The Number of Primary Care Doctors is Shrinking, and That is Really Bad News

Primary care shrinking
Access to primary care physicians is a matter of the number of doctors who choose to pursue primary care as a career. Pay for those roles is lower than it is for most specialists and no surprise, fewer are choosing to go into this important part of the healthcare profession.

On the Houston Healthcare Initiative Podcast

The Number of Primary Care Doctors is Shrinking, and That is Really Bad News

July 20, 2021 – The Number of Primary Care Doctors is Shrinking. An important contributor to the health of Americans is shrinking and the effects on the overall health of people in this country is and will continue to be negatively impacted. This is the subject of the latest edition of the Houston Healthcare Initiative Podcast.

Lower Pay

Fewer medical school graduates are choosing primary care because it pays significantly less than other specialties. Worse still, a lower number of primary care doctors is linked to 85 deaths every day, according to a study published by the National Academy of Sciences. Can primary care doctors make more money? “Under the current system of payment via employer funded health insurance it will be challenging to make that case,” Dr. Goldstein said. “But there may be a chance for new primary care doctors to ignore most of the insurance companies and their accompanying rules and work on a cash basis.”

Cash Only Please

Even patients who have their own health insurance can often save themselves money by paying cash. Doctors will not have to hire staff to process insurance claims, hassle with them over payment or non-payments. Patients save money on premiums and the doctors have fewer expenses. Patients pay less, doctors keep more of the fees because of lower expenses.

Covid Pandemic Bankrupts Many Practices

In addition to a shortage of practicing doctors, primary care visits declined significantly during the COVID-19 pandemic. Add to that a good number of primary care practices were not able to access federal funds and relief and went under. “If these trends continue, it will have a very negative impact,” Dr. Steven Goldstein told his listeners. “Regular visits to the primary care or family doctor allows that physician the chance to know his or her patients better. What are their medical histories, prescribed medication, allergies, or family histories that could affect a diagnosis? These are details that the primary care doctor will know because he or she has a history with patients.”

What Difference Does It Make?

A single visit to a primary care doctor makes a difference for the patient. “When you get sick, that doctor knows how to treat you,” Dr. Goldstein said. Primary care is a health care component where an increased supply is associated with better population health and more equitable outcomes. “For this reason, primary care is a common good, which makes the strength and quality of the country’s primary care services, or its lack, a public concern.”

About the Houston Healthcare Initiative Podcast                                                                   The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To hear the podcast go to: SoundCloud, iHeartRadio, Stitcher, Backtracks, LibSyn, or the website at www.houstonhealthcareinitiative.org. Dr. Goldstein insists that for the health and welfare of the American public, the congress must pass reforms that limit the influence of the pharmaceutical industry and its lobby.

Healthcare Payment Reform is Critical to Improving Primary Care

Backs of doctors
Doctors are leaving the primary care practice in numbers that lead to 85 deaths per day. Better pay will retain more for this important healthcare function.

Access to and paying for healthcare is a topic that Dr. Goldstein talks about a lot on the podcast and this one is no exception. But in this case access to primary care is a matter of the number of doctors who choose to pursue primary care as a career. Pay for those roles is lower than it is for most specialists. A lower number of primary care doctors are linked to 85 deaths every day according to a study published by the National Academy of Sciences. In addition to a shortage of practicing doctors, primary care visits declined significantly during the COVID-19 pandemic. Add to that a good number of primary care practices were not able to access federal funds and relief and went under. How can we manage all this? For answers we turn to respected neurologist and the founder of the Houston Healthcare Initiative, Dr. Steven Goldstein.

Listen to the Houston Healthcare Initiative podcast about primary care physicians here. Healthcare Reform is Critical to Retain Primary Care Docotrs

UnitedHealthcare and the non-emergency emergency… Who Decides If You Need To Visit The Emergency Room?

UnitedHealthcare
UnitedHealthcare delayed a controversial decision to retroactively declare treatment in an emergency room not an emergency.

UnitedHealthcare and the non-emergency emergency…

Who Decides If You Need To Visit The Emergency Room?

