or edited 44 books, of which 14 focus on healthcare and health finance issues. Dave has spoken in more than 25 states and all across Minnesota as a keynoter or educator about healthcare, and a broad array of issues and ideas. Since 2005, he has been speaking about healthcare reform, including legislative and congressional actions related to the financing and delivery of health. Dave is also the President of DGRCommunications, Inc., providing research, writing, publishing, and communication services for a diverse group of individual and corporate clients, and is the founder and CEO of Alethos Press, a book publisher.

Putting the Patient First

By Dave Racer

How do you know whether you’re really getting what you need as a patient?

First, let’s define “patient-centered” care. It requires a precise definition, so I went to Merriam-Webster for the answer.

                             Patient – noun: a person who receives medical [and/or mental health]                                  care or treatment.

                             Centered – adjective: mainly concerned about or involved with                                              something special.

Patient-centered healthcare focuses on each individual, and considers each person as unique, special, and worthy of receiving care. The old original Hippocratic Oath acknowledged each individual’s immense value that is always worthy of a physician’s best efforts. “I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.”

Nearly everyone that talks about healthcare in any context uses the same buzzwords to make you think they are on your side. Today’s buzzwords include “patient-centered” healthcare, though not everyone walks the talk.

Andy Slavitt, the acting administrator of the Centers for Medicare and Medicaid Services (CMS), wrote about patient-centered healthcare in the context of electronic health records (EHRs).

“We will not tolerate business models that prevent or inhibit the data from flowing around the needs of the patient,” Slavitt wrote.

Mr. Slavitt sees that collecting bits of health data about millions of individuals, and compiling it into a massive database is essential for creating quality care for individuals. He recognizes the conflict between mass data collection and the use of that data. Slavitt acknowledges that there is a potential for abusing data by restricting the provision of healthcare to patients.

Slavitt is right to be concerned. When he talks about the “needs of the patient” (aka patient-centered care) he’s not talking about you as an individual. He is talking about you as part of a massively larger group – the millions of Americans who receive healthcare services each day. He hopes that somehow, as all that data is translated back to the patient at the bedside, it can remain focused on what is best for the patient.

The reason he is concerned is because, in our world of managed care, data is too often used to rationalize patient care, and render the patient as “just a number.”

Mr. Slavitt runs a department of government that oversees and pays for care for more than 100 million people. CMS is the largest healthcare management organization in the world (next to India and China). He, along with insurance carriers, is by definition concerned with caring for individuals, but always in the context of larger numbers.

Healthcare managers like Slavitt repeatedly ask the question, “How do we provide care to the largest number of people in a way we can afford to pay out of the resources available to us?”

Patients have a different set of questions from healthcare managers. “What care do I need right now? How can I reduce my pain and suffering? How can maintain quality of life? How do I live longer?”

No one is more concerned about your health than you.

The best definition of patient-centered care is taking care of yourself, and becoming your own best advocate. If you are physically or mentally unable to care for yourself, patient-centered care means that someone whom you love and trust puts your care at the center of their attention and advocacy.

When you decide that your own care is to be patient-centered, it usually means changing your attitudes and behaviors. Consider that 70 percent of Americans are obese (the government’s term). Patient-centered care means deciding to live healthier and do the work required to maximize your health. Thinking that the healthcare system will keep you healthy is chasing a dream, even when the doctor is your best lifelong friend.

Patient-centered healthcare requires each patient to not only take good care of their bodies, minds, and souls, but to work in partnership with medical professionals as their services are made necessary. In the past, before huge corporations and governments managed individual healthcare, patients often submitted to physicians without question. Most physicians could be trusted to do good on patients’ behalf, but such a one-sided relationship is still not patient-centered.

Today, many physicians are managed employees of large health systems and are subject to others making decisions for their patients. Increasingly, those decisions are made based on mass data collection.

How do you know if you are receiving patient-centered care? The first test is this: Have you taken control of your own healthcare, including taking Trig’s educational training? Be sure to log in and complete your training plan if you haven’t done so already.

The second test is this: Do you have the power to hire and fire your doctor? Or are you limited to accessing medical professionals in a network controlled by government or insurance companies?

Take charge of your own care, and know you have the power to get what you need.

 

Dave Racer is a writer, researcher, publisher, speaker, and teacher. As such, he has written and/or edited 44 books, of which 14 focus on healthcare and health finance issues. Dave has spoken in more than 25 states and all across Minnesota as a keynoter or educator about healthcare, and a broad array of issues and ideas. Since 2005, he has been speaking about healthcare reform, including legislative and congressional actions related to the financing and delivery of health. Dave is also the President of DGRCommunications, Inc., providing research, writing, publishing, and communication services for a diverse group of individual and corporate clients, and is the founder and CEO of Alethos Press, a book publisher.

