Near universal health coverage achieved in six states and DC

An article by Michael Rainey of The Fiscal Times (see link below), called “How six states achieved near universal coverage” noted the success of covering at least 95% of their people. These six states are Hawaii, Iowa, Massachusetts, Minnesota, Rhode Island and Vermont. The District of Columbia also fits the bill. Per the article:

“A half-dozen states and the District of Columbia have health care insurance rates of over 95%, achieving near-universal coverage. Three researchers at the University of Pennsylvania — including Ezekiel Emanuel, a key architect of Obamacare — said Monday that the Affordable Care Act has everything to do with those results.

Here’s how the states achieved such high insurance rates, according to the authors:

Expanding Medicaid: States that expanded their Medicaid programs as allowed under the ACA had about half the uninsured rate (6.6%) in 2018 as states that did not do so (12.4%). ‘Nearly 5 million people would gain health insurance if the remaining 14 states expanded Medicaid,’ they write.

Extending enrollment periods: High-coverage states countered the Trump administration’s efforts to shorten enrollment periods and reduce informational assistance.

Lowering premiums: States enacted additional subsidies and reinsurance programs to keep premiums low, a crucial factor in maintaining insurance coverage from year to year.

Simplifying options: Some states limited the number of options available to counteract “choice overload,” which can reduce signups through consumer paralysis.

Maintaining individual mandates: Five low uninsured states maintain some kind of individual and employer mandates, which may help persuade healthy people to sign up.

The lesson, the authors say, is that near-universal health coverage can be achieved without national legislation. ‘While it is easy to dismiss the ACA and focus on the promise of Medicare for All, there is a more straightforward path to universal coverage,’ they write, ‘adopting a handful of relatively simple policies and programs at the state level can ensure health insurance coverage for nearly all Americans.’”

This article echoes what can be achievable if Medicaid is expanded and the other above steps are taken. The three states who drag the results down for the country – Texas, Florida and Georgia – did not expand Medicaid nor run their own Healthcare exchanges. Of the six states over 95%, it should be noted Iowa and Hawaii use the federal Healthcare Exchange, while the other four run their own exchanges.

I have long said Medicare for All is something to be explored, but it requires detailed analyses (and time) of its costs and impact. In the interim, I have strongly advocated improving the Affordable Care Act. The goal is access to care, in my view. The employment paradigm has been changing for some time, where fewer full-time workers are being used than before. We are seeing several industries move to a largely part-time workforce, such as in the retail, restaurant, and hospitality industries. We have seen contractual employment continue as well as the growth of gig economies. Health care access needs to come from somewhere.

What I do not care for is the hyper-politicization of this topic. Republicans (including the president) have actively sabotaged the Affordable Care Act, cutting funding to insurers, not mentioning the negative talk about it. It has still survived. Some Democrats choose to throw progress out and go full bore with Medicare for All. Again, that is a detailed undertaking and no candidate can accomplish this without buy-in from both parties.

So, let’s improve what we have. States who have not expanded Medicaid have been economically short-sighted and harmed their citizens. I have argued for repaying insurers who were harmed by the reneging on funding commitments, inviting them back into markets. Where choice is not available, introduce a Medicare option. I would also lower the eligibility for Medicare to age 60 or 62.

These are practical options that may move the needle upward like in those six states. Let’s talk about that.

https://finance.yahoo.com/news/6-states-achieved-near-universal-224827646.html

KISS – Keep it Simple Stupid

We should remember this acronym, KISS. It stands for Keep it Simple Stupid. Donald Trump certainly does. There is a reason why he speaks in a bumper sticker fashion. He does not know or care to know details. He just needs a prop, a message or a hook. Then, he repeats it over and over, sometimes a half-a-dozen times in one a short speech.

Whether people think Mike Bloomberg or Tom Steyer are the best candidates for the Democrat nomination, note how simple they are keeping their messages in TV commercials. They focus on how weary we all are of the current president. But, the ideas are straightforward:

– we must act on climate change (both)
– we must improve health care access (Bloomberg)
– we must help more people prosper under the economy (both)
– we must have better gun governance (Bloomberg)
– we must have term limits (Steyer)

Steyer has added another key element which I like, people are treating each other better than the folks in Washington treat each other. That has resonated with me and someone I know who voted for Trump because he disliked Hillary Clinton.

I am not saying these are the best candidates. But, I am saying they are worthy of people’s consideration. I encourage all Democrat candidates to boil their messages into simpler themes. And, stop the circular firing squad. A good idea should not matter from whence it came.

