Health All Day

Archive for April, 2010

Do You Make These Mistakes in Choosing Your Health Care Plan

There are a lot of details to consider when you are choosing a health care plan, whether it’s one offered through your employer or one you buy on your own. No matter what age you are, your health should be a primary concern, although young people often act as if they will live forever and sometimes postpone making health care decisions.

Here is a list of common mistakes that people make all the time when choosing a health care plan. They are in no particular order, and all are important to consider, carefully and completely. If you are not conversant with all the terminology or are finding it difficult to make the decisions, you should ask for help from a neutral third-party such as family member or friend. Don’t ask a health insurance company unless you want to hear a sales pitch!

Common mistakes
- You don’t check out your doctor, or any others – Although some healthcare plans require you to use a physician in their own network, other plans are more inviting. If you already have a physician, and are buying your own insurance, check with the doctor to see what plans he is a member of. If you do have to choose a new doctor, you should look into the health plan doctors’ credentials by contacting the AMA.

- You forget “location, location, location” – The location of your doctor or clinic, and the travel time required, are other factors you should consider when considering health care plans. Find out where the doctor is located and also look into the regular and emergency hours of the facility.

- You don’t consider specialists – If you already need specialist care, or think you may need to in the future, you need to know the health care plan’s procedures on using them. Some plans require you to contact a primary care physician, while others allow you to make specialist appointments directly.

- You don’t consider your own specialist – You should definitely find out if your current specialist is in the health care plan you are considering. If not, perhaps your specialist can refer you to one who is.

- You forget to check the policy on “pre-existing conditions” – Even though this should be a “no-brainer,” people forget to ask about the policies on pre-existing conditions. Coverage for pre-existing conditions varies widely among health plans. Some exclude them entirely, and will not even consider coverage, while others cover them fully. Many health care plans fall somewhere in the middle, offering coverage after a certain amount of time, or for a certain amount of time or expense. Rules promulgated by the Health Insurance Portability and Accountability Act guarantees you coverage for your pre-existing conditions if you join a new group plan offered by your employer after being insured the previous year.  Do your research to make sure you know what your policy covers.

Less common oversights
- You don’t ask about physicals and health screenings – Again, it seems an obvious thing to ask, but if you appreciate getting regular physicals and health screenings you should ensure that they are covered. Most “managed care” plans do cover these types of procedures, usually on an annual basis, but there are some plans that do not cover them. If you have children, make sure to ask if “well baby” check-ups, physicals and immunizations are covered.

- You forget about additional services – Everything, from prescription drug coverage to mental health care, is an important consideration. You need to consider which of the various additional services that you may need are, in fact, covered when you are comparing health care plans. Other examples of these additional services that may be important to you are drug and alcohol counseling and treatment, home health care, nursing home or extended care, hospices, experimental treatments, alternative and complementary medicine, chiropractic care and physical therapy.

Bottom line considerations
- You don’t price things out correctly – Once you know what you want in your health care plan you need to compare costs, and you need to do it right, which means covering all the bases. You will need to know exactly what deductibles must be paid first before the health care plan coverage starts paying, and don’t forget to ask if the deductible needs to be met before certain services can be utilized. Find out about “out of network” charges if you anticipate having to go beyond your plan facilities or physicians. Finally, there are co-payment, cap amounts and total-care limits you need to know about. Some plans have lifetime limits, some have lifetime and annual limits, and others have mixed formulas for making this determination. Get all the facts.

- You don’t check the exclusions – If you don’t read the exclusions list, you will not know what is not covered. You need to see if any condition you currently have, or that you expect to contract in the future, is included. This is an important bottom-line consideration since, if you don’t get this settled and dealt with up front, you will likely spend a great deal of money down the line to treat excluded conditions.

It is a difficult thing to look at your health in a dispassionate, dollar-oriented way, but that’s life. As we age, more of our energy goes into thinking and planning against death and disability, but the subject need not be morbid or depressing. Do your best to get a health care plan that covers what your particular needs are, and remind yourself that you are worth the trouble – and the expense.

