May
30
A Health Savings Account or Hsa Medical Plan Offers Significant Tax, Premium, & Retirement Savings
Filed Under Wellness | Leave a Comment
Andy Devore asked:
Since first being signed into law in December 2003 by the Federal Government, Health Savings Account plans (a.k.a. HSA medical insurance plans) are already a proven success & the number of people switching to HSAs from traditional health plans is growing greatly each year. HSAs are here to stay & a few million have already come on board. Health Savings Accounts are literally available today to any person over 18 in the U.S. They offer significant financial benefits including tax, premium, & retirement savings to you, your family, and/or your business. Knowledge is real power when it comes to your finances. Become informed. I advise people not miss out on the extraordinary short & long term benefits HSAs create.
Medical Insurance is the newest form of an investment vehicle. Today, having an HSA qualified health insurance policy (component #1 - the health insurance) in partnership with a Health Savings Account (component #2 - the savings account) is very wise decision. First off, from this point forward, we’ll refer to the two components just discussed above as one single entity, either a Health Savings Account, HSA, or HSA Health Savings Plan. They all mean exactly the same thing.
HSA health savings plans are actually simple to understand.
A Health Savings Account enables you to:
1) Have access to a wide PPO network and in most all cases provides the coverage to allow you to continue seeing your current doctors & specialists.
2) Lower your health insurance premium by 25% - 50%. To accomplish this, be sure to compare health insurance plans with different carriers. An individual can typically save between $80 to $250 dollars per month when they change their plan over from a traditional health insurance plan to a HSA qualified high deductible health savings plan. A family can save even more. Now the next point is critical! Since HSA plans all have higher deductibles than most traditional health plans, forget any negative preconceived notions you may have about having a plan with a high deductible. Do not pay attention to what you may have heard. Don’t be deceived. Yes, you’ll now have high deductible insurance, but there are plenty of safety nets that will be there to protect you if & when the need arises.
After you are setup, the first step to take is to place the money you are saving from having a new lower HSA monthly premium and place it into your new Health Savings Account each month. Realize that doing this doesn’t cost you anything; you are just transferring the money you are saving into another location.
3) Next, enjoy the IRS created triple tax advantages (see the “a-b-c” listed below) that only HSAs offer. You can reduce your annual out-of-pocket income taxes up to $1800 or more per year. Save EVERY year on these income taxes. View below your three main tax-saving pillars.
a) HSA Contributions (deposits into your HSA) are 100% tax free
b) The interest earned on all of your HSA account contributions are also 100% tax free. The choice of investments are yours and range anywhere from typical low-interest, virutally zero-risk bank rates to the widest range of stocks, bonds, & mutual funds. The level of risk is entirely up to you and you can increase or decrease it at anytime.
c) Make 100% tax-free withdrawals for virtually all medical expenses. View a list of HSA Eligible Expenses.
While your funds grow tax free, you are now building a significant retirement account of up to several hundred thousand dollars. If you must use the money to cover any part of your deductible, you may make a 100% tax free withdrawal.
Here is the point: All of these above benefits & factors strongly diminish the impact of having a high deductible plan. Realistically there will be many periods of time where your money is only growing and never being withdrawn because you have little or no medical expenses.
Here’s another benefit. The Internal Revenue Service (IRS) rule says that at age 65 the money from your Health Savings Account may be withdrawn penalty-free for any reason, not just for qualified medical expenses. In this case, you’ll pay just the regular income taxes, just as you would when withdrawing from your IRA. However, your income during retirement generally goes way down as will the taxes required to pay. You will be paying much lower income tax on these withdrawals than before you were retired. Finally, understand that the funds in your HSA are always yours, without exception, and they rollover from year to year. You are also allowed to do a one time rollover from an IRA into a Health Savings Account without any penalty.
And yes, you may continue contributing to your IRA every year while still also making the maximum allowed HSA contributions. Having both types of retirement accounts is the ultimate scenario, but if you can afford contributing to only one type…I would certainly recommend the Health Savings Account. This is because HSAs are more than solely a retirement savings vehicle. Read another article I have written about improved benefits and higher limits in 2009 .
The company HSAHealthSavings genuinely specializes in HSA plans so consider contacting us (for contact info, read below “About the Author”). The straight truth is that many people are rather unclear about HSA Health Savings Plans and what they truly accomplish. Too often, an individual or business’s insurance broker has not kept them properly “up-to-date” on all of the many benefits available to them with an HSA. It is not that these brokers are not competent. But the question to consider is, what incentives do they really have to educate their clients on HSAs if doing so will lower their commissions? Not much of one perhaps. But you are the party who is really losing out. Any licensed agent or broker is obligated by a legal fiduciary duty to serve his or her client’s best interest at all times. This duty should be taken seriously, but isn’t typically enforced by the Department of Insurance.
Last but not least, although insurance companies are legally binded to offer HSA health savings plans in their line of products, they are not going out of their way to promote & publicize these plans. Doing so would also lower THEIR profits.