Those imperfect candidates

The search for nirvana, whether it is the perfect partner, job, setting, workout, dinner, vacation, etc. is an endless search. There is no such thing. The same goes for presidential candidates, regardless of party, country, state, locality, etc. And sadly, the better candidates get tainted once they have been elected as they make compromises and decisions which you may not like. Or, maybe when looked back on with a different context, those decisions look foolish.

I have been watching the circular firing squad of the Democratic party candidates for several months. I see more fanatical followers of candidates use a scorched earth mindset to destroy the candidates that are not their favorite. I witnessed this in 2016, when some Bernie Sanders were so adamantly against an imperfect Hillary Clinton, they could not bring themselves to vote for her. The current US president used this ammunition to create even more distaste and get those voters to stay home, vote for Gary Johnson or Jill Stein or even vote for him as a change agent. It worked as he needed less than 100,000 voters spread among three states to win.

Every Democratic candidate has good selling points. And, every Democrat candidate has faults. I will not belabor either one of these lists, as my purpose is not to analyze the veracity of one or the other here. I will save that for a future post, when the slate gets more manageable. I will add every Democrat candidate has a better moral and ethical compass than that of the incumbent president. Conservative writer David Brooks noted that Trump does not seem to be able to show empathy. Almost every situation is exploited to elevate himself. Yet, in so doing, he reveals a very shallow and egomaniacal person. At times he reveals his corrupt nature.

Yes, I want the next president to focus on climate change, healthcare, career training for new and emerging jobs, better gun governance, etc. Yes, I would like them to deal with the debt and deficit. Yes, I would like them to restore America’s reputation as a trusted, fair and reasonable global partner. But, I would like my president to represent our better angels, not our worst demons. The current one does not. Issues are used to divide, not galvanize. I want a president to shine a spotlight on poor behavior, not condone it or discount it.

So, as people look for perfect candidates, remember this biblical example. We had only one perfect person walk the earth – and we killed him. Let’s not kill the Democrat candidate in search for nirvana.

Former Arkansas surgeon general brags on Medicaid expansion

I have written often about the Affordable Care Act not being fully implemented since 15 states have not expanded Medicaid. Rather than repeat my arguments, let me reference the attached editorial written by Dr. Joe Thompson, the former Surgeon General of Arkansas, which I read in Friday’s The Charlotte Observer. The reason for their interest is North Carolina has a Democrat governor working with a Republican majority General Assembly and the issue of Medicaid expansion is of importance. The editorial is entitled “Medicaid expansion works in deep red Arkansas. It would work in North Carolina too.”

“My home state of Arkansas is unusual among Southern states in having adopted Medicaid expansion early and in our own fashion.

I was Arkansas’ surgeon general in 2013 when the state first faced the question of whether to expand Medicaid. Like North Carolina now, Arkansas then had a Democratic governor and a Republican-controlled legislature. Fortunately, we avoided an impasse; lawmakers on both sides of the aisle came together to approve an innovative alternative to traditional Medicaid expansion that provides private health insurance coverage to about 250,000 people earning up to 138% of the federal poverty level.

The effect on Arkansas’ uninsured rate was swift and dramatic. A 2015 Gallup report showed that since Arkansas’ Medicaid expansion program took effect in January 2014, the state’s uninsured rate had been cut roughly in half, dropping from 22.5% to 11.4% ― the biggest reduction in the nation.

According to the U.S. Census Bureau, Arkansas’ uninsured rate was 8.2% in 2018. North Carolina’s was 10.7%, the ninth-highest rate in the nation. Arkansas’ reduced uninsured rate led to a 55% reduction in uncompensated-care losses at hospitals. This has been especially important for rural hospitals, which treat many low-income patients.

Since January 2010, only one rural Arkansas hospital has closed for financial reasons. In the five neighboring states that have not expanded Medicaid, more than 50 rural hospitals have closed, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.

Expanding Medicaid also has helped stabilize Arkansas’ health insurance market, improve competition and control premiums. Since 2014, at least three insurers have offered plans through the Health Insurance Marketplace in each county in the state. The competition encourages low rates: In 2014, 38 states had marketplace premiums lower than Arkansas’; today, only six states have lower premiums.Medicaid expansion has brought billions of new federal dollars into Arkansas’ economy: $1.7 billion between January 2014 and June 2015 alone, according to the Kaiser Family Foundation. Arkansas also is saving money because some individuals previously covered under traditional Medicaid, which in Arkansas is 30% state and 70% federally funded, are now covered under Medicaid expansion.