Differences Between Senior Home Health Care And Nursing Home Care

Home health care can often be better for seniors that need one on one assistance and care. Skilled and certified nurses operate within most of these businesses to verify high levels of professional service. You and your parents are the absolute decision maker on who you want to use for therapy and nursing services through home health care. While you need to utilize a Medicare certified agency to have Medicare pay for services, you and your parents have the right to use any home health agency that you desire. Home health care services are offered all around the country, which means that there is one close to your loved ones. Elderly home care consists of many services, however, Freedom Home Health offers:

•    Home Health Aides
•    Physical Therapy
•    Occupational Therapy
•    Speech Therapy
•    Nursing

Nursing homes are more about companionship for the elderly. If you are looking to make sure your parents always have a close eye kept on them as well as their health, an assisted living facility is necessary. These services are available in most nursing home facilities:

•    Wellness Program
•    Activities and Entertainment
•    Assisted living
•    Meals   

Take the time to analyze which option will best suit your parents necessities. A free home health assessment can be taken at Freedom Home Health to help you understand the needs of your loved ones.

Do not hesitate to ask questions when searching for local home health care or nursing home services. This is a decision that requires a lot of research to ensure you are making the proper decision for your family member.

Health Care Costs is Rising – What you Need to Know

Americans pay more than one and a half trillion dollars for medical care each year and costs related to all manner of health care, such as prescription drugs, continue to skyrocket. While some of reasons behind this booming bill are understandable, Americans caught in a cash crunch might be surprised to find out some of the lesser-known causes of high health care costs.

The words health care might invoke images of doctors, nurses and hospitals, but the reality is that the medical field is a business and a ruthless one at that. Individual practitioners, researchers and participants may have wonderful intentions and a true desire to help people, but the structure of the American health care system ensures profit is the number one issue of importance.

Here are some facts that may help explain the high costs of American health care:

Pharmaceutical research and development companies spend roughly billion each year on R&D, and about the same amount on advertising and self-promotional marketing activities.

There is sure to be a grin on your face once you get to read this article on health insurance. This is because you are sure to realize that all this matter is so obvious, you wonder how come you never got to know about it!

Additionally, drug companies have as many sales people as there are doctors in the United States. One of the responsibilities of this sales force is to convince doctors to attend pharmaceutical company-sponsored seminars where drugs are showcased.

According to some economists, the purchase of new technology is responsible for more than 50 percent of new health care spending over the last three years.

Much of the money Americans pay for health care finds its way into the rising profits on health care-related products and services such as the provision of medical insurance. Even higher costs have been forecasted for the future, especially for prescription drugs.

For many Americans who are unable to afford the health care they need, rising costs represent an ever-increasing barrier to medical services and products. The financial burden is also felt on the larger national scale with about 15 percent of gross domestic product going toward health care costs. That is equal to about one quarter of the annual federal budget.

Comparatively, Canada invests around 10 percent of its GDP on its public health care program. Unlike the United States, Canada’s health care program is universally available to all citizens and permanent residents without cost. Other countries, such as Germany, where there is a public/private delivery system model for health care, manage to serve their populations for even less while still having better longevity than Americans. This proves that the quality of health care does not rise proportionally with the amount of money spent to attain it.

While many Canadians supplement their universal health care with added insurance to cover the cost of medication and perks such as semi-private or private hospital rooms, health care insurance is much more essential in the United States. Unfortunately, costs have been rising dramatically, making health care insurance out of reach for many Americans. Currently, more than forty million Americans do not receive any kind of health care benefit.

Developing a vision on health insurance, we saw the need of providing some enlightenment in health insurance for others to learn more about health insurance.

For employers, providing health care insurance for employees is also becoming more expensive, with increases dramatically outpacing inflation rates. Some years, the difference is four or six fold. Even if premiums were to remain static, offering health care insurance to employees still costs several thousand dollars per worker. For smaller companies, or for those who employ a large number of people, these costs can be prohibitive.

Measures to reduce health care costs are always under consideration, though many are not popular choices. Suggestions that have been put forward by various sources have included:

Increased drug awareness and education. Millions could be saved if health care insurance covered only generic versions of drugs that have been proven just as effective as their more expensive brand name counterparts.

Terminate expensive treatment options will only add a short amount of time to a patient’s life, particularly if it will not be quality time (i.e. patient is in a coma).

Promote preventative care such as smart lifestyle choices, proper nutrition and exercise.

Examine to ways to control drug advertising to consumers. There is speculation that advertising has led to prescriptions of non-necessary drugs.

Limit malpractice liability so doctors and medical professionals do not feel pressured to cover themselves by ordering unnecessary tests to substantiate conditions they already know to be present.