Now you are probably starting to see the light. As a consumer today you really have to take matters into your own hands and become authentically informed. The expert advisors at HSAHealth Savings are on a mission as millions of folks and their families are missing out on the tremendous financial benefits that are so readily attainable RIGHT NOW. We are excited! The benefits of health savings plans can literally transform one’s financial portfolio in both the short and long term. And HSAs are actually beneficial for just about everyone, not only the wealthy, or just older folks. Regardless of your income level, if you pay for health insurance at all, you owe it to yourself to consider and compare the benefits of HSA health savings plans versus the more traditional health plans you are accustomed to.
Kevin
Since first being signed into law in December 2003 by the Federal Government, Health Savings Account plans (a.k.a. HSA medical insurance plans) are already a proven success & the number of people switching to HSAs from traditional health plans is growing greatly each year. HSAs are here to stay & a few million have already come on board. Health Savings Accounts are literally available today to any person over 18 in the U.S. They offer significant financial benefits including tax, premium, & retirement savings to you, your family, and/or your business. Knowledge is real power when it comes to your finances. Become informed. I advise people not miss out on the extraordinary short & long term benefits HSAs create.
Medical Insurance is the newest form of an investment vehicle. Today, having an HSA qualified health insurance policy (component #1 - the health insurance) in partnership with a Health Savings Account (component #2 - the savings account) is very wise decision. First off, from this point forward, we’ll refer to the two components just discussed above as one single entity, either a Health Savings Account, HSA, or HSA Health Savings Plan. They all mean exactly the same thing.
HSA health savings plans are actually simple to understand.
A Health Savings Account enables you to:
1) Have access to a wide PPO network and in most all cases provides the coverage to allow you to continue seeing your current doctors & specialists.
2) Lower your health insurance premium by 25% - 50%. To accomplish this, be sure to compare health insurance plans with different carriers. An individual can typically save between $80 to $250 dollars per month when they change their plan over from a traditional health insurance plan to a HSA qualified high deductible health savings plan. A family can save even more. Now the next point is critical! Since HSA plans all have higher deductibles than most traditional health plans, forget any negative preconceived notions you may have about having a plan with a high deductible. Do not pay attention to what you may have heard. Don’t be deceived. Yes, you’ll now have high deductible insurance, but there are plenty of safety nets that will be there to protect you if & when the need arises.
After you are setup, the first step to take is to place the money you are saving from having a new lower HSA monthly premium and place it into your new Health Savings Account each month. Realize that doing this doesn’t cost you anything; you are just transferring the money you are saving into another location.
3) Next, enjoy the IRS created triple tax advantages (see the “a-b-c” listed below) that only HSAs offer. You can reduce your annual out-of-pocket income taxes up to $1800 or more per year. Save EVERY year on these income taxes. View below your three main tax-saving pillars.
a) HSA Contributions (deposits into your HSA) are 100% tax free
b) The interest earned on all of your HSA account contributions are also 100% tax free. The choice of investments are yours and range anywhere from typical low-interest, virutally zero-risk bank rates to the widest range of stocks, bonds, & mutual funds. The level of risk is entirely up to you and you can increase or decrease it at anytime.
c) Make 100% tax-free withdrawals for virtually all medical expenses. View a list of HSA Eligible Expenses.
While your funds grow tax free, you are now building a significant retirement account of up to several hundred thousand dollars. If you must use the money to cover any part of your deductible, you may make a 100% tax free withdrawal.
Here is the point: All of these above benefits & factors strongly diminish the impact of having a high deductible plan. Realistically there will be many periods of time where your money is only growing and never being withdrawn because you have little or no medical expenses.
Here’s another benefit. The Internal Revenue Service (IRS) rule says that at age 65 the money from your Health Savings Account may be withdrawn penalty-free for any reason, not just for qualified medical expenses. In this case, you’ll pay just the regular income taxes, just as you would when withdrawing from your IRA. However, your income during retirement generally goes way down as will the taxes required to pay. You will be paying much lower income tax on these withdrawals than before you were retired. Finally, understand that the funds in your HSA are always yours, without exception, and they rollover from year to year. You are also allowed to do a one time rollover from an IRA into a Health Savings Account without any penalty.
And yes, you may continue contributing to your IRA every year while still also making the maximum allowed HSA contributions. Having both types of retirement accounts is the ultimate scenario, but if you can afford contributing to only one type…I would certainly recommend the Health Savings Account. This is because HSAs are more than solely a retirement savings vehicle. Read another article I have written about improved benefits and higher limits in 2009 .
The company HSAHealthSavings genuinely specializes in HSA plans so consider contacting us (for contact info, read below “About the Author”). The straight truth is that many people are rather unclear about HSA Health Savings Plans and what they truly accomplish. Too often, an individual or business’s insurance broker has not kept them properly “up-to-date” on all of the many benefits available to them with an HSA. It is not that these brokers are not competent. But the question to consider is, what incentives do they really have to educate their clients on HSAs if doing so will lower their commissions? Not much of one perhaps. But you are the party who is really losing out. Any licensed agent or broker is obligated by a legal fiduciary duty to serve his or her client’s best interest at all times. This duty should be taken seriously, but isn’t typically enforced by the Department of Insurance.
