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Doctor’s Blog
Weekly blog by Dr. Steven Goldstein. Dr. Goldstein is a highly respected Houston based neurologist and the founder of the Houston Healthcare Initiative CO-OP.
How Will Healthcare Change After Coronavirus Covid-19
How Will Healthcare Change After Coronavirus Covid-19
Doctors, hospitals, state and federal government agencies along with drug and insurance companies have all made concessions to the public during the time of the Coronavirus Covid-19 pandemic. This emergency affects every American so it stands to reason that what follows will too. But will common sense, red tape cutting, sensible changes that benefit patients remain, or be disposed of like so much medical waste? And what about preparations for future outbreaks? Houston based neurologist Dr. Steven Goldstein of the Houston Healthcare Initiative shares his views on this topic with his podcast audience. The podcast is available on iTunes, Soundcloud, Libsyn, and on www.houstonhealthcareinitiative.org.
Telemedicine
While remote access to doctors via Internet based communications is nothing new, it was never widely used until the outbreak of the Coronavirus/Covid-19 pandemic. But will patients continue to use this convenience? “It depends on what insurance companies will cover as well as what the regulations are from the state board of medical examiners,” Dr. Goldstein told his listeners. “There are plenty of good reasons to maintain this capability. Remote locations, lack of transportation resources and the reality that sick people are not keen to go to a clinic or doctor’s office whether they have the flu, a stomachache or even the Coronavirus should all help persuade the insurance industry to maintain payments for remote appointments.”
Lessons from the Pandemic – Rapid Strike Force
The speed that a viral outbreak is met with can prevent wider infection. Borrowing from an analogy coined by Bill Gates, Dr. Goldstein compared treatment to fighting a war. “We need a standing army to spring into action when a virus is first found and ready to travel anywhere in the world to go to work,” he said.
Dr. Goldstein envisions teams of doctors, nurses, epidemiologists, virologists, and other medical professionals who can very quickly construct field hospitals on the site of the outbreak, isolate and treat the sick people and find treatments for them. “This would be like a ‘Mobile Army Surgical Hospital’ or MASH unit; fully equipped, staffed and right at the front line. The enemy is disease and must be fought aggressively.”
No Excuses
Goldstein thinks that the federal government must put a greater emphasis on public health and do more to keep people from getting sick. “This is not the first epidemic we’ve faced in recent years just the most recent,” Dr. Goldstein said. He described the many recent health crises the world has faced and faces including HIV/AIDS, Ebola, Zika, MERS and lately the Coronavirus/Covid-19 outbreak. “There will be no excuse for any lack of preparedness when this happens again, and we know it will happen again.”
About Dr. Steven Goldstein
The goal of Dr. Steven Goldstein and the Houston Healthcare Initiative is to be a catalyst for change in the way Americans receive and pay for medical treatment. To cause change his web site is an aggregator of information, tools, and targets for the reform of the healthcare industry with an emphasis on free market innovation and personal responsibility.
Follow-Up To Help Prevent the Spread of Coronavirus/Covid19 Patients Benefit From Telemedicine Appointments
Follow-Up To Help Prevent the Spread of Coronavirus/Covid19 Patients Benefit From Telemedicine Appointments
March 19, 2020 — Until a couple of weeks ago, the use of telemedicine was mostly for convenience. Now, it is a necessity as people work to keep their collective distances from each other. As announced previously, Houston neurologist Dr. Steven Goldstein will offer his diagnostic and medical skills via virtual or ‘telemedicine’ appointments for both new and existing patients. “As long as Houstonians are suffering from the effects of the pandemic, I will waive copayments for those who have health insurance and significantly lower fees for those without insurance,” Dr. Goldstein said. With so many working hard to prevent the increase of the virus, using an existing technology without sacrificing access to himself or staff is a beneficial service.
Looser Rules Benefit Houstonians
On Friday March 13, 2020, when Gov. Greg Abbott declared a state of emergency, he made it possible for state agencies to use telemedicine. The Texas Medical Board also allowed for the medical community to use telemedicine, including the use of phone only, to see patients.
