Gay Fresno - Health
Medical Matters - Affordable Healthcare?
- Parent Category: News
- Created on Friday, 17 May 2013 11:38
- Published on Friday, 17 May 2013 11:38
- Written by Ted Fleischaker
This month's column contains a bit of advice, a bit of commentary and a bit of a warning — all aimed squarely at anyone who plans to visit a doctor's office, have a test for anything or pick up a prescription. And that biggest bit of advice is to find out what you can do and what you can't, as well as what it's going to cost you, before you make plans. Otherwise you might just find yourself reporting for that physician's appointment or procedure only to find out that unless you pay out of pocket it's not happening.
A friend of ours found out his dad's company changed insurance as of the first of the year — but dad never told him. Now he has a $77 doctor's bill he needs to pay as they changed his deductible from $0 to $1500 a year. Dinged!
At our house meanwhile insurance no longer will cover Nexium, which we've taken for acid reflux for years. They say they'd gladly cover several "as good" other meds for "only a $5 co-pay" but there's an issue: the ones they are willing to pay for don't work for us — one causing severe side effects and the other being less useful than sugar cubes. Of course, we CAN still get Nexium if we are willing to pay out-of-pocket to the tune of $1000+ for a 90 day supply. Dinged again!
So what is the point here? To remind readers that health plans change and so does coverage. And often it's not for the patient's benefit at all. Despite guarantees from Washington, a lot of the shenanigans insurance firms, employers and government pull are bad and only going to get worse, leaving us to hope for national health one of these days and meanwhile to tell readers that they'd better stay on top of what their (or their spouse's, if they are fortunate enough to have care extended to them) coverage will and won't do and pay for. And if you think for even one minute things are getting better, we'd suggest you have it all wrong. At our house and many others' the red tape associated with The Affordable Healthcare law is bad and getting worse.
Included in all this are simple, almost laughable, things. We were informed by our physician last visit that she now has to ask us our date of birth "every time I come into the room." Asked what that means she said "well, I have to ask it to confirm it's you when I first greet you and do the basics, then say I leave to get a flu shot to give you, again I have to ask when I return just so the officials know it's really you who got the shot!"
The regulations also now require that each visit we be asked "Are you in an abusive relationship?" As our doctor is very gay-friendly and sees us as a trio, it was only after a huge burst of laughter that we all said in chorus during a recent visit, "YES!" That, of course, brought even more laughter, but we aren't sure what she put down as our reply.
And speaking of putting down, say goodbye to the pen, pad and grunted "uh-huh" when you talk to the doc. By later this year fines will be levied against practices where they still use paper and not iPads or laptops when they keep medical records. At least one physician we asked in Louisville told us she was planning on paying the fine because at age 66, she declined to fork over the $100,000+ it would cost to change records from 30+ years of practice to the electronic format.
So what should you do?
As we already said: confirm and reconfirm coverage if you have health insurance. Also see what options you have. Maybe your insurance firm will allow a 90-day refill of on-going scripts but only if you use their mail order service. Also, see what generics they will cover if they refuse name brand pills. Synthroid, a common thyroid supplement, seems high on the "hit list" of pharmaceutical plans and while at least two doctors have told our family that they feel generic versions are not as good, the choice is between payment or non-payment by our health insurance. All this means that while the health coverage folks are staying within the letter of the law and allowing doctors to diagnose and prescribe, they are de facto doing the job by denying coverage for anything they feel is too costly. Same thing goes for procedures and routine tests. Doctor send you for blood work? Great, but call first and see if you have coverage or that needle in the arm will not only cost you a few ounces of blood, but will shoot right into your wallet and could cost $1,000 or more for the tests.
Also don't forget to negotiate. Yes, you read that right: Ask your doctor's office what choices you have or what they'll do for you. You may be shocked to find out that just as you don't have to buy that shirt at one department store but can instead get one elsewhere, you can sometimes shop prescriptions and care to save big bucks. Most doctors have "negotiated rates" with healthcare firms, then you hand over a co-pay. The two together amount to what the doc gets when you see him or her. If you want to save you might be able to negotiate a much lower price if you skip insurance and pay for that office visit. It never hurts to ask as at least one doc we know of gets $95 for an extensive office visit if you pay with insurance, but if you just pay out of pocket, she asks $65. She saves filing, waiting and hassle and you save cash, so it's win-win.