Better Sleep at a Better Cost

By Dave Racer

C-PAP machines are quite expensive. Do you know what they cost?

I found out the easy way.

A few years ago I took a sleep test. My wife had been complaining about my snoring for some time – the couch had become her bed. We had learned that snoring can be a symptom of something more serious, which had come to be called “sleep apnea.”

For thousands of years, humans have put up with snoring in a number of ways, like my wife did. Modern medicine, however, found that snoring and cessation of breathing often go together. When a person quits breathing it can result in all sorts of dangerous conditions – stroke, heart attack, and more.

When my sleep test revealed I had sleep apnea, the doctor prescribed a C-PAP machine. If you are an older person, especially a male, you are probably familiar with C-PAPs. They force air down your throat to keep you from snoring, and make it possible to get quality, deep sleep each night. My C-PAP pushes moisturized air down my throat to protect against headaches.

My doctor sent me to a durable medical device shop that specializes in devices for aging people, including C-PAP machines. It’s sobering to look around a showroom and see walkers, motorized carts, oxygen tanks, and many other devices that you just know someday you will have to own – or rent.

I used my first C-PAP machine for about four years, and went to the medical device shop to get a new one. The kind clerk told me about the swell new device, all enclosed in one machine, that would replace my clunky failed device. At this point, I upset her day.

“This is great,” I said, smile plastered on my face. Without breaking a beat, I added, “How much does it cost?” I asked the question for the reason that I should ask it, plus I had a high deductible health plan. I expected I would have to pay for the device out of my pocket.

The clerk looked at me as though I had asked her the last time she had been to Mars. I doubt that anyone before me had ever asked how much a device cost.

“I really don’t know. Maybe $2,500?” she said.

“Well, in Minnesota, the law says you have to give me a good faith estimate of the cost of any device if I ask for it.” She told me to call the business office.

“How much does it cost?” I asked the business manager. He asked for my health plan member number, and then replied within seconds.

“$200 a month on a 10-month lease,” he said, referring to his easy price guide.

“I want to buy it,” I said. “I don’t want to lease it.” I wondered, too, what would happen in month 11. “How much is it if I pay cash for it?”

$1,395,” he said, without hesitation. I told him to write it up, and I picked it up later that day.

Saving $605 or more over 10 months made sense to me, because I paid the bill myself. Yet, if my insurance had covered this expense, I also know saving the insurance company money would, when combined with everyone else’s savings, serve to help keep my premiums lower.

The lesson to be learned from this experience is that anytime you spend healthcare dollars, ask the question, “How much does this cost?” You, too, can enjoy seeing the medical provider’s face go into contortions as he or she fumbles for an answer, and then sends you to someone who does know.

When you ask, “How much does it cost?” over time, you will find that you are buying healthcare services, devices, and medications that you need at a price you can better afford.

By the way, I am now on my third C-PAP, and sleeping soundly each night, and happier because I have saved money over time.

Dave Racer is a writer, researcher, publisher, speaker, and teacher. As such, he has written and/or edited 44 books, of which 14 focus on health care and health finance issues. Dave has spoken in more than 25 states and all across Minnesota as a keynoter or educator about health care, and a broad array of issues and ideas. Since 2005, he has been speaking about health care reform, including legislative and congressional actions related to the financing and delivery of health. Dave is also the President of DGRCommunications, Inc., providing research, writing, publishing, and communication services for a diverse group of individual and corporate clients, and is the founder and CEO of Alethos Press, a book publisher.

Check Out Our New Website

If there’s anything we *really* love here at Trig, it’s cooking up something exciting for you, our fantastic members.

That’s why we’re super proud to share our latest news:

We have a brand-new website!

Check it out here: www.trigls.com.

The new website features a sleek new look; brand-new articles and educational resources of all kinds; shows our most recent media coverage; and so much more.

Take a look at our new site and let us know what you think! We’d love to hear about your experience using it.

A Simple Way to Spend Less on Health Care

By Dave Racer

Simple questions are powerful. One of the most powerful questions you can ask when you see a doctor or other medical professional is, “How much does it cost?”

When you ask a medical professional how much their service or product costs, you may see a look of surprise on their face, or shock, or fear. Seldom does anyone ask a doctor about the price of their services. And doctors almost never know the prices, though the business office does.

Compare how you purchase healthcare with purchasing auto repairs.

When you ask an auto repair technician, “How much does it cost?” within a few minutes you receive an answer. The technician can give you a fair estimate based on the cost of parts and the projected time to make the repairs. Knowing your cost of an auto repair makes a great deal of difference in how and when you receive services. Often you have no choice but to move ahead to purchase the repairs, but at least you have time to think through how to pay the bill. Sometimes you can delay the repair and plan to do it later, when you have the money at hand.