There are many benefits as so many people are staying away from public spaces during the Coronavirus/Covid19 outbreak. Here are a few of those advantages:
- With telehealth services, patients avoid unnecessary office or hospital visits, hopefully lowering their risk for contracting or spreading Coronavirus/Covid19.
- Through an emergency declaration under the Stafford Act and the National Emergencies Act, Medicare coverage will now include three types of virtual services: Medicare telehealth visits, virtual check-ins, and e-visits.
- Virtual check-ins allow Medicare beneficiaries to communicate from their home with a provider.
- Those who must rely on public transportation will not have to venture outside their homes to come in contact with other people and surfaces where the virus can remain for some time.
Medical Specialties
All of the medical news is about the spread or containment of Coronavirus/Covid19. But people will still need to be seen by specialists, including neurologists like Dr. Goldstein. For those with symptoms that suggest a neurologist, Dr. Goldstein is available. Some symptoms include:
- severe headaches,
- seizures,
- numbness,
- weakness,
- double vision,
- dizziness,
- passing out,
- tingling,
- trouble with movement,
- memory challenges or confusion,
- and trouble sleeping.
How To Be Seen
To be seen by Dr. Goldstein via ‘telemedicine’ call his office and make an appointment, just like always; give the patients’ email address and then go to the App Store and download Zoom Cloud Meeting. Zoom is free. Dr. Goldstein will email a link to the patient to use during the time of the appointment. Dr. Goldstein can diagnose, order tests, and prescribe medication via the Zoom link. To make an appointment call (713) 451-5421, or (281) 481-4236.
Zoom App Information
Zoom is available for Apple, Google Play and Windows. For all the ways to download and use Zoom go to their download page here: https://zoom.us/download.
Follow Dr. Goldstein from his Facebook page at: https://www.facebook.com/Houston-Healthcare-Initiative-192537484753616/?modal=admin_todo_tour. Or his website address: https://houstonhealthcareinitiative.org.
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To Help Prevent the Spread of Coronavirus/Covid19 Houston Neurologist Makes Telemedicine Appointments Available
Houston, TX. (March 19, 2020) – As a result of the Coronavirus/Covid19 outbreak and efforts to contain exposure, long time Houston neurologist Dr. Steven Goldstein will offer his diagnostic and medical skills via virtual or ‘telemedicine’ appointments for both new and existing patients. As long as Houstonians are suffering from the effects of the pandemic, Dr. Goldstein will waive copayments for those who have health insurance and significantly lower fees for those without insurance. “With so many of us all working hard to prevent the increase of this virus, I wanted to leverage existing technology and keep access to myself and my staff available without putting any of us or our patients at unnecessary risk,” Dr. Goldstein said. “It seemed like a pretty good way to be of service here in the greater Houston area during such a challenging time.” Those who do not have insurance pay $75.00 for a first time visit and $35.00 for any needed follow-up visit. Virtual office visits are conducted via the free Zoom Cloud Meeting app. Payments via debit or credit card are available through the office.
Telemedicine
The use of technology along with the reduced price makes Dr. Goldstein’s expertise available to people who cannot come to his office or afford to see a specialist like him or both. “Virtual medicine is nothing new, but it has not caught on like other remote services have,” Dr. Goldstein said. “This way of seeing patients now may be a turning point for the use of remote communications technology during this health crisis, with positive implications into the future.”
Treat Patients & Prevent the Spread of Coronavirus/Covid 19
The focus of the medical world now is on the prevention of Coronavirus/Covid 19. But there are plenty of people with symptoms a neurologist needs to diagnose and treat. Some symptoms include:
- severe headaches,
- seizures,
- numbness,
- weakness,
- double vision,
- dizziness,
- passing out,
- tingling,
- trouble with movement,
- memory challenges or confusion,
- and trouble sleeping.
How To Be Seen
To be seen by Dr. Goldstein via ‘telemedicine’ call his office and make an appointment, just like always; give the patients’ email address and then go to the App Store and download Zoom Cloud Meeting. Zoom is free. Dr. Goldstein will email a link to the patient to use during the time of the appointment. Dr. Goldstein can diagnose, order tests, and prescribe medication via the Zoom link. To make an appointment call (713) 451-5421, or (281) 481-4236.
