Health insurance providers, both public and private, are looking for ways to cut spending. One of their strategies is to deny claims for treatments they deem unnecessary. The effectiveness-testing studies receiving funding in Congress’ healthcare reform bill is a case in point. While that’s a laudable goal, what if your doctor recommends an unusual course treatment?

Experts recommend that you never tell your health insurance plan that you are receiving an “investigational” or “experimental treatment; or if you are enrolled in a clinical trial. These phrases are codewords that make insurers more likely to look closer and reject your claims. First off, health insurance plans will cover treatment your physician considers medically necessary. When it comes to insurance, you obviously shouldn’t lie (that could lead to cancellation of your policy, leaving you uninsured); but you also shouldn’t give more information than is specifically asked for.

You may even be wrong about the experimental status of the procedure. Some procedures aren’t typically used, but are proven medically effective nonetheless. In that case, health insurance plans should cover it. Check with your doctor, even if he or she used wording such as wanting to “experiment with a treatment”. Don’t let semantics cost you!

With all the concerns over seasonal flu and swine flu (H1N1) vaccinations and whether the vaccinations will be delivered in time…you may be wondering if there is anything you can do on your own to protect yourself from the pandemic. Here are some home remedies that could save you from being infected.

1. Wash your hands with soap in warm to hot water. The amount of infection that could be transferred to other parts of the body can be reduced. Alcohol-based hand cleaners are also effective.

2. Avoid touching your eyes, nose or mouth. Germs spread this way.

3. Try to avoid close contact with sick people. If you must have close contact with a sick person (for example, hold a sick infant), try to wear a facemask or N95 disposable respirator

4. Clean your nose.  Dip a cotton swab in warm salt water and clean out your nostrils. Right before bedtime is a great time to do this. The salty water will cleanse your nostrils and prevent anything that may have settled in your nose from germinating further.

5. Bring on the Vitamin C. Vitamin C supplements and eating lots of foods that are high in Vitamin C can give your immune system just the boost it needs to ward off the flu and other virus’ that may be lurking around.

Lenneice A. Drew is an experienced journalist currently focused on healthcare reform. She is working to help others achieve better lives by finding affordable health insurance alternatives and reporting stories related to the healthcare industry. She lives in Miami, Florida.

There is yet another food scare to warn you about and it could affect your health.

Some people are refusing to eat canned foods from their pantry. A new consumer report says a potentially dangerous chemical called bisophenal A is being used in the production of hard plastics including plastic water and baby bottles.

The chemical has also been found in certain name-brand canned foods, according to a study. In its December issue, Consumer Reports tested soups, juice, tuna and green beans, and found that 19 name-brand foods contain some amount of BPA.

And organic foods were not exempt — they didn’t always have lower levels of BPA than non-organic foods. Some labels also declared their cans BPA-free, but this claim wasn’t always true either.

Consumer Reports found that the highest levels of bisphenol-A were found in Del Monte Fresh Cut Green Beans Blue Lake, Progresso Vegetable Soup and Campbell’s Condensed Chicken Soup.

The study also found much-maligned BPA in Similac Advance Infant Formula and Nestle Juicy Juice in a can.

Both the Food and Drug Administration and the Centers for Disease Control and Prevention maintain that low levels of BPA exposure are safe for people and will not affect your health.

What to do
You can and avoid putting plastics the microwave (where they can release dangerous chemicals when heated) or the dishwasher (where they can degrade in the heat and excessive moisture). You can also choose smart plastics that use polyethylene (#1, #2, and #4) and polypropylene (#5), which require the use of less toxic additives. They also are non-chlorinated.

You can also select freezer bags or fresh produce which is also healthier than canned goods.

Lenneice A. Drew is an experienced journalist currently focused on healthcare reform. She is working to help others achieve better lives by finding affordable health insurance alternatives and reporting stories related to the healthcare industry. She lives in Miami, Florida.

If you chug back a couple of diet sodas a day, you may want to reconsider your choice of beverage.

One study examined more than 3,000 women for 11 years, and found those who drank two or more diet sodas a day were at double the risk for kidney damage.

The researchers did not learn whether it was the soda or the artificial sweetener in the drink that caused the damage.

“You can’t conclude that the sodas caused this problem conclusively but it suggests that there’s an affect on kidney function so people have to be aware that there’s a possible issue in doing anything in excess,” said Dr. David Goldfarb, kidney specialist with NYU Langone Medical Center.

Goldfarb said this is one of the first studies on the effects of diet soda and a lot more needs to be done before people make drastic changes.

Moderating your diet soda intake is the best thing to do for now.

Lenneice A. Drew is an experienced journalist currently focused on healthcare reform. She is working to help others achieve better lives by finding affordable health insurance alternatives and reporting stories related to the healthcare industry. She lives in Miami, Florida.

