Tag Archives: insurance

Bribes from Big Insurance

I had to comment on this.  The scanned in document below comes from a post that I saw from a friend of a friend on Facebook.  To me it illustrates everything that is wrong with the way health care is implemented in this country.  Take a look at the picture below and read it carefully.  I can’t believe this is even legal.

This letter comes from United Healthcare, which is a major U.S. health insurance company.  They are “encouraging” people to get their children vaccinated by bribing them with $20 gift cards, one of which is to McDonald’s!

In one breath they are asking you to do something they say is healthy for your child which is get vaccinated.  Whether vaccines are healthy or even safe is a topic for another blog but let’s forget that point and take the view of the health insurance company.

United Healthcare actually believe vaccines are a good thing.  They believe it so much that they are offering $20 to their clients whose children are not up to date on their vaccines.  One of their offers includes $20 to McDonald’s!  This company is supposed to be getting people healthier, not encouraging behavior that will make you exceptionally unhealthy!

More and more, people are exercising their right not to vaccinate their children.  This blog is not about whether that is right or wrong but suffice it to say, I support parents who make that decision if they feel it is right for them.

This type of letter, sent to thousands of parents, is a way for Big Insurance and Big Pharma to get people to use their products and services more frequently to make more money.  The facts in the letter aren’t even true.  No child “needs” certain vaccines before a certain age.  The current vaccine time line is in place only to provide pediatricians with a template to vaccinate their patients and make it easier to keep track of.  The letter implies that these vaccines are necessary before the age of two or they won’t work.  Do you really think a vaccine given to a 2 year old works any better than one given to a 4 year old?  Of course not.

I also cannot figure out how this is legal.  I was under the impression that medical service companies, doctors, pharmaceutical companies, etc. were not allowed to offer gifts in exchange for any kind of service or product.  Of course, with major insurance and big pharma involved the laws always seem to bend just enough to allow them to walk that fine line between lawful and unlawful.

I hope those of you reading this can see through this type of deceptive marketing because that’s all it is.  The insurance companies do not truly care about your health or else they wouldn’t offer $20 to McDonald’s to go get vaccinated.  This is just another way for you to use their services and for them to make more money.

 

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Chiropractic saves 40% on care for low back pain.

Chiropractic Caduceus

Image via Wikipedia

My blogs generally focus on nutrition and other topics that relate to health.  That is the main focus of my practice.  But as a chiropractor by training I still see some patients that want just that – chiropractic.  I enjoy those patients because I feel as if it gets me back to my roots, so to speak.

Recently I came across a study that was just too good not to share with all of you.  It was about low back pain, its costs to patients and insurance carriers, and how starting your care with a chiropractor can save an astonishing 40%!  This is big news in this day and age with health care costs skyrocketing.  The medical profession and insurance companies should take notice and stop putting so many road blocks in the way of getting quality chiropractic care for people.

The new study showed that people who initiated care for low back pain with chiropractors saved an average of 40% over people who initiated care with a medical doctor.

The study collected data from 85,000 Blue Cross Blue Shield beneficiaries.  It concluded that insurance companies that restrict access the chiropractic will likely end up paying more for care.  This is precisely what insurance companies should be trying not to do.

The study was published in the December 2010 issue of the Journal of Manipulative and Physiological Therapeutics. It looked at Blue Cross Blue Shield of Tennessee over a two year span.  The people in the study had open access to medical doctors and doctors of chiropractic through self-referral.  There were no limits applied to the number of MD or DC visits and no differences in co-pays.

The study showed that people who started their care with a chiropractor instead of a medical doctor saved their insurance company almost 40%.  They calculated that would save BCBS of Tennessee $2.3 million annually.

I’m not one to listen to the insurance companies crying poor.  This story isn’t about saving insurance companies more money.  The point is that chiropractic has been shown to be more effective than conservative medical care and this study shows that it is also more cost effective.  Considering 85% of people will experience back pain in their life time and in a time when health care costs are on the national stage, this story should be front and center.

So next time you have back pain, make sure you see a chiropractor first.  Not only is it more effective, it will save you money!

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A (small) step in the right direction

No more letting industry help pay for developing medical guidelines. Restrictions on consulting deals. And no more pens with drug company names or other swag at conferences.

These are part of a new ethics code that dozens of leading medical groups announced Wednesday, aimed at limiting the influence that drug and device makers have over patient care.

It’s the most sweeping move ever taken by the Council of Medical Specialty Societies to curb conflict of interest — a growing concern as private industry bankrolls a greater share of medical research.

