Save money – When to call an ambulance

I recently read an article about a man who was taken to the ER in an ambulance for a sprained wrist.

And then he was astounded when the ambulance company charged him $250!

“If I wanted to go to the emergency room, I could have taken a cab costing less than $10,” he said.

Or Uber. Or a friend. He learned the expensive way that ambulances are costly—$250 is actually on the cheap end—and should not be used without good cause.

Ambulance costs can range anywhere from a couple hundred dollars to well over $2,000, depending on the length … Continue reading

Screening eye exams in older adults

Just yesterday I posted about the United States Preventive Services Task Force (USPSTF) and the fine line they walk between providing evidence-based recommendations for screening tests and making medical specialist groups happy.

Sometimes it just doesn’t happen.

The task force recently gave an “I” grade to vision screening in patients over 65. An I grade, or Insufficient evidence, means that the task force can’t definitively say that the benefits of vision screening in older adults outweigh the possible harms.

The American Academy of Ophthalmology (AAO) doesn’t agree.

Specifically, the task force reviewed the evidence for primary care doctors screening for … Continue reading

5 tips to save money on prescription drugs

save money on prescription drugsOne of the driving forces behind rising health care costs is the increasingly high cost of prescription drugs.

And because 60% of Americans take at least one prescription drug, that adds up to a lot of money.

Insurance companies are trying to rein in costs by having tiered copayments (higher for brand names) or limiting the selection of drugs on their formularies (the list of drugs your insurance will cover).

This post gives you some suggestions to save money, and some resources that might be helpful.

But first, ask yourself and your physician if a prescription drug is really … Continue reading

Will Congress fight the high cost of prescription drugs?

Last November, with much media coverage, several members of Congress announced the formation of The Affordable Drug Pricing Task Force, promising to “take action to combat the skyrocketing costs of pharmaceuticals.”

Finally! I thought.

Related post: Prices continue to increase for generics

But I haven’t heard much since then.

There was a little noise earlier this month when the House Oversight Committee (of which the task force is a subcommittee, I believe) attempted to grill the now infamous Martin Shkreli about why he thought it was okay to jack up the price of Daraprim from $13 a pill to … Continue reading

New adult vaccination guidelines

The Advisory Committee for Immunization Practices (ACIP) and the Centers for Disease Control (CDC) have just released an updated vaccination schedule for adults.

I’ve included the schedule and accompanying information from the CDC’s website at the end of this post.

You can also print it out to take to your primary care provider.

Related post: Adults need vaccinations, too!

It’s color coded to make it easier to follow the recommendations, and I think it’s an improvement over last year’s chart.

A yellow row/column means the vaccine is recommended for everybody in that age group; purple indicates the vaccine is for … Continue reading

The “financial toxicity” of cancer

We’ve all heard the phrase “cancer kills.”

But guess what? So can the high cost of treatment.

I just read about a study that came out of the Fred Hutchison Cancer Research Center here in Seattle.

The results won’t surprise anyone familiar with how much cancer treatment costs (a lot!), but researchers found:

…cancer patients who go bankrupt are nearly 80 percent more likely to die than patients who don’t, and some cancers had significantly higher mortality rates. Prostate cancer patients who filed for bankruptcy were almost twice as likely to die; bankrupt colorectal cancer patients were 2.5 times more

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Overuse of CT scans is dangerous and expensive

I read two articles yesterday that complemented each other:

In Kaiser Health News (KHN) Heavy Use Of CT Scans Raises Concerns About Patients’ Exposure To Radiation

And on KevinMD two radiologists posted The financial costs of treating CT-induced cancer

Each underscores the fact that CT scans are significantly overused in American healthcare.

Although CT scans are an essential diagnostic tool, the Food and Drug Administration reports that an estimated 30 to 50 percent of imaging tests are believed to be medically unnecessary.

Considering we spend tens of billions of dollars every year on diagnostic imaging, that’s a lot of wasted … Continue reading

Medical identity theft – A growing problem

Keeping our money and personal information safe from hackers is an ever-present, and ever-expanding, problem.