When you remodel your home, you might ask two or three contractors to bid on your project. In this manner, you have a better chance knowing your cost ahead of time, and perhaps discovering the best contractor in your area at the fairest price. Most importantly, you will know what you can afford and when you can move ahead, if at all. Knowing this information helps you take a careful look at your current living conditions before deciding to spend on home remodeling.

Unlike an auto or home repair, when it comes to healthcare decisions, patients seldom ask about prices. This should change. If patients (healthcare consumers) ask “How much does it cost?” it changes the patient-doctor relationship.

No matter who pays the bill – you or your insurance company, or both – the provider will charge for it, and ultimately, it is your responsibility to make sure it’s paid. Therefore, you have a right to know the price.

Whether your doctor gives you the price, or sends you to the business office for it, the question “How much does this cost?” creates yet another, important question. “Why is it necessary?”

You wouldn’t replace the brakes in your car if they were not worn down. Neither should you have a medical procedure unless the doctor can explain the reason for it. It is at this point that you can and often will learn about options.

The best medical outcome occurs when you and the doctor have a discussion about what is being recommended and why. This gives you a chance to determine need and value.

Then you can ask other questions. “What does this involve?” “When should I do this?” “What if I don’t do this?” Where should I go to have this done?”

True enough, if you have a health insurance policy that pays nearly all of your health care expenses, or if you have already spent your deductible for a year, you might think the price makes no difference since you won’t pay it – directly – anyway. The reality is that whomever pays your insurance premium – you, employers, government, etc. – when you ask “How much does it cost?” you have a direct and indirect positive effect on healthcare spending for everyone.

Incidentally, at least in Minnesota, the law requires your medical provider to give you a good faith estimate of the cost of your care ahead of time. But you have to ask, “How much does it cost?”

Try it sometime, and enjoy the results.

Dave Racer is a writer, researcher, publisher, speaker, and teacher. As such, he has written and/or edited 44 books, of which 14 focus on health care and health finance issues. Dave has spoken in more than 25 states and all across Minnesota as a keynoter or educator about health care, and a broad array of issues and ideas. Since 2005, he has been speaking about health care reform, including legislative and congressional actions related to the financing and delivery of health. Dave is also the President of DGRCommunications, Inc., providing research, writing, publishing, and communication services for a diverse group of individual and corporate clients, and is the founder and CEO of Alethos Press, a book publisher.

Why Health Literacy Matters

Do you consider yourself health literate?

“The Centers for Disease Control and Prevention defines health literacy as the degree to which one has the ability to obtain, communicate, process and understand basic health information and services in order to make appropriate health decisions,” says writer Steve Rush in a column about health literacy. “Low rates of healthcare literacy are linked to poor outcomes, including higher rates of re-hospitalization and lower adherence to medical regimens.”

He goes on to say this lack of literacy costs Americans $238 billion each year.

Trig can improve your health literacy significantly, saving you time, money and hassle in the process. Trig is the world’s first comprehensive training program designed to empower consumers to play an active role in their healthcare.

If you’re not yet a member, click here to learn more about Trig. If you are a member, be sure to complete your training plan — and let us know if you have questions.

Do you have a story to share about a healthcare experience? Go to Voices on Care — by clicking here — and share your story today. If you’d rather be interviewed by one of our staff members, we can arrange that as well. E-mail us at info@trigls.com and we will set a time for an interview.

Trig. Innovations for empowered healthcare.

Journalists Find Medical Errors Rarely Disclosed

A group of journalists studied patient safety for three years, and found that healthcare providers typically don’t disclose medical errors.

“Washington-based ProPublica, in conjunction with The Daily Beastpublished insights from its latest project in patient safety: a three-year effort to collect detailed stories from more than 1,000 people who suffered or watched a loved one suffer harm during medical care,” the article says. “The results might be shocking to some, but unsurprising to those who understand that medical error has been called the third-leading cause of death in the U.S. (ProPublica cited that 2013 study, by a group called Patient Safety America.)”

This is another reason why it’s imperative that consumers empower themselves with information.

Enter Trig. Trig teaches consumers to be mindful about going to the doctor. We teach patients healthcare literacy so that they understand how to use the healthcare system in a way that saves time, money and hassle — and that reduces medical errors.

If you’re not yet a member, click here to learn more about Trig. If you are a member, be sure to log in and finish your training plan.

And do you have a story to share about a healthcare experience? Perhaps it was about medical errors or another issue. Or maybe you have a positive anecdote. Either way, go to Voices on Care — by clicking here — and share your story today.

Trig. Innovations for empowered healthcare.