Healthcare, The User's Manual

By Mark Friedman

This book is THE indispensable guide to navigating the chaos that is healthcare in the US today. It will help you understand how we got to this point and what you can do NOW to obtain the best possible healthcare for you and your family.

• Language: English
• Publisher: Mark Friedman
• Release date: Dec 12, 2012
• ISBN: 9780971845213

Book preview

Healthcare The User’s Manual: Navigating the Chaos of the System

Copyright © 2012 Mark L Friedman MD

All rights reserved

Published by First Stop Health at Smashwords

222 N Columbus Dr., Suite D

Chicago, IL 60601

First Stop Health ® is a trademark of First Stop Health LLC

ISBN: 978-0-9718452-1-3

Disclaimer:

Nothing in this book is meant to be construed as medical advice or as a substitute for consultation with a licensed physician.

IF THIS IS A MEDICAL EMERGENCY

PUT DOWN THIS BOOK AND DIAL 911!

If it’s not, or if you’re not sure, you may continue to read.

TABLE OF CONTENTS

INTRODUCTION

Conflict of interest disclosure

How to use this guide

QUICK START GUIDE

What to do in an emergency

Access to care

UNDERSTANDING THE PROBLEMS WITH HEALTHCARE

Why healthcare is such a mess

History of the current system

THE HEALTHCARE GAME: The players

Patients, doctors, hospitals, insurance companies, government

STEP ONE

MEDICAL INSURANCE: How to play like a pro

Insurance theory

Understanding your options

Selecting a carrier

Long-term care insurance

The Affordable Care Act (ACA) / Obamacare

How to deal with a medical bill now

Insurance alternatives

How to read an EOB

How to find / contact your insurance company

Insurance games, scams, frauds, abuses and other fun stuff

STEP TWO

ACCESS TO CARE: How to …

Find and choose the right doctor / hospital

Contact your doctor

Talk to a doctor

Listen to a doctor

Make medical decisions

Special situations: Travel medicine / remote locations / medical evacuation

STEP THREE

DEALING WITH THE RESULTS OF STEPS ONE AND TWO

Medical Records

Family and Social History

TROUBLESHOOTING: Where to turn for help

Why to consider a patient advocate

Getting a second medical opinion

DIY: The do-it-yourself solution

Self DX (diagnosis)

Self RX (treatment)

The perfect DIY medical case

How to search the medical literature

PREVENTION: The best medicine

5 steps to good health

Vaccinations: Why choose them

Trauma prevention

Dieting and other prevention tips

ALTERNATIVE MEDICINE: Alternatives to medicine

What is alternative medicine?

When to consider it / How to approach it / Why some people like it

How to spot scams and crooks

Complementary medicine

PARTS LIST

Why should we care about the cost?

Resources

INTRODUCTION

Congratulations and welcome to the American Healthcare System. Whether you have privately purchased medical insurance, some form of government insurance, or no insurance at all, you are in for the experience of a lifetime.

Like most people (myself included), you have probably already tried to use this system without first reading the manual. You may object that no one ever gave you a manual before, so how could you read it. Absolutely correct – until now.

In actual fact, there is no system either. According to Funk and Wagnall’s Standard College Dictionary, a system is: (An) orderly combination or arrangement of parts, elements, etc. into a whole; especially … according to some rational principle. If you think that this describes the current discombobulated conglomeration of entities providing healthcare in this country, then skip right to the section on psychiatric care. Healthcare in 21st Century America can better be described as utter disorder and confusion – the definition of chaos.

As you read this manual you will begin to understand why this is so and what you can do about it in your own personal circumstances to obtain the best healthcare (and the best health) possible.

Conflict of interest disclosure:

Let me make it clear from the outset of this document: as co-founder and chief medical officer of First Stop Health, I have a definite interest in getting people to subscribe to (and pay for) our wonderful service. In fact, I will give you this book for free if you just sign up (so please do). Beyond that I have a genuine need to write about what I know, of which things medical care is one. As a writer, it is my additional hope that I may in some small way entertain you and provide knowledge you will find of value. Additional healthcare-related articles of interest (as well as some of the contents of this book) are available on the First Stop Health blog.

How to use this guide:

If you have an immediate healthcare need, jump to the QUICK START GUIDE. If you would like to talk to a doctor or a health advocate on the phone now, sign up at First Stop Health and go to the FSH USER’S GUIDE on the website. If you have a medical bill that is an immediate problem, go to the section on dealing with a medical bill now. If you would like a deeper understanding of healthcare in America, start at the beginning and read through to the end.

QUICK START GUIDE

If you need to use the system immediately, read this section.

ACCESS TO CARE

If this is a medical emergency, dial 911. In most of the U.S. this will connect you to a dispatcher who will gather appropriate information and send help (ambulance, police, or fire department resources) to your location. If possible, place the call from a landline phone so that the dispatcher can immediately determine your physical location. If the call must be placed from a cellular phone, be prepared to give your exact address (including number, street, and city or town). Some cell phones are equipped with the ability to determine latitude and longitude, but that is of more use at sea or in the wilderness. Most likely you will be calling from a street address. If you are on the highway, specify a route number, mile marker, intersection, or prominent landmark. Don’t let them have trouble finding you.

Describe the emergency and ask advice about what to do while awaiting the arrival of help. Although this is not the ideal circumstance under which to learn first aid (more about that later), the dispatcher may be able to tell you how to manage until help arrives. First aid instructions can at times be life-saving (direct pressure to stop bleeding, for instance) and many 911 dispatchers can even give you telephone instruction in CPR. Stay calm and answer the dispatcher’s questions clearly. Do not hang up until you are sure the dispatcher has. You may hear clicking, but remain on the phone.

What if you are unsure if this is an emergency? According to the American College of Emergency Physicians, warning signs of a medical emergency include: difficulty breathing, chest or abdominal pain, fainting, weakness, dizziness, changes in vision, confusion, difficulty speaking, severe pain, uncontrolled bleeding, severe vomiting or diarrhea, coughing or vomiting blood, or suicidal feelings.

When deciding whether to go to the ER, use common sense, but err on the side of caution. Better to go if you are not sure. If symptoms are severe or getting worse, call 911 to get an ambulance.

If you are having a less acute problem, consider more cost effective and convenient alternatives. Your primary care physician may see you on a walk-in basis, or you may have to schedule an appointment. Urgent care centers have extended hours and see walk-in patients. Or you can use First Stop Health to locate a facility near you. Another option is to consult a telemedicine physician.

Telemedicine is a relatively new development. However, in some respects, it is similar to the good old days when you could call your doctor and actually get him on the phone. Today, services exist where you can speak to a doctor immediately and get professional advice. In situations where you may be unsure of what to do this has been found to significantly improve survival, according to The New York Times. A physician call can often help you make the decision as to whether to go to the ER or arrange for an alternative like an urgent care center or a doctor appointment. In simple cases they can even phone a prescription in to your local pharmacy.

Do not call the ER or hospital switchboard for advice (unless you need driving directions to get there). They will invariably tell