Posted by Positive Aging SourceBook on 10/16/2021

Interactive discussion with Author of How to Avoid Being a Victim of the American Healthcare System


Learn “what to do if you have to go to a hospital, how to handle an insurance company’s claim denial, how to find an alternative to high-priced prescriptions and why the current pay-for-fee system is inadequate. Featuring Dr. David Wilcox Author of How To Avoid Being a Victim of the American Healthcare System: A Patient's Handbook for Survival

Podcast Recording

Questions Answered by Panelist

  • Distinction between  being admitted vs being observed ?
  • how to hire your own nurse to go the the hospial for e.g., surgery, etc.?
  • They inform consent you but we cant inform consent them, I received an out of network bull for radiologist who did work on me without knowing this while in the hospital,  How do we enaure all who treat us are in the network?
  • What is the MOON Rule
  • Under Medicare,  if the patient is sent for rehab/snf - if they were "observed" they will be responsible for paying the SNF or rehab. Also, if the patient doesn't have Part D, they will have to pay for all meds
  • I have severe multiple chemical sensitivity and reactions to many substances (whether alcohol fumes or incipientes in drugs).  What is best way to flag those to be sure they will be seen and taken seriously if emergency and I can’t speak for myself).  Also other unusual health conditions that make me very worried about having to be in hospital in emergency
  • I gave each local hospital my advanced directives can I be sure they will access those if/when needed?
  • Can you give your opinion on Medicare Advantage vs Medicare Supplement Plan/Medigap?
  • But, dont the social workers get paid ny the hospital too?
  • Do you provide any health care consultion services and or health care advocacy services. Thank you for your book and your hard work. We need this so much
  • How is the medical community responding to your book?
  • MOLST AND POLST, Medical order Life sustaining treatment.Physician Orders for life sustaining treatment? Can you explain and talk about these two signed directives and if your wishes are that you do not want to be taken to the hospital can you protect from being taken to the hospital if you are concerned.
  • Instructions for MOLST AND POLST are to be printed on pink paper and placed on your refrigerator or in a clearly visible place so if emergency medical teams come to your home they will know your wishes
  • If you do the nurse friedn strategy would they get in trouble for providing you professional advice?
  • What does he think of the website  Healthgrades  that grades doctors  and hospitals

Chat Transcript 

12:12:30     From  Tom Shipe : Tom Shipe, Realtor with Long & Foster Realtors

703-946-4844  tom.shipe@LNF.com

Founding Member: Superior Options For Seniors (SOS)

https://www.superioroptions.org/

12:12:34     From  Chuck Thornton : Do you serve seniors and/or persons with disabilities in Fairfax County?  Do you have employment vacancies?  Collaborating non-profit and government partners are hosting a FREE “Virtual Health & Care Job Fair for Northern Virginia” on Wednesday, December 8th, from 1 to 4 PM.  Employers can have a FREE virtual booth in this event to promote YOUR employment opportunities!  Employers are reserving FREE booths now.  You should contact Chad Hoyte in the Fairfax County Economic Development Authority Office at Choyte@fceda.org to reserve your booth now!  This one-of-a-kind Health & Care Job Fair is a collaboration of the Fairfax County Economic Development Authority, the Fairfax County Long Term Care Coordinating Council (LTCCC), the Central Fairfax Chamber of Commerce, ProAging, Virginia Employment Commission, Fairfax County Department of Family Services, Britepaths, and Virginia Career Works.  Do contact us to reserve your booth now!  Chuck Thornton, Volunteer with the LTCCC, 703-678-1377, chuck.thornton50@gmail.c

12:14:15     From  B Barnett   to   Hosts and panelists : You said to bag up your pills.  Will the hospital give you your pills?

12:14:16     From  Catie Ramos : Catie Ramos with Goodwin House at Home here! If you are located in Northern Virginia or DC and interested in aging in place, we would love to chat with you! 703-575-5202 www.goodwinhouse.org/age-in-place

12:15:03     From  Steve Gurney - ProAging Sourcebook : How To Avoid Being a Victim of the American Healthcare System: A Patient's Handbook for Survival https://www.amazon.com/Avoid-Victim-American-Healthcare-System-ebook/dp/B097YVVD5P

12:19:50     From  Cedar Dvorin : IT's a big difference in Medicare reimbursement.'

12:20:53     From  Mary Barney-Butler : Yes and prior to COVID could prevent Medicare failure to pay for re-hab-

12:23:17     From  Mary Barney-Butler : It's so good to hear a health care professional honestly addressing the chaos in our healthcare system

12:24:37     From  Bonnie Elliott : Not everyone can afford an aging lifecare manager, nurse, patient advocate - is there anyone at the hospital like the case manager, social worker who can assist?

12:26:21     From  Steve Gurney - ProAging Sourcebook : Cedar Dvorin 12:21 PM 

Under Medicare,  if the patient is sent for rehab/snf - if they were "observed" they will be responsible for paying the SNF or rehab. Also, if the patient doesn't have Part D, they will have to pay for all meds

12:26:49     From  Cedar Dvorin : Reason after reason that we need to have a single-payer system /(greatly improved) Medicare for All.

