HOW’S THE NEW HEALTHCARE PROGRAM GOING FOR YOU?

A candid Q & A with Elson M. Haas MD

Q:  So, Dr. Haas, now that we are several months into the Affordable Care Act, what is your assessment from a provider’s point-of-view?

A:  Well, so far as I can tell, no one’s very excited about the ACA (“Affordable Care Act”), including me, my associates, and my patients. Many are paying too much for poor coverage.

 

Q:  Not excited?  Why is that?

A:  It seems that insurance companies are now covering less, including fewer doctors on their plans and being subsidized by taxpayers in the process. Many are paying more for an inferior product; we don’t like that in America.

 

Q:  If that’s the case, what are the consequences at your clinic?

A:  The first thing we noticed was that our reimbursements for the new plans are reduced by about 30-40 percent for our patient visits.  As you can imagine, this has had a huge and negative impact upon our clinic operations.  We also noticed that a number of our patients who were previously covered found out that they were no longer covered when they came to us for care.

 

Q:  Your patients who were previously covered found out that they weren’t able to see you anymore and be covered by insurance!?  How did that happen?

A:  Good question—the only thing we know is that I was, and am an Anthem Blue Cross provider (for example), and when my patients who were previously covered by this plan moved to Covered California they found that their plan was now being managed by another company with very few doctors involved, and my name wasn’t on the roster. And we had no communication from Anthem about this.

 

Q:  Is this an isolated situation?

A:  No.  We have had a number of patients come into our clinic and find out to their surprise and dismay that they are no longer covered.  So the impact is multiplied—we don’t provide care, the patient doesn’t receive care, and we don’t get paid.  I don’t think that’s what the authors of the ACA had in mind.  The only thing that seems to be working is that the insurance carriers are being paid handsomely for providing less coverage.

 

Q:  This sounds like a very critical situation.  What do you see happening in the months ahead?

A:  We wish we knew.  We certainly can’t continue to operate under this broken system, especially since I feel primary care doctors using the insurance model were being underpaid before the ACA took effect.  It has been challenging enough being reimbursed for the level of integrative and preventive care we provide with little consideration for the time and effort we invest on our patients’ behalf above-and-beyond the visit. This includes phone time, prescription re-fills, weekend calls and more.  The only thing I can see is that if we are going to remain solvent as a clinic, patients are going to have to pay more and more for these services which were previously covered.

 

Q:  Dr. Haas, what message do you have for patients who are currently involved with the ACA?

A:  I would ask anyone covered under the ACA—in California or elsewhere:

How is it working for you?

What has been your experience so far?

What suggestions do you have to make insurance better?

 

I would also encourage people to read my previous blogs about this matter, in which I promote an approach where we as individuals assume a greater responsibility for our health through preventive care and healthy lifestyle choices, and keep our “insurance” focused on coverage for catastrophic events and serious injuries.

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If you have thoughts you would like to share with Dr. Haas about the ACA, please leave comments below.

 

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Health Insurance for Your “Body Vehicle”

I have been studying the Affordable Care Act (ACA) since it was first crafted by President Obama and the U.S. House of Representatives in 2009. Now that the ACA has become the law of the land, I am watching its impact upon individuals and the whole society. My original sense was—and remains—that the ACA is primarily an updated insurance program. It is not healthcare reform in the basic sense, other than in its attempt to provide coverage for more people with the same old insurance model we’ve been living with for decades. The ACA is going to be costly to the government (and indirectly to taxpayers) and it is a boon to the insurance industry. At this point, only time will tell if it adds any real “health” care and supports preventive services as it has been purported.

Decades ago, I became a proponent of a preventive approach to healthcare, this during an era when “fix-it” care was the standard and there were few alternatives to what is frequently referred to as the allopathic or Western medical model. My nutritional and detox approach to natural and preventive care was not widely respected then, and even today the massive medical, pharmaceutical, food and other linked industries are doing little to promote its expanded use by U.S. Citizens. I find it ironic that “preventive care” is listed as one of the core priorities of the ACA, yet we’ll need to see what transpires this year.

