medical insurance

Your Medical Insurance – perfect?

Posted on by Michelle Fritsch, Pharm.D.
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Does you medical insurance meet your needs? Is it a right?

You likely have medical insurance if you live in the United States. As of 2014, 90% of Americans did. When the 2015 data is released, that number is likely to go up a bit. It increased 2.9% from 2013 to 2014.

Does your insurance policy cover all that you want it to cover? Are all of the types of care you desire covered? Is your care ever delayed longer than anticipated due to insurance company authorization steps?

Our family just experienced this for the second time this year. It is very easy to get frustrated with insurance-related delays. Your doctor orders a test or procedure, and your insurance company takes time to authorize it.

There is a series of checks and balances between the healthcare system (doctors, clinics, hospitals, etc.), insurance companies, and lawyers. Sometimes it seems to tip, leaning more in one of these three directions, but each aspect is needed. Insurance provides you with coverage to maintain your health without losing all of your money due to an illness. It also provides checks and balances to assure cost-effective use of resources, such as procedures, surgeries, and devices. Lawyers help assure you have recourse if healthcare harms you rather than help you.

As a healthcare provider, I have seen numerous examples of excellent healthcare that has prevented or effectively treated a medical issue. I have seen unnecessary use of resources such as antibiotics or procedures. I have seen mistakes and the ramifications. I have seen heroic efforts by all involved to pull together, analyze mistakes, and create safety procedures to prevent such a mistake from happening again.

Is healthcare a right?

A question I annually ask students is whether healthcare is a right. It always leads to great discussion. If it is a right, then how should the system look that provides healthcare to the uninsured? Right now the emergency department (most cannot turn people away for lack of payment) is often the only source for uninsured people. That is a grotesquely expensive misuse of the specialized skills of emergency department personnel. But if you had no insurance, and your child was sick, what would you do? I know I would take my child to the emergency department if that were my only choice.

If it is not a right, then what should happen to uninsured people who are unable to access the healthcare system? Should we stand by and watch suffering and disease that could be treated? Could you walk down the street and just pass by someone suffering? (Do we already do that every day? If you live in Baltimore or another city of significant size, I know that you do.) It’s so easy to focus on ourselves and lose sight of those around us. I challenge you to get to know at least one uninsured person and hear his/her story. What should happen next time that person is injured in an accident or has trouble breathing due to asthma?

Is your medical insurance perfect?

I imaging your answer is ‘no.’ I know mine is far from perfect. But, I am so grateful to have insurance! I am grateful for the coverage I do have. Next week my daughter will get a sports physical to be sure she is healthy enough for her sport; my other daughter will be assessed for a nagging cough; my husband will see a surgeon to create a plan to treat his shoulder. All of these things are possible due to insurance. If all of that was out-of-pocket, my youngest would not play a sport, my middle child would continue to cough, and my husband would try to continue to function with one arm.

Perspective

Next weekend I leave on my first international medical mission trip. In the excellent materials I have been given to prepare, there is a statement that I will see more worms, scabies, and lice than I have seen in my entire career. Caring for the homeless of Baltimore, I have seen some of these things, but apparently not in the quantity I will see next week. How many times have you been treated for scabies, lice, or worms? Probably not many, if ever. We will also be caring for people with diabetes, hypertension, asthma, and the chronic conditions we treat in the affluent in the US. I am especially looking forward to analyzing the needs of a growing population over age 65.

I don’t claim to have the answers. But I do know there are several issues to be pondered. If you have ideas and opinions, please share them with me at www.medsmash.com/contact/.

BIBLICAL APPLICATION

There is no shortage of social issues that need to be addressed. Quality of insurance for the insured and what to do about the uninsured are certainly on that list.

Our pastoral team has been delivering a series based on Deuteronomy this summer. Here is a verse that very directly addresses these questions:

Deuteronomy 15:11 ESV

For there will never cease to be poor in the land. Therefore I command you, ‘You shall open wide your hand to your brother, to the needy and to the poor, in your land.’

This is from the Old Testament/Hebrew Bible, but wow, is it not as relevant today as it has ever been?