Zoom App Information
Zoom is available for Apple, Google Play and Windows. For all the ways to download and use Zoom go to their download page here: https://zoom.us/download.
Follow Dr. Goldstein from his Facebook page at: https://www.facebook.com/Houston-Healthcare-Initiative-192537484753616/?modal=admin_todo_tour. Or his website address: https://houstonhealthcareinitiative.org.
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Houston Based Neurologist Explains Reason for ‘Surprise Hospital Bills’
A Houston based neurologist, Dr. Steven Goldstein, explains the reasons patients can get very expensive hospital bills even if they went to a hospital, clinic or emergency room that is part of their insurance network on his latest podcast. The Houston Healthcare Initiative podcast can be heard on Soundcloud, iTunes, Libsyn, or on www.houstonhealthcareinitiative.org
No Insurance Network Required for Doctors
While the insurance industry has trained patients, doctors, and hospitals that we all must have insurance and be part of an insurance network the same is not the case for doctors. While in-network doctors and hospitals have agreed with the insurance company how much procedures and tests will cost, not all doctors who work in hospitals are part of any insurance network and can charge more than what insurance will cover. To make this worse for patients and the ultimate cause of ‘surprise hospital bills’ hospitals, emergency rooms or clinics are not required to disclose this to patients or their loved ones. As Dr. Goldstein told his listeners, “behind the scenes, the in-network doctor and the hospital agreed in advance what the charges were going to be. So, the in-network doctor is paid a flat rate based on that agreement. The doctor who works at the hospital but is not part of the insurance network can charge more and get paid more. He is under no obligation to say anything about this to the patient and will not.”
How Can This Be? Private Equity Companies
Private equity companies that own staffing firms and place doctors to work in hospitals along with the American Hospital Association have stated publicly that restricting the independent pricing capability will make putting doctors in geographic or socially challenging locations much more difficult, as higher pay is the biggest incentive for going to work in rural or economically disadvantaged areas. These doctors have no incentive to join an insurer network, which would require them to cut their fees. These are the source of many surprise medical bills.
Doctor Patient Unity Unmasked
A shadowy lobbying group known as Doctors and Patients United are owned and funded by TeamHealth and Envision Healthcare, private-equity-backed companies that own physician practices and staff emergency rooms around the country. In late July, 2019 Doctor Patient Unity placed more than $28 million in ads opposing the legislation that would ban surprise medical bill, without disclosing who was behind the ads.
Current Information on Federal Legislation
There are several committees and bills on this being considered. At this writing the following bill was being considered: S 1895: Lower Health Care Costs Act. The bill was introduced by Senator Lamar Alexander (R, Tennessee) on June 19, 2019 and reported June 26, 2019. The committees assigned to this bill sent it to the House or Senate as a whole for consideration on June 26, 2019. For resources and the information to act on this bill please go to: https://www.govtrack.us/congress/bills/116/s1895.
Well-known and respected Houston based Neurologist Dr. Steven Goldstein is dedicated to reforming healthcare in the U.S. through education and information to the people who need it most. To learn more about the Houston Healthcare Initiative please go to www.houstonhealthcareinitiative.org.
Unexpected Emergency Room Bills Add To Patient Ills
Patients may go to the hospital designated as in network by their insurance, but the doctors who treat them may not be part of that network. This is one of the main reasons for big bills even among those who have health insurance. Patients rarely have any say about who treats them, especially in the case of accidents where they are incapacitated. This is the message that Dr. Steven Goldstein has for podcast listeners this week. The Houston Healthcare Initiative CO-OP podcast can be heard on Soundcloud, Google Play, and iTunes. The podcast and much more information is available from the Houston Healthcare Initiative CO-OP website: www.houstonhealthcareinitiative.org. Or click here to listen:
Wide Awake Nightmare
Imagine leaving the hospital after recovering from an accident, illness or some other unexpected and unwelcome ailment thinking that the worst is over, but then getting a walloping big bill to pay even with really good health insurance. It’s a scenario that plays out ever day and one that respected Houston based neurologist and founder of the Houston Healthcare Initiative CO-OP thinks the public has a right to know.