The federal government currently is paying 93% of Medicaid expansion costs and will pay 90% in 2020 and thereafter. A consultant told a legislative task force in 2016 that Medicaid expansion would save Arkansas $757 million between 2017 and 2021.Thirty-six states have now decided to accept Medicaid expansion.

Arkansas has become a firmly red state, but it has reauthorized its Medicaid expansion program with a supermajority vote every year because of the demonstrated benefits to the working poor, the economy and the health care infrastructure. Last year, Arkansas added a work and community engagement requirement that currently is blocked by a federal judge’s order, but however that issue ultimately is resolved, it is clear that Medicaid expansion has had tangible, positive results. There’s a reason the number of states rejecting it continues to shrink each year.

Joe Thompson, MD, MPH, is president and CEO of the Arkansas Center for Health Improvement. He was Arkansas’ surgeon general under Republican Gov. Mike Huckabee and Democratic Gov. Mike Beebe.”

In spite of efforts to naysay it, hobble it and kill it, the Affordable Care Act is stabilizing some. It needs more stability and Medicaid expansion would help in the remaining 15 states. I have also advocated the US government paying back the money they withheld from insurers causing some to leave the market, inviting those companies back to the market. I have also advocated the reduction of the Medicare eligibility age from 65 to age 62 or even 60. And, where options don’t exist, Medicare could be offered as an option for younger adults.

What frustrates this retired benefits manager, consultant and actuary is the fact people getting harmed by decisions to harm the ACA is not a major factor. There is too much focus on winning an argument that people getting screwed does not seem to matter. Please help make it matter. Even as we speak, the eating away at the edges of the ACA could lead the Supreme Court to rule it unconstitutional. If this occurs it would be a damn shame.

Medicaid expansion is needed for NC says this retired benefits professional

As North Carolina continues its stalemate on Medicaid expansion, it might be interesting to heed the words of former Ohio Republican governor John Kasich. When Ohio moved forward with the Medicaid expansion, he called it a “no brainer.”

Now why would he say that? Kasich noted Medicaid expansion would not only help people, it would bring $13 billion to his state over several years. George Washington University did a study that said Medicaid expansion would help a state’s economy, help a state’s rural hospitals and help people. We should also remember NC Republican Mayor Adam O’Neal of Belhaven walking to Washington seeking the expansion of Medicaid after his colleagues in Raleigh turned him down as he tried to save his town’s hospital.

Rather than offer stale arguments, it would be nice if the Senate and House leaders figure out a way to get this done. Let me add the voices of The Commonwealth Fund, RAND Corporation and Economic Policy Institute that echo the results of the GWU study. NC is already in the minority on this. Please let’s find a way to help people.

Let me close with a truism about health coverage to think about. Those with coverage will see doctors earlier and will have access to prescription drugs to avoid future train wrecks. Preventive care and health maintenance are better paths forward for people and healthcare financing.

Note: The author of this post is a retired benefits professional who is a former actuary, former benefits consultant and benefits manager for a Fortune 500 company

The most realistic path to ‘Medicare for All’ says a former Insurance CEO

I said back in 2010 to a healthcare consulting colleague, we will eventually need to consider national health insurance, but it won’t happen. When he asked why, I responded the “Healthcare industrial complex is too powerful.” People forget the reason we have the Affordable Care Act is CFOs were tired of rising healthcare costs to their bottom line.

Healthcare is a complex topic and the ACA added to that complexity. It has since gotten better, but we need to shore it up to stabilize it more, rather continue to allow it to be diminished as its opponents have down for several years.

But, national health care under the banner of “Medicare for All” is worthy of consideration with data and analysis. This retired actuary, benefits consultant and benefits manager supports data driven analysis to improve what we have and consider more substantive changes. JB Silvers, a former health insurance CEO and professor of health care finance at Case Western University, penned an article called “The most realistic path to ‘Medicare for All'” in The New York Times earlier this month. Here are excerpts from the article:

“Much to the dismay of single-payer advocates, our current health insurance system is likely to end with a whimper, not a bang. The average person simply prefers what we know versus the bureaucracy we fear.

But for entirely practical reasons, we might yet end up with a form of Medicare for All. Private health insurance is failing in slow motion, and all signs are that it will continue. It was for similar reasons that we got Medicare in 1965. Private insurance, under the crushing weight of chronic conditions and technologic breakthroughs (especially genetics), will increasingly be a losing proposition.

