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Health Affairs had an analysis of why hospital bills are so high and said you could “Blame the Paperwork”. Anyone in the health industry could have told you that! The amount of waste and expense in getting the bill paid by the insurance company could cover the uninsured in the U.S.

The study, funded by PNC Financial Services Group, contends that about one-third of all healthcare costs can be attributed to administration—an unacceptably high share, according to the 1,000 consumers who were surveyed along with 200 hospital and insurance company executives. Here is what they found:

• Hospital executives reported that one in five claims submitted is delayed or denied and 96 percent of all claims must be submitted more than once.
• Hospitals that do not use electronic billing or claims submission processes reported resubmitting a claim 11 times or more, or nearly four times more than those hospitals using electronic processes.
• Insurance executives surveyed say they go back to hospitals twice, on average, to get all the information needed to pay a claim.
• Nearly a quarter of consumers reported having had a legitimate claim denied by their health plan, and one in five ultimately paid the claim out of pocket.

Hospitals and doctors spend millions TRYING to get claims paid.

Let me break this down into its simplest form. Insurance companies are for-profit, wall street conglomerates. There is no mystery why the largest buildings in any metropolitan city are insurers. They have posted record profits for years. They make their money by taking in more money than they spend on health care. Denial of claims, rules that no one understands, underwriting only healthy people and then dropping them when they get sick all means profit. If they can delay paying claims for several months, billions of dollars are the “float” that they keep. For smaller claims, like doctors bills, we just give up and eat it because we can’t afford to keep submitting claims for $50.00. Patients give up too. Wall street loves the insurance industry… America loves them….Politicians love them.

Paula Fryland, executive VP of PNC’s national health care group said: “I don’t think there’s anyone to blame, per se; it’s a reflection of the complexity of the payment relationship between insurers and hospitals. The benefit we have in our system of choice and customization is part of what makes things more expensive.”

Wake up, America! There is plenty of blame! This system of choice and customization provides little benefit at great cost. The major benefit goes to Wall Street. I love profitable companies also. I just don’t want the profits to come from my health care dollar. I want that dollar to pay for health care…either mine or my fellow American.

Patients are always complaining that they take so many prescription drugs. Most drugs people take are not treatment but are preventing disease and early death. That’s why they are taken chronically. (and are such a financial boon for the pharmaceutical industry). The top 10 drugs prescribed by Internists in 2006 are:

1. Lipitor (a statin for high cholesterol..now used for diabetes too)

2. Lisinopril (an Ace inhibitor for high blood pressure and diabetes and congestive heart failure)

3. Hydrocodone/APAP (a narcotic pain reliever..you know it as Vicodin)

4. Atenolol ( a beta blocker used for high blood pressure, congestive heart failure and migraine)

5. Hydrocholorothiazide (a diuretic mainly used for high blood pressure)

6. Levothyroxine (a thyroid replacement)

7. Furosemide (a diuretic called Lasix used for congestive heart failure)

8. Norvasc (a calcium channel blocker used for high blood pressure and angina)

9. Metformin (used for diabetes and polycystic ovary called glucophage)

10. Toprol XL (a beta blocker used for high blood pressure and congestive heart failure)

I was surprised there were no antidepressants or antianxiety pills on the list. Ten years ago, Valium would have been there. Does this mean we are getting more mentally healthy as our vessels and blood pressure deteriorates?

The next time you feel like complaining because you have a crummy boss or benefits are being slashed…think about work conditions in Delhi. This eye opening glimpse of the life of “ragpickers” from the New York Times is enough to silence any whiner.

“More than 95 percent of New Delhi has no formal system of house-to-house garbage collection, so it falls to the city’s ragpickers, one of India’s poorest and most marginalized groups, to provide this basic service. They are not paid by the state, relying instead on donations from the communities they serve and on meager profits from the sale of discarded items. On Oct. 2, Gandhi’s birthday, the Delhi state government will make a small but significant concession. In response to pressure from a ragpickers’ union, it will supply about 6,000 with protective gloves, boots and aprons.” They would prefer earning more than $38/month so they can feed and clothe their children.

It drives me crazy that tobacco farmers are subsidized by our government and that tobacco makers have targeted other countries to pick up the slack of decreased cigarette smoking in the United States.