The out-of-network billing problem exists in part because insurers have sought to rein in costs by shrinking their provider networks and steering patients to less expensive doctors and hospitals. But some specialists and provider groups have deliberately stayed out-of-networks because they can make more money.“This is especially true in emergency rooms, where the patients’ inability to choose their doctors provides a strong incentive for physicians not to cut deals with insurers,” Dr. Goldstein said. “For example, a 2017 study on surprise bills by Yale University researchers reported that one group of emergency room physicians that exited networks to bill as out-of-network providers charged twice as much for care as their ERs used to charge. It’s ridiculously unfair.”
Facts About Bad Surprises
Unwelcome E.R. and hospital bill surprises are not unusual and that is the disappointing part. On average, 16% of inpatient stays and 18% of emergency visits left a patient with at least one out-of-network charge. “Most of those came from doctors offering treatment at the hospital, even when the patients chose an in-network hospital, according to researchers from the Kaiser Family Foundation,” Dr. Goldstein told his audience. “But the news gets worse because the same study found that when a patient is admitted to the hospital from the emergency room, there’s a higher likelihood of an out-of-network charge. As many as 26% of admissions from the emergency room resulted in a surprise medical bill.”
Why We All Tolerate This
When asked about the reasons the public chooses to tolerate this, Dr. Goldstein replied, “the medical and insurance industries have trained us all to think that there is but one choice for us and that is to work with them, exclusively, and that there are no alternatives available for anyone not old enough to get Medicare.” There are alternatives, like the one we have at the Houston Healthcare Initiative CO-OP, but so few are aware of this and other similar organizations that we all simply take and pay for what is available.”
To learn more about the Houston Healthcare Initiative CO-OP please visit the web site atwww.houstonhealthcareinitiative.org
Retired But Too Young for Medicare? What Now?
Retired But Too Young for Medicare? What Now?
There are plenty of people who retire before the age of 65, whether this was their choice or had retirement thrust upon them. Regardless of the circumstance, these people need health coverage. And since they are ‘retired’ they likely need low or lower cost coverage without sacrificing their quality of care. There are several options for those people according to Houston based neurologist and founder of the Houston Healthcare Initiative CO-OP, Dr. Steven Goldstein.
Fear of Loss
Employees fear losing their company subsidized health insurance and when accepting or choosing retirement, that benefit ceases along with the paycheck. According to Dr. Goldstein, it is a situation worth examining and planning for. “There are several alternatives for people who are not old enough for Medicare,” Dr. Goldstein said. “For one, they can choose an extension of their former employers’ insurance through what is known as COBRA.”
COBRA
COBRA stands for “Consolidated Omnibus Budget Reconciliation Act. “It’s a law that since 1985, provides for continuing group health insurance coverage for employees and family members after what they call ‘job loss’,” Dr. Goldstein said. “But, it only applies at companies with more than 20 employees and to state and local government workers. It does not apply to federal workers, churches, or some church related organizations. What’s more this is a short-term fix because there is an 18-month limit on this option. So for someone who is 60 this will get them to 61.5. But there are those other 3.5 years remaining.” COBRA is also a costly choice. Those choosing it can expect to pay up to 102% of the premiums including the part your employer used to pay.
Affordable Care Act
Options for the Affordable Care Act or Obama-Care are available on line. While the politics of healthcare mean that future choices may be different or even non-existent, but at the moment the law remains in place. “Here in Texas, everyone is required to have health insurance, but they are not required to purchase it through the government,” Dr. Goldstein said. “There is no longer the threat of a fine from the federal government for not having health insurance but going without is never a good idea.”
