Clinton and Obama supporters, I need your help in re: Health

[ayeshahaqqiqa]

I've seen the candidate's health programs spelled out from the patient's point of view. What I'd like have are some facts from the doctor's point of view.

I am not an MD, but I am on the Board of a holistic health education foundation. Our founder is an MD who uses a variety of treatments at our demonstration clinic. Some are conventional, some rely on the very latest techniques that have been researched and tested.

Here are our major concerns:

One of the big complaints from staff is the paperwork insurance companies require. They aren't uniform, and this adds to the load. Will your candidate's plan make paperwork uniform?

The next complaint is that insurance companies interfere with the doctor's recommendations-for example, disallowing payment for one medicine in favor of another one, even though the latter will interfere negatively with other medicines the patient is taking. Will your candidate's plan make sure that insurance companies can no longer dictate to doctors in matters like this one?

The third area of concern is that some insurance companies refuse to pay for treatments given because they label them "experimental" even though they have been written up in the literature, including the JAMA. Will your candidate's plan make sure that insurance companies are required to pay for treatments that, though not "conventional", have been shown to be effective?


How does your candidate address these three concerns? Thank you in advance for your replies.

[bicentennial_baby]

1. Kick!!

:kick:

[sandnsea]

2. National Health Insurance Exchange

The Obama plan will create a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend upon health status. The Exchange will require that all the plans offered are at least as generous as the new public plan and have the same standards for quality and efficiency. The Exchange would evaluate plans and make the differences among the plans, including cost of services, public.

You can find the answers to the rest of your questions at the web site.


http://origin.barackobama.com/issues/healthcare/

[ayeshahaqqiqa]

3. THANK YOU

for taking the time to answer my questions! :)

[MH1]

4. Paperwork: Obama plan includes "standards-based electronic health information systems"

http://www.barackobama.com/issues/healthcare/#lower-costs

Lowering Costs Through Investment in Electronic Health Information Technology Systems: Most medical records are still stored on paper, which makes it hard to coordinate care, measure quality or reduce medical errors and which costs twice as much as electronic claims. Obama will invest $10 billion a year over the next five years to move the U.S. health care system to broad adoption of standards-based electronic health information systems, including electronic health records, and will phase in requirements for full implementation of health IT. Obama will ensure that patients' privacy is protected.

This doesn't specifically refer to insurance paperwork, but I think that would have to be included, or in any case more uniform insurance paperwork would be facilitated by a standards-based health information system.

[Beaverhausen]

9. any security concerns with electronic systems?

I guess it's inevitible, but I'm really hoping there can be safeguards to this system.

[MH1]

13. Electronic Medical Records are being implemented now.

There are security concerns. There is a law called HIPAA that requires private medical info be adequately secured.

Having a standard protocol will improve security, imo, as compared with a proliferation of proprietary formats (the current situation as I understand it). It is similar logic to why election software (if you use any at all) is better if it is open-source.

[ayeshahaqqiqa]

10. Another great idea!

And thank you for posting this! Yes, I would think it rather simple to do something like requiring that the codes for diseases and tests and procedures all be uniform. As someone who works extensively with computers (and whose husband maintains the computers at the Foundation) I applaud this idea. We had to build a storehouse for all the paper records. Far easier to keep them on CDs or even jump drives. And this is something that could be done using existing hardware, I think.

Thank you for this information. It has been extremely helpful. I would recommend that your local Democratic committee send you out to talk to health care professionals in your area when your candidate wins the nomination. Your explanation could, I believe, land many doctors in our camp.

[MH1]

5. Coordination of care

I'm guessing that the medication conflicts you mention arise because of at least one chronic condition. So this part of Obama's plan might help there:

http://www.barackobama.com/issues/healthcare/#lower-costs

Helping Patients:

1. Support disease management programs. Seventy five percent of total health care dollars are spent on patients with one or more chronic conditions, such as diabetes, heart disease and high blood pressure. Obama will require that providers that participate in the new public plan, Medicare or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs. This will improve quality of care, give doctors better information and lower costs.
2. Coordinate and integrate care. Over 133 million Americans have at least one chronic disease and these chronic conditions cost a staggering $1.7 trillion yearly. Obama will support implementation of programs and encourage team care that will improve coordination and integration of care of those with chronic conditions.

I didn't find (yet) where he explicitly states something about the insurance companies not being able to disallow specific meds. I have a feeling that is going to be very tough to do directly, as long as we have an insurance-based model of healthcare.

[ayeshahaqqiqa]

7. THANK YOU

for the citation and quote. I've been to the link and am excited about what is said, because this sort of work is a large part of what our Foundation does. We have group office visits, for example, where the doctors and people with heart conditions, or diabetes, or digestive problems all meet together. They are part of an interactive discussion of issues, and many who have participated say it is great because others there think of questions that they wouldn't have thought about. Lively and helpful discussions have ensued.

We also have a weight management clinic that is individualized, and includes classes on cooking. Personally, this program has been very beneficial to me, as any question or concern I have had has been immediately addressed by the staff.

Every year we have a Health Fair, which includes free health screenings.

We also are in the process of making audio and video recordings of lectures on various topics.

[BlackVelvet04]

6. Here is some of the info from Hillary's plan:

Proposes a 7-Step Strategy to Reduce Health Costs:

* A national prevention initiative;
* A “paperless” health information technology system;
* Chronic care coordination to improve outcomes;
* Elimination of insurance discrimination to help reduce administrative costs;
* An independent “Best Practices Institute” to help consumers and other purchasers and plans make the right care choices;
* “Smart purchasing” initiatives to constrain prescription drug and managed care expenditures (permit the Secretary to negotiate prices for Medicare prescription drugs, limit direct-to-consumer advertising of prescription drugs and change patent laws to increase the availability of generic drugs; and reduce payments to Medicare Advantage plans to create more level reimbursement with traditional Medicare);


I haven't seen anywhere where either candidate deals expressly with the concern of insurance companies dictating to doctors. I do know that the FEHBP plans that Hillary's Plan offers are strictly monitored to make sure claims are not denied. I had a FEHBP plan for 20 years and they covered, alternative care that other insurance companies did not....chiropractic and acupuncture was covered. I believe they added benefits for massage therapy as well but I'm not sure. While I was using the FEHBP I never had a prescription challenged because it wasn't on the insurance "list".....I did later with other insurance companies but not with the FEHBP.

[ayeshahaqqiqa]

11. THANK YOU

especially for your personal experience.

[BlackVelvet04]

14. You're welcome.....

good luck. Insurance is always a complicated issue.

[BlackVelvet04]

8. here is a link to a comparison chart

http://www.health08.org/sidebyside_results.cfm?c=11&c=16

[ayeshahaqqiqa]

12. This will be very helpful

Thank you for posting it. And thank you for coming here to tell me about your candidate. I would encourage you to do the same with people face to face, especially health care people.

[BlackVelvet04]

15. You're quite welcome.....

that's a good way to compare the two side by side.

What is the most important thing in the eyes of health care people in your opinion?

[ayeshahaqqiqa]

16. To be able to practice medicine without interference

from insurance companies. The next concern is the long time it takes for some insurers to pay, followed by unnecessarily complicated paper work.

[BlackVelvet04]

17. I had a doctor in AZ

that almost starved when she refused to work for an HMO and struck out on her own.

She prescribed a medication for me that the insurance company didn't want to pay for (this was after I no longer had the FEHBP insurance) and she called them up and told them off. I got my medicine paid for.