Last but not least, although insurance companies are legally binded to offer HSA health savings plans in their line of products, they are not going out of their way to promote & publicize these plans. Doing so would also lower THEIR profits.
Now you are probably starting to see the light. As a consumer today you really have to take matters into your own hands and become authentically informed. The expert advisors at HSAHealth Savings are on a mission as millions of folks and their families are missing out on the tremendous financial benefits that are so readily attainable RIGHT NOW. We are excited! The benefits of health savings plans can literally transform one’s financial portfolio in both the short and long term. And HSAs are actually beneficial for just about everyone, not only the wealthy, or just older folks. Regardless of your income level, if you pay for health insurance at all, you owe it to yourself to consider and compare the benefits of HSA health savings plans versus the more traditional health plans you are accustomed to.
Kevin
May
27
Social Justice Through Health Care
Filed Under Wellness | Leave a Comment
Pardeep Kumar Sharma asked:
SOCIAL JUSTICE THROUGH HEALTH CARE
We hardly come across a person who may be fully satisfied with the health care delivery system run by either the government or the private sector. This is true not only for developing but for all the developed countries as well. Every law abiding, contributing individual has some legitimate expectations from the state. Disenchantment with present dispensation of health care compels people to seek better options across the borders. Even the present flow rate of patients from developed to developing countries has assumed the proportions of Medical tourism. Medical tourism is not a one-way traffic. Poor from India are known to visit Rashid Hospital at Lahore for kidney transplants. Medical tourism will definitely bring in world class equipment and services in our corporate hospitals. These corporate tertiary care hospitals can act as excellent referral hospitals. Lack of enough clinical material, as the patients are often referred to in medical parleyences is prompting the doctors from developed world into medical adventurism. Very recently two NGO’s headed by renowned plastic surgeons of Indian origin were in India, claiming to their credit hundreds of cleft lip and palate surgeries conducted in one week. During my brief interaction when I asked them one basic question that how do you justify single step surgery by a single specialist for a clinical entity that require 3-5 set up surgeries by 10 specialists over a period of 20 years, there was no answer. On record local doctors conduct all these surgeries. These NGO’s bring in a battery of trainee resident doctors for hands on training. Dumping of questionable services and drugs continues unabated in the absence of stringent regulations. Clear-cut up to date guidelines by health authorities have yet to be issued to safe guard the health interests of this nation. Most of the drugs banned in developed countries are still being dumped in the Indian market. Commerce alone dictates the policies of multinational companies in health sector of developing countries. State and national medical councils, the watch dogs of our national health interests are controlled by elected representatives from among the doctors. Competitive populism for being elected to these high offices takes away the very sting off these regulators. In this ‘market forces’ driven health sector, apart from other factors, size of the population, economic prosperity and literacy levels dictate the out look of key players. Subjective as well as objective assessments of the health care operations leave people confused with huge piles of data and endless interpretations. At the tail end of govt. health care delivery system is the rural dispensary or the slum revamping center, and the end user an illiterate or semi literate villager or a slum dweller. Dispensary is the humane face, the welfare state can present to its people. In yesteryears the service providers were from among the same social class they used to serve. Doctor can be a friend, philosopher and guide to the locals. Unfortunately the economic and social disparity between the service providing doctors and the service user population has grown enormously. Ad-hocism in health care delivery should be done away with immediate effect. Doctors and paramedical staff appointed on yearly contract basis are not showing any interest in the national programmes. Established private health care providers also have not shown any meaningful commitment for national programmes. Middle class itself has fragmented. Now it is fashionable to assign economic values to any issue like gender, but for social responsibility and justice. In this era of fast paced growth, the unorganized, silently suffering millions can not be wished away. Once reading on biodiversity I stumbled upon a very interesting quote, “only the species with economic importance will survive”. In our active pursuit for magnetizing economy, we assigned economic values to any thing except for morals. Commercialization of education has produced a new breed of professionals who have scant regard for professional ethics. Privatization is the buzzword with governments, because it takes away government responsibility. Private sector players are eyeing many ‘viable’ health institutions. There are no takers for commercially non-viable rural institutions. Rural health institutions dispense social medicine. Very recently one of the key players from private sector health care quoted the cost of developing one bed in corporate hospital at Rs. 30-60 lacs. These corporate health services are definitely out of each of the common man. These type of hospitals are definitely required for a nation with the present rate of growth but ‘bharat’ definitely needs different kind of hospitals. There are very strong social under currents against the exploitive private healthcare, inadequate government sector health care resources and the indifferent approach of welfare state. Health for all is a very lofty but expensive proposition. There are ways and means to reduce the pressure from government institutions. Private-public partnership, health insurance, monitoring and regulation of private