On the latest edition of the Houston Healthcare Initiative podcast, respected neurologist and Houston Healthcare Initiative founder Dr. Steven Goldstein discusses the proposed UnitedHealthcare policy of after the fact review and in some cases possible denial of  some emergency room visits. The Houston Healthcare Initiative podcast can be heard on: SoundCloud, iHeartRadio, Stitcher, Backtracks, LibSyn, Soundcloud, or the website at www.houstonhealthcareinitiative.org.

Declaring the Emergency, a Non-Emergency

UnitedHealthcare is the nation’s largest health care insurer. In early June 2021 UnitedHealthcare announced that it would change how they assess emergency department claims, and thus allow ‘United’ to retroactively deny claims it deemed “non-emergent” or not an emergency. The aim is for the insurance company and their customers to save money, but others say the consequences could be more costly or even deadly. The new policy was originally scheduled to begin on July 1, 2021 but after a wave of criticism from among others, the American College of Emergency Physicians, United backed off and later said they would wait until the pandemic was past to make a decision about this decision.

Bad Policy With Usual Solutions Tried

Like the American College of Emergency Physicians Dr. Goldstein also believes this policy is unwise. “The answer is not to retroactively deny payment for ER care already rendered,” he told his listeners. “What this does is force the hospitals to refuse care for “non-emergency care” as defined by UnitedHealthcare. However, this is not practical because the hospital is more afraid of a potential lawsuit if a patient is refused care and has a poor outcome as a result. The patient then will be stuck with a large bill that cannot be paid.”

Dr. Goldstein states this is another example of an insurance company trying to “manage care.” “They (insurance companies) see a problem, namely they think that Emergency Room services are over-utilized and think they can manage the problem,” Dr. Goldstein said. “They try their usual method of operation and simply deny payment.”

On The Other Hand

UnitedHealthcare claims there are big problems with the misuse of emergency rooms which costs the U.S. healthcare system roughly $32 billion annually. UnitedHealthcare states that misuse typically manifests as patients seek out costly care for minor ailments that could be addressed through other avenues like an urgent care type of clinic. According to the UnitedHealthcare web site, “two-thirds of hospital ED visits annually by privately insured individuals in the U.S. – 18 out of 27 million** – are avoidable.”

Does UnitedHealthcare Have A Point?

Dr. Goldstein stated that United had a point “if the point is that healthcare administered in an emergency room is too expensive.” But he also point out, “UnitedHealthcare negotiated the prices they pay with the hospitals. If it is too expensive, why did they negotiate such a high price?”

About the Houston Healthcare Initiative Podcast

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To hear the podcast go to:

Dr. Goldstein insists that for the health and welfare of the American public, the congress must pass reforms that limit the influence of the pharmaceutical industry and its lobby.

Healthcare and Nanotechnology

Nanotechnology concerns the manipulation of materials so small that they are on the molecular or even subatomic level. The new technology, according to SciDev.Net, has enormous implications for the practice of medicine.

Healthcare and Nanotechnology

For example, people who are given drugs to combat cancer do not experience the entire dose at the site of the tumor. This fact is one reason why chemotherapy can be such a stress for the human body, as healthy cells are destroyed along with the tumor.

However, drugs can be carried to the site of a tumor using nanoparticles as carriers, attacking only the cancer cells and leaving the rest of the body alone. Nanotechnology means that people suffering from cancer can see higher remission rates with far less stress on the rest of their bodies. The FDA has approved the first generation of cancer drugs that use nanotechnology.

Nanotechnology has also been used to ensure early detection of diseases such as HIV and cancer. Something called quantum dots has been used successfully to detect a variety of diseases, including tuberculosis and malaria.

Even vaccine development, a matter of great concern in the era of the Covid-19 pandemic, is benefiting from nanotechnology. Aerosol and patch-delivered vaccines are being tested using nanoparticles as a delivery system. Even more conventional injectable vaccines have proven more potent when the inactive virus is delivered by a nanoparticle.

