Healthcare Gal

Foundation for Growth

Invest in fundamentals and growth to move forward

Scarcity mindset is toxic to you and companies. It is a result of something lacking in your life that causes you to do things for short term relief rather than taking actions that provide long term benefit.

I had several exchanges with colleagues recently and scarcity mindset came up in every exchange whether the topic was foreign investment or potential business partners taking information for their own gain. When people feel their job or survival is threatened they tend to protect their turf with short sited decisions.

It’s hard to make any meaningful progress in business when people are protecting their turf because it limits their ability to think creatively and resourcefully. People need a certain level of support to shift their mindset to growth. It’s why leading edge companies provide employees with continual learning opportunities and benefits that support health and wellbeing.

Processes will be automated and jobs will be eliminated. As leaders we need to be thinking ahead, making investments in people and supporting their transition in the workforce. There is always something better when people can imagine their role in a brighter future.

Reframing mistakes, screw ups and failure all have a seemingly negative impact but they are not all the same and shouldn’t be treated the same way.

Screw Ups are just simple mistakes that happen even though you normally get whatever it is right. Don’t beat yourself up over a screw up. Just make amends and move on.

Failure is a necessary part of growth. If you try something new and it doesn’t work as expected, don’t get caught up in negative self talk. Grow from the experience and achieve something even better.

Representation matters. You might not agree with what was done in the past but when you see opportunity, you can change the future.

A few years ago, colleagues questioned my decision to work with a certain client. Admittedly, that client operated with business practices that were definitely questionable in terms of ethics, but that were not illegal. I had even struggled with the decision at the time because the practices didn’t fit with my own moral code of conduct and later wondered if I made a mistake.

However, watching the interview with Bozoma Saint John, Chief Brand Officer for Uber her words confirmed for me that I made the right decision. Accepting the client didn’t mean that I condoned their past business practices. Rather I saw the opportunity at the time to move the client forward in a way that created a win for everyone.

Some health plans have been developing narrow networks that are economically credentialing some providers out of their networks for past behaviors. Unfortunately, no one really wins with that strategy because patients value choice and penalizing providers usually forces more consolidation which drives up the cost of healthcare.

No one can change the past. We have to look for the opportunities to correct past wrongs and move forward in a way that serves everyone’s best interests.

You don’t have to cheat to win. Healthcare is a tough business but investments in the fundamentals pay off over time and ready your organization for the future.

1. Market Assessment: Assess your value to the patient population you serve in terms of the 3 P’s of marketing: product [your service], place and price.

2. Invest in your People: Too often healthcare companies only provide required training to professionals. They forget that every single person within the organization affects the overall patient experience. Leading edge companies that routinely invest in their people perform 45% better than their competitors.

3. Automate all Routine Processing: Streamlining and automating processes increases accuracy, increases cash flow and enhances the experience for healthcare consumers [patients] by giving them more control. Training investments make it easier for people to transition up or out of the organization when the time comes.

4. Manage your Contracts: Use data from your market assessment to negotiate ‘fair value” rates with commercial payers and mange those contracts. 3–5% annual increases may not seem like much but when you compound it over time, it adds up.

Laying the foundation takes some upfront work and investment but the pay off is long term financial success.

More change ahead is likely as patients demand more transparency and become sophisticated healthcare consumers.

Reference pricing offers way to engage healthcare consumers that allows for more choice and full access to providers. What is it?

The allowed amount for a specific service is limited to a defined contribution or in other words, a flat amount for a specific service. If a more expensive provider is chosen, the employee/patient has to pay the difference. The employee receives the full benefit when treated by low cost providers.

A reference price gives employees/patients more control over the entire experience in terms of their providers [facility and physicians], setting, implants, drugs etc. which is what most people want. The challenge is the lack of pricing transparency.

The prices available to most patients now are estimates based on historical claims data. The data fails to reflect real time market changes resulting from consolidation, new contracts and new technology or services. The only way to get accurate prices is from the providers involved and the health plan contracts with those providers.

We have standard transaction sets for authorization and claims submission but for some reason we’re not using them to facilitate estimates. The question is why not? Current revenue cycle costs exceed $52 Billion annually and do little to serve the healthcare consumer.

Collection Risk is a real problem for healthcare providers especially when patients are underinsured. Who should pay for the collection risk?