To view our recommended sources for health insurance, or to read more articles about health insurance, visit: http://www.insurance-quote-puppy.com

Home health care services ? the need of elderly beings

Home health care can provide you with services in the comfort of your own home; these services are generally coordinated by a home health care agency. Some of these services include skilled nursing care, physical and occupational therapy, speech-language pathology services, and medical social services as advised and ordered by your physician. Additional home health care services may include personal care, some housekeeping, meal preparation, and general health management. Home health care can help facilitate staying in the home for senior citizens and disabled individuals.

Home health care agency staff can teach you and your caregivers to continue care such as wound care, therapy, and disease management. If you are leaving a hospital or skilled nursing facility, the discharge planner can help you to set up in-home care.

In order to be eligible for Medical coverage, the health services used must be both reasonable and necessary in the treatment of an illness or injury. A certified Home Health Care Agency may provide the following services:

Part-time or intermittent skilled nursing care by a registered or a licensed practical nurse
Personal and occupational therapy
Speech-language pathology services
If you are receiving skilled care or other therapy from the home health care agency, you may also receive part-time or intermittent home health aide services
Certain medical supplies that are part of your care, including wound dressings
Durable medical equipment such as a walker

Choosing a right home care agency always turns out to be a headache as there are so many referrals and recommendations that it becomes really difficult to choose the right one for your elders. There is no dearth of information pertaining to Home Health Care Agencies. One can refer to search engines on the internet or look up phone directories or contact information providers or get references from the family doctor. But the best way to choose the right agency is to ask people who have utilized home health care agencies as they have first-hand experience. Moreover, if they are recommended they are probably more reliable and good. In the event of not knowing anyone who has availed of home health care services it is best to interview caregivers from a few agencies and shortlist the best.

Besides taking into consideration word-of-mouth reputation and the services required, one should also consult the insurance company that is going to cover the expenses of the treatment and care. It is more convenient and advisable to contract with a Home Health Care Agency which is listed with your insurance company, provided the agency in question offers you what you are looking for. This avoids cumbersome paperwork and complications.

