I can only imagine how many differing opinions there are about how to solve our healthcare crisis.  But how many opinions are out there about what is wrong with our healthcare system?  Dare I start a list…

Anyhow, in doing some recreational reading and email sorting this morning, I came across a link to an article (sent from a colleague) “Government Contemplates Financial Bailout While Taxpayers File Bankruptcy for Medical Bills – When Will Congress Intervene in Skyrocketing Healthcare Costs?”  Great title, right? As I read through the article I couldn’t help but wonder how many people think that our healthcare problem should be “solved” by our government. Yes, yes, please let the government solve our healthcare crisis (read: tax payers pay for it).

I do not have beef with the article, or with the government “solving” problems for that matter.  The piece is very well written and highlights the problems and costs Americans are facing in relation to their health expenses.

I guess my question lies in this last paragraph, “The unacceptable result of all this is that an increasing number of Americans are foregoing expensive but much-needed drugs and treatments, including those for serious conditions such as diabetes and high blood pressure, which if left untreated can result in worsening conditions, hospitalizations, or even death. The problems in our health care system need to be addressed by Congress now.”

Hmmmm, so what does Congress do… implement a mandatory exercise hour across America?

Our solution has to be a JOINT EFFORT.  This is not solely the government’s problem!!

Yes, a lot of this is their fault. However, I would argue that there are five major players in this mess, one of which is the government. (See my previous posts for the four contributors – since then I have added one). The other four: doctors, pharma (newly added), individuals, and insurance companies. Unfortunately, I have yet to appoint percentages of blame.

The majority of Americans know our system is failing, but are unwilling to make any sacrifices or changes. We have had a third party paying for our care for far to long, with ever increasing bottom lines and stricter rules for coverage. On top of that, the government cannot bail us out of our obesity (or sub other unhealthy behaviors) and sense of entitlement. Insurance companies sure aren’t going to help either.

There are three things that are going to help fix this system, and individual accountability is one of them.  We have to stop running to the doctor every time we have the sniffles. We must make health and wellness a priority – and start exercising.  Second, is transparency.  No one really knows what the true cost of healthcare is.  Guess what folks; an office visit does not cost $20.  To be accountable, cost and quality information must be available to consumers.  Last, is competition.  By being accountable for our decisions, and knowing the true cost and quality of healthcare, providers can begin to compete for our care. Until doctors/hospitals have to be accountable for the quality of care they provide and the amount they charge, nothing is going to change.  Every other market has competition, why should healthcare be any different.

Many humble thanks to Elizabeth Cohen, CNN Medical Correspondent. In the latest edition of her Empowered Patient segment, she was kind enough to include us in the article on “6 Ways to Save Money on Drugs and Doctors.” And we’re slated to be included in the  “House Call with Dr. Sanjay Gupta” at 830 a.m. Saturday and Sunday ET.

As a result, we’ve seen a bit of spike in traffic (and a small amount of smoke issuing from the back of the servers). They also featured our recent book, and we’re getting loads of folks downloading the free PDF version of My Healthcare Is Killing Me.

It’s a wonderful compliment, and let’s be sure the credit goes where it is due. We have a great team that supports change:healthcare. THEY make it happen, while CP and I get the handshakes and backslaps that they all deserve (we’re supposed to just look good, so if you’ve seen the book cover, you know we’re not holding up our end of the deal very well).  And a special shout out to our PR Director, Frank Limpus whose own personal PR is some of the most understated you’ll ever see.

Some interesting stats from the big boys on how adoption of CDHP is going. The numbers are not staggering by any means, but it is reflective of the growing trend toward consumers having to take responsibility. The trend will only accelerate as employers shift to move consumer-centric plans.

Most of the larger companies we have spoken with have the PPO, HMO and now HSA plan options. However, as a bit of clarification, the HSA is generally just a type of PPO with a higher deductible. As companies look to shift to consumer-directed plans the pure PPO will eventually go away and become the HSA-PPO.

Plan design – or a steady reduction in the scope of benefits – has been the traditional approach to holding down healthcare costs. You may be old enough to remember having a dental plan, visions plan and behavioral health – all of which have been partial or total victims of the “plan design” cuts. Before long, we will be able to say, I remember when we used to have a PPO without a high-deductible. That day is just around the corner.