The 2007 farm bill was passed in July and continues the 75 year tradition of tobacco subsidies. As the tobacco farmers line up for government handouts, the Wall Street Journal reports:

“Nationwide, the tobacco crop has been rebounding. Today there are 355,000 acres under cultivation — still down from the 408,000 acres in 2004, but on the rise. Some farmers reinvested their buyout cash in their tobacco operations. In big tobacco-producing states such as Kentucky, and in smaller ones like Wisconsin and Pennsylvania, many tobacco farmers are enjoying renewed prosperity. Tobacco production in Pennsylvania has more than doubled since 2004. In Illinois, production has gone from practically none to at least 1,000 acres.”

At the same time as our tax dollars are used for growing tobacco, scientists from UCLA published an article in AM. J Public Health that showed more than 100 cigarette additives have pharmacological actions that are detrimental to human health. Some of the additives camouflage the odor of cigarette tobacco smoke and enhance nicotine delivery. Other additives contain chemicals that can make it easier for cigarette smoke to penetrate the lungs - possibly increasing the addictiveness.
They even found chemicals that anesthetize the smoker and make it easier to avoid coughing.

Enough is enough. Cigarette smoking is the single most preventable cause of premature death.
Cigarettes kill more Americans than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined.

Although 70% of smokers want to quit and 35% attempt to quit each year, fewer than 5% succeed. The addictive properties of cigarettes rival cocaine and heroin.

It is a schizophrenic society that subsidizes tobacco growing, has no oversight or regulation on what goes into cigarettes and then cries about the rising cost of health care when those very cigarettes are the main cause of cancer and death. Hmmmmm.

Our Maasai visitors have left and we feel an emptiness in our home. They were so loving and warm and touch is a huge part of their culture. We really feel blessed to have experienced these wonderful, musical people from Kenya and we hope to visit them there when we can.

The Maasai’s are a tribe of 350,000 found in Kenya and Tanzania. They are semi nomadic cattle herders and warriors who now live on the driest and least fertile areas because of less and less available land. Polygamous, the men can have as many wives as they can afford. Each wife has her own hut made of grass, mud and cattle dung and she and the children care for her own herds of cattle.

Girls are circumcised at about age 13 and married at puberty to an older male. Young men are circumcised in a ceremonial ritual at age 18 and they reenter society as men. They are not eligible for marriage, however, until they are 28-35 years old. It is a male dominated society and women do most of the work.

The Maasai healer is called a laibon and is known for his herbal remedies and rituals that absolve social and moral transgressions. Access to western health care is rarely available or affordable for the Maasai.

The Maasai have a rich culture and history and have managed to preserve it despite the encroachment on the land. Spending time with them actually brought a quiet peace into the home and they were the most gracious and thankful guests. They have a philosophy that we could all benefit from that is not to put off saying something or hugging someone because you don’t know if tomorrow will come. They truly seem to live in the moment and “do it now” is not just a saying but a way of life.

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Its Sunday and for anyone who missed the link to Post Secret website, I wanted to give it again. Each week the secrets change so check back every sunday for the new ones. Some are pretty heartbreaking!

Readers of Everythinghealth like to be on the cutting edge so here are so here are some new Food and Drug Administration (FDA) approvals.

Home-Based Fertility Screening: The first at-home fertility screening test for men and women enables couples to assess fertility earlier. the screening kit includes male (motile sperm) and female (follicle-stimulating hormone) tests proved 95% accurate. It is cleverly called “Fertell.”

Lipid Profile Device: CardioChek PA is a diagnostic devise that can measure a patient’s lipid profile in the office or waiting room in less than 2 minutes. (you can buy it for home use but be prepared to spend $149 for the machine, plus cost of various test strips, shipping, etc).

Estradiol Spray to Treat Menopause: Evamist has been approved by the FDA for the treatment of menopause symptoms. The spray is delivered in metered doses. ( I have been unable to find any information on this and I am not aware of any physicians prescribing it. Please comment if you know more)

First Artificial Cervical Disk: The FDA has approved the Prestige cervical disk for treating degenerative disk disease. It is used to replace the impaired natural disk during surgery and would fusing the bones after removal of the diseased disk.

Urinary Flow Measuring System: The FloPoint Elite Uroflow System measures and records a patients pattern of flow, allowing a physician to assess bladder function and patterns. It is installed in a standard toilet, with no awkward chair and uses digital wireless technology. (I am not sure what technology this replaces but the standard toilet part sounds good)

Smart Brace for Stroke Victims: The e100 NeuroRobotic System has been cleared by the FDA for marketing as a portable elbow brace. The devise is designed to help people relearn how to move paralyzed upper limbs. When a patient’s electrical muscle activity signal fires in response to attempted movement, the devise senses the signal on the skin and reinforces the normal movement.