The council includes 32 medical societies with 650,000 members, from neurologists and obstetricians to family doctors and pediatricians. They include the American College of Physicians, the American College of Cardiology and the American Society of Clinical Oncology, the largest group of cancer specialists in the world.

“We take very seriously the trust that is placed in us by physicians and patients to be authoritative, independent voices in cancer care,” ASCO’s chief, Dr. Allen Lichter, said in a statement. He led the panel that developed the code.

One of its most controversial rules: requiring top leaders of any medical society and top editors of its journals to have no consulting deals or financial ties to industry.

“When a physician stands up to represent medicine and his or her specialty, there shouldn’t be any confusion as to who they’re speaking for,” said Dr. Norman Kahn, the council’s chief executive and a former rural medicine doctor from California.

The code requires groups to:

  • Publicly post any industry support the group receives, such as money for continuing education sessions.
  • Decline industry funding for developing medical practice guidelines, such as who should get a drug, a test or treatment. Require that most members of a guidelines panel be free of financial ties to industry.
  • Disclose any financial ties that leaders and board members have with companies.
  • Ban company or product names and logos from pens, bags and other giveaways at conferences.

Fourteen groups in the council, including ASCO and the College of Physicians, have already adopted the code. Most of the rest plan to by the end of the year.

Last year, leading medical journals agreed to use a uniform conflict-of-interest disclosure form for researchers publishing in their journals. The new ethics code the council is adopting should make financial ties more transparent to patients and breed professionalism and trust in doctors, Kahn said.

Via: USA Today and the Associated Press.  See Full Article

Dr. Court’s Comments

I certainly think this is a step in the right direction.  Pharmaceutical companies control medicine completely now.  They control the treatments, the research, the education and worst of all, your options.  Their reach is as far as you can possibly imagine.

Treatments that are natural, effective and inexspensive get passed over because Big Pharma wants it that way. They make sure to “educate” (indoctrinate is more like it) as many doctors as possible that any natural remedy is quackery.

Medical guidelines are written by doctors with significant ties to Big Pharma and the insurance companies reimburse treatments based on these guidelines.  Let’s use an example to illustrate:

You enter your doctor’s office and he is holding your recent blood test in his hand.  He tells you that your cholesterol is high and you need to start Lipitor right away.  You ask you doctor if there are any other treatment options, but because your doctor has just been to a conference sponsored by Pfizer (the maker of Lipitor) he tells you that there are no better options for you.  He is telling you this because he just learned that “the research” (done by Pfizer) says Lipitor is the most effective treatment for high cholesterol and that it’s the only medication studied that shows it reduces heart attack and stroke risk.  He was also told that diet and exercise only reduce cholesterol by 10%-15% so you shouldn’t bother because you need to lower it more than that.  All these “facts” he is quoting you are from research Pfizer has conducted on its own product.  And if this weren’t enough, your insurance company will pay the most for Lipitor because the guidelines written for cholesterol management were written by a team of 10 physicians, 4 of which had financial ties to Pfizer.

What he didn’t learn at his conference is that things like diet and exercise are very effective tools for reducing cholesterol when applied correctly.  Low carbohydrate is the way to go on that one.  He also did not mention that things like red yeast rice, niacin and plant sterols are very effective ways to reduce cholesterol without resorting to a poisonous chemical like Lipitor.  These things were not mentioned at his conference because alternatives would hurt overall sales.  By the way, your insurance company will reimburse you exactly $0 for anything that isn’t a drug because they don’t have billions of pharmaceutical dollars behind them.  They also won’t pay for you to go to the gym and actually get healthy.

Hopefully these new guidelines will have an effect, but because they are not federal acts I doubt they will have any real impact.  Your best bet is to be your own advocate.  If you don’t want to take a drug, find out from a nutritionally trained physician what you can do.  If you’re concerned about the effectiveness the fix is simple – do objective testing like blood work to see if what you are doing is working.  I think you’ll be surprised to find out just how effective these natural alternatives are.

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As your health care premiums rise, insurance companies make money off fast food

This is a post from the Time wellness blog.  There is a link to it below the article.  Health insurance companies should not own stock in fast food restaurants.  It’s a total conflict of interest.

Time Article

McDonald's and other fast food chains get support from, who else, health insurance companies.

