The Top Ten Reasons for US Healthcare Spending

Everyone complains that U.S. healthcare is too expensive and it certainly is! Where is all that money going: well over $2 trillion/year? Objective analysis shows ten reasons why we spend money on healthcare.

Ten Reasons For U.S. Healthcare Spending

1. New value

2. More people living longer

3. Action without evidence

4. Bureaucracy

5. Disconnection

6. Perverse incentives

7. Defensive Medicine

8. Adverse outcomes and errors

9. Money removed from healthcare

10. Fraud and embezzlement

We actually want to spend money on the first two. The other eight are costs we would like to minimize – elimination is desirable but improbable in the extreme.

The 19th century doctor’s black bag had little in it: strict bed rest, amputation, home remedies, and medicines made from garden plants. Today, doctors can operate on the heart without even opening the chest; replace failing organs with new ones; and prescribe pills that can target specific areas or functions within the body. Whooping cough, rabies, diphtheria, and polio have become the purview of medical historians rather than practitioners.

Modern capabilities – inconceivable in the 19th century – provide 21st century people with new value. They come with a price, sometimes astronomical. You can buy an expensive pill, say Flomax at $2 for one pill, and avoid a $20,000 surgery. You can have a quarter of a million dollar heart transplant and live, or take the cheaper route and die. We get new value and we should gladly pay for it.

There are more people today who are living longer. When you add new value to more people, two reasons for increased healthcare spending become apparent. This is spending we like. We are getting something we want for the money we spend.

Thirty percent of all healthcare dollars is paid to providers of all kinds. Thirty percent reimburses institutions: hospitals, pharmaceutical companies, wheelchair manufacturers and the like. The remainder (40% or roughly $920 billion in 2008 in the USA) just…disappears. It goes to activities and services that provide no health care for patients.

If Congress makes laws without proof in advance of what the law will actually do (reason #3), bad things happen. The Public gets two undesired outcomes: laws that harm us and huge costs, invariably much, much more than Congress projected when they passed the legislation. In 1990, the GAO showed that Medicare had already cost 845% more than estimated in 1965.

Two good examples of how Congressional action-without-evidence harms us (reason #3) are HIPAA (Health Insurance Portability and Accountability Act) and CPSIA (Consumer Product Safety Improvement Act). The first – HIPAA – was a draconian and expensive solution for which Congress never proved there was a problem. CPSIA was supposed to protect consumers from lead poisoning. By its requirements, CPSIA unintentionally killed the entire cottage industry of children’s clothing.

The Federal bureaucracy consumes so much money because a) it performs so many tasks, and b) it has no incentive to be efficient. In addition to administering the flow of dollars, people and papers, the bureaucracy engages in quality control, enforces regulatory compliance, is constantly trying to reconcile, and is engaged in a never-ending battle to root out fraud and abuse. However, cost/benefit analysis – a requirement in all other activities that involve money – is not part of how the Federal bureaucracy operates.

All free markets work by allowing supply and demand to balance each other. The government does not determine that balance: consumers and suppliers do. In healthcare, supply and demand are “disconnected” (reason #5), and therefore they cannot balance. The consumer does not pay the supplier. A third party does that. Neither consumer nor supplier has any reason to economize. The result is a system that cannot achieve balance. No wonder the cost spiral keeps rising without stop. There is nothing to stop it.

Healthcare pays when we are sick. The sicker we are, the more it pays. This is called a perverse incentive: rewarding what you don’t want rather than what you do. Incentives are perverse not only for dollars but also behaviors. Doctors fear they will be blamed for bad outcomes even when they did nothing wrong. Therefore, they increase healthcare costs by practicing defensively: every head injury gets a CAT scan and every murmur gets an echocardiogram.

Adverse outcomes and errors (they are notsynonymous) cost money by direct payments to providers, by lost productivity, and through the legal process. Most of these costs are avoidable.

The commercial side of healthcare takes money out of the system and gives it as dividends or equity growth to shareholders. Thereby, for-profit enterprises such as insurance and pharmaceutical companies remove dollars from healthcare (reason #9). Whether we wish them to do so or not is an open question.

Finally, there is the most obviously undesirable expenditure – overcharging (accidental), fraud, and embezzlement – which is also the smallest of the costs of healthcare.

Do we want to spend less? Do we want to spend more effectively? Of course we do! Then we need to reduce reasons three through ten by identifying the root cause of each and then treating it, not the symptom.

