Although it is not surprising that the number of uninsured is increasing during this deep recession, the low adoption of COBRA coverage as described in a recent article is startling. COBRA exists to help the unemployed maintain quality health insurance when they have lost their job. However, the cost of health insurance has increased so dramatically in the past 10 years that COBRA is not affordable to many that lose their job. The article states that only 9% of those eligible for COBRA are signing up compared to 18 – 26% in previous COBRA surveys. The fact of the matter is that unemployment benefits are insufficient to pay for housing, food, and health insurance so health insurance is dropped.

HealDeal can help those that do not have health insurance find affordable care. For the increasing number of people that do not have insurance and don’t qualify for Medicaid, it is critical that they spend their health care dollars wisely.

HealDeal consolidates pricing information from multiple providers and many medical services. This enables the uninsured to shop around and view prices before paying for the service. Check it out and/or pass it on to someone that could use the help in this difficult economic climate.

The average American’s household’s health care spending in the next 20 years will exceed 41% of the household income an increase of nearly 20%. This prediction by the outgoing secretary of Health and Human Services, Michael Leavitt assumes that the health care industry and current legislation do not change and the cost of health care continues to rise at the current pace.

What is the cause of this increase?  Several factors contribute to this prediction; the current economic climate is of course a leading factor, an increase in the elderly population relative to the working population (the baby boomers are aging and living longer), an increase of more and more complicated procedures that drive up the cost of health care services (hip and knee replacements as well as cardiovascular procedures account for the top three hospital procedures.) These factors are in one sense a given, we cannot reduce the number of elderly and cannot impede the progress of health care procedures that improve longevity and quality of life. The one factor that secretary Leavitt identifies as a way to reduce this health care burden is to provide health care recipients with the cost of procedures up front.

Currently there is little or no accountability and no process for comparing prices for common procedures. This Leavitt likens to an auto manufacturer accepting the cost of an automobile component and simply passing on the cost to the consumer. If health care providers were forced to compete in the marketplace the costs of all health care would be reduced directly for consumers as well as indirectly in a reduction of government health care spending and a potential reduction in taxes.

What can we do? As consumers of health care we can demand open and transparent pricing, value comparisons across providers and access to information to make informed decisions.Our mission at HealDeal is to:

• Provide an understanding of the consumer driven health care marketplace. 
• Empower the consumer with health related cost and quality information to improve the ability to make smart choices.
• Champion transparency in the health care marketplace that promotes value and cost comparisons.

This is a step in the direction of a transparent and open health care marketplace.

Indeed the blog is back after my hibernation period. During this period I was working with my committed and experienced team, on our innovation, HealDeal Inc.

HealDeal is a novel idea driven by the urgent need of these times of rising uninsurance and worsening economy. As it is well written by the esteemed Harvard Business School Professor, Mr. Clayton M. Christensen ‘How hard times can drive innovation’.

We want to help those who are paying for healthcare out of their own pocket (self-pay patients). We believe they must have the right information to make smart choices. This information comes to them directly from their chosen physicians or healthcare provider. Hence providing transparent cost and relevant quality information.

I invite you to engage in this process of innovation by visiting www.healdeal.com, and giving us your feedback.

Archana Dubey, MD

Insurance company cancelled a policy for a patient suffering from cancer reports NPR.

The payments from the insurance company stopped while patient was still in the process of receiving treatment. This was part of Healthnet’s incentive program in which it paid bonuses to an administrator for meeting targets of policy cancelations.

This yet again exposes the bottomline approach of the insurance industry.

Consumers of healthcare need to assume the risk of their own care and take control of their medical decisions and expenses.

Archana Dubey, MD

This is a call for all the consumers of Healthcare aka. patients, please get to know the mandatory ‘Universal’ Healthcare solution, either you will be within network or without one.

Dear Consumers of Healthcare:

1. If you thought ‘Universal Healthcare’ increases our access to heathcare then be ready for unpleasant surprises.

There is a difference between universal coverage and actual access to medical care. Many countries provide universal insurance but deny critical procedures to patients who need them. Britain’s Department of Health reported in 2006 that at any given time, nearly 900,000 Britons are waiting for admission to National Health Service hospitals, and shortages force the cancellation of more than 50,000 operations each year. In a 2005 ruling of the Canadian Supreme Court, Chief Justice Beverly McLachlin wrote that “access to a waiting list is not access to healthcare.”

The solution of mandatory purchase of health care products from private for profit insurance companies is a simply unjust. Those who can only afford the minimal plans will remain largely exposed. The premiums are still too high and can cause real economic hardship for those who do not qualify for subsidization. The program increased the number who qualify for subsidization but had no provision to fund them. The cost of that legislative blunder is already being passed on to those who can least afford it in the form of more penalties in 2008, a discriminatory and possibly illegal act that essentially raises the income tax rate for a targeted population.

2. If you thought insurance improves the quality of healthcare then think again.

The New England Journal of Medicine study in 2006 found that- “health insurance status was largely unrelated to the quality of care.”

The Access Project, based in Boston, released the findings of its recent independent study of the health insurance industry- “The Illusion of Coverage.” The report demonstrates the specific ways in which health insurance products deliberately fail to protect people financially and fail to guarantee their access to needed care.