Great article from a freelance writer in The Morning Call. Richard has some of the ledgers from NY and Pennsylvania banks the 1950s to 1960s showing how household expenses were distributed. Of particular note is that the family paid all of their medical bills in cash. When someone came down with a more serious illness, there were more and more payments finally totally a whopping $1084 for a fairly serious medical condition. It offers a great idea of household life during those times prior to privatized medicine and reminds us as we see the shift to consumerism in healthcare that history always repeats itself.

Looks like we have taken a giant leap into the world of print.  Yes– we have actually done something on paper!!! The crew at change:healthcare has published a book, “My Healthcare Is Killing Me: A Survival Guide for the American Healthcare Consumer.”

You can purchase the book for $16.00 (includes shipping) from www.myhealthcareiskillingme.com or better yet, download the FREE ebook!!

Written by Robert Hendrick, Christopher Parks and Katrina Welty, a trio of authors with a wide background of healthcare experience, the book provides an easy to read, straight-forward guide to navigating healthcare in its current state of confusion and chaos.

“We just want to see consumers take the book, implement its lessons and really help their families live a better life,” Hendrick said.  “Seeing more transparency in this industry and consumers taking greater personal control of their healthcare as a result is all the satisfaction we need.  Because then, we’ll know we’ve truly changed healthcare.”

The book is also available through all major book retailers including Amazon.com, Borders and Barnes and Noble, and others.

Let us know your thoughts… write a rant, review, or tell us your story!!  We look forward to hearing from readers like you!

Visit MyHealthcareIsKillingMe.com for more information!

The proof of our book is in and people have already started to latch onto the free downloadable PDF version at My Healthcare Is Killing Me.

Seems like we might have struck a bit of a nerve.

Thanks so much to Bob Coffield for the shout out on the book. Can’t wait to catch up with him at Health 2.0 in just a few weeks. Bob is a master of Twitter. If you don’t know him, he’s @bobcoffield.

We’ll probably catch a lot of hell from Steven Krein at OrganizedWisdom for not calling it change:healthcare, but we’re working on that as another title and hope to have it out before November .

And many thanks to the others like Frank Hone and “Why Healthcare Matters” and Zane Safrit who have started to pick up on the book.

Recently we have published our healthcare consumer “survival guide” titled My Healthcare Is Killing Me. Though we have only recently received the hands on printed version… the PDF has been available (for FREE) online for about a week or so now. We have not really spoken of it much – we were waiting till we had real copies – but it looks like the cat is out of the bag thanks to Christopher!

So without further ado: Check out My Healthcare Is Killing Me at www.myhealthcareiskillingme.com. As I mentioned above, you can download a free PDF, read it online, or (if you like the real deal – as I do) you can purchase it through this site as well.

And – lets give some love to those individuals that have taken early note of the book…

Thanks to Zane Safrit (check out his post – make sure to scroll down) for writing such nice words.

He says, ” My Health Care is Killing Me is…a well-written resource for those like me, a consumer of our health care system, who look for help and hope as we navigate the maze of players who provide the services and the billing and the restrictions and yes, sometimes, quite often, the excellent care (if you can afford it, find it, negotiate with it…) that make up our health care system.”

Thanks to Frank Hone at the Why Healtcare Matter Blog for taking the time to check out change:healthcare, the Healthcare Consumerism Index and giving My Healthcare Is Killing Me a shout out!

Last but not least, to JenMcCabeGorman for Twittering about MHIKM. I think she may have started something

We’ve come a long way from the days of the snake oil salesman doctors. We have metrics, proof, real information, process, procedure and healthcare is FAR better as a result.

But I’m reaching saturation point with the quality talk. The only available quality metrics are on the hospitals, but they are comprised of individual docs who make up the numbers. Those docs come and go. The fact that even USA Today points out, is that most are clustered around an “average.” And that means you get basically the same quality of healthcare service in the US wherever you go with few exceptions.

As for those exceptions, they are few and far between, so they’re not accessible for all of us. And if we all go them, their ability to provide that quality of service will suffer as they realize increased volume and stress on their systems.