sector health care can all make the things bit easy. Preventive health care education can go a long way in improving the public health. Community participation in health care has produced few but wonderful examples. Complementary community participation can make up for minor but critical deficiencies in the government run health care system. Setting up of health system corporations with World Bank assistance has already improved the working of govt. sector health care institutions considerably. Community participation through NGO’s can still improve the system, but most of the meaningful NGO’s turn their back on govt. run health care institutions because of their doubts on the integrity of government officers. Government health care institution are increasingly seen not as caring hospitals but like police stations, where medico legal reports are written and postmortems conducted. Most of the government doctors’ time is spent in courts appearing as medico legal experts witnesses. Emergency, post mortem, and then the VIP duties in addition hardly leave the doctors free for any meaningful job at government hospitals. There is an urgent need to have separate curative, preventive, legal, administrate and health intelligence wings. Government hospitals attract the poorest of the poor, mostly people from the unorganized sector. Their contribution to national GDP is by no means small. With the present growth rate, upward social mobility is seen in every strata of society. Many segments of this unorganized sector can be organised so that they also enjoy the patronage of welfare state in the form of health insurance policies. Apart from direct benefit to these segments of society, the state will benefit from the ‘off loading’ of burden from government run health care system and loading it on insurance driven private sector health care institutions. Poorest of the poor will repose faith in welfare state. Sanjivini, health insurance policy with the Punjab Milkmen Cooperative Societies is already a big success. ECHS (Ex servicemen Contributory Health Scheme) is an other success story. These success stories can be replicated with countless groups like, panwallas, dhabewallas, autorikshaw drivers etc. Simply organize the unorganized sector. There is no dearth of role models from among government doctors also. Their inclusion rather than drift after dissent from the present dispensation of health care will immensely improve the system. Stability of tenure is an excellent incentive government can give to its doctors without costing anything to exchequer. Yet tenure beyond decades should be discouraged as it leads to development of vested interests of the old incumbents and denial of chance to the youngsters. Resource mismatching is a major problem in the govt. run health care system. There are dispensaries where specialists are posted and still many more civil hospitals where non-specialist are posted. These mismatching result in defective and inefficient health care. Nodal Hospitals can be created for round the clock emergency services by cannibalizing defunct and sick institutions where equipment worth crores is lying unused and salary bills are bleeding the exchequer white. Most of the medical officers retire in the same administrate rank. This undue stagnation has forced many a brilliant doctors out of service. By simply seeking options for place of posting, honestly implementing with minimum displacement on merit can also revitalize the govt. doctors’ cadres. Private sector health care delivery system is a totally market driven commercial enterprise. So called ‘market forces’ have least respect for ethical and moral value systems. Multi level marketing chains have evolved in the name of referral systems. End result is exploitation of the unsuspecting common man, who still regards his healer a holy person. This ‘incentive’ system is strengthening the hold of unqualified, unscrupulous and unregistered medical practitioners on illiterate masses. Not many qualified doctors are unscrupulous. A large section of private health care providers feel genuinely threatened by blackmailers of all sorts. Consumer protection act is a very convenient beating stick in the hands of their tormentors.
Under the constant threat of being blackmailed, the private health care providers are becoming more defensive in attitude. More patients are being referred to tertiary care institutions for this reason only, thereby flooding the referral institutions. People have a common feeling that sickness is an invitation for exploitation at the hands of private health care providers. Even the charitable hospitals are charging as heavily as fully private hospitals. Medical profession is fully responsible and capable of self-correction. Medical councils and associations can jointly evolve a fail-safe mechanism to keep their black sheep under check even without government help, but the buck stops with the government. Welfare state is duty bound not only in providing health care delivery system but also proper health care administration and social justice through its health care delivery mechanism.
Name : Dr. Pardeep Kumar Sharma
Email-ID : omfspardeep@yahoo.com.
(M) : 0988456296
Date of Birth : 12.02.1962
Education Qualifications : BDS (Bachelor of Dental Surgery)
MDS (Master of Dental Surgery in Oral and Maxillofacial Surgery)
Educational Institutes Attended
Govt. High School Bargari : Matriculation (1969-1977)
Distt. Faridkot, Punjab, India
DAV College Chandigarh : Pre-University (1973-79)
(Punjab University)
Barjindra College Faridkot : Pre-Medical (1980)
Dental Wing, Medical College : BDS (1981-1986)
Patiala
Dental College and Hospital : MDS (2003-2006)
Amritsar
Professional Experience
House Officer, Christian : 1987-1988
Medical College & Hospital,
Ludhiana
Research Officer, All India : Jan. 1989 to June 1989
Institute of Medical Science
AIIIMS, New Delhi
Dental Officer, Indian Armed : July 1989 to August 1994.
Forces in the Rank of Capt.
3
Medical Officer (Dental) : w.e.f. Nov. 1995 till date
in Punjab Civil Medical Service
(PCMS)
Research papers Published
“Role of Programmed cell death in dental anomalies associated with cleft lip and Palate”. “Medical Hypotheses” Churchil Living Stone Publishers London-1991
Post traumatic polatoglossal adhesion, a case report stomatologica India (1990).