Also look at pharmacy plans and shop those. You know the ones where you get a 60- or 90-day supply for one cheaper co-pay. Each drugstore chain has their own list of "approved" meds on that list. They say it's much better to use one pharmacy and stick with them because interactions and problems can be easily spotted by their staff and computers. We totally agree, but what if the "pay one price for 90 days" works for some of the meds you take at ding store A, while others are on ding store B's plan, but not on As? You might find driving a few blocks can save you 10, 20 or even 50% so always ask and investigate. There's no humiliation using two drugstores. Just be sure your doctor's office checks for interactions and prescribes accordingly.
The same is tine with the mail-in pharmacies so many health plans push these days. Cost for 90 days of something you routinely take might be lower as you may have only one co-pay, but what if the generic they ship you is inferior to what you get up the street at the local pharmacy? We know one mail-in drugstore which sent such a cut-price generic nasal spray that it was lacking even the usual pleasant smell while another sent out a skin cream generic made in India. Note: There's nothing to say any of these prescriptions will not work as well as what the patients reporting them had been getting, but always ask if you suspect too many corners are being cut. It might be worth paying the extra $20 the nasal spray patient told us about because he doesn't like what he was sent. And as for the salve, that one was dispensed to this writer who told his pharmacist he wants something made in the U.S., even if it does cost more.
Finally, always remember that you are the customer. You pay the healthcare plan, the doctor and the pharmacy. That means you can shop and ask for a better price, a different doctor or a discount. You may not always get what you want, but it never hurts to ask. Stay knowledgeable about your care and needs, then remember at the end of the day it's your choice — one you might pay more for, but what's peace of mind worth?
To keep our lawyers happy, be advised that the recommendations which are contained in this column are suggestions, but are not to be taken as medical advice. Always consult your physician or a healthcare professional before undertaking any physical fitness or other exercise program.
Medical Matters - Spring
- Parent Category: News
- Created on Saturday, 13 April 2013 14:47
- Published on Saturday, 13 April 2013 14:47
- Written by Ted Fleischaker
April is here and that means the seasons are about to start changing...for some it's a pleasant relief because those days when depression hits with clouds and snow and rain will soon be on the wane. For others it means spring allergy season is almost upon us and with the first buds will come the runny noses and watery eyes. Others will be happy to see more sunny days to get outside and run or work out, while others will start planning those summer pool parties, half marathons, bike tours and other events.
What we're trying to say is that this time of year, more than almost any other, presents plenty of challenges for our bodies — whether it be mental as days lengthen or physical as some try too hard to get set for Speedo and Spandex season. Here are a few thoughts and things to watch out for:
—If you are planning to boost your physical regimen with the change of seasons, start with a visit to your doctor’s office and get checked over. After a long winter, you might need to start more slowly than you’d like, plus muscles and bones unused to all that work might need to be checked to make sure you don’t end your season before it begins with a sports injury.
Be sure to get your doctor's OK before you start that new activity — be it biking, running, lifting, boot camp or whatever. Also, Spring is a good time to think about losing a few pounds you might have picked up in front of the TV this Winter, so ask the doc for some diet recommendations. Just remember that fad diets are just that — fads which rarely work, often can cause harm to your body and all-too-regularly don't allow you to eat properly so you keep weight you might lose off. This is also a good time to visit http://nhlbisupport.com/bmi/ and calculate your body mass index (BMI).
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Federal Court Gives Green Light to California Law Protecting Youth from Dangerous Practices by Therapists
- Parent Category: News
- Created on Tuesday, 04 December 2012 20:59
- Published on Tuesday, 04 December 2012 20:59
- Written by EQCA
Being Transgender No Longer a Mental Disorder, APA Says
- Parent Category: News
- Created on Friday, 21 December 2012 12:03
- Published on Friday, 21 December 2012 12:03
- Written by scott
Advocates welcomed the American Psychiatric Association’s decision on Saturday to remove being transgender from its list of mental disorders.
The APA specifically removed the term Gender Identity Disorder from the Diagnostic and Statistical Manuel (DSM) of Mental Disorders and replaced it with Gender Dysphoria.