Health insurance companies in the U.S., Canada and Europe hold nearly $1.9 billion in fast-food company stock, according to a new study from researchers at Harvard Medical School and the department of medicine at Cambridge Health Alliance. In the study, published this week in the American Journal of Public Health researchers examined major insurance companies’ stock holdings with five leading, publicly traded fast food chains: McDonald’s, Burger King, Jack in the Box, Yum! Brands (which owns KFC, Taco Bell, and others), and the Wendy’s/Arby’s Group. They found that, as of June 11, 2009, major health insurers owned $1.88 billion in fast-food stock, representing 2.2% of the companies’ total public holdings.

While some of the insurance companies have disputed the accuracy of these figures, the researchers found that U.S.-based insurance providers Prudential Financial, Massachusetts Mutual and Northwestern Mutual owned $355.5 million, $366 million and $422 million respectively in fast-food stock as of last June, with Northwestern Mutual representing the largest fast-food stock holding of any insurance company included in the study. ING, the insurance provider based in the Netherlands, held $406.1 million in these stocks. Canadian insurance provider Manulife held $146.1 million worth of fast-food stock. Those numbers, according to the study, were based on data from Yahoo! Finance from June 11 of last year.

The study authors argue that these findings show a disconcerting disregard among insurance companies for the a growing understanding of how the fast food industry is “increasingly understood to negatively impact public health.” Though they concede that fast food products can of course be consumed responsibly, the researchers emphasize that “the marketing and sale of products by fast food companies is done in a manner that undermines the public health,” and that having the very organizations that provide health insurance support these fast-food chains indicates corporate irresponsibility. As study author Dr. J. Wesley Boyd told the Wall Street Journal health blog:

“They’re profiting directly off the people who eat fast food, and if that leads to obesity or cardiovascular disease, they’ll charge you more for premiums if you have some of those conditions… They’re making money in either case.”

Health insurers should be “held to a higher standard” Boyd and colleagues argue before presenting two means of achieving that loftier standing. Insurance companies can either “divest themselves of holdings in fast food companies as well as other industries that have a clearly negative health impact,” they suggest, or they can use their ownership as leverage to force fast-food chains to adopt “practices consistent with widely accepted public healthy principles.”

The researchers concede that there are a few logical explanations for why health insurance providers might hold fast-food stock—to offset financial liability “associated with their policyholders consuming fast food,” due to a lack of understanding of the potential negative public health impact of excessive fast food consumption, or even simply due to a lack of communication between departments. Yet none of these explanations let the insurers of the hook, they argue. “If insurers are to play a greater part in the health care delivery system they ought to be held to a higher standard of corporate responsibility,” they write. “This responsibility includes aligning all o their resources—including financial investments—in ways that improve health or, at the very least, do not harm it.”

Dr. Court’s Comments

This is an obvious conflict of interest.  It is also another reason health premiums are so expensive.  The health insurance industry is helping fund the very industry that is making people sick!  It’s outrageous.

These are the very same companies that will charge higher premiums if you gain weight or cancel your policy if you cost them too much money.

Just the other day I had a patient come in and tell me she had been dropped by her insurance company because she had “reached her lifetime cap” in terms of spending.  That cap by the way was $1 million.  This was and continues to be a very sick woman, but the insurance company does not care.  All they know is that she is costing them too much money.

Apparently these insurance companies see nothing wrong with investing in fast food though.  Why don’t they invest in tobacco companies too?  There really is no difference.  A lifetime of smoking is not any worse for you than a lifetime of eating fast food.

There are plenty of other ways to invest the large amounts of money that insurance companies make every year.  Investing that money in fast food companies only makes your premiums higher.  It’s like the local police force supplying the drug dealers with cash. It makes absolutely no sense whatsoever.

The insurance company will be the first to raise your premiums for eating at fast food chains.  Of course they don’t know when you actually eat there, but they do require you to have regular physicals.  If your cholesterol goes up, if your weight increases or any other health marker changes negatively, you can expect an increase in the amount of money you pay them.  They’ll turn around and invest that money back into the very problem that is plaguing society.

Fast food companies will say that their food can be eaten as part of a healthy diet. I do not agree and their marketing is designed to get you to eat at their chain as often as possible.  They’d like nothing more than for you to eat every meal at their restaurant.  However, doing this is extremely detrimental to your health.

Obesity costs this country billions each year.  The insurance companies make billions off high premiums and denying care at every turn possible.  With their profits they invest irresponsibly in companies that are playing a significant roll in the  high cost of health care in this country.  In my opinion this should be illegal.

They have the right to invest their money, don’t get me wrong.  They should be investing it in areas that improve health, not destroy it.