Most big retailers and financial institutions are fighting back and making it more difficult for hackers to get our personal and credit info. That’s great, but unfortunately the hackers are just moving to an easier target—our medical identities.

Medical data breaches are expected to be a big problem in 2016.

Medical information is in shorter supply, so hackers can sell it for more. Plus, most people now know to keep an eye on their credit and bank statements for signs of fraud. However, few people

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How narrow networks limit access

The health care blog KevinMD is a great place to read firsthand accounts of how our expensive and fragmented health care system really works (or doesn’t).

Last week I read a post by a physician who described his friend’s experience of trying to get treated for an ordinary but painful kidney stone. (I’ve never had one, but I’ve been told they are extremely painful!)

Sadly, his friend had a narrow-network insurance plan and he wasn’t able to find either an in-network specialist—urologist—or the specialized treatment that would alleviate his pain.

So here was Jeremy, an insured, otherwise healthy patient in

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Health insurance literacy – It’s not easy

Health insurance literacy is a term that has been used a lot in the media since the Affordable Care Act (ACA) rolled out a few years ago.

It basically means how fully a person understands how his or her health insurance works, as well as the lexicon of insurance-speak: words and acronyms like coinsurance, copay, deductible, premium, subsidy, provider, allowed amount, out-of-pocket maximum, balance billing, HSA, FSA, HMO, PPO, EPO, PCP, and so on.

If only people understood their health insurance, the experts moan, they would make better health choices and protect themselves financially.

I’m sure that’s true, but … Continue reading

Heads up about Medicare changes

This post if for any of my readers who are Medicare age or about to be Medicare age.

I think it’s important to understand what changes are in the pipeline that will affect your doctors and their ability to be able to treat you.

Some doctors already refuse to see Medicare patients because of government red tape and poor reimbursement.

But starting in 2017 it’s going to get worse, and many physicians are wondering if they should follow their colleagues and drop out of the Medicare game altogether.

I recently read two posts by physicians on the health care blog … Continue reading

The high cost of dementia

November is Alzheimer’s Disease Awareness Month.

It’s hard to find anyone who isn’t aware of—and scared of—dementia**. Or who hasn’t had a family member or friend stricken by it.

Alzheimer’s is a horrible disease that damages not only the individual, but family and friends, as well, especially the primary care giver—most often the spouse.

Adding insult to injury is the incredible cost of getting help. A recent study published in the Annals of Internal Medicine confirms what many already know—Alzheimer’s disease and other forms of dementia cost families way more than almost any other disease.

Why? Cancer is one of Continue reading

Cost sharing and narrow networks

It’s that time of year—open enrollment for health insurance.

If, like me, you buy an individual health plan for yourself or your family, and you have been informed by your insurance company that your current plan will no longer be available, you are once again shopping for a plan that meets both your needs and budget.

The new plan I’ve been offered has both a higher premium and a higher deductible, but as far as I can tell our provider network will remain the same. That’s important, since my husband has a doctor he really likes. I had to change … Continue reading

Sad but true – CYA medicine works

A few months ago I posted about CYA—Cover Your Ass—medicine being one reason why too many diagnostic tests are ordered and health care costs are high.

CYA medicine is when the doctor or doctors are pretty sure what your problem is, but they order extra scans and x-rays and blood tests anyway because “failure to diagnose” is one of the leading causes of medical malpractice suits. They aren’t going to take any chances, and who can blame them?

Related story from KevinMD: This is why doctors practice cover your ass medicine

Besides, they don’t pay your resulting medical bill, so … Continue reading

Confused by mammogram guidelines?

October is Breast Cancer Awareness Month, so I can’t let it pass without commenting on the American Cancer Society’s (ACS) recently updated screening mammogram guidelines.

Before, the ACS recommended annual mammograms starting at age 40.

Now they recommend annual mammograms for ages 45 to 54, with screening mammograms done every other year after age 55.

But, they add, women should still have the choice to start screening at age 40 and have yearly mammograms thereafter.

The confusion arises not only because the ACS is a bit wishy washy on its guidelines, but because the American College of Obstetricians and Gynecologists … Continue reading