Balance billing

More and more frequently I come across stories of patients who have inadvertently received care from “out-of-network” providers. And it can be a costly mistake.

When you are billed for the costs that your insurance company has denied, that’s called “balance billing.”

My insurance company doubles the deductible for out-of-network care; instead of $10,000, our deductible becomes $20,000. But insurance companies aren’t required by law to put a limit on a patient’s out-of-pocket spending when it comes to out-of-network care. In theory, you could get hit with tens of thousands of dollars in medical bills even though you have insurance.… Continue reading

Common sense health and wellness

I like all things snarky so I enjoyed reading a recent post by a physician poking a bit of fun at health and wellness fads.

Remember the old aphorism You are what you eat? Well, forget it. In today’s busy world who has time for “eating in moderation” or “being heart healthy”? I think that if there’s one thing that the health and wellness industry has proven time and time again is that miracle cures and gimmick diets work. Every. Single. Time. Not only are they logical and effective, but also completely safe.

(Don’t forget he’s kidding here!)


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Headaches are overtreated

A study coming out of Harvard this week reveals that ordinary headaches are being overtreated, and it’s costing billions of extra dollars in health care spending.

Each year more than 12 million Americans visit their doctors complaining of headaches, which result in lost productivity and costs of upward of $31 billion annually. A new study by researchers from Beth Israel Deaconess Medical Center (BIDMC) suggests some of that cost could be offset by physicians ordering fewer tests and an increased focus on counseling about lifestyle changes.

The study looked at over 9,000 doctor visits for headaches over a 10-year … Continue reading

Controlling health care costs

The fact is, when you need health care the most, you are least able to “shop around.”

That’s why one of health care reform’s goals of pushing consumers to “have more skin in the game” won’t always work.

Sure, when our health concerns are not urgent we can take time (lots of it) to make phone calls to providers and insurance companies. But when we are sick or injured, we can’t. And sky-high deductibles and narrow provider networks make controlling costs more difficult.

A pediatrician on his blog writes the following post:

In today’s enlightened times, health care isn’t

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The overuse of antibiotics

Here’s another great video from Healthcare Triage by Aaron Carroll, MD, on the overuse of antibiotics.

I’ve posted on this topic a few times. Whether it’s physicians prescribing unnecessary antibiotics because they think it’s what the patient wants, or patients demanding antibiotics because it’s what they think they need, too many antibiotics are still being prescribed.

Related posts:


Antibiotic prescriptions are particularly abundant during the cold and flu season, even though the vast majority of colds, coughs and sinus infections are viral and don’t need antibiotics.

Save … Continue reading

Lack of transparency keeps medical costs high

Profits stay high, too

On Monday, the New York Times published another brilliant piece by Elisabeth Rosenthal in her series “Paying Till it Hurts.”

Testing has become to the United States’ medical system what liquor is to the hospitality industry: a profit center with large and often arbitrary markups. From a medical perspective, blood work, tests and scans are tools to help physicians diagnose and monitor disease. But from a business perspective, they are opportunities to bring in revenue.

And American doctors, clinics and hospitals tend to order lots of tests. “It’s one of the most lucrative revenue streams they

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Two reasons why we spend too much on health care

One: Doctors order too much

A primary care physician, thinking he was sending a patient for a simple evaluation by a specialist (that was his first mistake), shares this:

A few months ago I assessed a patient with dementia.  I dutifully ordered the appropriate blood testing and MRI.  As I delved further into the history, I was concerned that there may be a component of depression. Pseudodementia (memory disturbance and dementia like symptoms caused by depression) can often mimic classic Alzheimer’s disease, but resolves with proper treatment.  The best way to differentiate these two syndromes is neuropsychological testing.  I

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More ways to save money on generics

I posted a couple weeks ago about how the prices of many generic drugs have been rising to crazy heights over the last 18 months.

Here’s another post by a health care advocate with some more tips for trying to save money on generics.

Unless your health plan’s drug formulary covers your medication, you might be out of luck. A drug formulary is a list of prescription drugs, both generic and brand, that are preferred by your health plan.