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My Take on “Health Care” Reform…

In light of the recent health reform bill that passed the legislative branch of the government and that President Obama has signed into law today, I thought I would take a closer look and see who will actually benefit from this historic piece of legislation.

This health reform does little to change the actual problems with health care in the United States.  This bill will not make us any healthier.  It may insure more people, but having health insurance does not make you healthy.  As a matter of fact, one could argue that people without health insurance are the ones who watch their health more closely so they can avoid the large doctors bills that might accrue should something happen.

The reason Americans are so unhealthy has nothing to do with insurance coverage.  It has everything to do with lifestyle choices.  You can’t drive through many towns in the country and not see at least 3 or 4 different fast food chain restaurants.  They provide a service that people love – quick, easy good tasting meals.  Some argue that they actually taste good, but you can’t argue with results.  Check out these numbers:

McDonald’s claims to have served over 99 billion people.  It’s right on their signs.  Some have changed to say “billions and billions served” to reflect the even higher numbers suggesting it is now too high to count.  I tend to agree, it is probably too high to count.  But let’s take the 99 billion as our number.  We can safely assume the number is at least that high in the United States alone because we are “rounding down” to put it plainly.  If we consider that McDonald’s started in 1948 with the process we would recognize as fast food, that means they’ve served 4,374,723 meals per day to reach 99 billion served in the last 62 years. No wonder America has a health problem.  This just McDonald’s.  This doesn’t take into account Pizza Hut, Burger King, Wendy’s, Jack in the Box, Taco Bell, KFC or any other fast food chain!

Big Pharma Wins Again (Ugh…)

It is clear that our problems go far beyond a lack of health insurance coverage in this country.  Another part of the problem is our thought process when it comes to health and being sick.  When most people get sick (or have an ache or pain, etc…) their first thought is, “What pill can I take to get better.”  There’s nothing wrong with taking an antibiotic if you have a raging bacterial infection or taking a life saving drug if it indeed is life saving.  These cases, however, are the vast minority of cases!  Drugs are over prescribed and the benefits over sold while natural and more cost effective treatments are available. They aren’t marketed like pharmaceuticals and aren’t patentable like pharmaceuticals so they aren’t recognized as well. 

The pharmaceutical lobby had a lot of work ahead of itself when the talk of health care reform began.  They eventually got behind the reform and supported it wholeheartedly.  And now we know why.  They made out like bandits in this reform!

Initially, price control on pharmaceuticals was discussed.  This was a huge point of contention for the pharmaceutical industry.  Once this was eliminated support for the reform bill was gained.  As evidence the industry spent an estimated $100 million in TV advertising, grass-roots organizing and other marketing efforts to promote reform.  Many people will point to the concessions the industry agreed too.  They agreed to contribute $85 billion toward the cost of the bill in the form of industry fees and lower prices paid under government programs over 10 years.  While $85 billion certainly is a lot of money, it pales in comparison to industry revenue.  Take this into consideration – the top 12 pharmaceutical companies had a combined revenue of $237.7 billion in 2006 alone (the most recent year for which I could find statistics)!  When you consider that the $85 billion is spread out over 10 years you realize it really is just a small drop in the bucket for them.  Consider that the hospitals agreed to a much higher number of $155 billion over the next 10 years mainly by accepting lower fees through medicare.

What you must also realize is that the pharmaceutical industry sees this as a way to gain another 32 million costumers.  These are the individuals who are currently uninsured and who do not take prescriptions, see the doctor or get surgery unless they absolutely have to.  Big Pharma sees them as an untapped resource.  No longer will these people leave prescriptions unfilled or forgo their Lipitor because it is too expensive.  The pharmaceutical industry will more than make up for the $85 billion in revenues with sales of more drugs from more insured people.

This legislation, while historic and idealistic, will do little to curb the ridiculous health care costs in this country.  This is for two reasons.  First, the bill does nothing to actually change health care.  We are in this situation because we view health and health care backwards.  People get procedures and drugs paid for once they are already sick.  It should be just the opposite.  Pay to prevent illness.  Insurance companies should be paying people to go to the gym and paying for office visits to nutritionists in the same way they pay for an office visit to your primary care.  Secondly, the bill did nothing to change the price of pharmaceuticals.  These prices are artificially inflated and insurance companies still pay it.  This is a huge burden on the finances of this country.

Hopefully I’m wrong and this significantly improves the health care industry in this country, but the major problems were not addressed.  I am sorry to say that in 10 years I think we’ll still be in the same boat.