Policy benefits are assigned to the provider when care is provided. Assignment of benefit was meant to protect the provider from patients who fail to remit insurance payments made for their care.

The problem now is that providers may or may not get paid even when they have been assigned the benefits. In many cases, the first dollars under many policies are now due from the patient not the commercial payer.

There are new solutions to help providers collect from patients but it’s adding more time and effort to the process. Many small retailers cringe at the thought of a credit card transaction fee which is a drop in the bucket compared to the cost of collection in healthcare. Even with the new tools and increased effort, collection risk is increasing because patients don’t have the money to pay or just don’t pay.

Should insurers selling the policies and/or companies providing the policies be required to reinsure the underinsured? Technology being used to help people select policies can probably also predict the reinsurance need. So should premium dollars be set aside to cover the collection risk?

Gravity Problems: Watching “ObamaCare” twist in the political winds has not been easy especially for those directly impacted by the changes.

I have started reading a new book called Designing your Life. It breaks life down into 4 aspects: Work, Play, Love and Health and uses a metering like system to help you evaluate what areas are working and what areas need improvement. I like the simplicity of the framework.

One idea that has stuck with me is “gravity problems” and the fact that you can’t change gravity. You have to work with gravity or work around it to achieve whatever it is that you want. Gravity problems can be environmental, circumstance related or even political.

So tackle the problems that you can solve, change your tact on some and prepare for others that are likely in the future.

Innovation: Companies that want to innovate and perform better need to accept that failure is part of the process. The learnings are as valuable as the result if you allow people to harness the insights into doing or creating something better.

Not everyone is prepared or willing to take on the risk to chart a new path or create a new product. So people willing to take the risk should be rewarded not punished when they fail especially when they can explain and act on their learnings.

Innovation is about experiments. The very nature of experiment is about trial and error. The concept of innovation gets lost when people make huge bets that don’t pan out. Don’t make a huge bet until you know what works.

Subscribe to get the latest developments in healthcare and/or follow us on Facebook or Medium [@healthcarestrategist] or LinkedIn.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

Join us on Hello Workout for help covering the weekly minimum requirements for good health, telehealth appointments with Sports Medicine experts and other tips to help you achieve more success in work and life.

Fair Price for Healthcare

Getting a fair price for healthcare is tricky because it’s not an apples to apples comparison.

Benefit season is starting soon. I’ve compiled some of my recent posts to help you get your arms around the latest strategies being offered to establish a fair price for healthcare services and to help you manage your total cost of healthcare.

Charges [aka List Price]:

Healthcare charges still seem to be a bit of a mystery to everyone. So let me start by explaining how most providers develop their list price and why.

The charge for most services in healthcare is based on a multiple of the Medicare fee schedule — at least initially. There are so many billing codes that it would be really hard for providers to keep up with the cost of each one which is why most base their charges on Medicare.

The tricky part is the multiple because every payer has their own methodology for payment. To capture the full amount due, the provider has to establish a charge that is sufficient to capture any outlier payer. Unfortunately, the multiple [aka: the markup] can make the charges seem unreasonable.

The charge for new services usually captures part of the cost savings so that providers are incentivized to adopt new technology. It helps them cover the cost of doing so. The charge and the price [contracted rates] consumers pay usually go down over time assuming the provider updates their chargemaster.

Then there are what I will refer to as the “fraudsters” who will keep increasing their charges to capture more and more from insurers as benefit loopholes close, such as out-of-network coverage. Their charges defy all logic and unfortunately, create an aura of mistrust.

Tip: The best way to protect yourself from fraudsters is to ask for an detailed estimate prior to service. Have them explain it to you.

Ambulatory Surgery Centers (ASCs):

ASCs offer a lower cost alternative to hospital based services and are a good option for surgeries and other service for the low acuity population. For those with increased medical risks [obesity, heart disease etc.] hospitals are a safer option.

The Ambulatory Surgery Center (ASC) industry grew rapidly from 2000–2008 largely because it provided surgeons a way to make more money from something they already do. It also gave them more say in and in some cases, more control over their work environment in terms of support staff, supplies and business practices.

Unfortunately, many were more focused on making a fast buck from the out-of-network strategy [aka: fraudsters] rather than providing an efficient service to lower the cost of healthcare. That’s changing.

Economical Credentialing and Narrow Networks:

Some health plans have been developing narrow networks that are economically credentialing some providers [aka: the fraudsters] out of their networks for past behaviors. It’s one way to lower cost but many not be a win for those that value choice.

