HEALTH MESSAGE BOARDS
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There is little or no doubt that the Health Insurance Industry has a strangle hold on doctors and other healthcare providers and the delivery of healthcare. There may be little hope as a significant number of these health insurance companies get richer and richer; their buildings get taller and taller and they become more powerful political lobbyists. CEOs may command six or even seven figure salaries. In a significant number of cases, bonuses grow and flourish as life-saving or health preserving medicines and care are denied. This series of articles will focus on the abuse inflicted on healthcare providers and the healthcare system by a significant number of health Insurance companies. “The nation’s HMOs reported a $3.6 billion profit for the first three months of 2005, representing a $646 million, or 21.4 percent, increase over the $3.0 billion earned during the first quarter of 2004″ according to Weiss Ratings, Inc.
Abuse #1: Pre-existing Condition.
Patient walks into a doctor’s office to be seen and he or she presents his or her health insurance card. The staff verifies insurance coverage and / or obtains a valid referral (permission) from the insurance company to see the patient. The patient is seen to take of the concerning health problem. The insurance company is billed. The doctor’s claim for payment is denied. Pre-existing condition is the reason given by the insurance company. In other words this condition started before (pre-existed) the insurance coverage. However, a doctor cannot know this unless he or she first sees the patient and takes a history. The doctor or other healthcare provider may never get payment. The patient despite paying premiums may get stuck with the bill. The insurance company pockets this money. The fight is on. Guess who usually wins, the company in that 20 or 40 story plush corporate office building that has enough red tape to tie up the healthcare provider for months to come. Guess who usually gives up.
Example: I was asked to consult on a hospitalized patient because she was passing blood and in pain due to a kidney stone. Imagine my surprise when my claim for payment was denied for pre-existing condition. The insurance company claimed that the stone was pre-existing!
Abuse #2: Referral or Prior Authorization
It is my opinion that the practice of insurance companies mandating that healthcare providers get special permission (referrals or prior authorizations) should be banned. These referrals or prior authorizations may be imposed on a healthcare provider before he or she can give a patient a health preserving medicine, diagnostic test, hospitalization or even an office visit. Referrals or prior authorizations in too many cases delay care and may place a patient’s health in jeopardy. They are barriers to care and in many cases are used as weapons to deny care in order to line the pockets of the insurance company. Isn’t it silly to think that healthcare providers who have spent many years in training and are indeed experts can’t determine on their own if a patient needs to be seen or is in need of a medicine or test.
Example: A patient presented to my office just after closing. I had seen her in consultation in the past for uncontrolled high blood pressure. She was not feeling well and she complained that her blood pressure was elevated. The insurance company was closed so we could not get a referral number. I obviously saw the patient and administered medicine to reduce her blood pressure. She felt better. I also prevented a needless emergency room visit. The next day we called the insurance company to explain our situation and they said they would deny our claim since we saw her without permission.
Healthcare providers and patients must speak up and demand that our elected officials make health insurance industry reform a priority.
Orville Campbell, MD is an internist and nephrologist. He is board certified by the American Board of Internal Medicine. His expertise include: health and wellness, hypertension, diabetes, vitamin D, and kidney diseases. Dr. Campbell is an entrepreneur. He has owned several businesses and medical practices since finishing Emory University in 1995.
My Blog: http://www.WorldHealthBlog.com
My Website: http://www.ClaimWellness.com
i am looking for trusted indian health forum or health message board exclisively for gastroenterology?
indian gastro forum is unlikely here, you could try to search for yahoo groups for this, good luck
Health Anxiety Message Board – Health Anxiety Message Boards
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A woman from Puerto Rico recently asked me why her eye doctor administers drops to dilate her pupils during an examination. She mentioned that she found this to be very annoying because in Puerto Rico there is a lot of sun and, when she went outside after her appointment, the light made her eyes hurt.
This is a very important question and is one about which I am sure that many other people have wondered.
So… is pupil dilation really necessary?