Social Justice Through Health Care

SOCIAL JUSTICE THROUGH HEALTH CARE

We hardly come across a person who may be fully satisfied with the health care delivery system run by either the government or the private sector. This is true not only for developing but for all the developed countries as well. Every law abiding, contributing individual has some legitimate expectations from the state. Disenchantment with present dispensation of health care compels people to seek better options across the borders. Even the present flow rate of patients from developed to developing countries has assumed the proportions of Medical tourism. Medical tourism is not a one-way traffic. Poor from India are known to visit Rashid Hospital at Lahore for kidney transplants. Medical tourism will definitely bring in world class equipment and services in our corporate hospitals. These corporate tertiary care hospitals can act as excellent referral hospitals. Lack of enough clinical material, as the patients are often referred to in medical parleyences is prompting the doctors from developed world into medical adventurism. Very recently two NGO’s headed by renowned plastic surgeons of Indian origin were in India, claiming to their credit hundreds of cleft lip and palate surgeries conducted in one week. During my brief interaction when I asked them one basic question that how do you justify single step surgery by a single specialist for a clinical entity that require 3-5 set up surgeries by 10 specialists over a period of 20 years, there was no answer. On record local doctors conduct all these surgeries. These NGO’s bring in a battery of trainee resident doctors for hands on training. Dumping of questionable services and drugs continues unabated in the absence of stringent regulations. Clear-cut up to date guidelines by health authorities have yet to be issued to safe guard the health interests of this nation. Most of the drugs banned in developed countries are still being dumped in the Indian market. Commerce alone dictates the policies of multinational companies in health sector of developing countries. State and national medical councils, the watch dogs of our national health interests are controlled by elected representatives from among the doctors. Competitive populism for being elected to these high offices takes away the very sting off these regulators. In this ‘market forces’ driven health sector, apart from other factors, size of the population, economic prosperity and literacy levels dictate the out look of key players. Subjective as well as objective assessments of the health care operations leave people confused with huge piles of data and endless interpretations. At the tail end of govt. health care delivery system is the rural dispensary or the slum revamping center, and the end user an illiterate or semi literate villager or a slum dweller. Dispensary is the humane face, the welfare state can present to its people. In yesteryears the service providers were from among the same social class they used to serve. Doctor can be a friend, philosopher and guide to the locals. Unfortunately the economic and social disparity between the service providing doctors and the service user population has grown enormously. Ad-hocism in health care delivery should be done away with immediate effect. Doctors and paramedical staff appointed on yearly contract basis are not showing any interest in the national programmes. Established private health care providers also have not shown any meaningful commitment for national programmes. Middle class itself has fragmented. Now it is fashionable to assign economic values to any issue like gender, but for social responsibility and justice. In this era of fast paced growth, the unorganized, silently suffering millions can not be wished away. Once reading on biodiversity I stumbled upon a very interesting quote, “only the species with economic importance will survive”. In our active pursuit for magnetizing economy, we assigned economic values to any thing except for morals. Commercialization of education has produced a new breed of professionals who have scant regard for professional ethics. Privatization is the buzzword with governments, because it takes away government responsibility. Private sector players are eyeing many ‘viable’ health institutions. There are no takers for commercially non-viable rural institutions. Rural health institutions dispense social medicine. Very recently one of the key players from private sector health care quoted the cost of developing one bed in corporate hospital at Rs. 30-60 lacs. These corporate health services are definitely out of each of the common man. These type of hospitals are definitely required for a nation with the present rate of growth but ‘bharat’ definitely needs different kind of hospitals. There are very strong social under currents against the exploitive private healthcare, inadequate government sector health care resources and the indifferent approach of welfare state. Health for all is a very lofty but expensive proposition. There are ways and means to reduce the pressure from government institutions. Private-public partnership, health insurance, monitoring and regulation of private sector health care can all make the things bit easy. Preventive health care education can go a long way in improving the public health. Community participation in health care has produced few but wonderful examples. Complementary community participation can make up for minor but critical deficiencies in the government run health care system. Setting up of health system corporations with World Bank assistance has already improved the working of govt. sector health care institutions considerably. Community participation through NGO’s can still improve the system, but most of the meaningful NGO’s turn their back on govt. run health care institutions because of their doubts on the integrity of government officers. Government health care institution are increasingly seen not as caring hospitals but like police stations, where medico legal reports are written and postmortems conducted. Most of the government doctors’ time is spent in courts appearing as medico legal experts witnesses. Emergency, post mortem, and then the VIP duties in addition hardly leave the doctors free for any meaningful job at government hospitals. There is an urgent need to have separate curative, preventive, legal, administrate and health intelligence wings. Government hospitals attract the poorest of the poor, mostly people from the unorganized sector. Their contribution to national GDP is by no means small. With the present growth rate, upward social mobility is seen in every strata of society. Many segments of this unorganized sector can be organised so that they also enjoy the patronage of welfare state in the form of health insurance policies. Apart from direct benefit to these segments of society, the state will benefit from the ‘off loading’ of burden from government run health care system and loading it on insurance driven private sector health care institutions. Poorest of the poor will repose faith in welfare state. Sanjivini, health insurance policy with the Punjab Milkmen Cooperative Societies is already a big success. ECHS (Ex servicemen Contributory Health Scheme) is an other success story. These success stories can be replicated with countless groups like, panwallas, dhabewallas, autorikshaw drivers etc. Simply organize the unorganized sector. There is no dearth of role models from among government doctors also. Their inclusion rather than drift after dissent from the present dispensation of health care will immensely improve the system. Stability of tenure is an excellent incentive government can give to its doctors without costing anything to exchequer. Yet tenure beyond decades should be discouraged as it leads to development of vested interests of the old incumbents and denial of chance to the youngsters. Resource mismatching is a major problem in the govt. run health care system. There are dispensaries where specialists are posted and still many more civil hospitals where non-specialist are posted. These mismatching result in defective and inefficient heal
th care. Nodal Hospitals can be created for round the clock emergency services by cannibalizing defunct and sick institutions where equipment worth crores is lying unused and salary bills are bleeding the exchequer white. Most of the medical officers retire in the same administrate rank. This undue stagnation has forced many a brilliant doctors out of service. By simply seeking options for place of posting, honestly implementing with minimum displacement on merit can also revitalize the govt. doctors’ cadres. Private sector health care delivery system is a totally market driven commercial enterprise. So called ‘market forces’ have least respect for ethical and moral value systems. Multi level marketing chains have evolved in the name of referral systems. End result is exploitation of the unsuspecting common man, who still regards his healer a holy person. This ‘incentive’ system is strengthening the hold of unqualified, unscrupulous and unregistered medical practitioners on illiterate masses. Not many qualified doctors are unscrupulous. A large section of private health care providers feel genuinely threatened by blackmailers of all sorts. Consumer protection act is a very convenient beating stick in the hands of their tormentors.

