Also serving the communities of De Luz, Rainbow, Camp Pendleton, Pala and Pauma
Also serving the communities of De Luz, Rainbow, Camp Pendleton, Pala and Pauma
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For end-of-the-year columns, it’s customary to recap the events of the past 12 months, usually highlighting a mix of the good and the bad. Because this year has been dominated by health, in particular COVID-19, and my beat is health, it seems fitting to reflect on where we are. Where we are is not good. A headline in the Los Angeles Times seemed to sum up the current state of the U.S. healthcare system: “Bodies pile up, patient care falters as COVID-19 devastates L.A. county hospitals.” In the Times’ story, a hospita...
It seems that nothing ever changes when it comes to hawking insurance to fill the gaps in Medicare coverage for seniors. The fervent sales pitches, the misinformation and the incomplete and deceptive information continue to proliferate. For the last several weeks I’ve heard ad after ad, particularly on the TV news shows, urging older viewers to call 800 numbers to learn about the latest and greatest Medicare Advantage plans. Retired football star Joe Namath says you need to “get everything you’re entitled to.” Namath rattles...
If you were hoping that this was going to be the year of government action to lower prescription drug prices, I’m here to say that is not going to happen – even though the House of Representatives passed far-reaching legislation almost a year ago that would allow Medicare to begin negotiating drug prices for beneficiaries. Recall that the 2003 law that made possible a prescription drug benefit for older adults prohibits the government from negotiating with drug companies in order to lower prices. The Senate has not taken up...
Steve Schneider owns a digital marketing agency in Indiana where he insures six people on the company’s health insurance plan – two employees and their dependents – for about $37,000 a year. He said it’s an “ultra-high” deductible plan that requires each family to pay the first of the year’s $12,100 in medical costs out of their own pockets and charges totaling $6,050 for each family member before the insurance plan pays. That’s hardly insurance, but that is the norm. “Every year, it’s how much can we offer and how much...
Steve Schneider owns a digital marketing agency in Indiana where he insures six people on the company’s health insurance plan – two employees and their dependents – for about $37,000 a year. He said it’s an “ultra-high” deductible plan that requires each family to pay the first of the year’s $12,100 in medical costs out of their own pockets and charges totaling $6,050 for each family member before the insurance plan pays. That’s hardly insurance, but that is the norm. “Every year, it’s how much can we offer and how much...
Testing! Testing! Testing! That’s what the experts said is necessary to move the country back to normalcy. Almost daily, local TV stations in New York City where I live run public service announcements urging viewers to get a test for COVID-19. Those announcements tell how to find a testing site, and most point out that the tests are free. Many New Yorkers, as well as people in other states, are undoubtedly confused about the kinds of tests available, wonder about the delays in getting results and worry about the tests’ rel...
At the height of the pandemic, many Americans are experiencing firsthand the flaws in the Affordable Care Act and the health insurance it guaranteed. They are also facing the possibility that even the protection it does afford may be stripped away. The fate of the Affordable Care Act, also known as “Obamacare,” is again uncertain. The 2010 law that began to whittle down the large number of uninsured Americans is back at the U.S. Supreme Court awaiting a decision – most likely next year – about whether it is constit...
How soon will there be a vaccine to protect people from the coronavirus? That’s the question uppermost on the minds of many Americans, especially the elderly and others especially at risk for a severe bout of the disease. Everyone wants the vaccine yesterday. Maybe that’s why the media cheered in late May and hope soared when Moderna, a 10-year-old biotechnology company based in Cambridge, Massachusetts, issued a news release with hopeful information. Positive Phase 1 data, although early, showed promising results, the com...
The Affordable Care Act, nicknamed “Obamacare,” turns 10 years old this month, and what a tumultuous run the health care law has had. The law’s rocky existence hasn’t smoothed out yet, and it faces additional scrutiny by the U.S. Supreme Court in the fall, the result of more legal challenges to its future. Nevertheless, the occasion of the law’s 10th birthday is a good time to take stock of what it has done and what it has not. How have Americans been helped? What serious challenges facing the health care system remain? N...
As insurance companies push doctors to save money by switching their patients to generic drugs, complaints about those generics appear to be on the upswing. That’s the observation of journalist Katherine Eban, who has written a book, “Bottle of Lies,” that tells a very dark tale about the generic drug industry and the safety of generic drugs Americans are increasingly taking. “My inbox is full of communications from patients who were on a drug that worked but were switched to a generic that didn’t work,” she told me. “Patien...
The next time you hear someone – likely a politician or representative for a medical special interest group – argue that America’s health insurance arrangements are fine because they offer lots of choice for patients, don’t take them seriously. What choice are they talking about? Almost anyone navigating the health system over the last decade knows that insurers have limited where they can go for care and whom they can see. The concept of limiting patients’ choice of doctors, hospitals, and other medical services like radi...
People know too well the cost of American health care keeps rising as far as the eye can see. In 1995 health care accounted for 13.4% of gross domestic product; in 2018, it consumed 17.7%. It is projected to rise even more. Despite all the talk about how they should become wise consumers of medical care, patients can’t really do much to stop the big hospital systems, the big physician groups or the powerful drug companies from charging the prices they do. In our system, those groups pretty much control what medical care c...
