Posts Tagged ‘Medicare’

The Great Money Shift

July 8, 2009

Primary Care Physicians (PCPs) are getting a pay raise! That’s great news, they certainly deserve it. But it’s not new money – we really can’t afford to put much more in the Medicaid/Medicare system – the government is re-shuffling the deck. Increases in one area means cuts in another, and Cardiologists are among those taking the hit this time. The American College of Cardiology… as you can expect, they aren’t happy campers.

But what is the answer? I’m not smart enough to know. I think that whatever the answer is, it’s gonna hurt – and that is the last thing that politicians want to do. But given the choice, I’d rather take some pain now than the hurting thats going to happen when Medicare/Medicaid payments outrun the national economy. We haven’t seen that kind of pain.

Work It!

June 4, 2009

There really shouldn’t be any doubt about it – if you have a chronic illness such as a heart defect, you have got to take care of yourself. Obtaining health insurance is difficult if not impossible – yet we are the ones who need it, as we’ll need doctor’s appointments and prescription medication more often than most people. Public assistance (Medicare or Medicaid here in the United States) is available, but both programs make you jump through bureaucratic hoops and limit the amount of pay you can earn. Most CHDers I know have bum hearts but sharp brains, and we’d rather not go that route.

One of the best things you can do for yourself is exercise: you’ll feel better, and hopefully you’ll be able to hold the doctor at bay for a little longer. You usually can’t weight – lift yourself off of your medicines, but improve your health and the doctor might not need to see you nearly as often. After I went into heart failure and then had a stroke, my cardiologist wanted to see me once a month for eight months – That’s the cost of gas to from my home to Atlanta and back (about 500 miles one way), meals, and a hotel room every 30 days. It adds up.

So do what you can to take care of yourself. First of all, discuss your exercise options with your doctor. If you propose to start walking, he’ll probably be cool with that. If you want to climb Mount Everest… I doubt he’ll agree!

As you may know, I walk. I would have loved to have walked the Bolder Boulder, but my cardiologist had said “No.” because of the altitude, and I followed his advice.  A good brisk walk that gets your heart rate up is a great thing. It gives you time to sort through your problems and make important decisions. It also gives you a natural high, a sense of feeling good and actually doing something to help yourself. And recent research has shown that feeling lasts a lot longer than you might think – even though you don’t “feel” it, your body is supercharged! Obesity and Diabetes make a case of heart failure worse, so it stands to reason that if you are susceptible to heart failure, avoid the other two. Exercise can reduce your risk of both conditions.

So go for a walk. Play in the neighborhood. Put some music on the stereo and dance around the house – I promise I won’t laugh, I can’t dance either! Just do something. Just get up and start taking care of yourself!

Do yourself a favor and move those muscles;

“Like sands through the hourglass…

December 4, 2008

… so are the days of our lives.”

Ever notice that the sand in the hourglass on the daytime show Days of our Lives never runs out? It just keeps going forever and ever and ever…

To bad it has nothing to do with reality. There was a very alarming report in the Boston Globe that states the bad economy could drain Medicare part A pretty quick. When that money runs out… it’s gonna get nasty. Doctors are already upset; the government is running them out of business. Some doctors are doing their own laundry to save money and others can’t afford to replenish their drug supplies. It’s getting scary out there, folks.

If I were a doctor I’d probably be looking for something else to do. Some of them are, and others are changing their mind about going into medicine in the first place. The Association of American Medical Colleges (AAMC) recently did a study that showed the numbers are dropping as the demand is rising. Massachusetts is already getting slammed. The Canadian system isn’t the answer, either. USA Medicine is ahead in technology, but the men and women of the Maple Leaf have better office systems. An alliance is looking pretty good right about now.

Dr. Wes bemoans the fact that healthcare costs are climbing more than inflation. Health Insurers are willing to forget about pre-existing conditions (Yay!) and insure everyone if the Government does certain things. (Now wait a minute… where’s the money coming from?) And whatever happened to all that savings that was supposed to occur if we switched to generic drugs?

We need to close the bar and then check ourselves into rehab.

For these links we give thanks

November 26, 2008

Just in case you didn’t know, helicopters don’t glide very well. There have been a rash of medical helicopter crashes lately, which makes some people wonder if they are used too often. This issue is being investigated, and the use of air ambulances is down. So either the number of serious illness and injuries are down (doubtful) or the choppers are flying less. Hmm… why would anyone call for an airlift when it wasn’t needed?

Don’t go here for your medical information, they’ll scare you half to death. And don’t always believe these guys. And if you are looking for drug information, don’t look here. Check out Medscape instead. It’s FREE, and Medscape has a much better drug reference page.

Dr. Wes’ brother asks “Hey, you wanna see an operation?” If you want to see an operation (double bypass heart surgery) click this link. WARNING: The blood is real, and the bone saw is pretty loud.

Laurie smells a familiar smell on a subway car and it takes her back… to an unpleasant place.

