It is less about rule changes and more about preparing for 2013 and beyond. 

The Affordable Care Act (“ACA”) as signed into law by President Obama, will impact most Americans whether they realize it or not. The implementation process is moving along with various scheduled projects and changes set for this year. But there are several challenges to be faced in 2012. Not the least of which is the current economy, the constitutional Supreme Court case and the establishment of your local Health Insurance Exchange scheduled to be operational by the end of 2012.

Millions Spent to Save What?

By now you must know that the majority of changes will occur beginning in 2014. Between then and today, more is happening they you may know.

As stated earlier, millions of dollars are being spent to consult, study, build, and market the concept of operational health insurance exchanges. The ACA also calls for standardized electronic billing methods. The switch to electronic coding and filing may be lower cost in the long run, but the health care industry still keeps many things on paper. As medical billing gets more advanced it should reduce errors. However, the problem is while conversion is implemented, it will likely increase cost for additional personnel training and systems upgrades which many providers and hospitals will need to pass on in the form of higher fees.

Another challenge impacting reform is the projected 2012 economy. Simply put, it’s not likely to generate enough jobs.  As a result, there are still many people who are unemployed or under-employed and unable to afford health insurance. Typically, people who can’t afford insurance go to hospitals for treatment where care is provided at a higher cost, and this cost is shared over those who do have insurance and use hospital services.

I have to make a critical point here.  I differ in opinion from other health reform writers. Top benefit news analyst suggest “The free care comes at a price to those with health insurance because medical fees are raised to try and make up the difference somewhere. It then becomes a vicious cycle of the medical industry raising costs and the government trying to lower them.”  This is load of crap. If everyone had insurance, but were unable to afford it, the government would provide some form of welfare benefit, or credit to those unemployed or under-employed and the rest of us who can afford insurance would pay for that. Maybe not under our healthcare budget, just higher taxes. In either case, those who can afford to pay either health care or health insurance pay while supporting those who are less fortunate and cannot. Reform by government is therefore only interfering in the health care and health insurance economies and adding no value. 

Health Exchange to No Where

So the government is spending our money to build health insurance exchanges, forcing providers to spend on systems upgrades while insurance keeps getting more expensive.

Will 2012 reforms will affect private insurance prices?

The challenge here determining fact from fiction. Some say “Obamacare” will cut the cost of health insurance across the board. Their claim believes that health insurance policies could be reduced by as much as a $2,500 per year. Other critics are less optimistic. They forecast a dramatic increase in the net cost of health insurance. For example, if you believe the Office of the Actuary in the Centers for Medicare and Medicaid Services, they project that health insurance will jump almost 14%, compared to the 5% percent if “ACA” had never been enacted.

I have read reports that actuaries project a slight reduction in premium cost increases after 2014. This is only a reduction in the rate of increase, during a very difficult economic time. Many more critic’s warning that the new health reform law will dramatically increase insurance costs is not a good sign. Some believe this may force some medical practitioners to leave their practice creating a shortage of doctors and creating a situation where only at grossly-inflated fees will get you quality care.

Where is the Wellness Incentive?

Here is another example, one provision of the bill impacts small business when buying health insurance. Experts suggest the bill will cost small businesses by about $750 per year. They see other provisions that that negatively impact cost. Such as being young and or in excellent health will not matter when plans no longer recognizes your physical status. Insurance companies will no longer be allowed to underwrite insurance based solely on an individual’s health. Buying a health insurance policy using this new rule means smokers, alcoholics and obese people will have their premiums partially paid by healthier policyholders. 

For me this looks like the incentives are all wrong to help control cost. What do you think?

Cold and Flu Viruses are everywhere….

……Manage your immune system to prevent or avoid this common illness.

But if your system is compromised, you can treat the symptoms. Consider these tips….

Hot drinks can help reduce the symptoms of cold viruses.

Yes, your mom was right! Hot tea and soup may be the basics to feeling better when you’re down with a bad cold. In a recent study published in the journal Rhinology, researchers in England suggest sipping a hot beverage can provide immediate and sustained relief from the cold symptoms, like coughing, sneezing, runny nose, and sore throat. Basically the research tested hot beverages versus room-temperature drinks. The new feel better remedy just may be herbal tea with a squeeze of lemon and one teaspoon of honey.

Here is another interesting fact. The average person gets 200 colds in their lifetime. Shocking, but that is what the experts estimate is the number you will have suffered by your 75th birthday. Assuming the standard time a cold takes to pass, that is two years of your life coughing and sneezing. Children typically get between 4 and 8 colds per year. This number decreases as we age. The experts believe most elderly people have already been exposed to the majority of cold viruses circulating about society. I guess they stay home more and not mix in schools or work. It should be noted that any new virus can be devastating our elderly populations that is connected with an upper respiratory illness.

Believe it or not Colds are really not that contagious.

Starting around October each year, we constantly hear about the dreaded rhinovirus.  People are actually afraid of a handshake.  Yes, it is true that germs are commonly transferred from mouth to hands while coughing, but experts disagree on this subject. A recent study conducted at the Cardiff University Common Cold Centre found that when healthy people were put in a room with cold sufferers, it was “remarkably difficult” to spread the infection from one person to another. Here is the key takeaway. the cold virus has to have the ideal conditions when making contact with your body to infect you. The centre concluded that, “Colds are not very contagious, and most colds are caught at home from kids and partners from prolonged and close contact.” This supports our Wellness Effect strategy that suggests you maintain your immune systems with a healthy diet and exercise program and you will most likely avoid the cold and flu season, even if you bump into the occasional sicko. Use your common sense when repeated exposure is the issue. Wash your hands, clean counters and help others improve their immune system. Read the rest of this entry »

What the experts say you can do if you live with Fibromyalgia?

First of all, Fibromyalgia is one of those conditions that has no known identifiable cause.  Many wellness journals suggest it is consistently excluded from many medical text books and other health reference materials. Although there is information scattered over the web. This post is not intended as medical advise. We think it is a source of links to information, so you can discuss your condition, as a knowledgeable consumer, with your doctor. Remember, you are accountable for you health, manage your health and you manage your health insurance costs.

For lack of better Definition, here is what they say at the Mayo Clinic:

“Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.

Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.

Women are much more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.

While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.”

Some areas to future research:

• The link between your immune systems and your chronic condition
• Managing your “weariness” that boosts your energy levels
• Treating your muscle pain without medications
• Reducing inflammation through diet.
• Eating but still experiencing “malnourishment”.
• Links to food allergies, coffee, sugar and refined foods.
• Enzymes and stomach acid play some role
• Digestion and food absorption may be a factor – Add “good” bugs reduce the bad ones.

Hope this helps you find the answers to your healthy life. Share your comments and what you learn with others below.