In recent days, several tweets shared ominous news about the state of health insurance in the country. One woman tweeted she bought an Affordable Care Act policy for a $1,200 monthly premium and a $7,500 deductible. By May, she said, she could no longer afford that premium. Another tweeted her 59-year-old friend would be paying $900 a month in premiums with an out-of-pocket maximum of $8,150. The friend has assets, but the insurance restricts where she can get care, a common policy feature. A third tweet said he was...
Community Health News Service If you’re buying health insurance on your own this year, the marketplace is more complicated – and dangerous – than ever. Dangerous? How can that be? I’m talking about health insurance, not some sketchy internet site. But the reality is that the scam artists are out in full force, and anyone buying a policy by shopping online had better watch out. There’s a high likelihood you could buy something that won’t provide much coverage, but will shortchange you mightily when you get sick. Pennsylvani...
Two years ago in Dallas I met an 85-year-old woman and her 65-year-old son. Both were very hungry with almost no food in their fridge or in their cupboards. After they had paid their bills, their meager monthly income from Social Security was dwindling. For lunch, the mother wanted boiled cabbage with lima beans and collards, but the son reminded her there was no money for it. It was the second week of the month. They had been on waiting list for food from the Visiting Nurse Association of Texas, the Meals-on-Wheels provider...
Along with crunchy leaves and pumpkins, fall brings a slew of advertising for insurance plans that fill the gaps in Medicare coverage. Misleading and confusing messages continue to reach beneficiaries and those nearing Medicare age. To take myself as an example, I’ve received an invitation to a Medicare Advantage plan informational meeting. I’ve gotten a solicitation from my physicians’ medical group offering a “zero-cost, no obligation way to review coverage” online or over the phone. The “review” is likely to bring a sales...
Maybe – just maybe – Americans will get some relief from the relentlessly rising prices of pharmaceuticals. That, of course depends on Congress pushing back against the drug companies’ formidable lobbying machine, their generous campaign contributions, and the industry’s historical coziness with members of Congress. But this year seems different. When considering that the country’s spending on prescription drugs increased by 28% from 2011 to 2016, it’s easy to see why it’s harder for politicians to ignore the public anger...
Are e-cigarettes becoming the next public health hazard? Increasingly, health officials seem to think so, and in early September the Centers for Disease Control and Prevention suggested that Americans stop vaping until health officials know more about an epidemic of lung disease that has made some 450 people sick and caused three deaths. A study just published found that more than 80% of the patients said they used THC, the psychoactive ingredient of marijuana, but more than half also used nicotine, the culprit in...
People would think that making the prices charged by hospitals and doctors available to their patients would be a no-brainer. After all, they’ve become accustomed to knowing the price they pay for cars, carrots, comic books and almost everything else they buy. Why not knee surgery or appendectomies? The medical establishment, it seems, isn’t keen on letting the public in on what health practitioners charge for their services. Despite lots of talk about price transparency from government officials, including the Trump administ...
Consumers who are hoping a couple of recent policy proposals might lower prices for their prescription drugs may be out of luck, at least for now. Earlier this year the Trump administration had proposed a rule that would have required prescription drug manufacturers to disclose list prices for drugs advertised on TV. Drug makers would have had to tell the public the list price of a 30-day supply of any drugs covered under the Medicare and Medicaid programs that cost at least $35 a month. Some experts argued the rule would...
Is the U.S. ready for a discussion about paying for caregiving, an increasingly vexing and costly problem for a growing number of Americans? The answer may be “yes.” It has become obvious that long-term-care insurance is not the answer to paying for nursing home and other kinds of care for the elderly. Sales for this product have been declining, the result of sky-high premiums, rate increases and the difficulty of qualifying for a policy if you’re sick. But the elderly are not the only Americans needing care. At the other end...
The Senate Special Committee on Aging has just released one of the most damning reports on the nation’s nursing homes that I’ve seen in a long time, www.aging.senate.gov/press-releases/casey-toomey-secure-cms-commitment-to-publicly-release-monthly-list-of-underperforming-nursing-facilities-. The short document should be required reading for any family thinking of moving a relative to a nursing facility. Pennsylvania Sen. Robert Casey, a Democrat, who is the ranking member on the committee along with Pennsylvanian Sen. Pat...
If ever there were a weak link in hospital care, it’s what happens when someone leaves the hospital. It’s becoming clear that the process known as discharge planning is deficient, can be harmful and sometimes results in a patient’s decline. One in five patients across the country needs further care after discharge from a hospital, according to a series of four reports published by the United Hospital Fund in New York City. That’s a lot of people, and many times their families don’t know where to turn for help. The fund said...
This New York City subway ad recently caught my attention: “When researching hospitals, consider how much research they do.” The ad for Mt. Sinai Health System advised riders that the research “we do today drives medicine we will do tomorrow,” and the hospital system was proud that it ranked among the top four medical schools in the country in research dollars per investigator. I’m used to outlandish and questionable advertising, but this ad rose to a new level. If I were looking for a hospital for a surgical procedure...
If ever there were an award for the best “buyer beware” story, a tale detailing the pitfalls of short-term health insurance would certainly rise to the top of the list of nominees. Short-term term policies – not to be confused with association policies I’ve written about before – are hitting the market once again, sanctioned by the federal government and pushed by insurers and agents. These policies are sold for short durations such as three months, six months or a year, but coverage can be for as long as three years und...