The H1N1 may spread worse because people say they can’t afford to to stay home if they get sick.

Public health experts are raising concerns that workers who deal with the public, like waiters and child care employees, are jeopardizing others by reporting to work sick because they do not get paid for days they miss for illness.

Tens of millions of people, or about 40 percent of all private-sector workers, do not receive paid sick days, and as a result many of them cannot afford to stay home when they are ill. Even some companies that provide paid sick days have policies that make it difficult to call in sick, like giving demerits each time someone misses a day.

Public health experts say policies like these encourage many people with H1N1, commonly called swine flu, to report to work despite official warnings from the government and most companies that they should stay home.

Some people who are really caught on a weekly income might say they are desperate for money and that they are going into work even though they are sick.

Many of these financially squeezed workers might also send their flu-stricken children to school, infecting others. Many will not see a doctor because they do hot have health insurance. Although there are affordable health insurance plans.

Well before President Obama declared H1N1 a national emergency, the federal Centers for Disease Control and Prevention was emphasizing that businesses should adopt “flexible leave policies” to allow workers with the flu to stay home. In one advisory, the C.D.C. encouraged employers “to develop nonpunitive leave policies.”

Despite such recommendations, some employees say they have no choice but to go to work sick.

Lenneice A. Drew is an experienced journalist currently focused on healthcare reform. She is working to help others achieve better lives by finding affordable health insurance alternatives and reporting stories related to the health care industry. She lives in Miami, Florida.

There has been panic over the H1N1 (a.k.a. swine flu) vaccine shortage. Unfortunately, the pharmaceutical companies responsible for producing the vaccine have had various production problems. These corporations, including GlaxoSmithKline and AztraZeneca, have been working with the U.S. government to get the vaccine out as soon as possible. In addition, as Health & Human Services Secretary Kathleen Sebelius explained to the New York Times, the actual reproduction of the vaccine in eggs chicken eggs has grown slower than expected. While the goal is to get all Americans vaccinated, only 30 million doses of the vaccine will be available by the end of this month.

Still, the situation’s not as scary as it sounds–even though it’s Halloween! Supplies are steadily growing, and H1N1, while serious, is not yet a nationwide pandemic. There’s still time for the vaccine to roll out, which it has been doing. Moreover, it’s only a subset of the population that is at higher risk:

• Children
• Pregnant women
• Teenagers & young adults
• and those with existing health problems.

Those groups need the vaccine as soon as possible, and most clinics have been rationing the vaccine for the moment. High-priority populations are moved ahead of the line, and others will receive any leftover vaccines. Some regions are seeing higher demand than others–and live vaccines for the H1N1 virus eventually expire. The worst scenario is for the vaccine to be thrown away; therefore, it should be then be offered to lower-priority populations, e.g. senior citizens (unlike the seasonal flu, senior citizens aren’t at high risk for the swine flu). Remember also that you only need a single shot of the vaccine for it to be effective.

Does your health insurance plan cover the H1N1 vaccine? It most likely does, if your primary care physician has it. If he or she doesn’t have a supply on hand, there are free and low-cost clinics available from county and state governments, as well as pharmacies like Walgreens and CVS.

(Image: Ben Chau under CC 2.0)

Rationing: It’s a dirty word.  Some politicians and activists warn of the dangers of a public option that would have the government ration out health care, and point to Europe as a cautionary tale; others claim that care is already being rationed indirectly by a patient’s health insurance plan. Either way, the thought of being denied needed medical treatment because of a callous calculation is scary. Costs need to be cut, either by the federal government or private insurance companies looking to maximize their profits–therefore, everyone’s looking for whatever procedures may be considered unnecessary and wasteful.

How do you know if you’re a victim of rationing, as opposed to a recipient of high-quality, sensible health care? In Newsweek magazine, medical school professor Christopher Moore acknowledged this dilemma. Sometimes, excess treatment can hurt the patient more than it helps. Take CT scans, for example. Admittedly, they are costly, with prices continuing to rise (and also being passed onto your family health insurance bill); but CT scanners are amazing medical technology that can identify if a head injury is life-threatening. However, studies have shown that the probability of that being the case are relatively tiny. Meanwhile, there is up to a 1-in-1,000 chance of each CT scan causing eventual death from cancer (due to the radiation involved), even more so for younger patients. The medical risks of doing a CT scan on a teenager with a concussion could outweigh the benefits, even after removing cost from the equation. Keeping a close watch on the patient might be a better bet.