Healthcare Co-Ops
People can and probably should consider one of the health sharing cooperatives. There are several from which to choose, not the least of them the Houston Healthcare Initiative CO-OP. But according to Dr. Goldstein, there is more to the Houston Healthcare Initiative CO-OPthan inexpensive health coverage. “Our first priority is to improve our members health first and help pay for ‘sick care’ second,” Dr Goldstein stated. “As people work with us to manage their own health, the cost goes down. When they do get sick, we can provide lists of places to get the best prices on prescription medicine, tests, imaging and hospitalization. But, and I want to really stress this, our approach to managing the cost of healthcare is to find ways to be sick less often. We help people manage their weight, level of fitness and other choices they can consciously make to be healthier. So, if you want to save money on healthcare, find ways to be sick less often.”
To find ways to be sick less often and save on health coverage, then look to the Houston Healthcare Initiative CO-OP and visit the web site at www.houstonhealthcareinitiative.org.
Special Offer From The Houston Healthcare Initiative
The Houston Healthcare Initiative began for one reason and that was to improve health, lower healthcare costs and provide access to doctors, medicine and treatment. There is a myth promulgated by the insurance companies that you can’t get access to healthcare if you do not have insurance. This is just not true. Starting Monday June 1, 2020, The Houston Healthcare Initiative is offering a FREE Seizure Clinic.
For seizure patients out of work because of the pandemic, we will see in office for no fee as well as provide 30 days of seizure medication for free as long as supplies last. Patients may pay office visit fees after they get back on their feet. During the COVID-19 pandemic, new patients can be seen using telemedicine for $75 & followups for $35. Insured patients will have copays waived.
Houston Healthcare Initiative Offers Affordable Health Care Via “Cooperative” Payments
A new way to fund healthcare is now available. The Houston Healthcare Initiative (HHI) is a member owned, non-profit medical co-op that is now open for business. Led by Houston based neurologist Dr. Steven Goldstein, the HHI (https://houstonhealthcareinitiative.org) will replace traditional health insurance for qualified individuals and families and provide incentives for members to adopt healthier lifestyle habits. HHI will provide affordable medical coverage through a combination of negotiated rates, low monthly payments, personal accountability and lifestyle incentives. The medical co-op promises to save qualifying individuals and families money on health insurance. At the same time, HHI will help uphold quality care by asking members to bear some responsibility and individual accountability for maintaining their personal health.
Complexities of Health Coverage
Healthcare and what causes rates for services and insurance to go up at a startling rate are complicated. What is not that complex is the need for an affordable way to pay for most medical and doctor related expenses. That is what the Houston Healthcare Initiative (HHI) is offering in the form of a member owned co-op. The HHI initiative can replace traditional health insurance for qualified individuals and families. HHI will provide affordable medical coverage through a combination of negotiated rates, low monthly payments, personal accountability and lifestyle incentives. The medical co-op promises to save qualifying individuals and families money on health insurance. At the same time, HHI will help uphold quality care by asking members to bear some responsibility and individual accountability for maintaining their personal health.
What HHI Offers
The HHI is similar to traditional insurance but with some unique distinctions. One is the health of the person(s) applying impacts the price charged by the co-op. The amount of the monthly payment is based on personal lifestyle outcomes. For example, a non-smoker who has a body mass index of less than 25 and can walk a mile in less than 30 minutes gets the best rate because he/she is the healthiest.
People who do not match these criteria pay more but have the opportunity to get the lowest rates if their weight and fitness levels improve. “We wanted to have a system that rewarded people who are healthier with lower rates while at the same time, provide incentives for them to improve,” said Dr. Steven Goldstein, founder of HHI. “With the exception of charging more for smokers, traditional insurance generally does not distinguish between healthier people nor does it give them a financial incentive to lose weight or become more physically fit. HHI does both.”
HHI Issued Debit Card
Members of the co-op receive a personal/family healthcare account that allows payment for routine medical procedures with a member debit card, issued by the HHI bank. The other is a trust that is maintained to allow members to pay for non-routine charges like hospital stays, specialists, surgery, and extensive tests to name a few. In addition to the cost savings, members receive a free screening (check-up) and access to the 24-hour free doctors’ hotline for routine questions. “Not every question for a doctor requires an office visit, which is why the hotline is so handy,” Dr. Goldstein said. “We believe that this approach to paying for health care will be a big help to people who are unable to afford it or do not receive employer subsidized health insurance.”
