Search Results for: cost-cutting edition

February 10, 2015 By e-Patient Dave Leave a Comment

I’m on Medicare! Here’s how I made it easy.

Here’s the punch line: Get a good insurance agent. Mine is Wendy Reed Johnson [right]. She didn’t cost me a thing, and saved me a ton of angst.
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For years in my cost-cutting edition series I’ve been blogging about my experiences as a highly activated shopper for medical services, most recently six months ago when I announced:

Six month countdown to Medicare!
What do I need to know?

Well, it’s six months later, I’m turning 65 this month, so on the first of the month I went on Medicare. (In some situations you can wait, but I opted not to, so I had decisions to make.) Considering how much I blogged in that series about insurance shopping in the past, including the difficulty of figuring out the right plan for my needs, you can imagine that I was anticipating more misery. But Wendy asked the needed questions, laid out all my options, and in short, made it easy.

I highly recommend that before you approach 65 you hunt for a Wendy. Find someone who’s a delight to work with – for you, because people are different – and who, when you ask questions, is happy to hear them and can answer in a way you understand.

IMPORTANT: Medicare is not one big system that you just sign up for. It still has many many options and flavors. Plus, you have to pick one plan to cover doctors, another to cover hospitals, and another for prescription drugs. Frankly, I refuse to get into explaining here the perverted and needlessly complicated terminology (Part A, Part D, blah blah blah). I prefer to pay my agent to understand it. (Except I don’t have to pay her.) [Read more…]

August 21, 2014 By e-Patient Dave 20 Comments

Six month countdown to Medicare! What do I need to know?

65th birthday cake by Oana Go (Germany). Click to view project on Craftsy.

Yesterday I blogged about my business’s fifth birthday … and this week, it turns out, marks six months before I turn 65!

And that means I go on Medicare.

I’ve learned enough in these five years to know at least two things:

You’re a patsy if you think the American medical system will necessarily take care of you. It might, but if it does, it may be in the process of making itself a boodle of money.
- Yes, there are many exceptions – individuals and organizations who care and who work hard. But I’ll repeat: you’re a patsy if you sit back and assume the system will take good care of you.

When it comes to money in American healthcare, don’t expect anything to be explained clearly.
- 18 months ago I blogged about a famous policy paper, Hospital Pricing in America: Chaos Behind A Veil of Secrecy by Princeton economist Uwe Reinhardt. That paper was published 8 years ago, and hardly anything has changed. (The title of the article is real and not an exaggeration.)
- In 2013 I lived the chaos and the veil myself, in my own shopping for everything from CT scans to shingles vaccines to skin cancer treatments. I saw at close range that Reinhardt was not exaggerating, and I blogged it in a series called “cost-cutting edition.”

There are signs of hope, such as ClearHealthCosts, but although I work for change, I’m not waiting for the posse to save me.:-) I’m gonna be pro-active, engaged, empowered, responsible! I want to get educated, because I’ll be on Medicare for the rest of my life. And I want to approach the education from the patient’s perspective … not what the system wants to tell me, but what people like me have found necessary.

So, you who’ve been through it: what do I need to be aware of? What choices will I need to make?

I do know these things about Medicare: [Read more…]

June 5, 2013 By e-Patient Dave 9 Comments

“Chaos, behind a veil of secrecy”: Show me the cash flow

Original post here was June 2013. Or, jump to the Nov 2015 update below.

Latest in my series Let patients help, cost-cutting edition

I’ve blogged several times about the greatest truth I’ve learned about the business of medicine. It’s the title of a 2006 Health Affairs article by Princeton economist Uwe Reinhardt: The Pricing of US Hospital Services: Chaos, Behind a Veil of Secrecy.

The cost chart at right shows what’s happened since Reinhardt’s paper appeared, in the middle of the chart. It’s what you’d expect if slush is flowing around with nobody watching.

Today I was reminded that it ain’t just hospitals. :-)
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Last week I got my annual checkup. There were two separate problems in my hospital’s appointment system, so I ended up leaving too late to get the simple lab work my doctor had ordered; I said I’d get it done at a local lab.

Today I visited AnyLabTestNow, a chain with a local office. I called ahead, and for walk-in self-pay, it’s $49 for the chemistry panel I needed (Calcium, CO2, etc) and $49 for the cholesterol, total $98. And a $10 off coupon, on the site! Just $88.

Or not.

[Read more…]

February 11, 2012 By e-Patient Dave 57 Comments

I’ve started an RFP for my skin cancer

Be sure to scan the 57 comments readers added, below.

The other day I announced my new skin cancer diagnosis and discussed how I’ll blog my approach to it as an e-patient.

I’ve decided to explore my options by doing what companies do when they’re shopping for a solution: they write a Request for Proposals, and let vendors reply. But in this case what I published isn’t cast in stone – I invite discussion and suggestions. And, significantly, I start with the context: partnership; participatory medicine –

I’m approaching this through an RFP process because I believe in “participatory medicine,” in which patients play an active and responsible role in all aspects of healthcare. I believe patients should play an active role in making care more cost-effective and patient-centered, by being responsible about costs and by saying what they want.

Here’s the RFP, in Google Docs. At top right of that page there’s a place to leave comments, or discuss here. Thanks for helping!

Update: This triggered an enormous amount of discussion on social media, additional posts here (with the results of my shopping), and even an article four years later in the New York Times, which I posted about with additional thoughts and resources. [Read more…]

July 13, 2018 By e-Patient Dave Leave a Comment

“What will this cost?” Episode 4 of Power of the Patient, with Clear Health Costs

Episode 4 of the Power of the Patient podcast is live here.

Want better control over your health costs? Investigative journalism has finally come to healthcare, and it’s winning prizes bigtime.

My guest Jeanne Pinder is a former New York Times editor whose company Clear Health Costs has just won the Edward R. Murrow award for investigative journalism, for their contribution to the “Cracking the Code” series in New Orleans. [Read more…]

November 28, 2012 By e-Patient Dave 3 Comments

New Hospital Safety Score data: a key enabler for informed choice

Comparison of five hospitals' data (click to open PDF) — Comparison of five hospitals' data from this report (click to open PDF)

This is cross-posted from e-patients.net.

The PDF at right is a summary of sample data from this new dataset.

The Leapfrog Group is a highly respected patient safety organization. They’ve earned a reputation for carefully and thoughtfully assessing providers’ actual performance in quality and safety. Their mission statement:

To trigger giant leaps forward in the safety, quality and affordability of health care by:

Supporting informed healthcare decisions by those who use and pay for health care; and,
Promoting high-value health care through incentives and rewards.

Today, Leapfrog’s affiliated organization Hospital Safety Scores announced a major update of its A-through-F grades of thousands of US hospitals, and new smartphone apps to access the data on the fly.

Predictably, the hospitals who got an F – based on their own data! – are saying it’s “not a fair scoring system.” Happily, Leapfrog follows the best practices of open science: they fully disclose all their data, the methodology they used, and who designed the system. This means all buyers of care – e-patients, families, employers – can examine the data and assess claims of fairness for ourselves.

The full press release is here. I won’t take time to go into it; many others are doing so – here’s a current Google News search and blog search. Here, I want to focus on two aspects that are core to participatory medicine: understanding the data, and why this matters.

[Read more…]