Unfortunately, penalizing providers usually forces more consolidation which drives up price. Many ASCs are being sold to hospitals and healthcare systems that have more leverage with the payers to negotiate higher prices for their services. Pricing transparency tools that use historical claims data may not reflect the new higher prices.

Bundled Payments:

Bundled payments are catching on as a new reimbursement model in healthcare but not all bundles are the same.

Bundles are a flat fee paid to a healthcare provider for a full episode of care. By limiting the payment, it forces the provider to reduce the cost of care for the defined service and guarantee a certain outcome.

If you’re considering using bundles as a way to control your healthcare costs, there are several questions that you should be asking, such as:

1. Who are the providers included in the network? Not all providers are included in every network or selected the the same way.

2. What is the scope of service included? The services and amount of service included in the flat rate will vary bundle-to-bundle.

3. How is a quality outcome defined? Is the patient returned to pre-injury condition or returned to a basic ambulatory state or returned to work?

4. How much control do employees/patients get? Can they select all their providers or just some, the location, the time, the supplies and implants used or is that the tradeoff for a lower cost?

5. What is the expected cost savings over standard contracted rates? What level of savings makes it worth it to you?

Understand what you’re getting and trading off for a lower cost of healthcare. Bundles can pose problems is they are not Administered well because there are always some who will game the system. You have to think through these deals carefully.

Change is Hard Won

Changing the healthcare system takes time. Everyone needs to do their part to lower the cost of healthcare.

1. Healthcare Consumers: Many Americans don’t change their unhealthy habits until they have a major life event like a heart attack, cancer scare or some other health related crisis. The cost of all those unhealthy habits plus the life events drive up healthcare costs for everyone and no one wants to foot the bill.

2. Healthcare Providers: Healthcare providers don’t change until there is a financial benefit for doing so. Many providers didn’t adopt technology that costs maybe 1–2% of their revenue until the government incentivized them to do it. Why? Because they were focused on their top line rather than their bottom line.

3. Health Plans: Health Insurers don’t change their coverage and payment practices until they understand how something impacts their medical loss ratio. Untimely payment decisions make it hard for providers to change how they serve and delight patients. As you know, not many people are willing to work for free.

There are no silver bullets to fix healthcare. Americans need to take a good look in the mirror and own their part, providers need to focus more on the bottom line and insurers need to do more timely financial modeling to fix the incentives for providers.

Subscribe to get the latest developments in healthcare and/or follow us on Facebook or Medium [@healthcarestrategist] or LinkedIn.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

Join us on Hello Workout for help covering the weekly minimum requirements for good health, telehealth appointments with Sports Medicine experts and other tips to help you achieve more success in work and life.

Moral Obligation?

Is it a moral obligation to provide healthcare to all Americans – or not?

That is the question that as Americans we need to answer. It’s clear now that many voters did not understand that it was the question they needed to answer for themselves before voting to “repeal and replace ObamaCare” when voting for Trump. In fact, Trump himself may not have even understood that given his comment about the Republican healthcare bill being “mean”.

If you haven’t been following the development of the latest Republican healthcare bill, here is a simple explanation of the differences between ObamaCare and TrumpCare. You’ll get a good idea how it affects you as well as why at least some consider the policy to be mean.

The policy problem became crystal clear to me this week when I listened to an interview given by the former CEO of Aetna. He spoke briefly about how ObamaCare is based on incompatible policies. On the one hand, the Democrats wanting to provide everyone with “good insurance” similar to the policies provided to our elected officials. On the other hand, the Republicans wanting everyone to behave as healthcare consumers which is a cornerstone of their free market economic philosophy.

The Republican policies already in ObamaCare are the marketplaces created to sell health insurance, the high deductibles to ensure individuals have more “skin in the game” [that means more money from their own pockets], the marketplaces to sell healthcare services and enable “shopping” etc. Many of these consumer initiatives have failed to engage Americans as healthcare consumers or reduce total healthcare spending. That’s essentially why we are having the healthcare debate all over again.

What’s different about TrumpCare now?

The changes in coverage requirements for employers, the penalties for not having insurance and coverage reductions for pre-existing conditions. Forcing people to pay for something that doesn’t meet their needs is a tax.

