Don’t presume your provider’s office knows best

This guest post is from a good friend of mine. She’s not in the healthcare industry, but she is one of the most savvy healthcare consumers I know. When she was telling me about some of her recent dealings with providers and insurance, I immediately asked her to write up her experiences to share with my readers! 

I don’t willingly part with my money, especially when I see a healthcare provider.

I question unnecessary tests, and I don’t want the office staff to be cavalier about spending my money. I expect the office to be familiar with my insurance plan, … Continue reading

SmartQuit – An app to help you quit smoking

smartquit appA smart way to quit smoking

Is quitting smoking on your New Year’s resolution list? Or that of a friend or family member?

If so, consider the SmartQuit app.

But first I’ll tell you what I do and don’t like about it.

I like that it seems to be pretty effective. The SmartQuit program and app were developed by researchers at Seattle’s Fred Hutchinson Cancer Research Center and the University of Washington (my alma mater!), with funding from the National Cancer Institute.

It uses a particular type of behavior modification—acceptance and commitment therapy—that has proven more effective than other smoking Continue reading

Annual exams vs. annual wellness visits

Happy New (Calendar) Year!

It’s the start of a new year or, in health insurance lingo, the start of a new calendar year deductible. I’m reposting this from last January, because this month is the best time to start trying to schedule that annual exam or annual wellness visit (it could take weeks, after all, to get an appointment!)

I usually advise people to get any screening tests or annual exams done early in the year, just in case an abnormality is found and more testing/treatment is necessary.

Especially with the current trend towards enormous deductibles (up to $14,300 for Continue reading

Budget-busting prescription drugs

Taxpayers footing the bill

I watched this on my local news the other night: Runaway drug price hikes squeeze Washington’s budget.

Our state is one that expanded Medicaid under the Affordable Care Act (ACA), so I knew we were spending a lot. But I had no idea now much. Through the first 9 months of 2016, my state has spent $1.1 billion on prescription drugs.

Not total medical care. Just prescription drugs.

And Washington is not the only state facing a fiscal nightmare because of skyrocketing drug costs.

Almost half of that spending is for the really high-priced specialty … Continue reading

Choosing Wisely – Use less healthcare

My goal for 2017? Use as little healthcare as possible

How will healthcare change under a new president and political party?

That’s a question I can’t answer. As I wrote in my last post, both candidates had multiple-point plans to tweak/improve/repeal/replace the Affordable Care Act, aka the ACA or Obamacare.

But I don’t know what will change or when.

What I know for sure is that for 2017 my premiums will be 20% more expensive, my co-insurance and co-pays will be higher, and my current primary care doctor will no longer be in-network.

I can and will shop around … Continue reading

“Bridge Over Diagnosis”

I’m going with an overdiagnosis theme this week.

Here’s the latest healthcare parody video from pharmacy professor James McCormack, as he continues his much-appreciated effort to raise awareness of overscreening, overdiagnosis, and overtreatment in this country.

As usual, this video is full of supporting statistics and excerpts from leading healthcare journals, so take time to pause the video and really understand the information being shared.

As I said in a previous post, overdiagnosis and the resulting unnecessary treatments cost hundreds of billions of dollars every year.

Equally bad, if not worse, I think, is … Continue reading

Risk Benefit Theater – Screening mammograms

I’m all about high-value, evidence-based healthcare.

I’ve written a lot of posts about the problems, including high costs, of overscreening and overtreating. (We spend hundreds of billions of dollars every year on unnecessary healthcare!)

So I love this video by Andrew Lazris, MD, and Erik Rifkin, PhD. They use the visual of 1000 women sitting in a theater to illustrate why screening mammograms are not the life savers many women think they are.

A picture (or video) is worth a thousand words, isn’t it?

I understand Lazris and Rifkin want to create more videos to … Continue reading

Life Line Community Healthcare and Life Line Screening

Buyer Beware

I’ve posted before about the limitations of Life Line Screening.