Yes. As an eye-care professional, I have a dual responsibility: to ensure that you have the best visual acuity possible and to monitor your eye health. It is the second of these, monitoring eye health that requires administration of eye drops to dilate your pupils. The misunderstanding occurs because most people visiting an eye doctor are focused on the visual acuity aspect. Since pupil dilation is not needed to test visual acuity, it often is considered an unnecessary nuisance. However, as you soon will see, this is an indispensable tool that helps me to monitor the health of your eyes.
I perform pupil dilation for an eye examination because doing so enables me to get the best look at the back of your eye. In technical terms, this area is called the vitreous chamber. It is filled with a fluid called vitreous humor. The process usually involves administering two classes of eye drops: numbing drops followed by two different types of dilating drops.
Widening (dilating) a patients’ pupils increases the angle in which I can observe the back of the eye. I examine this area by pointing a beam of light through the pupil. Normally, in the presence of bright light, the pupils constrict to allow less light to pass through to the retina. This would create an unacceptable situation in which I only would be able to see a small point in the back of your eye. However, with the pupils dilated, I am able to see a much greater area and have a clearer view of this region.
Once I have administered eye drops for pupil dilation, I examine the optic nerve and the blood vessels in your retina. Specifically, I look for changes in the optic nerve that could be an indication of glaucoma or other eye health problems, such as macular degeneration. I also evaluate the quality of the blood vessels, including the way that they cross each other. Changes in the optic nerve, retina, or blood vessels from one eye examination to the next could be a sign that you are developing an eye disease. The earlier that I am able to detect this, the better the outcome will be for your overall eye health.
Because the eye is such a sensitive structure, it also can show early signs of other disease conditions, such as high blood pressure (hypertension), diabetes, and elevated cholesterol (hypercholesterolemia). Pupil dilation can help me to identify these problems early. However, there are certain conditions for which pupil dilation is not recommended. Foremost among these is primary angle-closure glaucoma. In this condition, the angle formed by the iris and the cornea in the front part of the eye, known as the irideocorneal angle, is narrow. This can impede the normal flow of fluid, known as aqueous humor, in this region and rapidly raise the pressure inside your eye. Dilating pupils in eyes that already have narrow irideocorneal angles can cause the angles to narrow further and result in a pupillary block, which is a medical emergency.
Following an eye examination, your pupils typically will remain dilated for 3-4 hours. During this time, you will experience sensitivity to light and may have blurry vision, especially during reading and other work requiring close focus. For this reason, I always recommend that my patients bring sunglasses with them so that they are not bothered by light when they go outside. I provide disposable sunglasses to patients that have forgotten to bring their own, but these resemble the 3-D glasses that are given out at movie theaters and are not particularly stylish.
As you can see, the benefits of pupil dilation for monitoring eye health far outweigh any short-term inconveniences. Most of these can be effectively managed, such as temporary sensitivity to light with sunglasses.
Under no circumstances should you attempt to drive an automobile after an eye examination in which your pupils have been dilated. If public transportation is unavailable, I recommend that you arrange to have someone able to drive either accompany you to the exam or be available to pick you up when it is finished. Similarly, if you plan to go to work after the examination, you should not operate any machinery or do other work that requires fine focus.
Persons over 50 years of age that have diabetes, high blood pressure, and/or elevated cholesterol should have yearly eye examinations in which their pupils are dilated.
Dr. Carolina Valdivia is a board-certified ophthalmologist (eye doctor) and eye surgeon. She helps thousands of people to better understand eye care and disease prevention, and to navigate through the maze of medical jargon on her website http://www.glaucoma-eye-info.com.
i am looking for trusted indian health forum or health message board exclisively for gastroenterology?
indian gastro forum is unlikely here, you could try to search for yahoo groups for this, good luck
Health Message Boards
Why would any sane person take medical and/or mental health advice from someone on a YA message board?
I mean really….are you kidding me?
I take friendship advice because I can’t really ask anyone else, and perhaps they will see a side of it that I didn’t. I usually do what I want to though.
Best of Boulder 2010: Food
The term “fusion” refers to cuisine that blends ingredients and cooking techniques from a variety of origins. Since 1993, chef Thuy (pronounced “Twee”) and her staff have offered Vietnamese food peppered with inspirations from France, China, Thailand and Indonesia, and the result is mouthwatering.
Health Anxiety Message Board – Health Anxiety Message Boards