Research Project Undertakes
“Malocclusion and associated Factors among Delhi Children” a study sponsored by Indian Council of Medical Research (ICMR).
Areas of Interest : Environment, Health, Defence, International Affairs and Rationalism
Heath
SOCIAL JUSTICE THROUGH HEALTH CARE
We hardly come across a person who may be fully satisfied with the health care delivery system run by either the government or the private sector. This is true not only for developing but for all the developed countries as well. Every law abiding, contributing individual has some legitimate expectations from the state. Disenchantment with present dispensation of health care compels people to seek better options across the borders. Even the present flow rate of patients from developed to developing countries has assumed the proportions of Medical tourism. Medical tourism is not a one-way traffic. Poor from India are known to visit Rashid Hospital at Lahore for kidney transplants. Medical tourism will definitely bring in world class equipment and services in our corporate hospitals. These corporate tertiary care hospitals can act as excellent referral hospitals. Lack of enough clinical material, as the patients are often referred to in medical parleyences is prompting the doctors from developed world into medical adventurism. Very recently two NGO’s headed by renowned plastic surgeons of Indian origin were in India, claiming to their credit hundreds of cleft lip and palate surgeries conducted in one week. During my brief interaction when I asked them one basic question that how do you justify single step surgery by a single specialist for a clinical entity that require 3-5 set up surgeries by 10 specialists over a period of 20 years, there was no answer. On record local doctors conduct all these surgeries. These NGO’s bring in a battery of trainee resident doctors for hands on training. Dumping of questionable services and drugs continues unabated in the absence of stringent regulations. Clear-cut up to date guidelines by health authorities have yet to be issued to safe guard the health interests of this nation. Most of the drugs banned in developed countries are still being dumped in the Indian market. Commerce alone dictates the policies of multinational companies in health sector of developing countries. State and national medical councils, the watch dogs of our national health interests are controlled by elected representatives from among the doctors. Competitive populism for being elected to these high offices takes away the very sting off these regulators. In this ‘market forces’ driven health sector, apart from other factors, size of the population, economic prosperity and literacy levels dictate the out look of key players. Subjective as well as objective assessments of the health care operations leave people confused with huge piles of data and endless interpretations. At the tail end of govt. health care delivery system is the rural dispensary or the slum revamping center, and the end user an illiterate or semi literate villager or a slum dweller. Dispensary is the humane face, the welfare state can present to its people. In yesteryears the service providers were from among the same social class they used to serve. Doctor can be a friend, philosopher and guide to the locals. Unfortunately the economic and social disparity between the service providing doctors and the service user population has grown enormously. Ad-hocism in health care delivery should be done away with immediate effect. Doctors and paramedical staff appointed on yearly contract basis are not showing any interest in the national programmes. Established private health care providers also have not shown any meaningful commitment for national programmes. Middle class itself has fragmented. Now it is fashionable to assign economic values to any issue like gender, but for social responsibility and justice. In this era of fast paced growth, the unorganized, silently suffering millions can not be wished away. Once reading on biodiversity I stumbled upon a very interesting quote, “only the species with economic importance will survive”. In our active pursuit for magnetizing economy, we assigned economic values to any thing except for morals. Commercialization of education has produced a new breed of professionals who have scant regard for professional ethics. Privatization is the buzzword with governments, because it takes away government responsibility. Private sector players are eyeing many ‘viable’ health institutions. There are no takers for commercially non-viable rural institutions. Rural health institutions dispense social medicine. Very recently one of the key players from private sector health care quoted the cost of developing one bed in corporate hospital at Rs. 30-60 lacs. These corporate health services are definitely out of each of the common man. These type of hospitals are definitely required for a nation with the present rate of growth but ‘bharat’ definitely needs different kind of hospitals. There are very strong social under currents against the exploitive private healthcare, inadequate government sector health care resources and the indifferent approach of welfare state. Health for all is a very lofty but expensive proposition. There are ways and means to reduce the pressure from government institutions. Private-public partnership, health insurance, monitoring and regulation of private sector health care can all make the things bit easy. Preventive health care education can go a long way in improving the public health. Community participation in health care has produced few but wonderful examples. Complementary community participation can make up for minor but critical deficiencies in the government run health care system. Setting up of health system corporations with World Bank assistance has already improved the working of govt. sector health care institutions considerably. Community participation through NGO’s can still improve the system, but most of the meaningful NGO’s turn their back on govt. run health care institutions because of their doubts on the integrity of government officers. Government health care institution are increasingly seen not as caring hospitals but like police stations, where medico legal