As a former health insurance company C.E.O., I know how insurance is supposed to work: It has to be reasonably priced, spread risks across a pool of policyholders and pay claims when needed. When companies can’t do those fundamental tasks and make a decent profit is when we will get single payer.

It’s already a tough business to be in. Right now the payment system for health care is just a mess. For every dollar of premium, administrative costs absorb up to 20 percent. That’s just too high, and it’s not the only reason for dissatisfaction.

Patients hate paying for cost-sharing in the form of deductibles and copays. Furthermore, narrow networks with a limited number of doctors and hospitals are good for insurers, because it gives them bargaining power, but patients are often left frustrated and hit with surprise bills.

As bad as these problems are, most people are afraid of losing coverage through their employers in favor of a government-run plan. Thus inertia wins — for now.

But there’s a reason Medicare for All is even a possibility: Most people like Medicare. It works reasonably well. And what could drive changes to our current arrangement is a disruption — like the collapse of private insurance.

There are two things insurers hate to do — take risks and pay claims. Before Affordable Care Act regulations, insurance companies cherry-picked for lower-risk customers and charged excessive rates for some enrollees…”

There is only one solution: pooling and financing many of the risks related to chronic and acute health care issues. A study by my former company noted generally 15% of participants drive 80% of the claims costs in any given year. It may not be the same 15%, but with major chronic issues, some could continue to be in the mix. The principle of insurance is to pool those risks, so that good risks can moderate the higher risks.

The ACA uses the private insurance system, exchanges and expanded Medicaid. Unfortunately, there are about 15 states who still have not expanded Medicaid. Medicare for All would consolidate the risk into one place, eliminating the profit load and reducing the relative administration cost of insurance companies. I have suggested for several years to do a pilot and expanded Medicare eligibility from age 65 to age 62, or even lower. This would let us measure the impact of such a change.

Yet, what we don’t need is this to become political. What people do not realize is the ACA has been sabotaged on several occasions by my former party which drove some insurers out of the market and increased premiums for everyone else more so than they otherwise would have been.

So, let’s cut to the chase and study options. And, politicians should let people who know what they are doing do the analysis. The ACA was made too complex and the exchange roll out was botched. On the flip side, what the GOP did in 2017 was sloppy and poorly staffed, so what was voted on woulf have been harmful to many.

Our children deserve better

Two time Pulitzer Prize winner Nicholas Kristof wrote an editorial earlier this week in The New York Times called “Our children deserve better.” It is a clarion call to our nation showing the plight of kids in America.

Here are a few quotes to frame the issue:

“UNICEF says America ranks No. 37 among countries in well-being of children, and Save the Children puts the United States at No. 36. European countries dominate the top places.

American infants at last count were 76 percent more likely to die in their first year than children in other advanced countries, according to an article last year in the journal Health Affairs. We would save the lives of 20,000 American children each year if we could just achieve the same child mortality rates as the rest of the rich world.”

“Half a million American kids also suffer lead poisoning each year, and the youth suicide rate is at its highest level on record….The Census Bureau reported this week that the number of uninsured children increased by 425,000 last year.”

These are different views and sources of the threats to US children that note we have a problem. Another source I read a couple of years ago noted America has a much higher maternal mortality rate at child birth than other civilized countries, which further endangers children as well as the mothers.

Yet, these issues are not being discussed in the halls of government. We have a poverty problem in our country with too many living in or just above poverty levels. We have not expanded Medicaid in fifteen states whose numbers are worse than these national numbers per capita. We have not addressed our national water crisis which has a Flint, MI like exposure to lead in too many cities and a volume of available fresh water issue in other places. We have not invested as we should to diminish crime and provide more opportunities for jobs in disenfranchised areas. There are several pockets of success that can be emulated in more cities.

We also need to address better gun governance, especially with the number one gun death cause by far being suicide and a non-inconsequential accidental gun death rate. And, we have not dealt with the continuing and rising exposure to technology and artificial intelligence which have taken and will take even more jobs in the future. Finally, there is that climate change thing we need to deal with.

These are real problems. And, they will get worse. Data driven analysis of causes and solutions are needed. They are both multi-faceted. Investing more now, will save huge amounts later. This is not just an urban issue, it is rural one as well. The opioid crisis is rampant in these impoverished rural areas, for example.

None of the solutions will fit on a bumper sticker. And, political attempts to oversimplify issues should be questioned. Here is an easy contradiction to spot – if people believe gun deaths are a mental health issue, then why the effort to eliminate or not expand mental health benefits?