We are challenged in at least 60 verses to address these issues.

Proverbs 19:17 ESV

Whoever is generous to the poor lends to the Lord, and he will repay him for his deed.

1 John 3:17 ESV

But if anyone has the world’s goods and sees his brother in need, yet closes his heart against him, how does God’s love abide in him?

Luke 12:33 ESV

Sell your possessions, and give to the needy. Provide yourselves with moneybags that do not grow old, with a treasure in the heavens that does not fail, where no thief approaches and no moth destroys.

Proverbs 14:31 ESV

Whoever oppresses a poor man insults his Maker, but he who is generous to the needy honors him.

Proverbs 29:7 ESV

A righteous man knows the rights of the poor; a wicked man does not understand such knowledge.

I am not suggesting you go out and give everything you have right now. I am not suggesting you feel guilty about what you have.

I am suggesting you join me in contemplating these issues. They will certainly be in my face next week. So, I will be back to talk more about this as my own understanding and experience continue to grow.

Blessings,

Michelle

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Four Components of True Health – Mental Health

Posted on by Michelle Fritsch, Pharm.D.
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Mental health is one of four components of total health

Mental health is the second of the four components of health. True health requires health in all four components. Last week we covered physical health. Over the next two weeks we will talk about each of the others separately.

Mental health is getting more attention as an essential component of health.  It requires a health system of diagnosis, treatment, and management similar to physical health. Insurance has historically not provided as much coverage for mental health compared with physical. But, finally, that is changing in a very positive way!

A new set of diagnostic standards was published in 2013. This update came after over 10 years of work to refine and identify diagnoses since the previous set of guidelines. The standards cover everything from neurodevelopment disorders (such as autism), schizophrenia, bipolar disorder, and depression to anxiety.  They also cover obsessive-compulsive disorder, trauma and stress-related disorders, eating disorders, substance abuse, phobias, and personality disorders.

There are several classes of medications that are prescribed to manage mental health conditions. Some examples include neuroleptics (also called antipsychotics), antidepressants, antianxiety medications, and some medications that are also used to treat seizures.

So what can you do to improve your mental health?

Consistency is very important with mental health. Accurate diagnosis is obviously also key.

These conditions are complex. They are true biologic medical conditions. Sometimes people think these conditions are something someone can control by him/herself. That can lead to shame, denial, or avoidance of these complex conditions. They DO require medical care.

From mentalhealth.gov:

Myth: Personality weakness or character flaws cause mental health problems. People with mental health problems can snap out of it if they try hard enough.

Fact: Mental health problems have nothing to do with being lazy or weak and many people need help to get better. Many factors contribute to mental health problems, including:

  • Biological factors, such as genes, physical illness, injury, or brain chemistry
  • Life experiences, such as trauma or a history of abuse
  • Family history of mental health problems

People with mental health problems can get better and many recover completely.

Counseling is often an essential component of care for these conditions. Qualified counselors listen, coach, and strategize. They can also help diagnose and participate in therapy decisions. They can educate and work with the person with the  condition and with all family and caregivers, as approved by the patient.

So mental health conditions are medical conditions just like cancer and diabetes are medical conditions. They are treated with counseling, procedures, and medications. Many require lifetime management (versus one time treatment). So, relationships with the healthcare team are important. You want providers with whom you are comfortable and can be open.

Note, for many mental health conditions, especially depression, medication needs to be taken every day for up to two months to see the full benefit. The medication very gradually changes transmitters in the brain back to healthy amounts. So, please be patient and take the medicine faithfully.

For more information about mental health, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

Mental illness impacts people of faith just as it impacts people who have never heard about Christ. So, can God use mental illness for His glory? Can anything good come from struggling with mental illness?

I believe God can use any of our weaknesses, any of our conditions, to His glory. Nothing is beyond His ability.

John 16:33 ESV

I have said these things to you, that in me you may have peace. In the world you will have tribulation. But take heart; I have overcome the world.

2 Corinthians 12:9 ESV

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me.