And still, I can go to the best hospital in town, but it comes down to the doc. If I have a condition the doc has not seen before, the quality is arguably going to suffer. Or possibly worse, if they’ve hired on some quack, and I get stuck with them in the ER, my quality experience will suffer.

That means that failing reliable data on a specific doc if all healthcare clusters around “average,” then the only quantifiable differentiator is price. So what is reliable data? Malpractice information? Do I look at number of claims or size of awards or awards in aggregate? Or should it be malpractice claims for a certain condition versus number of times treating that condition?

Maybe outcomes data is more important. So do I look at number of deaths? Make sure it’s severity adjusted so you don’t knock the doc for seeing a higher number of really sick patients. And be sure you take into account if the doc has just picked up a new procedure that will improve those abysmal outcomes he/she has been having.

This is why Zagats has gotten into the ratings game – it’ subjective – entirely. The meal you get one night at a restaurant is not the same meal you get the next night. The chef may change. The steak may be fresher. There may be a larger crowd.

It’s the same with healthcare. Have a procedure done. You might have a better blood pressure and better conditioning than the other person. Certain procedures may be valid for you but not for someone else.

It’s subjective. Quality in healthcare is almost entirely subjective. The quantifiable metric is cost. That’s the primary reason we chose to pick up the Hospital Value Index in our application because they factor cost in where others do not. So since everyone is basically “average” without specific data on a doc, ask this simple question the next time you require healthcare, “How much should I pay for this snake oil?”

Good thing I have health insurance… cause I’m not ready to be married!!! Seems in a recent article by the New York Times “Health Benefits Inspire Rush to the Alter” that 7% of adults say that someone in their household had married in the past year to gain access to health insurance (according to a Kaiser Family Foundation study).

Now at first glance that doesn’t seem like a large number, however I think it is important to not consider the actual amount of individuals who have married for insurance, but rather that they are willing to make a life changing decision in order to obtain health insurance coverage (the Foundation also cautions not to take the number literally).

I find this to be so interesting, and admittedly it could be due to my young age (23). But I simply cannot decide if it is better to be without health insurance coverage for myself (I am sure many of these decisions involve children) and suffer the burden of a system that shuns individuals without coverage, piling on bill after bill, or to get married. To marry or not to marry – for health benefits???

Ok lets get back to the basics – money and marriage are undeniably linked. The government provides tax “incentives” to married couples, some people simply marry for money, and dowries existed for centuries. But I feel pretty good in assuming “marrying for health insurance” is something that has recently taken flight due to the consistent increase in insurance premiums and healthcare costs.

The distress caused by these issues makes me nervous.. first for the upcoming election, and the next presidents willingness to address and hopefully solve these problems. Second, because I do not feel like we (American citizens) have a tangible grasp on a solution to rising healthcare costs. And third, not everyone is feeling the pain. This means that some people are struggling with their healthcare costs daily, while others are still frivolously accessing the system, paying their $20 copay, and having no idea of the real cost of their care.

Here’s an example of the other extreme. Mr. Moulton and his wife, who has liver damage, considered divorce. This was the only way she could qualify for affordable health insurance coverage which would have been provided and subsidized by the state. She said, “Nobody should have to make a choice like that. What happened to our country? I don’t remember growing up like this.”

Scary… gives me chills. Core family values are hard to maintain when you are broke, sick and uninsured. It makes me wonder what will happen to my generation if we do not get involved, control our costs, find a solution – but most importantly try to make a difference. I mean we are already marrying for health benefits… what’s next?

Saw this post on the DailyKos that just so perfectly illustrates the state of our healthcare system.

Jollygreen does a great job of breaking down his costs and pointing out how the hospitals have increased their chargemasters in an effort to drive up their reimbursement. To top it off, the hospitals are pushing through as many people as they want simply processing transaction with no regard for things in context such as sending the bill for an ultrasound along with the bill for the other services associated with the miscarriage of that child one week later.

This just underscores again what poor business people most healthcare companies are.

Their approach to smaller reimbursements is simply to increase the billing amount. The approach to dealing with them is to simply low-ball them. Go ahead. Call up the hospital billing office and ask for a discount. They did not feel bad about simply raising the price with no rationale as to the amount. You should not feel bad about not using any rational reason for the lower amount you want to pay.