Got Heart Failure? Then work it, baby!

I think I know why he is the Happy Hospitalist… he leaves all his frustrations on his blog. Here, Happy tells the story of the guy who thinks that free = more. I’ll take an eye exam, and a rotator cuff repair, with a side order of dental. Oh, and clean out my earwax, too; someone else is paying for it! The costs add up – an implantable defibrillator costs almost as much as some people make in a year. And when you consider this, you realize that our financial situation is just going to get worse. Pay off those credit cards, folks!

Maybe they’ll let us use a spider as payment.

Sometimes though, especially around the holidays, what we really need is a friend.

It’s almost Thanksgiving Day, and I’m spending Thursday with the family. Friday, a friend and I were supposed to just have lunch together, but she has the entire day off! So I’ll be away most of Friday, too. Have a safe, happy, and wonderful Thanksgiving; and remember to be kind to your fellow man and your four legged friends.

And don’t forget, Saturday is Red and Blue Day!

Always yours;

Steve

The Funky Heart

Night of the Living Link

November 23, 2008

My new phone arrived this week! Thankfully, I didn’t pay that price for it, every now and again it pays to “know someone who knows someone.” Before I can even think about updating Funky Heart from the road, I’ve got to get all the internet settings right, and that hasn’t happened yet. This replaces a phone that is 10+ years old, so I’m going to be playing catch-up for a while. It’s about as frustrating as being the Commander of the space shuttle and not being able to find the ENGINE START switch!

I’m also frustrated by the fact that there have seemed to be a lot of good links for you this week, but when I click through to read the article, most of them are subscription sites. *sigh* I’ve still been able to put together some good ones, though.

Beware the Transplant surgeon who will “adjust” the statistics. And kudos to the retired hero, who strapped on his guns one more time to restore order.

Patient attacks four nurses. Nurse/Victim/Witness testifies in court and tells the Truth, The Whole Truth, and Nothing But the Truth, so help her God. The Victim Impact Statement was a real party, too: “Mr. Jailbird’s attorney stood up and started screaming something about HIPAA. The judge told her to sit down and to be quiet.

Important Safety Tip: No Porn after Heart Surgery!

Another casualty of Hurricane Ike. Sad.

The Feds are pressing doctors who accept Medicare to get with the program on Electronic Medical Records. There is even a pilot program in two states – a program with a potentially HUGE flaw. And don’t think that something bad can’t happen.

Fast food chains in the United Kingdom promise to improve their menus. Hey guys… what about us?

“The time has come to speak of many things.”

November 14, 2008

Katie’s father continues to write on her website, working through his emotions at this trying time. He’s a really good writer! I’m sure he’s not writing for style or content, but he’s very eloquent.

While not concerning Congenital Heart Defects, this is important information to have in case of a heart attack: Find out if a hospital in your area supports the STEMI protocol, and try to find out their Door to Balloon time. Then contact the organization in charge of Ambulance Services in your area and find out if and how their vehicles and First Responders are coordinated with STEMI. During a heart attack, time is muscle – the longer it takes to get quality care, the worse the damage to the heart. A properly organized STEMI response can cut that time. Here’s a good example of STEMI in action: Ambulance dispatched: 8:07; Catherization Balloon inflated: 9:08. Another example is provided by Elaine, a brand new nurse who sees a STEMI developing in the ER. The STEMI system isn’t perfect, but it is a good start. CHDer’s usually don’t have “traditional” heart attacks, but it is good to know this information, just in case a friend or family member has one.

How to help prevent medical mistakes. Also, ten questions you should ask about your scheduled surgery.

If you see an elf, blast ‘im! (Link from The LawDog Files. The title of his blog always reminds of the classic line from the movie Tombstone.)

Gene therapy for Congestive Heart Failure (CHF)! If that doesn’t work, perhaps a gas will. (Careful of that gas, though! This is not a Do-It-Yourself treatment!)

This will be great – a pacemaker powered by the heart itself! Here’s a photo. And here’s Georgia Tech’s version.

Just in case you haven’t figured it out, we’re spending a lot of money on health care for chronic diseases. How much? TOO much – just read question 1. More than half of us can’t afford what we need, but a lot of that money could be saved… both in the private sector and in Medicare costs. New MRI scanners and CT scanners add a LOT to total Medicare costs – and that’s not installation costs.

There are two ways to cut your heart attack risk – take Crestor, which cuts your heart attack risk 44% (and costs a pretty penny) or get up off your butt, lay down the smokes, and take care of yourself! Exercise even helps Congestive Heart Failure (CHF) patients, who usually show up in the Cardiologist’s office so much, we qualify for frequent flyer miles. The problem is, given a choice between taking a pill (and perhaps having someone else pay for it) and taking care of ourselves, a lot of Americans would take the easy way out. And that little fact is making The Happy Hospitalist have a 100% officially certified BAD DAY.

I tend to agree with him.


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