Under the constant threat of being blackmailed, the private health care providers are becoming more defensive in attitude. More patients are being referred to tertiary care institutions for this reason only, thereby flooding the referral institutions. People have a common feeling that sickness is an invitation for exploitation at the hands of private health care providers. Even the charitable hospitals are charging as heavily as fully private hospitals. Medical profession is fully responsible and capable of self-correction. Medical councils and associations can jointly evolve a fail-safe mechanism to keep their black sheep under check even without government help, but the buck stops with the government. Welfare state is duty bound not only in providing health care delivery system but also proper health care administration and social justice through its health care delivery mechanism.

Name : Dr. Pardeep Kumar Sharma

Email-ID : omfspardeep@yahoo.com.

(M) : 0988456296

Date of Birth : 12.02.1962

Education Qualifications : BDS (Bachelor of Dental Surgery)

MDS (Master of Dental Surgery in Oral and Maxillofacial Surgery)

Educational Institutes Attended

Govt. High School Bargari : Matriculation (1969-1977)

Distt. Faridkot, Punjab, India

DAV College Chandigarh : Pre-University (1973-79)

(Punjab University)

Barjindra College Faridkot : Pre-Medical (1980)

Dental Wing, Medical College : BDS (1981-1986)

Patiala

Dental College and Hospital : MDS (2003-2006)

Amritsar

Professional Experience

House Officer, Christian : 1987-1988

Medical College & Hospital,

Ludhiana

Research Officer, All India : Jan. 1989 to June 1989

Institute of Medical Science

AIIIMS, New Delhi

Dental Officer, Indian Armed : July 1989 to August 1994.

Forces in the Rank of Capt.

3

Medical Officer (Dental) : w.e.f. Nov. 1995 till date

in Punjab Civil Medical Service

(PCMS)

Research papers Published

“Role of Programmed cell death in dental anomalies associated with cleft lip and Palate”. “Medical Hypotheses” Churchil Living Stone Publishers London-1991

Post traumatic polatoglossal adhesion, a case report stomatologica India (1990).

Research Project Undertakes

“Malocclusion and associated Factors among Delhi Children” a study sponsored by Indian Council of Medical Research (ICMR).

Areas of Interest : Environment, Health, Defence, International Affairs and Rationalism

Home health care services ? the need of elderly beings

Home health care can provide you with services in the comfort of your own home; these services are generally coordinated by a home health care agency. Some of these services include skilled nursing care, physical and occupational therapy, speech-language pathology services, and medical social services as advised and ordered by your physician. Additional home health care services may include personal care, some housekeeping, meal preparation, and general health management. Home health care can help facilitate staying in the home for senior citizens and disabled individuals.

Home health care agency staff can teach you and your caregivers to continue care such as wound care, therapy, and disease management. If you are leaving a hospital or skilled nursing facility, the discharge planner can help you to set up in-home care.

In order to be eligible for Medical coverage, the health services used must be both reasonable and necessary in the treatment of an illness or injury.

Part-time or intermittent skilled nursing care by a registered or a licensed practical nurse
Personal and occupational therapy
Speech-language pathology services
If you are receiving skilled care or other therapy from the home health care agency, you may also receive part-time or intermittent home health aide services
Certain medical supplies that are part of your care, including wound dressings
Durable medical equipment such as a walker

Choosing a right home care agency always turns out to be a headache as there are so many referrals and recommendations that it becomes really difficult to choose the right one for your elders. There is no dearth of information pertaining to Home Health Care Agencies. One can refer to search engines on the internet or look up phone directories or contact information providers or get references from the family doctor. But the best way to choose the right agency is to ask people who have utilized home health care agencies as they have first-hand experience. Moreover, if they are recommended they are probably more reliable and good. In the event of not knowing anyone who has availed of home health care services it is best to interview caregivers from a few agencies and shortlist the best.

Besides taking into consideration word-of-mouth reputation and the services required, one should also consult the insurance company that is going to cover the expenses of the treatment and care. It is more convenient and advisable to contract with a Home Health Care Agency which is listed with your insurance company, provided the agency in question offers you what you are looking for. This avoids cumbersome paperwork and complications.

Although most home heath care agencies are honest and use proper billing information, fraud is not uncommon. Fraud may include home health visits ordered by your doctor but which were never actually carried out or bills for equipment or services that you never received. So make sure you have done your homework before you finalize any home health care agency. For more details over home care agency and their services you can log on to at: www.thecaringspace.com