Our dangerous obsession with universal coverage will lead us to neglect important consumer reforms, such as enacting a standard health insurance deduction, expanding health savings accounts and deregulating insurance markets — that could truly expand coverage, improve quality and make care more affordable.

Healthcare isn’t really a priviledge or a right, it is actually a choice.

Archana Dubey, MD

New study finds-cancer diagnosis linked to insurance….

People who are uninsured or on Medicaid were more likely to be diagnosed with cancer in later stages. This includes common cancers that can be screened early like prostate, cervical and breast cancer.

This study further validates the negative impact of uninsurance, that has become a disease worse than even cancer. It also validates the negative impact of insurance- private or government.

The application of insurance in US Healthcare is very unlike in any other industry. In any other industry, consumers take control of their routine expenses and insurance is utilized for catastrophic needs. In Healthcare, consumers have come to expect utilization of insurance for routine care also, this has made us depend largely on insurance to prevent illness. When we land up with uninsurance, we do not take control of our health and lag in preventitive care and results are evident from the study.

This calls for shift in market, from the monopoly of insurance (private or state sponsered like Universal healthcare) to a free market. This shift will also enable us to address the huge problem of rising cost of Healthcare and will support quality Healthcare.

Shifting paradigm from “you manage my care” to “I manage my care”.

Working on it,

Archana Dubey, MD

Lets talk about California Healthcare reforms…really it is deformed:

1. California ranks 45th among U.S. states for the percentage of residents who receive health insurance coverage through an employer, according to a study by the Economic Policy Institute that used data from the U.S. Census Bureau. Only 55.7% of California workers had employer-sponsored health care coverage in 2006, compared with about 63% of workers nationwide. About 18 million workers in California were covered by an employer in 2005-2006, nearly half a million less than the amount covered in 2000-2001. Almost 40% of California’s uninsured work for small employers.

2. Nearly 1 in 3 uninsured have family incomes of $50,000 or more. The five-year decline has primarily affected middle-income workers, according to the study. Researchers also noted that more than 600,000 fewer children in California were covered by their parents’ insurance last year than in 2000.

Now these uninsured patients become ’self-pay’ when they seek medical care. You would think that, like any other industry, they should have access to cost and quality data. Not really, because the ‘Law’ prevents a healthcare provider or a services company to share this critical information, since they are not part of any insurance network.

Are these laws are meant to ‘protect’ the consumers or the monopoly of the Insurance industry? Unless you are part of one of the insurance network (that you can’t afford or have been denied care from) you have no clue where you should seek care from and how much it will dent your budget.

I appreciate Mr. Governer’s healthcare initiative and the efforts of California endowment, but maybe we should look into reforms to free the Healthcare market and provide access to information and access to care, rather than creating another ‘insurance package’ and let the people fall through the crack and suffer.  

A perspective from a healthcare reform supporter…

Archana Dubey, MD

I had a pleasure to meet the CEO of Sermo, Dr. Daniel Palestrant. What struck to me was his genuine efforts and focus towards his mission of providing a credible physicians networking web-lounge. Sermo provides free exchange of knowledge between physicians of various specialities, improving the process of decision making.

Health2.0 companies like these are bringing a shift in paradigm for healthcare delivery. They work on developing the patient outcome data that eventually have a potential to replace the conventional randomized control trials, hence shifting the medical innovation from a lab to the people.

Cheers,

Archana Dubey, MD

Back from my Mind Body Medicine conference at New Orleans where we were also working with people who survived Katrina and working to rebuild the ’soul’ city.

I need to congratulate Dr. Jim Gordon who founded the Center of Mind Body Medicine. He and his faculty have been working in troubled areas of the world like Gaza, Kosovo and now New Orleans.
We all learned various techniques of self care and self healing so we could teach our patients. It sounds like a great idea as a concept.

My first day back at the HMO (Health ‘Maintenance’ Organizations) ridden practice. Mind and Body was confused by suboptimal time available with each patient and mentioning the relaxation breathing further confused my patients causing more questions and longer delays in seeing the next patient. Rough landing to the real world…

Later in the week I wondered about all those great studies supporting these Mind Body techniques, why are those not mentioned in CNN or advertised with Lipitor, Viagra or Lunesta. Why is our healthcare delivery is focused on disease management and ignoring the Health Maintenance?

It is about time the consumers of healthcare industry start investing their time in self-care and take control of prevention of disease and partake in medical decision making. Health 2.0 revolution can work towards consumer empowerment.

To the mind and body….breathe soft belly….

Archana Dubey, MD

So we talked about scoring your health at the Health2.0 conference. Handing out another tool to the insurance industry to deny you of one of the most basic necessity- access to Health Care.

Besides, FICO score, Genome, DNA direct and the likes provide negative reinforcement to the average patient, who is already aware that he/she is failing in many more of these scores like BMI, Lipid panel, Hemoglobin A1C etc. To bring the change is so overwhelming for a patient that he gives up and spirals down to poor health.

In this Health2.0 generation we need to approach this with a disruption. Empowering patients with self care attitude and developing a happiness index as a score. This might ease out the stress of ’stress management’. This needs to parallel the example of healthy unconditional parenting where bribes or time-outs have a limited role and making the ‘right decision’ itself is the incentive.

So before we bring out these FICO scores to the table please think what really works for you.

The patient’s advocate,

Archana Dubey, MD