How can this new form of nanotechnology-based medicine be made more widely available, especially in the developing world, where diseases that are rare in the developed world are still common?

In any event, nanotechnology is enabling a new science of precision medicine, in which diseases are diagnosed more quickly and are then dealt with, resulting in more beneficial outcomes, increased lifespans, and quality of life. With proper investments, nanotechnology can decrease the cost of healthcare in the long term by making sick people well more quickly and with greater frequency.

For more information contact us.

Five Numbers That Could Reform Health Care

Five Numbers That Could Reform Healthcare

With over 40 years of health care and management experience, Randy Oostra President and CEO of Promedica presents at TEDxTraverseCity 2020. Randy Oostra, DM, FACHE (63), is the President and Chief Executive Officer of ProMedica, a not-for-profit mission-based, integrated health and well-being organization headquartered in Toledo, Ohio. The $7 billion organization serves communities in 28 states. It offers acute and ambulatory care, an insurance company with a dental plan, and post-acute and academic business lines. The organization has more than 56,000 employees, 13 hospitals, 2,600 physicians and advanced practice providers with privileges, 900+ healthcare providers employed by ProMedica Physicians, a health plan, and more than 400 assisted living facilities, skilled nursing and rehabilitation centers, memory care communities, outpatient rehabilitation clinics, and hospice and home health care agencies.

Randy has 40 years of health care and management expertise, with 22 of those years spent at ProMedica. Randy is regarded as one of the nation’s top leaders in health care and has earned a spot on several prestigious listings, which include Modern Healthcare’s 100 Most Influential People for three consecutive years and Becker’s Healthcare’s 100 Great Leaders to Know in Healthcare This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx

Houston Healthcare Initiative is a group of physicians and health conscious patients that have joined together in a Healthcare cooperative to maintain and improve the physical and mental health of each member of the group.

Healthcare consulting

Announcing a new Healthcare Consulting FREE SERVICE offered by the Houston Healthcare Initiative for companies providing health insurance to their employees.

Healthcare consulting

HEALTHCARE CONSULTING

What we will do

1.Listen

Allow the company to explain what are the specific problems they face with the health of their employees and how they are currently addressing them.

2.Learn

What are the details of the current healthcare plan? What data are available concerning current costs and how are these costs broken down. What data are available concerning the health of the employees.

3.Analyze

Use the available data to develop a plan to both improve employee health and lower healthcare cost. We do this from a physician’s perspective.

4.Propose

Steps to accomplish the dual goals of improving employee health and lowering healthcare costs. These steps can be implemented at no cost to the company!

5.Educate

Provide education to employees on how to shop for healthcare services and what they can do to improve their health

To learn more send an email to info@houstonhealthcareinitiative.org

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Most recommendations will include
1.Financial incentives to improve both physical and mental fitness. These incentives could include lowering of employee’s monthly premiums for insurance; sharing the savings on healthcare expenses with employees; employee recognition for improvement in health e.g. awards for weight loss
2.Annual physical exam to identify disease at an early stage, collect data on employee health and use the data to develop the financial incentives for employees to improve their health. Use the data to develop other strategies to improve the overall health of the employee population.

 

Do I Have to Pay for the Covid 19 Vaccine?

The short answer to the question as to whether you have to pay for the Covid-19 vaccine is no, according to the CDC website on the vaccine. The federal government, which paid for the development of the vaccines either directly or by promising to pay for their production, is providing shots free of charge. The idea is that the sooner people get the vaccine, the sooner the United States can achieve “herd immunity,” in which transmission of the virus is suppressed because so many people have been rendered immune. Then people can return to normal life without risk of sickness or death, something that the federal government has determined is well worth paying many billions of dollars to achieve.

Do I Have to Pay for the Covid 19 Vaccine?

In other words, you can make an appointment at any pharmacy or designated vaccination site and then walk in and receive your shot without cost. All you will have to do is to fill out some paperwork. You will get your shot regardless of your insurance status. You will not be charged for an office visit or anything else unless you request further healthcare services, which will be billed as appropriate.