Please make your legislators aware of these issues and ask pointed questions. These questions deserve answers, not bumper sticker slogans. These concerns deserve to be talked about, studied and acted upon.

Helping people climb a ladder – a perspective

The following is an edited version of a comment on Hugh Curtler’s (a retired college professor of philosophy) post regarding whether we should help people in need or let them fend for themselves. I provide a link below to his post. I am going to cite the work a charity I used to be a part of that builds off the book “Toxic Charity,” written by a minister who lived with the disenfranchised people he sought to help. His name is Robert Lupton.

Lupton’s thesis is simple: true charity should focus on emergency or short term needs. What he argued for to help others long term and we did (and still do) is help people climb a ladder back to self-sufficiency. That should be the goal. An easy example is he would advocate for food and clothing co-ops rather than giving the food and clothes away. People love a bargain, so let them maintain their dignity while they get discounted help. This dignity thing is crucial – people would rather not have to ask for help.

Note, we cannot push people up the ladder. They must climb it.  A social worker I have advocated with used to say “we walk side by side with our clients.” The folks we helped are homeless working families. We had two keys – they received a subsidy for rent based on their ability to pay, but they had to plan, budget, get financially educated working with a social worker and attending required training programs. Our homeless clients had to be responsible for rent and utilities up to 30% of their income, which is threshold for housing risk. Another key is we measured success. Success to us is being housed on their own without help after two  years.

As a community and country, we need to better identify what we mean by success in our help for people in need. Also, are things like healthcare a right? Is food on the table a right? Is a roof over the head a right? What we need is better measurement of what we spend and how it helps. It actually is cheaper to provide housing to chronic homeless and partially-subsidized housing to those who are more acutely homeless (due to loss of job, reduction in hours,  loss of healthcare, problems with car, predatory lending on a car, etc.) than let them go to the ER or commit petty crimes and be jailed. People should know all homeless are not alike, so the remedies to help need to vary.

My former party likes to argue off the extreme anecdotes – the significant majority of people do not cheat the system, but the perceived thinking of such is much higher in Republican ranks. When I have spoken to church groups, chamber groups, rotary clubs, United Way campaigns, etc., I come across this bias which is firmly believed. Just last month, the US president announced curtailing a rule on food stamps which will put 3 million people at risk, as one man was able to purposefully game the system. Yes, there is a small percentage of folks that do that, but the significant majority do not.

What people like David Brooks, a conservative pundit, tout is a dialogue on what kind of country do we wish to be? Our economy is a fettered capitalist model, with socialist underpinnings to help people in need and keep people out of poverty. What is the right balance? Is it better to pay a much higher minimum wage or have a higher earned income tax credit, e.g. Is it better to have a Medicare for All system, subsidize those in need or have a free market system only? A factor in this decision is many employers now employ a larger part-time or contractual workforce (the gig economy) to forego having to provide benefits. This is especially true in retail and restaurant industries.

At the end of the day, Gandhi said it best – a community’s greatness is measured in how it takes care of its less fortunate. With so great a disparity in the haves/ have nots in our country, I can tell you we are out of whack as our middle class has declined and far more of them fell into a paycheck-to-paycheck existence. Ironically, even in the age of Trump promises, we have many people who do not realize they are voting against their economic interests. Doing away with the ACA and not expanding Medicaid are very harmful to rural areas, e.g.

So, I agree with Gandhi, Lupton, and Brooks that we need to help people, but decide what is the best way. We should measure things and adjust them when they get out of whack. It is hard to fix what you do not measure. The group I was involved with would alter its model, if the numbers showed less success than hoped. What I do know is over 80% of the people we helped are still housed on their own after two years of leaving the program. In other words, they live without a subsidy.

Finally, what we need most is for politicians to check their tribal egos at the door when they enter the room. Having been a member of both parties, each party has some good ideas, but both have some bad ones, too. I do not care what a person’s party preference is or if he or she is more conservative or liberal than me  (I am fiscally conservative and socially progressive), we need to use facts and data to make informed choices. And, continue to measure the results making modifications, if needed.

Dilemma

Blue Cross Blue Shield of North Carolina ACA premium rate cut request

Earlier this week, Blue Cross Blue Shield of North Carolina (BCBSNC) has announced a request of a premium rate cut for the second year in a row under the Affordable Care Act. They announced a request of a 5.2% rate reduction for their 435,000 members and one of 3.3% for small businesses in the state. It would have been three years in a row, but as I mentioned in earlier blogs, the Trump decision to renege on paying insurers for absorbing co-pays and deductibles for people making less than 2 1/2 x poverty limit caused premiums to increase for all.

