Get the Health Care You Deserve!

Photo credit: Paul Delardeau/Flickr.

Any Californian who has been denied health insurance because of a medical condition, as I have, should read up on the federal pre-existing condition insurance plan. This plan was developed as part of the Affordable Care Act passed on March 23, 2010.

The plan went live in August, 2010 and covers visits with primary care doctors and specialists, hospital care, and prescription drugs. To be eligible, you must be a citizen or legal resident of the US, and you must have been uninsured for at least the last six months before you apply. This means that Californians who are currently covered by the State’s High Risk Pool are not eligible. The premiums for a single person are generally much lower than the $817 per month I was paying when I was covered by the State’s High Risk Pool. The $1500 deductible is similar, but the new plan includes a $2500 out of pocket annual limit.

To get a brochure that describes the Pre-Existing Condition Insurance Plan and compares it to California’s existing high risk plan, and an application form, click on: www.mrmib.ca.gov. To request an application by email, send your name and mailing address to FHRP@mrmib.ca.gov. There’s also a snail mail address available at the web site.

Sure, health insurance is expensive. But don’t go bare – that is, ie don’t go without health insurance. A hospital stay – think skateboard, bike, or freeway accident – is even pricier.

I’m about to leave for points East to attend a conference. The Centers for Disease Control and Prevention (the mother ship for us epidemiologists) provided a useful article about staying healthy while traveling.

Sure wish I’d known about this before I left for Japan last year to visit my daughter (luckily, she came through the recent earthquake/tsunami/radiation unscathed). Guess who didn’t know that paper towels do not exist in Japan and everyone carries their own fabric handkerchief/mini-towel? Guess who forgot the hand sanitizer? Guess who picked up a nasty cold while abroad?

I’m sorry that I missed notifying you about Patient Safety Awareness Week 2010, which was 2 weeks ago. PSAW is a national education and awareness-building campaign for improving patient safety at the local level. The theme this year was “Let’s Talk: Healthy Conversations for Safer Healthcare.”

The National Patient Safety Foundation, which sponsors PSAW, offers members some patient engagement tools that include fact sheets and checklists to ensure being safe when getting medical care.

Check their Patient Safety Tools and Resources here: http://www.npsf.org/hp/psaw/patient-tools-and-resources.php

The Agency for Healthcare Research and Quality (AHRQ) has a wide array of free materials in print, podcast, and video form to educate consumers in how to be safe in the health care system.

Check the Getting Safer Care page at: http://www.ahrq.gov/consumer/safety.html

For those of you who live in the Glendale, California area: The Los Angeles County Department of Health Services is sponsoring a free H1N1 influenza vaccination clinic for high risk individuals tomorrow. Eligible individuals include pregnant women, children and young adults from 6 months to 24 years, health-care workers, people who care for infants, and people between 25 to 64 with chronic medical conditions such as asthma or heart disease.

Date: Tuesday, November 3, 2009

Time: are 9:30 am – 3:30 pm

Place: Glendale Civic Auditorium, 1401 N. Verdugo Road

I’ll be there volunteering in the morning. Look out for me — I’ll be wearing my green CERT vest!

For readers in the Los Angeles area:

As Americans demand reform of our broken health care system, becoming an informed, empowered health care consumer is more important than ever. To meet this need, I will be offering a workshop, “How to Get the High Quality Health Care You Deserve” on August 15, 2009 from 9 am to 12 noon at East Los Angeles College, 1301 Avenida Cesar Chavez, Monterey Park.
If you, or anyone you know, would benefit from learning to navigate our broken health care system, please take a look at the description of the workshop below:

• Maintaining a personal health record
• Finding a well-trained, experienced primary care provider or specialist
• Finding reliable health information
• Determining the right insurance plan for one’s current needs
• Learning to budget for out-of-pocket medical expenses

I truly believe this workshop (my passion topic – empowering health care consumers) is valuable to all working adults, even with health care reform roiling on the horizon.

Participants in workshops I’ve given at other institutions can vouch for both for the usefulness of the information I share and the relaxed, humorous style I bring to the classroom experience.

For more information and to register, please call: 323-780-6700 or go online to: http://elac.edu/communityservices/index.htm

While planning your next business or pleasure trip, you might want to choose your hotel based on an amenity that has potentially more importance than an in-room spa or 24-hour room service. If you have (or are at risk of) heart disease, you might want to check if your lodging has installed automated external defibrillators (AEDs).