12:27:13     From  Steve Gurney - ProAging Sourcebook : https://www.healthcarebluebook.com/explore-home/

12:27:38     From  Mary Barney-Butler : Opps double negative- Medicare wouldn't pay w/o the 3 day stay. I was told by a casemanaer yesterday that the three day stay was still required- and she told an SSI Full medicaid client because she didn't have  medicare Part A that there was no rehab for her- Then she back tracked and said she was an observation stay not inpatient for 5 days after surgery and complications... no re-hab. She told me she could give me the Medicare policy I told her I she violated the patient's rights

12:28:40     From  Steve Gurney - ProAging Sourcebook : MOON rule https://www.tn-elderlaw.com/free-resources/blog/the-continuum-winter-2017/moon

12:28:45     From  Mary Barney-Butler : Opps I'm officially Medicare Certified via SHIP  and she thre some more untruths at me and the caregiver of the 82 year old.

12:30:28     From  Alison Lynch : How do I save the chat? there's no "save chat" feature on this call. thanks

12:32:59     From  Mary Moeder   to   Hosts and panelists : Is this like Good Rx?

12:33:10     From  Steve Gurney - ProAging Sourcebook : Pharmacy Benefit Managers and Their Role in Drug Spending https://www.commonwealthfund.org/publications/explainer/2019/apr/pharmacy-benefit-managers-and-their-role-drug-spending

12:34:14     From  Mary Barney-Butler : Big Pharma rules! Ehhhhh!

12:35:33     From  Steve Gurney - ProAging Sourcebook : https://www.goodrx.com/

12:40:21     From  Steve Gurney - ProAging Sourcebook : Value-Based Care https://my.clevelandclinic.org/health/articles/15938-value-based-care

12:41:51     From  Mary Barney-Butler : Do we have bona-fide value based care here in Northern VA?

12:42:46     From  Irene Rutter   to   Hosts and panelists : What if you don’t have a doctor and have to go to the hospital….are you at a disadvantage?

12:43:01     From  Mary Barney-Butler : Repeat that please

12:43:15     From  Steve Gurney - ProAging Sourcebook : Accountable Care Organizations https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO

12:45:00     From  Mary Barney-Butler   to   Hosts and panelists : Contact your local VICAP program at Agencies on Aging for that info

12:45:23     From  Mary Moeder   to   Hosts and panelists : Noooo, this is too good

12:45:25     From  Alexandra Varnon : Yes!

12:45:31     From  Judy Wagner : I can hear you.

12:45:31     From  Wendy Pachter   to   Hosts and panelists : Yes, can hear you

12:45:31     From  Alexandra Varnon : correct

12:46:13     From  B Barnett   to   Hosts and panelists : This accountable care organization / value-based medicine recommendation warrants another session.  There are pros and cons to ACO organizations — one is that they refer in network.  Another is that the insurance policies often are more of the HMO type that limit providers and that limit treatment options.  Look at the pros and cons of Medicare Advantage plans (medicare advocacy center) for some ideas about the pros and cons.

12:50:33     From  Steve Gurney - ProAging Sourcebook : David Wilcox (david@drdavidwilcox.com)

12:51:09     From  Mary Moeder   to   Hosts and panelists : I just ordered his book. Have my daughter, who's in college, going in for surgery in another state so this is all very, very,  helpful.

12:54:09     From  Suzanne Legault : Will this program be available to see again /recommend on Steve's website?

12:54:22     From  Steve Gurney - ProAging Sourcebook : MOLST AND POLST, Medical order Life sustaining treatment.Physician Orders for life sustaining treatment? Can you explain and talk about these two signed directives and if your wishes are that you do not want to be taken to the hospital can you protect from being taken to the hospital if you are concerned.    Instructions for MOLST AND POLST are to be printed on pink paper and placed on your refrigerator or in a clearly visible place so if emergency medical teams come to your home they will know your wishes

12:55:36     From  Susan Schifffman   to   Hosts and panelists : Where on the CMS website does it give ratings of doctors?  I just looked and couldn’t find it.

12:57:57     From  Cedar Dvorin : I may be wrong but I don't think MDs are rated. Hospitals, Nursing home, Part D & Part C plans are rated.

12:58:32     From  Steve Gurney - ProAging Sourcebook : Star Rating Fact Sheet https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/physician-compare-initiative/Downloads/Benchmark-Star-Ratings.pdf

13:01:22     From  Alexandra Varnon : This was so informative and insightful! Thank you so much for your time.

13:01:39     From  bob coulson : Great ptesentation!

13:01:53     From  Sally Jones   to   Hosts and panelists : Great program !

13:02:14     From  Bonnie Elliott : Excellent info - thank you!!

13:02:53     From  Alexandra Varnon : Sound is good

13:02:59     From  Mary Moeder   to   Hosts and panelists : Yes, we can hear

13:03:00     From  Steve Gurney - ProAging Sourcebook : can you hea?r ken ok

13:03:01     From  Chuck Thornton : We can hear you!

13:06:23     From  Twanda Young   to   Hosts and panelists : What is the monthly cost?

13:07:01     From  Twanda Young   to   Hosts and panelists : Thanks


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