Luke 1:37 ESV

For nothing will be impossible with God.

In the Bible, mental illness is sometimes referred to as having an ‘afflicting demon’. Understanding of mental health continues to grow. The medical/biological understanding of these conditions is much better understood than they were in Biblical days, but there are still questions to be answered.

Matthew 4:24-25 The Message (MSG)

He also healed people of their diseases and of the bad effects of their bad lives. Word got around the entire Roman province of Syria. People brought anybody with an ailment, whether mental, emotional, or physical. Jesus healed them, one and all. More and more people came, the momentum gathering. Besides those from Galilee, crowds came from the “Ten Towns” across the lake, others up from Jerusalem and Judea, still others from across the Jordan.(emphasis mine)

The multiple components of total health – physical, mental, emotional, spiritual – are recognized throughout the Bible. Mental health conditions require treatment and must be addressed to reach a state of true health.

There is no shame. Again, these conditions have biological sources. We are called to love and support each other.   Education, understanding, and unconditional love can help us help each other find God’s purposes in each of our afflictions.

Blessings,

Michelle

Image Source:  National Institute on Aging; National Institutes of Health; U.S. Department of Health and Human Services

Four Components of True Health – Physical Health

Posted on by Michelle Fritsch, Pharm.D.
ThinkstockPhotos-464212219
Physical health – one of four essential components of health

Physical health is the first of the four components of health. True health requires health in all four components. Over the next three weeks we will talk about each separately.

Physical health is the type that is usually thought of first when describing ‘health’. It relates to medical conditions, joint and muscle function, infections, bones, and organ systems. It is the primary reason we go to the doctor.

The main emphasis of health insurance has historically been physical health.

Most of the medications that are prescribed are for physical health. Medications for diabetes, high blood pressure, pain, asthma, etc. are prescribed to improve physical health.

Your physical health is often part of your decision-making. It is the main motivation to choose healthy foods, exercise, avoid smoking, and limit alcohol.

So what can you do to improve your physical health?

First, there are several things you can do to preserve your physical health. Prevention is key. To prevent heart disease and diabetes, diet and exercise are especially important. They help maintain a healthy weight. Lack of exercise and poor food choices lead to excess weight, which adds to risk for many medical conditions.

Avoid smoking. Quit if you smoke now. The negative effects on physical health are enormous.

Limit alcohol intake. An occasional drink is probably fine unless you are genetically at risk for alcoholism. Excess alcohol has many health risks.

If you have been diagnosed with a medical condition, be sure to ask plenty of questions to fully understand your diagnosis and treatment plan. Then, follow your treatment plan while keeping track of your response. Communicate your response and any medication side effects to your healthcare team.

If you have more than one medical condition and/or if you have more than one provider, keep everyone informed. You want healthcare providers who communicate with each other and take time to communicate with you. Each provider needs to know exactly what the others are doing.  Each also needs to know how you actually take each of your medications. It is only then that the safety of all your medications together can be assessed.

For more information about your physical health, contact us at www.medsmash.com.

BIBLICAL APPLICATION

We learn in Genesis we were made in God’s image. Each cell, each hair, each component is specially designed. If you’ve ever experienced the birth of a baby and watched it grow, you have seen the astounding complexities of the human body.

Physical health allows us to perform our daily tasks. It also allows us to pursue the plans to which God has called us. There are several verses throughout the Bible that pertain to health. Here are a few:

1 Corinthians 6:19-20 ESV

Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body.

1 Corinthians 3:17 ESV

If anyone destroys God’s temple, God will destroy him. For God’s temple is holy, and you are that temple.

1 Timothy 4:8 ESV

For while bodily training is of some value, godliness is of value in every way, as it holds promise for the present life and also for the life to come.

1 Corinthians 9:27 ESV

But I discipline my body and keep it under control, lest after preaching to others I myself should be disqualified.

3 John 1:2 ESV

Beloved, I pray that all may go well with you and that you may be in good health, as it goes well with your soul.

Consider the steps to maintain your health and the role your health plays in your response to God’s call for your life.

Blessings,

Michelle