So if your doctor refuses to perform an expensive test or other procedure, it’s very likely that he or she has a legitimate medical reason for it. If you get more affordable health insurance because of the reduced cost, so much the better, but that’s not the #1 priority.  Occasionally, a physician who performs the procedure might be doing it solely to avoid a malpractice lawsuit. The prospect of a government-run public option won’t stop that. Moore insists that a doctor who genuinely believes an expensive procedure is sorely needed won’t let cost concerns stop him or her from ordering it. Let’s hope so.

(Image: Akira Oghaki under CC 2.0)

Obesity has become an epidemic in America, and has been blamed for a significant percentage of rising healthcare costs. In the past, ambulances have had to improvise when transporting morbidly obese patients over 500 pounds to the hospital, and companies have eaten the cost. Now, with an increasingly obese population, ambulance providers are starting to pass the increased cost onto insurers, either public or private. This may be necessary, but it will probably reduce the availability of affordable health insurance policies. As for the uninsured, patients will also have to cover the cost of an ambulance ride themselves.

It’s two-and-a-half times more expensive to transfer an extremely obese patient than one at normal weight, according to the Associated Press. Reasons for this include the need for new vehicles and helicopters with larger doors and lifts, extra-large stretchers, as well as the need to hire more emergency crew members (and have them work longer hours) to lift obese patients. Insurance companies operating in Washington and Oregon already pay increased rates to cover those extra costs, despite fat-acceptance groups considering it to be another example of weight discrimination in medical care. Other advocates of the obese, however, are appreciative of the improvements that allow them to be transported with dignity.

The cost of specialized ambulances will certainly be passed on. Increased regulation in the healthcare reform bill may prevent people from charging extremely obese patients more for a health insurance plan. Therefore, everyone’s plan will cost a little bit more.  Medicare and Medicaid are resisting increased reimbursements, but the industry is fighting for fair compensation for their services. Without it, they claim that they will be unable to provide quality care that serves the needs of a significant percentage of the nation’s people.  Promoting public health (e.g. reaching a healthy weight and not smoking) would do a lot to reduce healthcare costs, and should be part of any healthcare reform. Otherwise, the population of morbidly obese will rise from its current 5%, requiring more specialized, costly care.

(Image: NIOSH – National Institute for Occupational Safety and Health under CC 2.0)

A recent story in the Boston Globe, while sad, has given me a deeper appreciation of those health insurance companies that provide mental health coverage. During a therapy session at Massachusetts General Hospital’s Bipolar Clinic, a patient with bipolar disorder stabbed his psychiatrist. The psychiatrist is recovering, thankfully; the patient was soon killed by a security guard after he failed to stop.

Many people forget that psychiatrists are also medical doctors that treat a variety of conditions and put themselves in harm’s way each day. While it appears that this particular patient was too far gone, millions of individuals with mental health disorders have seen significant improvements with the help of psychiatric treatment. People who need treatment are more likely to get it if they have health insurance with mental health coverage. There are insurance plans that cover most or all of the cost of psychiatric and therapy visits, as well as medications.

Please don’t wait to get help until it’s too late. If you or someone you love is struggling with paying for treatment of their mental illness, get a health insurance quote instead of giving up. I wish you the best of luck.

(Image: Pink Sherbet Photography under CC 2.0)

Having the best quality health insurance plan you can afford is crucial when you start a family. Unfortunately, there are extenuating circumstances when even excellent health care can still leave you in danger of bankruptcy. Two-year-old Linden Elliott is suffering from mitochondrial disease, a rare condition that is costly to treat. His father’s employer-provided Aetna insurance covers 100% of medical expenses after initial co-payments. So how do they end up having to shell out over $25,000 a year on expenses?

It’s depressingly simple, according to MSNBC. By itself, each co-payment seems reasonable: $100 per ER visit, $250 per hospital stay, $100 for each surgical procedure. The only problem is that in an average month, Linden had to stay in the hospital once and visit the ER twice. On top of that, his parents have to cover the cost of his medication; their total monthly expenditure is about $2,000. In addition, Linden’s chronic disease requires that his family cross state lines for specialized treatment unavailable locally; their family health insurance plan doesn’t cover travel expenses.

The Elliotts continue to fight for their son’s health, but it comes at a steep financial cost. Despite an upper-middle-class income, their medical debt leaves them unable to pay for basic utilities, even with familial assistance. While Linden is doing well for now, such stress could have a negative impact on his health in the future. His parents will have to continue to pay for treatments, such as the insertion of breathing tubes, for the foreseeable future; possibly for his entire life. Healthcare reform might enforce limits that reduce the out-of-pocket costs for people with chronic illnesses by creating a larger pool of health insurance plan buyers (making each individual one less expensive), but those with these diseases can’t wait. Although most severe chronic diseases can’t be avoided, try to find out exactly how much your insurance company covers in claims. You’ll still have to struggle medically, but at least there will be less shock on the financial side of things.

(Image: MSNBC)