Summary of Benefits Defining Types of Health Care/Health Challenges
- Preventative – covered by the free yearly HHI check-up and doctor hot line.
- Behavior modification – leads to lower priced coverage under HHI.
- Injury treatment – covered by HHI.
- Acute illnesses – covered by HHI.
- Degenerative and/or genetic illness – covered by HHI.
- End stage care – covered by HHI.
About HHI
The Houston Healthcare Initiative (HHI) is a non-profit, member owned medical cooperative that combines affordable health pricing with personal accountability and lifestyle incentives. With a single payment, members pay monthly into two separate accounts. To learn more visit the company website https://houstonhealthcareinitiative.org.
Four Reasons Snoring Is Bad For Houstonians & What To Do About It
February 5, 2019 – Because of the way their bodies are constructed, men snore more than women, but that is not the least of the reasons to be interested in this much discussed and debated subject. There are negative health considerations linked to snoring. These were the topic Houston based neurologist and founder of the Houston Healthcare Initiative, Dr. Steven Goldstein, covered with his podcast listeners this week. The Houston Healthcare Initiative Podcast can be heard on Soundcloud, Libsyn, iTunes, and www.houstonhealthcareinitiative.org. Beyond the gender-based differences, Dr. Goldstein says that snoring is bad for Houstonians.
Reasons Snoring Is Bad For Health
- People who snore do not get enough sleep. Occasional snoring is only an annoyance to you and possibly your partner. Chronic snoring however is a different issue as it will disrupt the snorers sleep patterns and those of his partner. Getting enough sleep is extremely important to physical and mental health.
- People who snore are far more likely to have cardio/pulmonary diseases including high blood pressure, coronary artery disease, and even heart attacks. There is medical information that states people with sleep apnea are twice as likely to have both nonfatal heart disease events and fatal heart attacks.
- Sleep disorders like apnea and snoring can also impact mental health. This could be everything from feeling cranky to serious depression. A recent study of 74 snorers showed that the more daytime sleepiness people report, the greater their chances of also having mild depression or anxiety symptoms. Medical science does not fully understand the relationship between sleep quality and depression but treating sleep apnea does seem to help ease depression.
- Strokes are linked to snoring. Strokes are among the most serious health conditions that can come from intense snoring. In one study the intensity of snoring was related to the risk of carotid atherosclerosis — narrowing of the arteries in the neck due to fatty deposits called plaque — and as a result, stroke. Simply put, the louder and longer you snore each night, the greater your long-term risk for a stroke.
But What Causes Snoring?
Dr. Goldstein pointed out that anyone can snore. “A stuffy nose can block the airways and cause someone to breathe through their mouth, he told his audience. “So, if you snore and have a stuffy nose during allergy season, that may be the cause.” He went on, “but ultimately, people who snore are likely overweight or obese because of the changes to the anatomy extra weight causes.”
More specifically, being overweight can cause the tissue in the throat to be bulkier than it is on people who are not overweight or obese. A fatter neck compresses the airway and squeezes it even more when lying down. So, the larger one’s neck is, the more likely they are to snore.
Another source of airway compression is fat around the middle body. Belly fat pushes up on the diaphragm and chest fat compresses the ribcage. Both of these shrink the amount of air the lungs will hold. Lower lung capacity restricts airflows and leads to snoring because more air is needed to maintain the correct shape of the throat during sleep. Less airflow means the wrong shape of the throat and snoring.
Which Is Easier To Treat?
When asked which of any of these ailments was easier to treat compared to losing weight, Dr. Goldstein stated emphatically that it was weight loss. “I’m a neurologist and I can tell you first hand that seeing people who had a stroke because of their weight issues require a great deal of treatment,” he said. “Stroke victims can lose motor functions, cognitive ability and even die. Losing weight is challenging but nothing compared to any of these.”
To Learn More
The Houston Healthcare Initiative (HHI) is a non-profit, member owned medical cooperative that combines affordable health pricing with personal accountability and lifestyle incentives. With a single payment, members pay monthly into two separate accounts. To learn more visit the company website https://houstonhealthcareinitiative.org.