From my perspective it is time to start calling it a tax and treat it as such especially if you believe healthcare is a moral obligation. There are more costs that can be rung out of the healthcare industry if we simplify it.

Single Payer

What I have also discovered recently is that many Americans don’t understand what a Single Payer system is or how it could help them. We don’t need to look to Canada or elsewhere for a good example. Our best example is Medicare. A lot of thought and work goes into that program and in many respects it is used by the private sector as a coverage and payment framework. The core of Medicare has 2 parts: Medicare Part A (Hospital Coverage) and Medicare Part B (Medical Coverage). Part A is covered with tax dollars and Part B is paid with premiums.

A national framework similar to Medicare that is paid with a blend of tax dollars for medically necessary services [i.e. no Viagra coverage] and premiums for services that increase quality of life [i.e. Viagra coverage] would work for Americans and the healthcare industry. People are being needlessly scared by the thought of rationing and long lines for healthcare if America moves to a single payer system.

Why now?

A single payer system is the one change that can make the biggest impact for Americans now. It would give all Americans peace of mind that they will be cared for when they are injured or sick.

Basic Income

Silicon Valley leaders are recognizing the need to provide people with a “basic income” as more jobs are automated. Basic income means that industry leaders are expecting more Americans to drop in socioeconomic class. The working class [low and middle income Americans] will be impacted the most by the Republican healthcare bill. So over time it could mean that even more Americans may not have healthcare coverage or access to healthcare services.

Hospitals are required to stabilize everyone who enter their doors regardless of their ability to pay and often in good conscious provide more service than that now. If there is not enough people who can pay, the cost goes up for those who can pay or those who can’t pay go without. That’s the reality of a free market system.

Pricing Regulation

California AB 72 has been signed into law. It limits the amount patients can be billed when treated by a non-contracted provider in a contracted facility.

For example: Let’s say you have surgery at your local hospital. Your surgeon and the hospital is in your health plan’s network. The fees are reasonable for the services being provided because they are discounted to the contracted rates. However, after services are provided you discover the anesthesiologist was not in-network. Now, unless the anesthesiologist has made an agreement with you prior to service, your liability will be limited to an estimate of a contracted rate. The bill limits the total amount due from you and your health plan to the greater of the average contracted rate or 125% of the Medicare fee schedule.

For healthcare providers, it impairs their ability to negotiate contract rates that reflect the “fair market value” of their services. It’s effectively like a company adopting a pay scale that has no exceptions for knowledge, skill, experience and performance. Everyone gets the same pay. That’s a step toward developing a single payer system.

Medical Risk

I attended a Designing for Behavior Change event recently. The one statistic presented that really shocked me was that 90% of the people at risk for chronic health conditions like heart disease and diabetes related to obesity don’t know it. One third [33.3%] of the American population is obese which means their BMI > 30. How is that possible after having an increased focus on wellness? It makes you wonder what exactly gets communicated to patients about their health status.

I have spoken with clinicians [doctors and nurses] as well as health plan administrators and most have little faith that they can change the obesity trend. Most feel that their words of warning are falling on deaf ears. It’s sad because when you combine that trend with America’s aging population Medical Risk has the potential to skyrocket.

That’s probably why budget conscious Republicans [also referred to as the far right] want to pull back on Medicaid funding and why we all as Americans need to make the decision about whether healthcare is a moral obligation or not. All of us — even those currently covered by employer based insurance — will be directly impacted by your decision.

Subscribe for Healthcare Gal posts to get your arms around healthcare in America and/or Follow Healthcare Gal on Facebook.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

Join us on Hello Workout for help covering the weekly minimum requirements for good health, telehealth appointments with Sports Medicine experts and other tips to help you achieve more success in work and life.

 

New Healthcare Services

New healthcare services that are user-friendly and cost effective for when you’re in pain.

Judging whether a medical issue is “emergency room worthy” isn’t always easy. A bad tummy ache could be gas or something more urgent such as appendicitis. Your pain level is usually a pretty good indicator of whether it’s something that needs immediate medical attention or a home remedy. If your pain level is off the charts, it’s best to go to your local emergency room and get checked out. It may cost a pretty penny or two but it’s better to be safe than sorry. If your pain level is tolerable, you’ve got some time to triage your situation.

Now there are several new healthcare services available to you that are user-friendly and cost-effective.