The screening tests they offer in their basic “wellness” package are either not recommended at all because they aren’t effective screening tools (carotid ultrasound), or are not recommended for the general public (abdominal aortic aneurysm ultrasound). Please read my previous post for more information on that: Don’t reach for Life Line Screenings

Screening tests are best discussed with your primary care physician. He or she will help you know which tests are right for you—based on your age, health history and family history—as well as how often they … Continue reading

Costs of Care story contest – Tell your story

And maybe win a prize!

Have you or a family member been the victim of crazy medical expenses? Or are you a healthcare provider who has witnessed again and again unreasonable and unfair healthcare costs?

Have you just been waiting for the chance to share your experience with a wider audience?

If so, then the healthcare advocacy group, Costs of Care, wants you to submit your story to its annual Story Contest.

Your story should be 750 words or less, and it should “focus on experiences that illustrate the challenges or opportunities to make healthcare more affordable.” (Check out… Continue reading

Do you know your drug formulary?

drug formularyThe shrinking drug formulary

Insurance companies have several ways to cut their costs.

We are all familiar with higher premiums, higher co-pays, increased deductibles, and narrower provider networks. These will all be apparent when we look at our policies for 2017.

A lesser-known strategy is to remove high-cost drugs from the drug formulary—the list of medications that insurance will cover.

Insurance companies typically work with a pharmacy benefits manager, or PBM, which acts as the middleman to negotiate drug prices with drugmakers.

Exploding drug costs

The Affordable Care Act made it mandatory that health insurance plans offer prescription drug … Continue reading

Don’t reach for Life Line screenings

I first posted about Life Line screenings two years ago. I’m re-posting today as this post still gets a lot of traffic and I wanted to reopen the comments. 

life line screeningsOvertreating, overspending

I just received an invitation in the mail!

Not to a party or a wedding or anything fun, but to a Life Line Screening event being held at a local church. The letter says they’re holding a spot for me on this particular date, but I must call NOW to confirm and register, because spaces are LIMITED!

“These aren’t just routine medical procedures—they can help save your life”

Oh, … Continue reading

Drug commercials do more harm than good

I think it was a mistake to allow prescription drug commercials on TV. In my humble opinion, at least.

But I’m not alone in disliking these commercials, or direct-to-consumer (DTC) ads, as they’re called.

The news website Vox recently released a video that explains more about how DTC ads came to be ever present on our TVs. They attempt to be fair and present both sides of the debate, but it seems to me they lean negative. What do you think?

One of my objections to DTC ads is that these multi-billion dollar campaigns are … Continue reading

Outrageous cost of EpiPens finally getting some attention

Wow. Talk about timing.

I just posted a few weeks ago about my dread of renewing my EpiPen prescription because of its cost—over $700 without insurance, and still over $600 with my insurance!

It seems other healthcare advocates, the media, Congress and even the presidential nominees are at last realizing how insane it is to charge that much for literally a few cents worth of epinephrine.

EpiPens are not even new to the market, like so many other high-priced drugs. It’s been around for a long time, so Mylan pharmaceuticals can’t claim it’s trying to recoup R&D costs. In fact, … Continue reading

View Prevnar 13 ads with caution

prevnar 13Prevnar 13: As seen on TV

I was watching TV the other evening and, as usual, was forced to sit through multiple back-to-back prescription drug commercials.

One that caught my attention was for Prevnar 13, which is one of the pneumonia vaccines. (13 because it protects against 13 strains of streptococcus pneumonia.)

The commercial stated Prevnar 13 was for adults aged 50 and older.

That statement’s true, but needs some clarification.

Yes, Pfizer did get FDA approval a few years ago to market Prevnar 13 to adults over the age of 50. Previously, the vaccine was only used for … Continue reading

Doctors don’t know what healthcare costs

Heard on the golf course

I don’t want to reinforce the cliché that all doctors play golf, but my husband (not a doctor) plays with a lot of them.

Recently he shared with me a couple of conversations he’s had with his MD golf buddies about the cost of healthcare, specifically prescription medications.

A few weeks ago I posted about how much it costs to buy an EpiPen—over $700 for a pack of two, if you don’t have insurance. Even with insurance, it can cost well over $500.

My husband mentioned this to a friend, a urologist, during a … Continue reading