Health tips and advice

There is no excuse or logic why so many people in the United States remain uninsured or have no accessibility to medical care. In a country so rich, with almost unlimited resources as the United States, I fail to understand any excuses that try and explain it. Politicians on both sides of the aisle have failed to find any reasonable solution to the biggest failure of the American Government (both under democrats and republicans) and to the American way of life.

The only two choices that have been presented to date are: government control of the medical care system (socialized medicine, as in Canada) which needs a lot of thought and consideration, or a private-sector Medical Care system whose accountability remains more involved with its investors. What we have now is a split between private sector control (accessible for those who can afford it) and a public medical care system for others who can’t (Medicaid). We also have non-profit medical providers which are supported partially by the government and private donations.

Although everyone agrees that change is needed, there are many differing views on which of these two choices would solve it. What we really need are enlightened economists/philosophers with vision to come along and propose more creative options, new ways of looking at this problem and perhaps rethink the whole medical structure in this country. The following are some of the current issues which have resulted from a mostly republican philosophy, expressed by the current republican administration.

The pharmaceutical companies control the price of drugs which they claim are high because they need the money to continue researching new drugs for treatment. Yet here in the United States, they spend billions of dollars to advertise new prescription drugs on television, radio and magazines, to manipulate the population to put pressure on their doctors to prescribe brand name medications even though generic drugs are perfectly good to treat most conditions. They claim that this advertising serves to “educate” the public. This money would better be served by putting it into research. These companies also pay undisclosed fees to Physicians for lectures and other services to encourage them to prescribe brand name drugs. They retain strong lobbies in Washington, influencing politicians of both parties to support their positions.

Part of the problem is that the pharmaceutical companies are businesses. Their accountability is to their stockholders not the American people. They are in business to make as much profit as they can. Their accountability always remains with their private investors. This is part of the complex problem of solving the Health Care Crisis in this country.

The cost of using HMO’s (also private corporations) have sharply risen for those who have them. When I started paying for an individual policy three years ago, it was approximately $320 a month, and is now just over $700 a month for standard individual coverage. Most HMO’s won’t touch you if you have any pre-existing conditions. That is standard policy with all HMO’s.

Children, the future of the American society, go uninsured throughout the country. People are forced to crowd the emergency rooms because they don’t have the money or the coverage to go to doctors, while the Medicaid system is forced to absorb all these costs at taxpayers’ expense.

The Republican Administration enacts laws to prevent people from getting medications from cheaper sources like Canada which they claim is for the benefit of the American population. They reason that Canadian drugs have not been proven to be safe for US consumption. The President and his administration, acting as the grand protector of the United States, will do everything to keep the American population safe, so the propaganda goes.

Anyone who has visited Canada, seen their medical system and the quality of their pharmacies, know that all that is a bunch of governmental fabrications aimed at propping up the American pharmaceutical companies to keep them in control of the costs. Everything that the Republican administration (and controlled congress) has done to date has been more for the benefit of the drug companies than for the American population.

The FOOD AND DRUG ADMINISTRATION has become more of a political arm for the Republican administration, by creating the illusion they exist to protect the American population. This is also true of the Environmental Protection Agency.

The politicians go on and on. The republicans would put a band-aide approach on the medical care system and prop up the HMO’s and American pharmaceutical companies while continuing to require Americans to pay exorbitant fees for everything medical.

The democrats, newly elected to control both senate and House, are still so lukewarm and disorganized about medical care reform that they provide no concrete leadership to rely on to negotiate a reasonable re-haul of the medical care system.

What we need to do is what Peter Finch did in the film NETWORK, where he told people to go to their window, open it up and yell as loud as they could: “I’m mad as hell and I’m not going to take it anymore.” We need to tell, not only the politicians, but the universities, the problem-solvers, creative thinkers and economists that they need to step forward and propose new ideas, any idea. It’s from these kinds of thinkers, with focused and dedicated politicians, that the answer must come.

It is very frustrating that solutions to this problem remain bi-polar. No new creative ideas. I believe the United States can do better. The answer won’t come from politicians alone. They will have to come from all of us.