Telehealth

Rather than calling your mom for advice or searching the web for answers, you can now chat with a licensed physician on demand via phone, teleconference or a mobile app about your medical issue and get professional advice on what to do next. The cost runs about $50 per appointment and may be covered by your insurance.

If you’re new to working out, a weekend warrior or an athlete, having on demand access to a Sports Medicine physician is not a bad idea. Chances are you will have more aches and pains than the average person. It’s good to know what’s causing the issue and whether it’s something that needs medical attention, modification or just recovery time. Injury prevention is key to improving performance and your health.

Home Visit

Physicians are making house calls again. If you or someone you love has a medical condition that makes it difficult to leave the house than a home visit might be just the ticket. Home health visits for people who are older, handicapped and/or really sick are usually covered by Medicare and/or Medicaid.

Cheer up if you’re too young and healthy to qualify for home health! There are also concierge services offering house calls for anyone feeling too sick to get out of bed [think bad cough or flu] or too busy to squeeze in a check up or annual flu shot. The cost runs about $99 which is about the same as an office visit and may be covered by your insurance.

Urgent Care

Urgent care centers are popping up in every neighborhood and are a great resource to help you rule out more serious medical issues or confirm a potential diagnosis. Rapid tests, exams and x-rays are performed on the spot to help diagnosis contagious things like strep throat and pink eye, evaluate tummy and chest pain and test for and splint broken bones. From there, healthcare professionals will direct you for any needed follow up care. The base cost starts at $250 and goes up with each test, exam, x-ray and/or service performed.

Now you know when and how to use the new healthcare services and roughly how much they will cost. The exact prices depends on who owns and operates the services, geographical location and whether or not discounts are offered by insurers and to patients who pay at time of service.

 

Subscribe for Healthcare Gal posts to get your arms around healthcare in America and/or Follow Healthcare Gal on Facebook.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

Join us on Hello Workout for help covering the weekly minimum requirements for good health, telehealth appointments with Sports Medicine experts and other tips to help you achieve more success in work and life.

Save on Healthcare

Shopping for healthcare takes a little research and know how but there is real money to be saved.

No one likes to pay more than they have to for anything.

Did you know you can buy car parts on Amazon? I didn’t until someone broke one of my tail lights and it looked like an easy DIY [Do It Yourself] project. I was able to find the exact part and as a Prime member got it shipped to me FREE. It was so easy that I couldn’t help but do a little more shopping.

Why am I telling you about shopping for car parts?

No one ever pegged me as someone who would buy car parts or attempt a DIY project on my car. Like many people, I have a trusted relationship with my mechanic and whatever repairs he recommends, I approve and pay him to do.

Similarly many Americans put their full trust in their doctors and approve their recommendations regardless of cost. However, that could change. My DIY project wasn’t as easy as it looked on YouTube. After breaking 3 finger nails and 2 screw drivers, I gave up and made an appointment with my mechanic. While there I decided to have a few more minor repairs done. This time I was speechless when I saw the quote. My mechanic quoted me 4 times [4x] the cost for the parts. How do I know? I remembered seeing the parts on Amazon.

A 4x markup is comparable to the markup routinely charged on high dollar supplies and implants in healthcare. The difference is healthcare consumers only pay a small portion of the marked up cost after the insurance discount and payment. I didn’t say anything to my mechanic at the time, but it made me realize that pricing transparency is a game changer.

Amazon for healthcare

Amazon has already announced plans to start selling prescription drugs. It’s going to take some work before they are ready to fill their first prescription but when they do, it could be a big cost saver for many Americans. There is currently no way to compare the cost of drugs at different pharmacies or covered by different health plans. Amazon could make it as easy as shopping for car parts by providing a marketplace for pharmaceutical companies.

Amazon already sells medical supplies.

Imagine how surprised my mechanic was when I drove into his garage with a trunk filled with parts. I had also purchased new lenses and seals to replace my cloudy headlight covers and was surprised when my mechanic refused to do the work. What I didn’t understand when purchasing the lenses was that changing only the lens would impair the integrity of the light and cause bigger problems later. He recommended a body shop if I absolutely wanted to do it. His refusal to do the repair requested may have been upsetting for some, but for me it spoke to his integrity as a trusted advisor. I returned the lenses and seals.

Can you see that scenario playing out if healthcare consumers start buying their own supplies and implants? Using the Amazon filters to narrow the options that are right for your make and model of car is easy enough but the process is still lacking the intelligence and judgement that you get from a highly trained professional. Let’s try not to imagine a medical DIY project guided by a YouTube video for now.