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Take Our Quiz – 10 questions to find out what you know about the latest health news!

Take our quiz and let us know how many you were able to answer correctly.  If you don’t know the answer, search our blog for it!

1. Q: Discount brands of fish oil were recently found to contain what carcinogenic chemical?

2. Q: A recent study confirmed what treatment was beneficial for depression relief?

A. Massage
B. Chiropractic Adjustments
C. Acupuncture
D. Yoga

3. Q: What genetic disease was recently demonstrated to cause infertility in women?

A. Rheumatoid Arthritis
B. Celiac Disease
C. Cystic Fibrosis
D. Diabetes

4. Q: If you want to improve your brain function, what activity should you participate in?

5. Q: Drinking more than two sodas per week increases the risk of cancer of the…?

A. Pancreas
B. Colon
C. Breast
D. Skin

6. Q: Low levels of what neurotransmitter were found in babies who died of SIDS?

A. Dopamine
B. Glutamate
C. GABA
D. Serotonin

7. Q: Which nutrient was recently shown to be linked to Autism?

A. Vitamin C
B. Vitamin E
C. Vitamin D
D. Vitamin A

8. Q: A new field of study has showed that our genetic make up does not necessarily control our entire health picture.  What is the name of this field of study?

A. Genetics
B. Epigenetics
C. Hypogenetics
D. Engineered genetics

9. Q: Recent epidemiological studies show that the US currently ranks ____ in terms of obesity rates in the world.

A. 1st
B. 2nd
C. 3rd
D. 4th

10. Q: What type of diet is most favorable for reducing inflammation and losing weight?

A. Low fat
B. Low carb
C. Combo of low fat and low carb
D. Low protein

The answers to all of these questions are listed below.  You can find the articles from which they came here on our blog.  Search our tag cloud on our home page for the key words if you want!

ANSWERS: 1. PCBs, 2. C, 3. B, 4. Napping, 5. A, 6. D, 7. C, 8. B, 9. C, 10. B

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$1000 Tooth Brush, $140 Tylenol! See the Video

Here is a short video from http://www.cnn.com that everyone should watch.  This is partly to blame for why health care is so expensive.

This piece by CNN really illustrates the problem with American health care.  In this piece they say that as long as the bill isn’t over $100,000 they just pay it.  Firstly, that isn’t true.  Being in the health care field I know how insurance companies can nickel and dime doctors to death.  Secondly, if it is true, then these insurance companies must be making exorbitant amounts of money.  They’d have to be to consider paying anything less than $100,000 without looking at the actual bill!

While some of these mistakes might be honest errors, I find it very hard to believe.  I have a personal experience with this as well.  My grandfather was in the hospital for an extended time and was also charged more than $120 for a single Tylenol.  It always amazes me that this doesn’t get more attention and that the hospitals don’t get into more trouble for their billing practices.

The double standard that exists between billing at hospitals and individual practitioners is astounding.  I have many colleagues who are forced to return money to insurance companies despite the fact that they were billing the insurance companies as they were told to. Later on they find out the rules had changed but the insurance company failed to notify them of this change.  Even in these scenarios, when it is clearly the insurance company who made the mistake, they sue to recoup the claims they paid to the practitioner.  It proves they are much more likely to go after the individual because they most likely have limited funds to fight the litigation, whereas hospitals will not be limited by money.

The insurance companies are being irresponsible with your money, which in turn, costs you more money.  The fact that they simply pay these amounts without actually looking at the bills from the hospital drives up your premium cost.  Is it any wonder that it cost almost $17,000 to insure a family of 4 in 2009. Think the cost of health insurance is not affected by such wasteful spending by managed care firms?  Check out the statistics.

  1. $16,771 for a family of four in 2009
  2. $15,609 for a family of four in 2008
  3. $14,500 for a family of four in 2007
  4. $13,382 for a family of four in 2006
  5. $12,214 for a family of four in 2005

From 2005 to 2009 it costs an extra $379 per month per family.  Many families don’t have that laying around to spend.  As it is, they are already spending $1400 per month on health insurance.  This is only part of the problem, however.

Insurance costs would decrease significantly if people became healthier in this country.  We need to teach people how to eat better and exercise.  This would significantly reduce the burden on the health industry resulting is lower costs overall.  Diets focusing on healthy fats and protein with less emphasis on grain and carbohydrate is the only way to achieve this.  Anything else, such as the low fat paradigm, will only make the problem worse.

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