The CDC site has some more information that should be transparent to you. You may be asked for your insurance or other healthcare provider information so that the provider of the vaccine can bill them for a portion of the cost. However, you will pay no out-of-pocket costs for the vaccine.

Therefore, the Covid-19 vaccine will be the best healthcare deal you will likely be offered. When you get your shots, either the two required by Pfizer or Moderna or the one by Johnson and Johnson, you may feel some minor side effects. But rest assure any fatigue or fever you might experience will pale in comparison to what might await you if you get Covid-19. In other words, getting the shot costs nothing and will impart peace of mind and protection against the deadliest pandemic in a hundred years.

For more information contact us

New Health Care Pricing Transparency Rules in 2021

The United States has the highest health care expenditures in the world, in terms of absolute dollars, dollars per person, and as a percentage of GDP 1.  The United States is also one of the few industrialized countries to have very limited government health coverage for working adults.  While insurance premiums are currently price transparent, many aspects of health care are not cost transparent at all.  Historically, it was not standard practice to publish prices of procedures or tests to patients prior to performing them.  Patients would not learn about the true cost until they received their bill later.  This was complicated by the various prices for the same test or procedure depending on the patient’s health care coverage, or lack thereof.  This made it very difficult even for informed patients to make financially informed decisions about where to obtain certain procedures or even if they were truly necessary.  One example from 2012 demonstrated, for mammograms in the Boston area, an average cost of $310 per mammogram but a range from $176-$529 2.  This information could have helped save a patient potentially hundreds of dollars had they had access to it.  Unfortunately, at the time of writing this entry, these prices are often only obtainable with persistence, if at all.

New Health Care Pricing Transparency Rules in 2021

The good news is that, as of January 1st, 2021, The Executive Order EO on Improving Price and Quality Transparency in American Healthcare to Put Patients First goes into effect 3.   This will mandate all hospitals and providers to provide the standard prices for procedures and services.  This includes both the gross price of all services and procedures, but also the amount charged to individual insurers 3.  The most immediate benefit will be that it will allow patients to make financially informed decisions about non-urgent services.  One big caveat is that while this executive order will provide information about cost, it will not include any information regarding the quality or value that any particular institution may provide.  Some information regarding quality of an individual organization can be found at Medicare.gov 4.  While competitive pricing is critical to help stabilize or even decrease the cost of health care, one should be careful to measure it carefully with the quality of the health care obtained.

For more information regarding health care transparency and medical reform, click here.

Bibliography:

  1. 1.”National Health Expenditures 2018 Highlights”. National Health Expenditure Data : Historical. Centers for Medicare & Medicaid Services. December 2019. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.
  2. “Provider Price Variation: For Mammography Services in the Commercial Market”. Center for Health Information and Analysis. October 2014. https://www.chiamass.gov/assets/docs/r/pubs/14/rp-mammography-chartbook.pdf
  3. Postma, Terri MD and Grimsley, Heather. “Hospital Price Transparency Final Rule”. Medical Learning Network. Center for Medicare & Medicaid Services.  December 2019.  https://www.cms.gov/files/document/2019-12-03-hospital-presentation.pdf
  4. “Hospital Compare”. HealthCare.gov. https://www.medicare.gov/hospitalcompare/search.html

Obesity And Inactivity During Pandemic Caused Greater Covid Infection

April 29, 2021 – On his latest podcast, Dr. Steven Goldstein told his audience that Americans gained a good bit of weight during the lockdowns caused by the Covid-19 pandemic. But that was not the only bad news. The sad irony that obesity increased the risk of hospitalization due to the Covid-19 infection was not lost on him or his listeners as obesity and inactivity during pandemic caused greater covid infection risk. The cruel combination of lockdowns that were supposed to help keep the American public safer created a situation that made the likelihood of infection and a difficult recovery more possible.

Fat people are at increased risk of morbid covidity
The vast majority—78%—of U.S. patients hospitalized with COVID-19 were overweight or had obesity according to the American Medical Association.