Amazon-like services available now

Pharmacy:

There are online pharmacies available now. If you do plan to purchase your prescription drugs make sure you buy from one of the Verified Internet Pharmacy Practice Sites [VIPPS] otherwise you might not get a quality drug. To save money now, talk with your doctors about generics and bio-similar drugs that can save you money and ensure you get the right medication. You may also be able to qualify for patient assistance from a pharmaceutical company.

Healthcare Services:

There are also web-sites that can give you “fair prices” for healthcare services including surgery. Fair prices are generated from historical claims data collected from participating companies, providers and payers.

Healthcare Bluebook is one of the sites available to consumers FREE and a good place to start your shopping. If you use the site, be sure to enter your Zip Code to get the prices for healthcare services offered near you and click on the Details to learn what’s included in the price. For surgery, the fair price on Healthcare Bluebook includes the fees for the facility [hospital or Ambulatory Surgery Center], surgeon and anesthesiologist plus all the supplies and implants. When the fees of different service providers are included in one price, it’s referred to as a bundle.

If you call a hospital or an ASC for a quote, ask them for a bundled price too. Chances are they have one that could save you money and make it easier for you to get your arms around the total cost and the billing.

Labs:

You can also order many of your own lab tests through HealthcheckUSA.com or Quest Diagnostics to check your cholesterol, diabetes, colon cancer, prostate etc. without a physician order. The rates are comparable to cash rates which are often significantly less than the full price because the labs get their money from you at time of service.

Subscribe for Healthcare Gal posts to get your arms around healthcare in America and/or Follow Healthcare Gal on Facebook.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

Join us on Hello Workout for help covering the weekly minimum requirements for good health, advice from professionals and other tips to help you achieve more success in work and life.

 

 

 

TrumpCare?

Success of TrumpCare depends largely on whether or not Americans have sufficient disposable income to purchase enough insurance and needed healthcare.

As many of you know, the healthcare industry is going through more changes. Americans like the parts of ObamaCare that gave them more protections for pre-existing conditions and extended coverage for their adult children. What they didn’t like was the cost of comprehensive coverage. Some Americans paid more for richer benefits that they may or may not have needed, while others benefitted from subsidized insurance that enabled them to get needed healthcare. Unfortunately, repealing ObamaCare also means repealing the subsidies that were largely funded with new tax dollars [3.8% investment tax] levied on wealthy Americans.

Going forward cost and coverage are the two variables that you need to keep in mind when choosing health insurance. More insurance options that trade off coverage for a lower cost are likely under TrumpCare. Less healthcare coverage is not bad but Americans will need to read the fine print closely to understand what they are buying. In choosing a policy, everyone will need to consider their savings, disposable income and health status.

If you’ve never had health issues, it might be hard to imagine scenarios when you would need healthcare insurance. It’s like purchasing a new car. You don’t expect repair bills beyond scheduled maintenance unless you have an accident. Unfortunately, accidents do happen. Imagine catching your pointy toe shoe in your pant leg and doing a high diving off the curb onto the street. Speaking from experience, there is a good chance that you’ll crack and/or break a bone or two. One accident like that can get you well on your way to meeting your Out-of-Pocket Maximum for the year. As you would expect, the repair bills for your car become more frequent and get bigger each year – same with your healthcare costs. Brand [genetics], mileage [lifestyle] and adherence to scheduled maintenance [check ups] affect the total cost of the annual repair bills.

You will also likely be paying more out-of-pocket for healthcare. To help you pay for health insurance, TrumpCare will likely provide tax credits for health insurance purchased rather than subsidies and help you save for qualified medical expenses by increasing the annual saving limit for healthcare savings accounts [HSA] so that you can save more tax free. To help Americans spend wisely, the cost of healthcare services are becoming more transparent and the billing easier for the average consumer to understand.

Some Americans value paying more for the peace of mind of having richer benefits or what some think of as “prepaid healthcare” while others skimp on coverage choosing a high deductible or catastrophic policy and pay more out of pocket. Whatever you choose to buy is fine as long as it gives you enough insurance coverage. Just don’t buy the cheapest insurance policy and expect it to cover everything. If you do, you might want to sharpen your “Go Fund Me” campaign skills.