This shows the ACA is stabilizing for insurance carriers who have been at it a few years. It would be nice to get more carriers back in for members to have choices. Many left when the Senate, led by the GOP defunded the risk corrider payments to the tune of 89% of the adverse selection cost. These carriers left the markets with the US government owing them money.

These two efforts to dampen the ACA have gone largely unreported. But, there is one more which is critical that impacts premiums and threatens the entire ACA. The tax bill passed by the GOP led Congress eliminating an unpopular feature of the ACA, which required individual coverage. It was called the individual mandate. By obligating people to have coverage, it lessened the risk on the insurers which will keep premiums lower than they would be otherwise.

Here is what BCBSNC said in their announcement as reported by The Charlotte Observer.

“The rate of decrease requested for 2019 would have been larger, the company told the Observer in 201, if the GOP tax reform legislation signed by President Donald Trump hadn’t repealed the ACA’s individual health insurance mandate.”

Further, several GOP led-states are suing the federal government to rule the ACA unconstitutional due to the elimination of the mandate. The tax laws are complex, but it is going to end up at the Supreme Court. It is thought by experts this case is weak, but the Trump Justice Department has decided to not defend the law which helps so many. Ironically, this is happening as it stabilizes even more, the GOP lost seats because of their ham-handed efforts to repeal it and when some Democrats want Medicare-for-all.

Medical errors are a problem – here are some thoughts on how to reduce them

Earlier this week, a US health news piece entitled “In a review of 337,000 patient cases, this was the no 1 most common preventative medical error” by Meera Jagannathan was made available on msn.com. This article echoes the findings of two pieces I have referenced previously, the first, a book called “Internal Bleeding: the truth behind American medicine’s terrible epidemic of medical mistakes,” written in 2004 by two internists Dr. Robert Wachter and Dr. Kaveh Shojania. The second was the Leapfrog Study which looked at deaths caused by medical errors toward the turn of the century. A link to the recent article is below.

The article reveals the results of four medical studies that analyzed medical death rates from 2000 – 2008. Of the just over 251,000 medical deaths, 9.5% of the deaths could be attributed to medical error. In other words, 1 out of 10 deaths could have been avoided as they resulted from a medical error.

The article focuses on nine things that should be done to reduce medical mistakes. I will just list them, but please click on the article link below.

  1. Make sure you fully understand the procedure and why it is necessary.
  2. Brief the doctors on your allergies, health conditions and medicines.
  3. Don’t assume every provider has access to your records.
  4. Bring a friend or family member if the patient is not good with asking questions about what is happening.
  5. Keep close track of your medicines and results.
  6. Make sure the doctors and nurses wash their hands.
  7. Research wisely.
  8. Don’t be afraid to speak.
  9.  Ask providers what they are doing to prevent  mistakes.

The Leapfrog study noted three things to reduce deaths due to medical errors.

  1. Have complex surgeries performed in centers of excellence where they have done multiple hundreds or thousands of the procedure.
  2. While dated, poor handwriting of prescriptions or instructions caused mistakes. Most hospitals now have electronic orders, but be sure you understand what is being asked or prescribed.
  3. Make sure there are doctors on site and not just residents in intensive care units.

I wrote earlier about the book “Internal Bleeding,” so I provided a link below. Reviewing that summary and comparing to the above, here are a few more thoughts from that post as well as a few others thrown in.

  • write a summary of your and your family medical history
  • write down what your symptoms are – people see the white coat and forget.
  • if you are not sick or injured, the hospital is the last place you should be; some hospitals incent ER doctors to admit patients; ask questions about this.
  • know your environment; if you have bladder or some other cancer it may be environmental not familial. Bladder cancer is a bellweather environmental caused cancer.
  • ask for other pain medications beside opioids; they should be only used for severe pain and for short durations.
  • introduce yourself to all providers; make sure they know who you are.
  • Complete the prescription regimen and don’t stop when you are feeling better.

Medical professionals do not want medical errors either. So, help them help you. And, if you have trouble advocating for yourself, take a trusted person with you.

https://www.msn.com/en-us/health/health-news/in-a-review-of-337000-patient-cases-this-was-the-no-1-most-common-preventable-medical-error/ar-AAEGPVF?ocid=spartandhp

https://musingsofanoldfart.wordpress.com/2012/07/28/internal-bleeding-be-your-own-health-care-advocate/