reports are written and postmortems conducted. Most of the government doctors’ time is spent in courts appearing as medico legal experts witnesses. Emergency, post mortem, and then the VIP duties in addition hardly leave the doctors free for any meaningful job at government hospitals. There is an urgent need to have separate curative, preventive, legal, administrate and health intelligence wings. Government hospitals attract the poorest of the poor, mostly people from the unorganized sector. Their contribution to national GDP is by no means small. With the present growth rate, upward social mobility is seen in every strata of society. Many segments of this unorganized sector can be organised so that they also enjoy the patronage of welfare state in the form of health insurance policies. Apart from direct benefit to these segments of society, the state will benefit from the ‘off loading’ of burden from government run health care system and loading it on insurance driven private sector health care institutions. Poorest of the poor will repose faith in welfare state. Sanjivini, health insurance policy with the Punjab Milkmen Cooperative Societies is already a big success. ECHS (Ex servicemen Contributory Health Scheme) is an other success story. These success stories can be replicated with countless groups like, panwallas, dhabewallas, autorikshaw drivers etc. Simply organize the unorganized sector. There is no dearth of role models from among government doctors also. Their inclusion rather than drift after dissent from the present dispensation of health care will immensely improve the system. Stability of tenure is an excellent incentive government can give to its doctors without costing anything to exchequer. Yet tenure beyond decades should be discouraged as it leads to development of vested interests of the old incumbents and denial of chance to the youngsters. Resource mismatching is a major problem in the govt. run health care system. There are dispensaries where specialists are posted and still many more civil hospitals where non-specialist are posted. These mismatching result in defective and inefficient health care. Nodal Hospitals can be created for round the clock emergency services by cannibalizing defunct and sick institutions where equipment worth crores is lying unused and salary bills are bleeding the exchequer white. Most of the medical officers retire in the same administrate rank. This undue stagnation has forced many a brilliant doctors out of service. By simply seeking options for place of posting, honestly implementing with minimum displacement on merit can also revitalize the govt. doctors’ cadres. Private sector health care delivery system is a totally market driven commercial enterprise. So called ‘market forces’ have least respect for ethical and moral value systems. Multi level marketing chains have evolved in the name of referral systems. End result is exploitation of the unsuspecting common man, who still regards his healer a holy person. This ‘incentive’ system is strengthening the hold of unqualified, unscrupulous and unregistered medical practitioners on illiterate masses. Not many qualified doctors are unscrupulous. A large section of private health care providers feel genuinely threatened by blackmailers of all sorts. Consumer protection act is a very convenient beating stick in the hands of their tormentors.
Under the constant threat of being blackmailed, the private health care providers are becoming more defensive in attitude. More patients are being referred to tertiary care institutions for this reason only, thereby flooding the referral institutions. People have a common feeling that sickness is an invitation for exploitation at the hands of private health care providers. Even the charitable hospitals are charging as heavily as fully private hospitals. Medical profession is fully responsible and capable of self-correction. Medical councils and associations can jointly evolve a fail-safe mechanism to keep their black sheep under check even without government help, but the buck stops with the government. Welfare state is duty bound not only in providing health care delivery system but also proper health care administration and social justice through its health care delivery mechanism.
Name : Dr. Pardeep Kumar Sharma
Email-ID : omfspardeep@yahoo.com.
(M) : 0988456296
Date of Birth : 12.02.1962
Education Qualifications : BDS (Bachelor of Dental Surgery)
MDS (Master of Dental Surgery in Oral and Maxillofacial Surgery)
Educational Institutes Attended
Govt. High School Bargari : Matriculation (1969-1977)
Distt. Faridkot, Punjab, India
DAV College Chandigarh : Pre-University (1973-79)
(Punjab University)
Barjindra College Faridkot : Pre-Medical (1980)
Dental Wing, Medical College : BDS (1981-1986)
Patiala
Dental College and Hospital : MDS (2003-2006)
Amritsar
Professional Experience
House Officer, Christian : 1987-1988
Medical College & Hospital,
Ludhiana
Research Officer, All India : Jan. 1989 to June 1989
Institute of Medical Science
AIIIMS, New Delhi
Dental Officer, Indian Armed : July 1989 to August 1994.
Forces in the Rank of Capt.
3
Medical Officer (Dental) : w.e.f. Nov. 1995 till date
in Punjab Civil Medical Service
(PCMS)
Research papers Published
“Role of Programmed cell death in dental anomalies associated with cleft lip and Palate”. “Medical Hypotheses” Churchil Living Stone Publishers London-1991
Post traumatic polatoglossal adhesion, a case report stomatologica India (1990).
Research Project Undertakes
“Malocclusion and associated Factors among Delhi Children” a study sponsored by Indian Council of Medical Research (ICMR).
Areas of Interest : Environment, Health, Defence, International Affairs and Rationalism
Heath
May
27
naturalstategal asked:
I have a homework assignment that requires me to gather info about health screenings, fitness center amenities, self-improvement classes, and wellness program benefits. Any and all help is appreciated!
Floyd
I have a homework assignment that requires me to gather info about health screenings, fitness center amenities, self-improvement classes, and wellness program benefits. Any and all help is appreciated!
Floyd
May
25
does anyone have any hints on how i can start my online wellness business?