The organization, which represents more than 36,000 psychiatrists from around the world, has revised the DSM five times since it was founded in 1844. The latest revision process began 15 years ago.Add a comment
Medical Matters - Pills & Heat
- Parent Category: News
- Created on Friday, 13 July 2012 19:34
- Published on Friday, 13 July 2012 19:34
- Written by Ted Fleischaker
Items which get too hot can have their potency compromised, so they just don’t work — or they don’t work right. Also, some creams, salves and even other meds can be affected by heat. Capsules can melt and leak. Creams and salves can separate and the medication they contain be weakened or ruined altogether.
So what should you do? Be realistic. Most things come with one of those info sheets or a box with some info on the outside.
First the really easy part: look for the sheet or notice on the box and then read it. See what the manufacturer or pharmacy advise. In most cases the temperatures will be a range. One salve we use says “Store at 20-25 degrees C (68-77 F). Avoid temperature above 30C (86F).” Sounds simple enough, but how many people would read and do it? According to a couple pharmacist and doctor friends we asked, sadly, not many at all.
And if they do read the notices, do you or they understand what the words mean? Again, likely not. So what does the notice above mean? It means long term this product should be kept between 68 and 77 degrees but it also means you can take it into the heat (to 86 degrees) for a brief while.
Some meds call this an “excursion” and the box or sheet would read “excursions to 86 permitted.” Our pharmacist friends told us that means a couple or three hours but not all day and no leaving the tube (even in a bag or suitcase) in the seat or trunk of the car where temps this time of year can easily hit 130 degrees and ruin the medicine.
Drops and pills also have their own limitations as one we checked says “Store upright at controlled room temperature 20 to 25 degrees C (68-77 F) and protect from freezing.” That means again what it says, and note that line about how to store it (not on its side) as well as the caution against freezing it in the cold months. Again, think that suitcase on a trip or even sitting in the bag in your car while you run into the grocery after you stopped at thedrugstore. The value of the pills or drops or salve will be, well, practically nil if kept too hot for too long.
There’s also the matter of what you do with your meds when you get them home. A handful say plainly “Refrigerate.” Others, though — the vast majority — are less clear but what all of the sources we consulted were unanimous on was the answer to this question: Where’s the worst place you can store your medicines?
Their answer: In the bathroom medicine cabinet.
Why? Because the moisture level there is unusually high and often that nice, steamy, warm shower you so love heats things up past 77 in the room, too. This can cause medicines to deteriorate and lose their potency or change composition so they might not work well, might work too well (become too strong) or have different side effects — none of which are desirable. So the best thing to do? Unless you have kids or pets with busy hands or mouths leave your pills on the bedside table and keep the lid securely on the bottle. Did we mention air doesn’t do a thing for pills but ruin their potency, too? For salves, sprays and the like the table or cabinet under work fine. Again, though, skip the “medicine cabinet” because it’s not a good, safe place to store medicines you want to last!
Finally, and we will have more on this in a future column, look for and observe the dates on medications. If they expired in 2007 they should have been recycled ages ago. And if you “always have pills left” as a friend does (He always says “in case I feel this coming on again later”.) then you are not following directions. Almost every medication — save for some people take on-goingly like HIV/AIDS or heart meds — need to be taken until they are gone. This is especially so with antibiotics. You may feel well or like you are “over” what ailed you, but if you quit before the medicine is done, the illness could regroup and hit again — often with increased resistance to the drug you were taking. Remember, too, that the doctor and pharmacist are a team and they know how many and what dose you need. Take the pills until they are finished.
Follow all of the directions given by your pharmacist and doctor, too, on interactions. Using a single pharmacy can make this easier as we recently got a call from our druggist that she was declining to fill a pill our physician ordered because it had a “type one interaction potential” — the most serious kind. Had we taken it, there could have been over a 40% chance of developing a stomach ulcer because of an interaction with potassium we also are prescribed. Instead of dispensing it she sent us back to our physician for a rethink which ended with another drug being used to accomplish the same thing.
Remember, the doctor and pharmacist work together and whether or not you use just one pharmacy or multiples, always keep your family doctor (GP) informed of what you are taking — especially if say a specialist or ER visit added something — as well as any changes in your condition. And above all at this time of year, keep cool and let your pills chill with you.