These devices can automatically reset your heart rhythm after you suffer a sudden cardiac arrest (heart attack). The American Heart Association not only recommends that hotels make these devices available (in lobbies, conference facilities, and fitness centers), but the organization only holds its meetings at hotels that are so equipped.

According to a recent story in the Wall Street Journal most hotels don’t have these life-saving devices installed. Approximately 1 in 5 Hyatt Corporation hotels has them, but most other chains would not tell the WSJ reporter how many of their locations had them.

The devices are easy to learn to use, and existing Good Samaritan laws legally protect legal people who make a good faith effort to render medical assistance during an emergency. But hotels, which are not required to offer them in most locales, hesitate to install the devices because of expense (costs range between $1300 and $3000 apiece) and misplaced concern about possible litigation.

Why should hotels make these devices available? And what does the issue have to do with health care? It all comes down to statistics. I suspect your eyes just glazed over, but I’m an epidemiologist, and statistics are my life. According to the American Heart Association, 35,000 Americans a year suffer sudden cardiac arrest in a public location (as opposed to a hospital or home). Someone who experiences cardiac arrest is twice as likely to survive if an AED is available, according to a study published in the New England Journal of Medicine in 2004.

When you travel yourself or book hotel stays for visiting elderly parents, ask a prospective hotel whether they provide AEDs in the facility, and how the devices are labeled for quick identification in an emergency. A phone call will be necessary — when I recently checked hotel amenities at several online booking sites, there is no indication of availability of AEDs. Let’s tell the hospitality industry, “If they build it, we will come.”

Even the simplest Level 1 visit to the Emergency Room in the US will cost at least $250 (about twice the cost of a visit to a primary care physician), and the cost can rise dramatically from there. Prevention being better than a cure, consider doing the following to avoid that expensive health care:

o Take a first aid course. If your local hospital doesn’t offer such a course, contact the American Red Cross.
o Learn CPR. Same sources as above.
o Keep a family health encyclopedia handy.
— The Merck Manual of Medical Information (2nd Home Edition)
— Healthwise Handbook
— Healthwise for Life (for those of us in the over 50 crowd)

While on a romantic getaway in Northern California last month, my garden variety ear infection turned into a painful nightmare, despite 2 previous rounds of antibiotics. Here’s what I learned the hard way:

*Double check that you packed your cell phone charger.

*Have your doctor’s office or cell phone number (or both) in your cell phone address book. That way you won’t waste time and money calling Information on the hotel phone. You also won’t have to struggle while half deaf to decipher the phone number recited by the operator.

*Only travel in large cities. The small wine country town we were in is underserved by specialists. I was assuming I could have my eardrum lanced, thereby allowing the fluid in my ear to flow out. But ear lancing is a surgical procedure that ER doctors do not perform, and the only local ear nose and throat specialist was out of town at a medical conference. So plan B was a shot of a major antibiotic and a scrip for major pain pills (soon to be unavailable to ordinary mortals).

*Even if you’re controlling your spending by paying cash only, when traveling, carry a credit card for emergency medical expenses. Like the 4th generation antibiotic that has a $112 co-pay.

*Know your insurance policy’s payment policy for out of town care — mine requires you to call for approval for emergency care.

The National Council on Fireworks believes that Americans can be “Sparkler Smart” this Fourth of July while celebrating our nation’s birthday. But statistics indicate that not everyone knows how to be safe with sparklers or other fireworks. In 2007, almost 10,000 people ended up in U.S. hospital emergency rooms to be treated for fireworks related injuries.
I have fond memories of lighting sparklers during my childhood — maybe you do, too. So if you live in a jurisdiction where owning fireworks is legal, be smart, and check out the guidelines for safe fireworks use at the National Council on Fireworks web site: http://www.fireworksafety.com/news_releases/sparkler2009.pdf

If your eyes don’t read small print as well as they used to, try this tip to make navigating the health care system easier for you and the staff at the doctor’s office.

Make a paper copy of the front side of your insurance card by placing the card in the middle of the copier glass surface. Than take that copy and tape your insurance card just below the image of the front side, but with the reverse side showing and make another copy. Then take the copy with both the front side/reverse side image and copy it again, enlarged to 200% of normal size.

I’d recommend making 2 copies of this enlarged image. Keep one handy at home to refer to when contacting your health insurance company — you’ll be glad you won’t have to squint when you need that Customer Service telephone number. Also keep one folded in your wallet to hand to the receptionist each time you visit a health care provider. They’ll appreciate you for saving them time and eyestrain headaches, too.