IS THIS HEALTHCARE REFORM???

Let’s consider a more sensible and economical way to cover more people and spend less money. Keeping people healthy is first and foremost up to each of us as individuals, and to parents for their children, of course. There is a great deal each and all of us can do to promote our good health—even in our senior years—and avoid many costly visits to physicians, specialists, ERs, surgical centers, and the pharmacy. Yet, even with all of our best preventive efforts, there are inevitable occasions with some of us experiencing problems that need expensive testing and treatments. In this respect, I agree with the ACA that everyone needs “catastrophic” coverage to prevent the huge costs of hospital and emergency care, where costs have also gotten out of hand. Also, having basic insurance can allow better rates for many services because companies contract for special, lower rates with hospitals and labs..

In my view, we need to be thinking about our health care very differently than is the current approach. I think we need to think “car insurance” for our “body vehicles” as well as our autos. We can require real “insurance” to cover serious accidents and injuries to our selves, others, our cars and other’s property. Let’s have the ACA mandate and cover people for real mishaps and major medical costs. That’s the basic plan that will protect people from the “medical bankruptcies” that are common nowadays.

Beyond “body vehicle” insurance, I recommend the rest of our coverage be whatever healthcare coverage we want and can afford—we would leave this aspect up to the individual and/or the employers. If someone wants more benefits, they can buy a fancier policy, just as people decide how much they wish to spend on their cars or their insurance coverage—some have a full policy that covers everything, while others pay less to not worry about dents and collisions. Still, the body is protected from catastrophic loss.

In past decades and really since its advent, health insurance has been seen as a “benefit” to use, and not just insurance for covering accidents, injuries, or major illnesses; we have called this “major medical.” We have used it to support our health care, often losing sight that our lifestyle and the choices we make is our true health insurance. Let’s all care for our health, as well as the other loved ones in our sphere, and we will reach our goal—better health for less expense!

The Affordable Care Act: An Improvement, or Less Care For More Money?

I don’t know what your position is about President Obama’s Affordable Care Act (ACA), but if you are like a majority of Americans you are either flatly opposed to it or you are scratching your head wondering how it’s going to turn out.

A mid-December, 2013 CNN poll of 1034 adults indicated that only 35 percent of those questioned said they support the new healthcare law–a five percent drop in less than one month–while 62 percent said they oppose the law, up four points from November.  To make matters worse for the ACA, its rollout these last couple months was nothing less than a fiasco, riddled with problems, glitches and delays.  These, combined with changing public sentiment, further erodes support for what was intended to be a sweeping reform of our nation’s healthcare system looking to achieve basic health care for all citizens. In truth, it’s not about “health” care really, but about insurance coverage.

Aside from the technical glitches, what’s wrong with the ACA?  As a practicing physician and long-time worker and student of America’s healthcare system, following are some of my initial impressions:

Who’s the Real Winner?

While the ACA has offered lip service to support of preventive care, practitioners have yet to see any tangible evidence.  What I see at the present time for many people is “less care for more money—such a deal!“  I predict that we’ll see the primary winner with ACA is going to be the insurance companies. Of course, some lower income people will be getting more coverage for much less cost, as subsidized by the government and taxpayers. Yet, many will pay more for coverage with higher deductibles and/or co-pays. Either way, the insurance companies are assured of increased revenues and profits, much of it at taxpayers’ expense and creating even more debt for our country and future generations.

So far, the ACA is not about health care. Let’s face it; it’s about insurance coverage. It will cover more people with an ideal to have more preventive services covered, and it does take away the “pre-existing” condition clauses, which also gives the insurance companies cause to raise their rates. So, for many consumers with reasonable incomes, they will pay more for lower quality coverage, while others will pay less for higher-level coverage. Hopefully, in due time these higher costs will get rebalanced with more competitive rates and better coverage for all.

I will be sharing more insights and solutions about the ACA, health care, and insurance in future blogs. Let’s all envision some positive changes that really address true health care and not just insurance coverage. Please send your comments to me at: elson@pmcmarin.com.

Dealing with Stress During the Holidays

For many of us it seems that the words “holidays” and “stress” go hand-in-hand. In fact, a recent research study by Greenberg, Quinlan and Rosner reported the following percentage of those surveyed experienced negative impacts during the holidays:

• Fatigue 68%
• Stress 61%
• Irritability 52%
• Sadness 36%
• Anger 35%
• Loneliness 26%

From a seasonal standpoint, Winter is a time to rest more, recharge and conserve energy, and not overindulge with sweets, alcohol and heavy foods. Eggnog anyone?  Well, the holidays bring all of those treats plus many other demands that don’t allow us to get to bed early or have good sleep.  It’s great to connect with family and loved ones, but we must watch out for overindulgences.  Maintain your cornerstones of health with a balanced diet, regular exercise, good sleep, or managing stress. And in Winter we can do more indoor and slower exercises like yoga and stretching.

 

Meditation and breathing are good ways to relax to reduce stress, as are:

• Setting limits on what you will commit to during the Holidays (events, shopping, food).
• Plan ahead and create some “down time.”
• Manage the Holiday Season—don’t let it manage YOU!
• Many nutrients and herbs  have potential benefits for protecting our health and helping us avoid colds and flu. Some items that have worked for me include fresh garlic, Astragalus herb, Maitake mushroom, plus vitamins C and A.

For me, the bottom line is first to recognize that the holiday season can lead to stressful circumstances, and to anticipate these by being pro-active in reducing stress in your life, mind and body.

Here is wishing each and all of you a low-stress and Joy-filled holiday season, and as always…

 

“Stay Healthy!”

  Dr. Elson

Detoxify your Body

 

Ten Tips for Losing Weight and Gaining Life

“The greatest discovery of any generation is that human beings can alter their lives by altering the attitudes of their minds” — Albert Schweitzer

Love yourself and care for your body with good foods and exercise. It’s the only body you have, and if you treat it with love, it will care for you for life.

I invite you to review and follow Dr. Haas’ ten steps below and to begin a new life from within. “Your body, and how you look and feel, is a result of your life. If you want a different result, then you may need to make changes. It takes some work, but it is really worth it!” This is one of the good doctors simple philosophies.

All we have to do is be guardians of the circle of dates, of our shared fates, and give thanks for our healthfully full plates, made out of the Earth, to create Nature’s promise and support our bodies with their restoration deep to the core.

Here are some tips from Dr. Haas for ways to enhance and support the cleansing process and Stay Healthy in Spring.