By: Doc Jon Percepto

Many dual income couples, include their children on each group health insurance plan to maximize benfits. However, without some sort of system in place to help the health insurance companies coordinate benefits, it’s possible that either you or your doctor would be reimbursed for more than 100 percent of the actual cost of your claim.

To prevent this, health insurance companies typically designate one parent’s health insurance plan as the primary plan and the other as the secondary plan. (That’s why the patient questionnaire at your doctor’s office asks for information on primary and secondary coverage.) The primary plan is responsible for paying covered expenses up to the limits of the policy. If any unpaid costs are left over, the secondary coverage kicks in.

THE DATE OF BIRTH DETERMINES WHICH HEALTH INSURANCE PROVIDES COVERAGE

The birthday rule is often used to determine which plan is primary and which is secondary. Under this rule, the plan of the parent whose birthday occurs first in the calendar year is designated as primary. The date of birth is the determining factor not the year so it doesn’t matter which spouse is older.

Like most rules, the birthday rule has exceptions:

- If both parents share the same birthday, the parent who has been covered by his or her plan longest provides the primary coverage for the children.

- If one spouse is currently employed and has health insurance through a current employer, and the other spouse has coverage through a former employer, the plan belonging to the curently employed spouse would be primary.

- In the event of divorce or seperation, the plan of the parent with custody generally provides primary coverage. If the custodial parent remarries, the new new spouse’s coverage becomes secondary. And finally, the non custodial parent’s health insurance plan would provide a third layer of insurance protection. This order of payment can be altered by a court issued divorce decree or by agreement, but the health insurance companies must be notified.

THESE ARE JUST HEALTH INSURANCE RULES NOT THE LAW

Keep in mind that these practices are common among health insurance companies, but they are not governed by law. Practices may vary from one insurer to another. Read your policy carefully to make sure you understand how your insurance company handles dual coverage. If the policy coverage is unclear, ask for help from your employers benefit specialist or your insurer’s customer service department.

By: Ivon T. Hughes

The health savings account is a relatively new tax-savings vehicle, but it’s one that makes a whole lot of sense. Learning to navigate this new option and understanding its benefits really can help people save a ton of money when unexpected medical expenses arrive.

Health savings account plans tend to come in two basic forms – employer sponsored and self-purchased. Since the rules for employer-sponsored plans might differ from business to business, we’ll focus in on ones people who buy their own individual health insurance policies might benefit from.

In a nutshell, these savings plans allow people to save money on a tax-free basis for qualified medial expenses and future retirement medical expenses. To qualify, people must be on High Deductible Health Plans, which means they pay at least $1,000 in deductible for self-only coverage. Most insurance companies will now let customers know when a plan they choose makes this option available to them.

The benefits of the health savings account are many. They include:

* Money in a health savings account is owned by the person who opens it. How to spend that money is entirely up to the person, but if it goes on non-qualified medical expenses, the tax benefit will be lost.

* The money “rolls over.” Whereas some employer-sponsored and supported health savings account set ups don’t allow for roll over from year to year, a self-opened account does. The money put into the account is income tax-free unless it is used for ineligible expenses.

* Helps people save up for expenses faster. Since income tax won’t come into play with these accounts, the money saved can help add up to a better accumulation of cash if and when it’s really needed.

* Easy to open. Most banks, credit unions, insurance companies with high deductible plans and so on will help people set up their own health savings account plans. The only requirement is the right kind of medical insurance policy. It should cost nothing to open one of these plans.

* Easy to use. Most HSAs come with a debit type card that can be used to pay for qualified medical expenses.

These plans are a little tricky to understand as far as all the minute details of what is an allowable expense and what isn’t. The federal government offers highly detailed information on qualified expenses, but there are some generalizations that can be made. The types of things typically included in the qualified list are:

* Insurance premiums. This is allowed for the payment of COBRA insurance and for those who are unemployed.

* Co-payments. Some times co-payment amounts can be charged to the health savings account.

* Prescription medications. These are generally considered eligible expenses as are over-the-counter medications and medical supplies.

* Dental and vision care. In most cases, expenses associated with non-cosmetic dental and vision care are considered fair game.

A health savings account can be a great way to bank up money to pay for medical expenses without having to feel the bite of income tax. As long as the money used in these accounts is spent on qualified medical expenses, the savings extends after use, as well.

By: M. Xavier