5 Remedies for Plantar Fasciitis Pain

The plantar fascia – the muscle running between your toes and your heel – is one of the most frequently stressed muscles in the human body. Although safe walking habits can do a great deal to prevent plantar fasciitis (AKA the strain and eventual microtearing of the plantar fascia), on average, we see one in ten individuals dealing with foot pain who end up needing to find a remedy for plantar fasciitis pain. Fortunately, surgical intervention only rarely is necessary; only five percent of plantar fasciitis victims will be unable to treat it through less drastic solutions. Of course, I would recommend these solutions as general well-being practices for anyone who indulges in jogging or other, equally strenuous exercise, regardless of whether or not they’re in need of a remedy for plantar fasciitis pain

1- Use footwear with adequate support, particularly for the arch. Using loafers, sandals or other shoes with poor support while running or walking for prolonged periods places additional, wholly unnecessary strain on the plantar fascia. Padded soles also can dull hard impacts on pavement and other man-made walking materials that can jar your foot.This also includes having the right footwear for when you’re walking around your own home. Avoid being barefoot or using slippers whenever possible.

2- If your plantar fasciitis is causing swelling, use cold ice packs on your foot. As long as you don’t do anything else to aggravate your foot, this will reduce the swelling and numb the pain until the symptoms relieve themselves. If you have access to one, a frozen golf ball or other round object can be rolled along the underside of your foot to massage the muscle while also providing the desired temperature.However, don’t use heat sources in a similar fashion, even if you’re ordinarily used to contrast baths (which, incidentally, have no proven medical effectiveness in contrast to ice packs). Heat frequently aggravates the symptoms of damage to your plantar fascia.

3- Stretch your feet regularly, especially just after you’ve gotten out of bed or had a prolonged period of being stationary. Personally, I recommend patients try out the towel stretch: roll up a towel, hook it beneath your foot, and apply gentle pressure to the towel while holding your leg straight from a sitting position. However, if you don’t have a towel on hand, other stretches can offer similar benefits without the need for props.

4- Buy separate insoles for your shoes with arch support. These products average out at cheaper than a comparative set of shoes with the arch support built-in, and allow you to keep your wardrobe without sacrificing your foot’s health. However, this remedy for plantar fasciitis pain does call for some cautious shopping, as there are many quality of life differences between brands, such as insoles failing to cover the entire foot or slipping once in place. You’ll also need to replace most brands once or twice a year purely due to wearing them out from use

5- Topical pain medications, usually in the form of a cream, are something I recommend only for cases when correcting self-destructive patient behavior in inadequate for dealing with the immediate symptoms of plantar fasciitis. Although the prescription recommended may vary with the individual in question, plantar fasciitis this severe usually will require a potent medication with anti-inflammation properties, as well as general anesthetic attributes to dull the pain. Over the counter equivalents also are available, albeit generally less effectual in cases that call for egregious measures.

Even though most cases of plantar fasciitis pain are a simple matter of the patient abusing his feet with unhealthy walking, running or standing habits, sometimes I see patients who aren’t even remotely to blame for their situations. Plantar fasciitis also can be a symptom of bone spurs (the outgrowth of additional bone along your normal skeleton, which is especially linked to foot problems in aging individuals) or even naturally ‘too tight’ calf muscles. When prolonged suffering is the result, turning to chemical solutions often is the best thing to do for the patient’s long term quality of life.

Copyright (c) 2014 Complete Healthcare Solutions

Acid Reflux Symptoms and Treatment

There are various acid reflux symptoms and treatment plans. Some people have found that a home remedy for acid reflux is effective. However, it is important to have your symptoms evaluated by a doctor, especially if chest pain is present, to rule out more serious conditions.

Heartburn, a sour or bitter taste in the mouth or back of the throat and difficulty swallowing are the most common acid reflux symptoms and treatment may include prescription and over the counter medications, dietary and lifestyle changes or botanical and herbal remedies. As you can see, acid reflux is more than just occasional heartburn, which almost everyone experiences at one time or another. As opposed to treating occasional heartburn, a home remedy for acid reflux will almost certainly include changes in diet. A food and symptoms diary is often helpful for identifying foods, beverages and other things (like cigarette smoking) that may trigger symptoms.

Persistent cough, hoarseness and upset stomach are examples of other problems that may be acid reflux symptoms and treatment, once the diagnosis is made, often begins with a group of prescription drugs called proton pump inhibitors. The coughing and hoarseness are caused by stomach acid leaking up into the esophagus, which is the tube that carries food from the mouth to the stomach. Unlike a typical home remedy for acid reflux, these are taken daily and actually prevent secretion of stomach acid. Like all prescription drugs, proton pump inhibitors may cause unwanted side effects, which may include headache, nausea, diarrhea, constipation, abdominal pain, fatigue and dizziness.