If you’re shopping for health plans now during open open enrollment (November through February, 2015) you might ask if the medications

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Nexium – Brand, generic, prescription or OTC

nexiumWhich is cheapest?

As I did my grocery shopping the other day, I ran into a large cardboard brochure holder at the end of one aisle. Literally ran into it. Why do store managers place these displays where they block cart traffic? Oh, right, to get our attention.

Well, it worked. But the bright purple brochures would have attracted my eye anyway. They touted the recent release of Nexium (“The Purple Pill”®) as an over-the-counter (OTC) medication; that is, you no longer need a prescription to buy it.

The brochure tells us that Nexium is the “#1 doctor prescribed acid … Continue reading

The high cost of Non-24

hetlioz non24Another drug we can’t afford

A few weeks ago I posted about the recent slew of commercials to “increase public awareness” of the chronic sleep disorder Non-24.

As Non-24 (formerly known as circadian rhythm disorder) affects totally blind people and is rare otherwise, it wasn’t clear to me why we needed increased awareness until I realized a new drug was coming to market.

When I wrote that post, this new drug, Hetlioz (tasimelteon), was not yet available in pharmacies. I speculated that it would be costly, perhaps as much as $10 per tablet. If only!

A few days ago … Continue reading

Walgreens’ Balance Rewards – Healthy savings or not?

walgreens balance rewardsA loyalty card with a (seemingly) healthy twist

Walgreens’ catch phrase is, well, catchy. 

Walgreens—At the corner of Happy and Healthy®

Who wouldn’t want to live (or shop) at that address?

I normally don’t shop at Walgreens, but a friend mentioned the Balance Rewards card to me because it allows cardholders to track healthy behaviors and earn rewards points, and she thought I might like that.

Absolutely! So I decided to check it out.

I looked at the Walgreens’ website and argh! is it confusing! Still, after a concentrated effort I was able to determine the main points or “rewards” … Continue reading

Use essential oils with caution

They are drugs, after all

As I’ve mentioned in a previous post, How NOT to whiten your teeth, I enjoy Pinterest. What I don’t enjoy is the poor health advice that gets pinned and re-pinned hundreds of times over. Like putting acid (lemon juice) on your teeth and then brushing with an abrasive substance (baking soda). Bad idea if you like your enamel. But I see variations of this “recipe” pop up dozens of times every day.

Essential oils are another frequently-used ingredient on the home remedy boards. There are hundreds of home remedies using essential oils to treat … Continue reading

Save money on cough medicines

‘Tis the season

Cold and flu season is peaking.

I came down with a cold a few weeks ago (following a plane trip to a very dry climate—see my related post on Humidity for sinus health!)

And now I’ve had a cough linger for almost three weeks.

But I’m reminded again and again in various doctor blogs that viral coughs take a long, long time to go away, two and a half weeks on average, and patience is the best medicine.

As one family practice physician writes:

[Our waiting room is] a chorus of coughs, high, low, dry,

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Home remedies for headaches

Oh, my aching head!

Headaches must be one of the most common health complaints. They affect all age groups, and have any number of underlying causes. Still, most headaches are a minor annoyance at most, and go away with minimal treatment.

But judging by the amount of money spent on over-the-counter pain relievers and headache medications (about half a billion dollars a year), we must be a country in a lot of pain!

The vast majority (90%) of headaches are the tension-type, or stress, headaches.

Luckily, tension-type headaches can be treated easily with inexpensive over-the-counter medications or simple home … Continue reading

Self triage and save money

Know some resources and use them

Triage is a commonly used word in medicine, especially in overcrowded emergency departments as staff do their best to determine which patients are sickest (will soon die unless treated) and which can wait. This process of prioritizing patients for treatment is known as triage.

But triage has a broader definition: The principle or practice of allocating limited resources.

And for most of us, money is definitely a limited resource!

In 2014 more health insurance policies will come with huge deductibles, and I think this trend will continue. Health care costs are not going to … Continue reading