Filed Under Wellness | 3 Comments
twitalele3 asked:
i have a wellness business that i would like to get started with. i figured the smart thing to do would be to get it going online until i pick up some business then i can move from there. but i dont know how to deal with taxes mostly.does anyone have any ideas on how i can do this?
Gilroy
i have a wellness business that i would like to get started with. i figured the smart thing to do would be to get it going online until i pick up some business then i can move from there. but i dont know how to deal with taxes mostly.does anyone have any ideas on how i can do this?
Gilroy
May
23
OSHOInternational asked:
Emotions that we don’t know how to handle effectively lie at the core of so many difficulties in the life of the individual. They play a profound role in how we feel about ourselves, and can even affect our physical health. Expressing our emotions can often hurt others, but by repressing them — even in the benevolent guise of “self-control” — we risk hurting ourselves. Osho offers a third alternative, which is to understand the roots of our emotions and to develop the knack of watching them and learning from them. Osho’s unique insights into emotions, the workings of the mind, and the “being” of the individual go far beyond the understandings of conventional psychology. Order this new book from amazon.cm: http://www.amazon.com/exec/obidos/ASIN/030733788X/oshointernationa Order from Random House: http://www.randomhouse.com/catalog/display.pperl?isbn=9780307337887
Conroy
May
18
Cleansing Your Body, and Regaining Your Health With Oxy-powder
Filed Under Wellness | Leave a Comment
Health Nut asked:
OxyPowder is a gentle, powerful, and safe, all natural colon cleanser. It has successfully assisted over 2 million people regain their health. This is twice as successful as the Dr. Natura’s Colonix. Since the product is safe, many continue to use it for years. It is very simple, and does not have to interrupt your day. There are no shakes or drinks to prepare, and you will not be glued to your toilet either.
How Is Oxy-Powder Different From Other Colon Cleansers?
Oxy-Powder along with all other products developed by Dr. Group are FDA approved and under Current Good Manufacturing Practices (cGMP). So, it is an environmentally friendly, 100% Kosher, Vegetarian Certified cleanser. This is particularly important for people who have specific vegetarian, religious, cultural, or dietary needs…
Ingredients
Oxy-Powder’s ingredients have been thoroughly researched. They include:
Ozonated Magnesium: helps motivate your colon, while promoting healthy bowel function.
Organic Germanium 132: helps lower and stabalize your blood pressure and cholesterol.
Natural Citric Acid: helps assist in the cleansing process while metabolizing fats, carbohydrates, and proteins.
Organic Gum Acacia: helps relieve symptoms of diarrhea, lowers your cholesterol, curb your appetite, and reduces malabsorbtion.
Using Oxy-Powder
You will start, in the evening, by taking 4 capsules with an 8 oz. Glass of water. You should be having 3-5 bowel movements every day. If you are not, increase your dosage by 2 until you are having 3-5 bowel movements a day. Once you reach this point you, this will count as day 1. You simply continue taking the same dosage for 7 days. This is the 7-Day Oxygen Colon Cleanse…
What Benefits Will I See From Oxy-Powder?
Since, cleansing your digestive system can have positive affects on the rest of your body, you can see the following results:
- improved body odor
- improved appetite
- weight issues improved and regulated
- improved breath odor
- relieved back pain
- increased energy level
- elevated mood
- relieved constipation symptoms
- improved immune system
- reduced bloating
- maximized ability to absorb nutrients
- improved ****** complexion
- detoxified body
Frequently Asked Questions
Is Oxy-Powder Safe?
Yes, Oxypowder is safe.
Is OxyPowder habit forming?
No!
Can I continue using OxyPowder every day?
Yes!
Does Oxy-Powder have side effects I need to know about?
You will notice watery gaseous stools. Be aware that this is not diarrhea. This is the result of Oxy-Powder liquifying the excess buildup of waste and toxins in your body. Colon cleansers also have die-off effects. This is a result of your body purging the toxins from your body. It is a perfectly natural response, similar to when you catch a fever or cold. Your body can get worse, before it gets better. If these die off effects are becomming problematic, you can simply reduce your dosage to make it more manageable.
Will I actually lose weight from using Oxy-Powder?
Yes, it is often observed that people loose weight from using Oxy-Powder. However this is not the intended purpose.
I feel perfectly healthy, and am in good shape. Is there any reason for me to take Oxy-Powder?
Many professional athletes have been using Oxy-Powder on a regular basis. Afterall, no one has a perfect digestive system.
What Specific Conditions Oxy-Powder Can Treat?
Irritable Bowel Syndrome (IBS), Hemorrhoids, & Candida
Edmund
OxyPowder is a gentle, powerful, and safe, all natural colon cleanser. It has successfully assisted over 2 million people regain their health. This is twice as successful as the Dr. Natura’s Colonix. Since the product is safe, many continue to use it for years. It is very simple, and does not have to interrupt your day. There are no shakes or drinks to prepare, and you will not be glued to your toilet either.
How Is Oxy-Powder Different From Other Colon Cleansers?