The Houston Healthcare Initiative podcast can be heard on: : Apple Podcasts, LibSyn, Spotify, Radio.Com, Listen Notes, iHeart Radio, Podcast Addict, Podbay, Backtracks, Player FM, Stitcher, and SoundCloud. There is a way to repair this and many other weight related health risks if individuals change their eating habits.

The Consequences of Obesity & Covid-19                                                                              

The vast majority—78%—of U.S. patients hospitalized with COVID-19 were overweight or had obesity according to the American Medical Association. The numbers for intensive care, invasive mechanical ventilation and death were nearly the same.  In short, the quarantine was and is associated with stress and depression leading to unhealthy diet and reduced physical activity. “The main culprit in all of this was what we choose to eat before and during the pandemic,” Dr. Goldstein said.

This Century’s Dietary Downward Spiral

The obesity rate in the U.S. steadily increased since the initial 1962 recording of 23%. By 2014, figures from the CDC found that more than one-third of U.S. adults and 17% of children were obese.  The National Center for Health Statistics at the CDC showed in their most up to date statistics that 42.4% of U.S. adults were obese as of 2017-2018 (43% for men and 41.9% for women).

Americans in general consume more calories than needed. “We eat out way more than we ever did before,” Dr. Goldstein commented. “School systems encouraged unhealthy eating practices among children by accepting soft drink and fast-food contracts because they provide large commissions for financially strapped schools. The increase in energy intake or calories has been paralleled by a decrease in physical activity. Not moving is the norm. And that was especially the case during the pandemic.”

Discouraging but Curable

Rather than be discouraged by this news Dr. Goldstein was hopeful because the treatment for this is known and within the reach of all Americans; that they all make better decisions about what they eat.  “Everyone in the USA can literally take control of their own health and well-being with better choices at the table, store and restaurant and that can start right now, for everyone,” he said.

The pandemic and lockdown brought a lot of significant change to American society. The tendency to sit and eat was exacerbated considerably. “With more people moving less than ever while snacking constantly it is no wonder that our collective weight is so far up,” Dr. Goldstein concluded. “This is an easy fix for us all if we will just make the changes.”

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

What you need to know in Health Care.

The right to health was initially recognized by the World Health Organization (WHO) in 1946. According to WHO, the enjoyment of health is a fundamental right of every human being regardless of race, political belief, or religion. The debate over whether health care is a right or privilege has been raging for more than a century. Here is a look at the definition of health care and health care providers and whether health care is a right or  privilege.

What you need to know in Health Care.

Health Care and Health Care Providers

Healthcare is the provision of medical care to individuals and communities. Healthcare careers are not limited to doctors and nurses but also include chiropractors, administrators, therapists, and technology professionals.

According to federal regulations, a health care provider is a doctor of medicine, dentist, podiatrist, clinical psychologist, nurse, or any medical personnel, authorized to practice by the State and working according to the standards laid out by State law. A healthcare provider is; therefore, anyone who is legally permitted to administer healthcare to patients.

Is Health Care A Right or Privilege?

The right to health care is internationally recognized but this does not mean this right is enforced worldwide. In the U.S., health care was included in the Second Bill of Rights that was drafted by Franklin Delano Roosevelt. His wife took his work to the UN which led to the clarification of health care as a human right in the Universal Declaration of Human Rights (UDHR).

After the adoption of the UDHR, all industrialized countries implemented universal health care programs to make sure their citizens enjoyed the right to health. However, in 2015, the U.S. report to the UN does not acknowledge health care as a human right. The U.S. does not have a health care system but only a health insurance system in the form of Medicare and Affordable Care Act. It is; therefore, reasonable to claim that in the U.S. and many developed countries health care is more of a privilege than a right.

The Houston Health Initiative is a group of health conscious patients and physicians who have come together to maintain and improve the health of each member of their group. The goal of HHI is to change the way Americans pay and receive medical care. If you want to learn about the state of health care in the country, or to make a change to the health care system in the U.S., Houston Healthcare Initiative has got your back.

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