Subscribe for Healthcare Gal posts to get your arms around healthcare in America and Like Healthcare Gal on Facebook.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

Join us on Hello Workout for help covering the weekly minimum requirements for good health, advice from professionals and other tips to help you achieve more success in work and life.

Intro to Healthcare Gal

We’ve started a new Facebook page called Healthcare Gal to help Americans get their arms around healthcare and the policy changes underway. Anything political runs the risk of inflaming emotions and causing outbursts. Our goal is to only share facts based on our readings and knowledge of the healthcare gained from 20+ years of working in the industry.

We’ve dusted off some of our characters created for the online training courses we did for the healthcare industry years ago to keep things light. The posts will be incorporated into the Rush 360 site soon. Here are a few posts from the week to get you up to speed on Healthcare Gal.

The Budget

The proposed TrumpCare got it’s origins from Speaker Ryan’s budget in 2011 called The Path to Prosperity. The problem was that the budget didn’t really promise prosperity to the old, poor or sick. Obama publicly shamed Ryan for rewarding the rich with tax cuts while taking healthcare away from those who need it most. Ryan’s budget called for “fixing” Medicare with a voucher system which would enable senior citizen to purchase their own healthcare. It’s no wonder Trump steered away from changes to Medicare during his campaign. The battle of TrumpCare vs. ObamaCare wages on with more tax cuts for the wealthiest Americans and less healthcare for the poor and sick. TrumpCare calls for tax cuts for the wealthiest Americans, block grants to the states to provide some Medicaid coverage and repealing of the ObamaCare Medicaid expansion. You have to wonder how much money one person really needs. Reportedly, the top 25 hedge fund managers are having a hard time getting by on $600 million/year.

Lunch vs. Healthcare

“What is wrong with you?” recently spoken by Michelle Obama in relation to Trump’s school lunch program. The healthy lunch program established to curb childhood obesity costs about $12 Billion/year. Good food costs more than junk but is worth it. The current cost to treat diabetes in America is $250 Billion/year. Geisinger Health started providing fresh fruits and vegetables to low income patients suffering with diabetes. The trial participants ate better, lost weight and reduced their symptoms related to diabetes. Not surprisingly, eating better food lowers healthcare costs. So you have to wonder, why our current administration would turn down a potential 20x ROI on the school lunch program? It’s not entirely clear but at least some of the billionaire Libertarians [i.e. Mars Candy Clan] reap the financial rewards if Americans keep eating junk food.

The Wall vs. America’s Drug Problem

Building a wall on the US/Mexico border may not be a cure all for America’s drug problem. As of 2013, 10% of the US population 12 years of age and older are using illicit drugs. Of which 7.5% of the population is using marijuana. As of 2017, nine (9) states have legalized it. Legalization of Marijuana makes it impossible to cut off supply. While not as deadly as other illicit drugs, healthcare experts are already seeing the negative impact on newborn health.

The remaining 2.5% is using other drugs, including prescription drugs for non-medical reasons and heroin. Prescriptions for opioids is up despite no change in reported pain levels which means physicians are overprescribing pain medications. Heroin use stems from prescription drug use and is becoming the drug of choice because it is comparatively cheaper and easier to get with the increased supply coming across the US/Mexico border.

It’s clear that we need to cut off the supply to fix the drug problem in America. However, the main problem seems to be within our borders. American tax dollars may be better spent fixing the prescription problem in healthcare, making public health ads to address the appropriate use of marijuana and cracking down on casinos that launder drug money.

The Climate and Our Health

The Climategate Scandal was funded by the foundations of billionaire Libertarian Koch, Bradley, Olin and Scaife to protect their own financial interests. Michael Mann, the scientist in question, was exonerated by the Inspector General of the National Science Foundation, which is the highest scientific body in the United States. The integrity of his work proving the genuine danger posed by climate change confirmed. The same billionaire Libertarian group continued to threaten and discredit other Republicans who tried to move legislation to curb global warming forward.

Check the Facts

Don’t believe everything you hear….these are just a few of the organizations funded by billionaire libertarians and other Republicans to spread falsehoods about “ObamaCare”, climate change and more.
– Center to Protect Patient Rights (CPPR)
– Americans for Prosperity Foundation
– Coalition to Protect Patient Rights
– Institute for Liberty
– Patients United Now
– Americans for Prosperity and FreedomWork

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About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

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