Workshop: Get the Most From Your Health Care Dollar

Sunday, August 9, 2009 15:31 | Filled in Payment, Personal Responsibility, Provider

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:

Protect Your Heart While Traveling

Thursday, July 9, 2009 12:21 | Filled in Personal Responsibility

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.”

Keeping Health Care Costs Low –Stay Out of the Emergency Room

Monday, July 6, 2009 17:32 | Filled in Payment, Personal Responsibility

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)

Healthcare Lessons Learned While on Vacation

Saturday, July 4, 2009 21:41 | Filled in Payment, Personal Responsibility, Provider

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.

Keep Health Care Costs Low — Stay Out of the Emergency RoomThis 4th of July

Thursday, July 2, 2009 22:33 | Filled in Personal Responsibility

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:

Tired of Tiny Type? Health Insurance Card Tip

Saturday, May 23, 2009 9:53 | Filled in Payment, Personal Responsibility

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.

Check It Out — National Women’s Checkup Day

Monday, May 11, 2009 17:42 | Filled in Announcements, Personal Responsibility

I just returned from seeing my doctor for an annual physical. When I made my appointment several months ago I didn’t realize that today is the 7th annual National Women’s Checkup Day, the kick-off to National Women’s Health Week ( , an observance coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health to empower women to make their health a top priority.

To get the health care you deserve, I encourage my readers (women AND men) to schedule a check-up. Too many people in my life have had mysterious symptoms they ignored too long before seeing a doctor, only to be diagnosed late in the course of a disease. These diseases include diabetes (friends and cousins) and cancer (3 of my grandparents, my father, cousins, cousins-in-law, and friends). Getting diagnosed early means you can get treated early.

In support of National Women’s Checkup Day, I encourage you to:
• Learn what a check-up should include using the interactive health screening tool on
• Schedule an appointment for at least one recommended screening test or vaccine to take place within the next 90 days.

Decisions, decisions: Prepare an Advance Directive Now to Guide Your Loved Ones Later

Thursday, April 16, 2009 7:39 | Filled in Uncategorized

Today is National Health Care Decisions Day, sponsored by the National Hospice and Palliative Care Organization. The purpose of this day is to publicize the importance of discussing your wishes for the thing we may dread most in life. No, not having to pay taxes yesterday — end-of-life decisions.

My father was diagnosed with pancreatic cancer at the age of 80…and 10 days later, he was dead. Nothing prepared me for the emotional impact of his death. But at least the ghost of Terry Schiavo did not haunt us. Luckily, he had prepared an advance directive, the formal name for a document that lays out his wishes (or lack of desire) for extraordinary life saving procedures. He wanted to die at home among his loved ones, and he got his wish.

I live only a few miles from where an out-of-control big rig killed two people and injured more before plunging into a bookstore in La Canada, California on April 1 this year. Life is short. Make it your action task to download an advance directive that is valid in the state where you live. Then follow through and make those tough decisions, write them down, and let your loved ones know what your wishes are.
Go to and click on Free Downloads to choose the advance directive specific for where you live.

To read the fine print, you have to have the fine print

Sunday, April 12, 2009 20:24 | Filled in Payment, Personal Responsibility

Has your health insurance company ever refused to reimburse for medical expenses that you thought should have been covered?

Mine has. And what I discovered is that the basis of those decisions resides in the fine print of the insurance plan benefits description. The print is so fine, in fact, that most of it doesn’t appear in the fancy marketing piece (often called the “summary of benefits”) that your company’s Human Resources department gives out at open enrollment: The real fine print is in the plan documents themselves. The plan documents describe in detail what will, and won’t be covered. These are sometimes called the “Combined Evidence of Coverage.”

If you or a family member have a chronic health condition, it is especially important that you ask HR or the insurance company for the plan documents directly. And read them completely.

When open enrollment rolls around again, you will need to decide what kinds of health care coverage are important to you, and perhaps consider switching to a different plan that will meet your needs better.

The Power of Happy Birthday to You

Monday, April 6, 2009 17:45 | Filled in Personal Responsibility

Today is my husband’s birthday, so I’ll be singing him “Happy Birthday to You” over a steak dinner tonight.

But, then again, I sing “Happy Birthday to You” every single day, multiple times. Why, when my husband and I each have only one birthday a year? Because the 20 seconds it takes to sing 2 choruses of HB2U is what is necessary to clean my hands effectively with soap and warm water after using the toilet.

As part of the “Clean Hands Save Lives!” campaign, the Centers for Disease Control and Prevention recommends that individuals
*Wet your hands with clean running water (preferably warm) and apply soap.
*Rub hands together for 20 seconds.

It’s especially important to wash your hands after using a public restroom. In a 2007 study, investigators observed 6,336 adults after using rest rooms in public venues in 4 different cities. Only 90% of women, and 75% of men, washed their hands before returning to the ball game or running to catch their trains.

Given these statistics, it would be wise to use paper towel to grab the doorknob when you leave a public rest room, so you don’t get exposed to the germs from those who don’t wash up. I was 40 years old before learning this technique from a public health nurse when I worked for Los Angeles County Department of Health Services — thank you, Geneva.

If the public restroom has gone green, and provides only a heat dryer for hands, grab a piece of toilet paper from a stall as a substitute, or if you must, use your shirttail.

Are you raising children who are old enough to understand the importance of hand washing? Check out these resources to help you reinforce your lessons:
A video from the Centers for Disease Control and Prevention (“Put Your Hands Together“).

A colorful brochure developed by the American Society of Microbiology and the Soap and Detergent Association, including a “Clean Hands” word search puzzle:
In English:

In Spanish: