The Happy Times in Healthcare Podcast is here to help healthcare consumers become better educated in order to receive the best possible healthcare available to them. This podcast series covers a wide variety of topics including paying for healthcare - when you are insured and when you are not insured, selecting a new physician, using healthcare quality rating tools, and understanding your medical record. In this episode:

Podcast: KDKA Interview Part 3 - Dr. Ruthann Russo joins John Steigerwald on KDKA News Radio 1020 to discuss how to take control of your healthcare in 7 steps.

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Question: Why large corporations are given a better insurance discount, while small employers struggle to provide coverage at all.
From: Kim W. of Colorado Springs, CO

Answer: This is a very interesting question and before answering, I would like to provide some statistics from the National Coalition on Health. In 2007, $2.3 trillion (or $7600 per person) was spent on healthcare in the U.S. Total healthcare spending equaled 16% of the Gross Domestic Product (GDP). During the same year, employer health insurance premiums increased by 6.1%, or 2 times the rate of inflation. The average annual premium for an employer health plan for a family of four was $12,100 and $4,400 for a single person. For employers with less than 24 employees, the increase was 6.8%. As we all know, employee contribution has continued to climb in an effort to offset the costs to the employer. But the higher the employee contribution, the fewer employees enroll. Various agencies define small employers differently. According to the Agency for Healthcare Research & Quality (AHRQ), ¾ of businesses in the U.S. are considered small employers and they employ nearly 1/3 of the private workforce. AHRQ’s reports indicate that medium to large employers have 50+ employees and small employers have less than 50 employees.

And now as to why smaller employers face higher rates. While larger firms hire Human Resource or Benefits Specialists to manage healthcare issues, the smaller employer relies on the insurance company or a broker to manage and administer. This means more work and cost per enrollee for the insurance company. Smaller firms tend to have higher employee turnover, again more time and cost to the insurance company. The smaller company has an increase likelihood of dropping and then adding coverage and has a higher risk of actually failing. When a company has only a few employees, it is harder to predict the health risks of that employee group and to spread the risk out among employees. To this end, some states even allow insurers to review the medical history of each individual in the group and charge higher premiums for groups that have individuals in poor health.

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Meditation is a path to inner peace. Peace and harmony, however, cannot coexist with negativity, mental corruption, or impurity. You use meditation to quiet your mind and allow the negativity, corruption, and
impurities to dissolve. You quiet your mind by observing your thoughts. If you observe negativity or other unsettling thoughts in your mind, they lose their strength and fade away. The more you practice observing without losing your mental balance, the easier it will be to maintain your balance when you face stress, negativity, or change.

Question: What doctors' average salaries are, in different medical specialties.
From: Cynthia R. of Philadelphia, PA

Answer: Average physician salary scales are easily found on-line. There are many sites that list average starting and average final salaries by specialty. I would like to take this opportunity, however, to share some points on how their salaries are determined. As you look through the sites, you will see that physician salaries depend on the needs of the community, the expected work schedule, medical training, expertise, and experience. For example, specialists need more years of training but tend to earn more than Primary Care Physicians. On the other hand, some PCPs in ideal locations make more than specialists. Physicians enter their practices with significant educational debt. As you know, physician malpractice insurance costs have increased significantly. At the same time they are starting their careers, physicians may be starting families.

Managed Care touted that physician compensation was heavily based on patient satisfaction. Other factors made up the formula including the physician’s corporate teamwork. Compensation is evolving back to productivity, efficiency and the physician’s revenue contribution to practice. There are several types of compensation structures but they are usually based on salary plus a bonus or incentive and are consistent with what other physicians with comparable skills and experience are earning.

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In Get What You Want from Doctors, Hospitals, and Insurance Dr Brickey and Dr. Russo discuss what you don’t know about healthcare can hurt you, even kill you. What if you knew how to get your doctor to focus on your goals, get the information you need from your doctor, and enjoy the process as well? What if you knew a little karate for getting specialists, hospitals, and nursing homes to do what they are supposed to do and share information with you? Would you like to know how to comprehend all those EOBs, bills, and statements? How about not paying $2 for an aspirin at a hospital? Would you like to know how to organize your medical records so you have the information when you need it and can even give it to your doctor?

Listen online at http://agelesslifestyles.com/2008/06/get-what-you-want-from-doctors-hospitals-and-insurance/

Related Links from the show:

• http://www.drbrickey.com/
• www.qualitycheck.org Joint Commission
• http://www.abms.org American Board of Medical Specialties
• http://www.healthgrades.com
• http://www.vimo.com
• http://www.Medicare.gov
• www.7stepshealth.com

Question: Is there a standard to share health information between various Health Care networks ?
From: Prabu K. of Middletown, CT

Answer: The ability to share information has started. As you may recall, in 2004, President Bush laid out several tenets of his vision for healthcare. Two are: medical information will follow consumers so that they are the center of their own care and clinicians will have the patient’s complete medical history, computerized ordering systems, and electronic reminders. According to the Health and Human Services Secretary Mike Leavitt, the goal is to “…link all health records through an interoperative system that protects privacy…resulting in fewer medical mistakes, less hassle, lower costs, and better health…” To accomplish this, there must be standards, infrastructure, and security to connect providers and consumers. HHS is guiding the development for Health IT standards. Health Information Exchange is defined as the mobilization of healthcare information electronically across organizations in a region or community. Regional Health Information Organizations (RHIOs) geographically defined organizations, are emerging to provide standards and structure for health exchange efforts.

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According to a recent survey by the University of Michigan's C.S. Mott Children's Hospital's National Poll on Children's Health childhood obesity tops the list of the biggest health concerns for children in 2008.

The complete list includes

1. childhood obesity
2. drug abuse
3. smoking
4. bullying
5. Internet safety
6. child abuse and neglect
7. teen pregnancy
8. alcohol abuse
9. ADHD, sexually transmitted infection (tied)
10. chemicals in the environment

Whether you are interested in weight loss, glycemic load, avoiding chronic disease, or transitioning to a raw diet, how and if your food is sweetened should be of interest. Synthetically produced or chemically altered products like Sweet’N Low, Equal, Splenda, or refined sugar are not in the vocabulary or the mind-set of the raw foodist. In addition, artificial sweeteners have no nutritional value and may even cause harm.

Depending on the school of thought that you subscribe to, terms like stevia (a naturally growing leaf ), agave (nectar from the cactus plant), and yacon (syrup from the yacon—a root vegetable plant) may represent some of the contents of the food on your plate. In my new book, The Raw Food Diet Myth, which will be released on 8/1/08, I describe various raw sweeteners as an alternative to refined sugar or chemical-based artificial sweeteners.

Over the next few weeks I will discuss examples of all natural raw sweeteners as time permits.

One of the natural alternatives to refined sugar or chemical based sweeteners is stevia. The herb stevia, has been used both nutritionally and medicinally for centuries by the Guarani Indians of Paraguay. By the 1970s, Japan started using stevia commercially and today, they are the biggest users of the extract, which has captured 50 percent of Japan’s sweetener industry. Today stevia is grown around the world from China, Japan, and other Asian countries to South America, Europe, India, the Ukraine, and even North America.

Stevia’s most obvious and notable characteristic is its sweet taste. It is a great sweetener alternative because it does not raise blood sugar levels. In fact, research has shown that concentrate of the leaf has a regulating effect on the pancreas and helps stabilize blood sugar levels. Stevia is useful to people with diabetes, hypoglycemia, and Candida infection. However, it does have an aftertaste similar to artificial sweeteners, so you will need to do a taste test before assuming this is the solution for you.

Stevia can be found in four forms. The fresh leaves are the most pure form, but they are difficult to find. Dried leaves are used in brewing herbal teas and for making liquid extracts. The powder form is dried leaves ground into a fine powder. It is used in teas and cooking but does not dissolve well. The powder form is usually about 10 to 15 times sweeter than sugar.

Stevia can also be found in liquid extract form. The extract is a concentrated syrup derived from the dried leaves. Using the version made with water and not alcohol will ensure you are getting the purest form of the plant. Liquid stevia made without alcohol is dark green in color. You can buy stevia in its dry or liquid form in most health food stores and on the Internet. Because stevia is not mass-produced like the common sugar substitutes on the market, you will likely pay more for stevia than Equal or Splenda.

Question: How do Doctors keep up to date on new info?
From: Lara D. of Cary, NC

Answer: Change is continuous in the world of medicine. New technologies, procedures, and medications have contributed to overall improvement in treatments and results. It is so important for physicians to keep up with these changes for the sake of their patients and their practices. You’ve probably been in a physician’s waiting room at a time when a drug rep is there. This is one way new medications are introduced to physicians. But physicians have numerous journals they may read such as the New England Journal of Medicine and the Journal of the American Medical Association. There are also many journals devoted to particular specialties. Other opportunities to maintain competence and learn of new areas or changes in their fields include inservices, conferences, and videos. As a matter of fact, numerous licensing boards require that physicians meet a set number of Continuing Medical Education (CMEs) credits for license reregistration. Some state boards even mandate the contents of some of the credits, such as HIV/AIDS, End-of-Life Palliative Care, Ethics. Most licensing boards do random audits to monitor compliance. Ways to earn CME credits may include live events, written publications, audio, video, or other electronic methods. All CME options must be approved by the Accreditation Council for Continuing Medical Education (ACCME).

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The Raw Food Diet Myth by Ruthann Russo is now available for pre-order on amazon.com for $16.95.  Order now and they will automatically send you a copy when it is available for shipping.

The Raw Food Diet Myth, What you need to know about the raw and living foods lifestyle to imporve your health, fitness and life.

Question: What is the U.S.'s health care system rank in the world?
From: Kim N. of Anaheim, CA

Answer: I wish I could tell you that we rank 1st but I’m afraid that isn’t so. Despite the growing cost of healthcare and the advancements in technology and medicine, the U.S. lags behind several other nations. We rank last to 2nd last when compared to 22 other developed countries in infant mortality (CNN report May, 2006). In a 1997, the World Health Organization ranked the U.S. 37.th France and Italy ranked 1st and 2nd respectively. Measures included health distribution, responsiveness, expenditures, level of health and health performance. The Commonwealth Fund () sponsored a survey of patients and physicians from the U.S., Australia, Canada, Germany, United Kingdom, and New Zealand. According to the 2007 report, the U.S was last or next to last in quality, access, efficiency, equity, and healthy lives. We ranked the highest in preventive care. Only the U.S. lacked universal healthcare coverage.

There may be several reasons for the U.S. lower rankings. 47 million Americans are without healthcare coverage. In April, 2007, newsman John Stossel also noted the U.S. homicide rate is 10 times higher than the UK, 8 times higher than France’s, and 5 times higher than Canada’s. The U.S. also has more transportation accidents than the others. These account for premature deaths which are factored into the ranking. In January, 2008, Reuters reported on new rankings of 19 industrialized nations, focusing on preventable deaths due to treatable conditions. These are deaths which could have been prevented by access to timely and effective healthcare. The U.S. ranked last with 109.7 deaths per 100,000 people. France was best with 64.8 deaths per 100,000 people.

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The Raw Food Diet Myth: What you need to know about the raw and living food lifestyle to improve your health, fitness, and life by Ruthann Russo is now available and shipping at http://www.rawfoodmyth.com/order.php for $16.95 + S&H. 

The Raw Food Diet Myth is a thought provoking exploration of the revolutionary philosophy of raw and living foods. Author and raw foodist Ruthann Russo proves that raw food is much more than a diet. She does this by bringing together an enjoyable and clear description of the food, lifestyle, treatment of the earth, each other and the quest for physical, spiritual and mental health within the raw food movement.

Depending on where in the US you live the growing shortage of Primary Care Physicians (PCPs) may be more or less evident to you. In a recent audio commentary Dr. Stephen Schimpff, author of The Future of Medicine, discusses the shortage of PCPs, especially in rural and economically depressed urban areas. Dr. Schimpff discusses some of the causes for this phenomena and offers some strategies on how we can reverse the situation.

"In the USA there are about 30% PCPs and 70% specialists. In other countries of the developed world, the ratio is the opposite. And PCPs now need to attend to many more patients with complex, chronic diseaes that last for life and require a team-based approach to care."

Download/listen to Primary Care Physicians - A Shortage

The Happy Times in Healthcare Podcast is here to help healthcare consumers become better educated in order to receive the best possible healthcare available to them. This podcast series covers a wide variety of topics including paying for healthcare - when you are insured and when you are not insured, selecting a new physician, using healthcare quality rating tools, and understanding your medical record. In this episode:

Podcast: Raw & Living Foods - Ruthann Russo joins Dr. Michael Brickey of the Ageless Lifestyles Institute on Ageless Lifestyles Radio to discuss the raw food movement and how an all raw diet consisting of fresh, natural, organic ingredients can have a positive impact on your health.

For more information about the raw and living foods lifestyle and Russo’s new book, The Raw Food Diet Myth, please visit http://www.rawfoodmyth.com

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Question: Who makes my health decisions if I am unconscious or in a coma?
From: Wendy H. of Webster, NY

Answer: Many of us remember the agonizing situations in the Quinlan (1976), Cruzan cases (1990), and more recently, the Schiabo cases which brought to light questions about right to refuse life sustaining treatment and the need to make your wishes known ahead. If you have been hospitalized in recent years, you have probably been asked if you have a Living Will or Advance Directive. Advance Directives may be written or oral directives made by an individual capable of making informed and voluntary decisions about treatment options for the possibility that he/she will be unable to express those choices. The Patient Self-Determination Act of 1990 mandated that patients be informed of the option to document treatment choices in an Advance Directive. An individual may designate someone to make or carry out wishes. Despite the publicity surrounding the above cases and information provided to the public, many do not have Advance Directives. In the absence of such documentation, clinicians in most states turn to surrogate decision makers. States recognize a relationship hierarchy to follow and to make treatment decisions the patient would make if he/she could. Surrogates are usually family members and loved ones but, in some cases (there is no family or they are not close), the surrogate may be a companion, neighbor, clergy member. Most states support the right of the family to authorize treatment or refusal of treatment based on the patient’s probable wishes and prior instructions. The obvious problem is when there is no clear indication of the patient’s wishes. Hospitals have an Ethics Committee made up of physicians, nurses, clergy, or others working closely with the patient. The Ethics Committee will assist in situations where there is no surrogate or they disagree. Guardians may be appointed by the court but this is not an immediate decision.

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Question: What does and does not constitute a preexisting condition?
From: Cassandra F. of Monroe, MI

Answer: A pre-existing condition is any medical condition diagnosed or treated before you join a new health plan. In the past, a new health plan could make you wait for a set period of time before paying for any pre-existing condition. The Health Insurance Portability And Accountability Act (HIPAA) now limits health plans from denying payment for a preexisting condition if you have been insured without interruption for the previous 12 months. This was designed to protect employees who move from one job to another from losing health insurance coverage due to a preexisting condition. There are also protections for individuals who move from a group health plan to an individual one. Let’s say that you were diagnosed with gallstones before changing health plans. The new plan may have had a 1 year waiting period for treatment of the stones. Since HIPAA, your new health plan will cover the treatment of the gallstones even if they were diagnosed before the change in plans. In the event that your coverage lapsed and you have a pre-existing condition, the longest you must wait for coverage is 12 months.

The Happy Times in Healthcare Podcast is here to help healthcare consumers become better educated in order to receive the best possible healthcare available to them. This podcast series covers a wide variety of topics including paying for healthcare - when you are insured and when you are not insured, selecting a new physician, using healthcare quality rating tools, and understanding your medical record. In this episode:

Podcast: The Healthcare Crisis - Dr. Ruthann Russo joins Ron Ross of the AM 1230 WJBC morning show to discuss the healthcare crisis in America and how the complexity of the healthcare system and consumer’s knowledge of the system contribute to the issues.

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