1. Self Love: Become current in your life in this inspiring season. Embrace yourself honestly as you look at all of your habits and areas of your own life. Even with all the worldly concerns, care for yourself and your loved ones. Assess the various aspects of your life to see where stresses or weaknesses exist—your diet, exercise program, work or relationships as examples—and focus on the ones that need improvement.
2. Personal Relationships: Take a close look at your personal relationships and see how they affect you and how you affect them. Include your significant other, friends, or relatives to go along with you in a Cleansing diet for their own good and for your support. For my cleanse groups, I find that personal support is extremely valuable for many people to achieve the success they want.
3. Conscious Habits: Instead of having negative habits control your life make the decision to adopt positive habits that support and empower you. Choose three habits that inhabit your life. How and when did they begin, and are you done with any? Which ones are most important for you to change or incorporate to create a healthier you? Do you need help or can you do this on your own? Mine are to eat more lightly at night so that I can digest more fully to be less full, to take more time for stretching and yoga, and to create a good nutritional program that works for me. It’s easier to give stuff up if you start something new, like breathing more often, walking, dancing, romancing, and overall, making more time for health.
4. Letting Go of Clutter: Clean and organize your home—this is the season of Nature’s New Year in clearing out the old and bringing in the new. I love this feeling of looking at my desk, my closet, and every nook and cranny around my house and office, and wanting to freshen it all. And it’s a good way to stay out of the kitchen (which also gets cleaner along with my fridge) and look at other areas of my life. Of course, after all my years of accumulating and with all the communication and journals I receive, it’s harder to handle everything in my existence as it was in my earlier years of cleansing. Yet, I do what I can and sometimes have my support team keep moving things forward and recycling what we can. Then, my life feels and looks cleaner and lighter at the end of my Spring Cleaning, and has space for the new to land.
5. Stay Fit and Stay Healthy: Get outdoors and exercise—move your Body! Friluftsliv is a Norwegian term for healing and de-stressing by going outdoors and exercising in the free and fresh air. Hike and explore your neighborhood and extended community or find a place you’ve heard about and wanted to visit. I love the lightness and easiness I feel when I am cleansing, and my body feels more flexible and able to do my aerobic exercise. A yoga class is a good experience to expand our flexibility. Breathe and relax as well. Play flute, dance, and make time for romance. Remember, it’s the gift of your own life that you are celebrating!
6. Look at Your Dietary Choices: What do you choose to put in that mouth of yours? And what do you fuel your other “mouths” with—those areas of energy intake, like your eyes, ears, skin, and heart? Write down a few days of your typical diet, then assess it and write a new plan based on your knowledge of what’s right for your body. You may also wish to take a break from the TV, news, violent movies, and stressful people while you are purifying your life. It’s good to have a reference by taking a break, even with substances like caffeine and sugar (Read The New Detox Diet book), to see how you feel and what level your dependence is on your favorite substances. I can assure you that it feels good to release yourself from those habits.
7. Mastering Feelings and Contacting Your Spirit: How do you feel usually? Are you low or depressed? Or more positive and energetic? Ideally, we can feel a wide range of emotions based on our daily life experience and not dwell on one particular emotion, which is the real problem. Embrace the whys of moods and energy levels with greater honesty of your true feelings—that’s the beginning of healing feelings. And I can tell you that many factors ranging from your diet and digestive health to your early childhood learned behavior patterns influence your mood, energy level, and emotions, and thus your Spiritual Well-Being.
8. Cleanse and Detoxify for 1-3 weeks. This could include juice cleansing, the Detox Diet, or a period off sugar, chocolate, sodas, milk products, wheat, or whatever you believe undermines your health. To do this successfully, it helps to write out a plan and focus on what you will do and will eat, and not what you are leaving out. Make a list of your good foods, shop for them, and have them available whenever you are hungry. And drink lots of good water.
9. Nutritional Supplements: Let’s take a look at the best supplements that you can use during a detoxification diet. I suggest, with a food-based Detox Program, a simple age- and gender-appropriate multivitamin/mineral along with additional antioxidants that include Vitamins C and E (mixed natural tocopherols), and selenium as the basic supplement plan. Also helpful for most people are herbs that stimulate bowel function, and blue green algae (like Chlorella or spirulina) for energy and Detox support. I also suggest drinking plenty of water and herbal teas. Calcium and magnesium before bed can help with relaxation and sleep or a buffered vitamin C formula with those minerals plus potassium help to alkalinize and cleanse the body.
10. Develop a Plan and Commit to it: Begin by looking at the key areas of life—Health and personal habits, Love and relationships, and Career or work. And if LOVE moves into all those areas, that’s all the better as you’ll care for yourself and your life, plus your relationships in a positive way. Human love is temporal for many, yet love in the Spirit is everlasting. We are all blessed to share this garden, this Earth, which needs our Love and Protection. We must take the time to Nurture Nature, in order to Nourish and Flourish.

Let us now be ready to embrace more—of our life

Be Blessed!

Yours truly,

Elson M. Haas, M.D.