There are those who choose not to use prescription drugs for the relief of acid reflux symptoms and treatment options for them may include botanical or herbal remedies. Some may consider this a home remedy for acid reflux since no prescription is necessary, but botanicals or plants and herbs were the first form of medicine. Prescription drugs are a fairly recent addition to healthcare. When used in combination with changes in eating habits, such as reducing the number of fried, fatty and fast foods, an herbal or botanical remedy may be just as effective as a prescription drug for the relief of acid reflux symptoms and treatment of the condition.

An herbal home remedy for acid reflux may include chamomile, meadowsweet, slippery elm, cancer bush, fennel, catnip, angelica root, gentian root, ginger root or other botanicals. Slippery elm was used historically by native peoples to treat stomach upset, diarrhea, constipation, heartburn and other digestive complaints. Fennel and gingerroot were also common “folk remedies” for the relief of indigestion. Modern herbalists have found that a combination of several of the herbs that had been used for indigestion could be an effective home remedy for acid reflux.

For the relief of acid reflux symptoms and treatment of the condition, products containing an extract from the aloe plant are sometimes suggested. Aloe was not used historically for stomach upset, but it is believed, by some to be effective for many common digestive problems. It was used historically to soothe burns and promote healing of external injuries and has been proven to be an effective laxative. As a home remedy for acid reflux, aloe or other herbs and botanicals should only be one part of a complete treatment plan. Avoiding coffee, alcohol, spicy foods and even losing weight may be necessary for long-term control of acid reflux symptoms and treatment of the condition. It is important to treat acid reflux and visit your doctor regularly, because the condition can eventually damage the lining of the esophagus and, it is believed, can even lead to cancer of the esophagus. For more information about acid reflux symptoms and treatment options, visit www.digestive-disorders-guide.com

Natural Migraine Relief – Seven Affordable Remedies

When all the usual approaches to migraine treatment or prevention fail, you might think there’s nothing left — that you’re stuck dealing with the headaches and other symptoms. If you haven’t considered natural migraine relief, now is a great time to start. Here are some common remedies and preventatives for migraines.

Herbal Remedies and Supplements

The Mayo Clinic lists feverview, magnesium, CoQ10, butterbur, and vitamin B-2 as potentially useful treatments. Consult your doctor before you start taking any of these remedies. Some can interact with other medications; are not recommended while pregnant or breast-feeding; or aren’t likely to be effective for you. Your healthcare provider can also tell you how much of each treatment to take and when.

Essential Oils

Lavender is one essential oil that’s known to relieve tension, which can ease migraine symptoms. When you notice the first signs of a migraine, try rubbing two drops of lavender oil into your temples. You can also put several drops in a diffuser that’s set up in the cool, dark room you use to recover from your headaches. However, one should exercise caution with this one. Some people with migraines are triggered by strong fragrances.

Chiropractic Care

For some people, misaligned neck vertebrae cause migraines. If that, or something similar, is the case, chiropractic care can be effective. Treatments might occur as often as three times a week to start, but generally taper off as patients improve.

Acupuncture or Acupressure

Both acupuncture and acupressure can provide natural migraine relief. If you’re squeamish or phobic about needles, you should probably look into acupressure first. Look for a qualified practitioner in your area who’ll explain how the treatment works and answer your questions.

Therapeutic Massage

Stress and tension cause some migraines. A therapeutic massage can reduce stress and help you relax, leading to fewer and/or less-intense headaches. This treatment can also relieve other symptoms, like nausea.

Biofeedback

Biofeedback teaches you how to monitor specific things happening in your body, like muscle tension or breathing, and control them with practice. Being able to relax on your own can be more convenient than appointments with massage therapists or other healthcare providers; in many cases, you can do this wherever you are, including work, the supermarket, or the movie theater.

Mindfulness

Many studies have found that significant migraine relief can be found with the regular use of mindfulness based meditation. Mindfulness turns off the stress-response system, boosts natural pain relieving neurotransmitters and alters brain chemistry that is associated with migraines. Not only does mindfulness alleviate the pain, but it also improves perception and tolerance of pain, outlook on life and mood, as well as enhances one’s sense of well-being.

As with Western medicine, alternative treatments don’t work the same for everyone. The information in this article is not intended to treat, diagnose or cure any disease. A conversation with your doctor, or other healthcare provider, can help you focus on the natural migraine relief remedies that are most likely to work. He or she can also make sure you understand the advantages and disadvantages of each treatment, helping you make a more-informed decision about your health.