Oxy-Powder along with all other products developed by Dr. Group are FDA approved and under Current Good Manufacturing Practices (cGMP). So, it is an environmentally friendly, 100% Kosher, Vegetarian Certified cleanser. This is particularly important for people who have specific vegetarian, religious, cultural, or dietary needs…
Ingredients
Oxy-Powder’s ingredients have been thoroughly researched. They include:
Ozonated Magnesium: helps motivate your colon, while promoting healthy bowel function.
Organic Germanium 132: helps lower and stabalize your blood pressure and cholesterol.
Natural Citric Acid: helps assist in the cleansing process while metabolizing fats, carbohydrates, and proteins.
Organic Gum Acacia: helps relieve symptoms of diarrhea, lowers your cholesterol, curb your appetite, and reduces malabsorbtion.
Using Oxy-Powder
You will start, in the evening, by taking 4 capsules with an 8 oz. Glass of water. You should be having 3-5 bowel movements every day. If you are not, increase your dosage by 2 until you are having 3-5 bowel movements a day. Once you reach this point you, this will count as day 1. You simply continue taking the same dosage for 7 days. This is the 7-Day Oxygen Colon Cleanse…
What Benefits Will I See From Oxy-Powder?
Since, cleansing your digestive system can have positive affects on the rest of your body, you can see the following results:
- improved body odor
- improved appetite
- weight issues improved and regulated
- improved breath odor
- relieved back pain
- increased energy level
- elevated mood
- relieved constipation symptoms
- improved immune system
- reduced bloating
- maximized ability to absorb nutrients
- improved ****** complexion
- detoxified body
Frequently Asked Questions
Is Oxy-Powder Safe?
Yes, Oxypowder is safe.
Is OxyPowder habit forming?
No!
Can I continue using OxyPowder every day?
Yes!
Does Oxy-Powder have side effects I need to know about?
You will notice watery gaseous stools. Be aware that this is not diarrhea. This is the result of Oxy-Powder liquifying the excess buildup of waste and toxins in your body. Colon cleansers also have die-off effects. This is a result of your body purging the toxins from your body. It is a perfectly natural response, similar to when you catch a fever or cold. Your body can get worse, before it gets better. If these die off effects are becomming problematic, you can simply reduce your dosage to make it more manageable.
Will I actually lose weight from using Oxy-Powder?
Yes, it is often observed that people loose weight from using Oxy-Powder. However this is not the intended purpose.
I feel perfectly healthy, and am in good shape. Is there any reason for me to take Oxy-Powder?
Many professional athletes have been using Oxy-Powder on a regular basis. Afterall, no one has a perfect digestive system.
What Specific Conditions Oxy-Powder Can Treat?
Irritable Bowel Syndrome (IBS), Hemorrhoids, & Candida
Edmund
May
13
themellos asked:
Tips and things to know before putting up, organizing, or beginning a spa, massage clinic or wellness center
Halsey
Tips and things to know before putting up, organizing, or beginning a spa, massage clinic or wellness center
Halsey
May
11
C.W. asked:
I rock climb at least 5 days a week in an indoor gym (and go outdoor when possible, Florida’s kind of flat) and work summer camp for it and I have a lot of trouble with muscle pain, knots from constant belaying and of course looking up while doing it.
I rock climb at least 5 days a week in an indoor gym (and go outdoor when possible, Florida’s kind of flat) and work summer camp for it and I have a lot of trouble with muscle pain, knots from constant belaying and of course looking up while doing it.
Any suggestions on how to keep this climber’s body healthy?
Barclay
May
11
Linda Rosenberg asked:
Why Pursue Mental Health Integration?
It is the right thing to do: The NCCBH vision statement provides the foundation for our work: We are committed to creating and sustaining healthy and secure communities, achieved through a system that holds the needs of consumers paramount, regardless of their ability to pay.
Vital to this commitment is a network of organizations and advocates promoting services of unparalleled value.
NCCBH members primarily serve public sector consumers, those with severe and persistent mental illness or serious emotional disturbance-the needs of this population are often overlooked in primary care and integration planning. We must assure that their needs as well as the needs of the broader community are appropriately addressed.
Many people in the broader community now receive their behavioral healthcare in a primary care setting, and the gap between the medical and behavioral healthcare systems must be bridged: As noted by Robin Dea and many other commentators, there is:
“evidence that many, if not most, people coming into primary care are being treated for psychosocial problems, not organically based medical disease . . . evidence of medical cost offsets from treating behavioral health problems presenting as physical health problems in the primary care setting . . . the assumption that if adequate detection of early stage psychiatric illness took place in primary care, there would be some prevention of patients going to more severe episodes of major psychiatric illnesses . . . and primary care is where most people who have behavioral health problems are in fact seen.”
Some of the important findings from the research field include:
-The Epidemiologic Catchment Area (ECA) Study and articles based on this survey data, reported the finding that about 50% of care for common mental disorders was delivered in general medical settings. However, many subsequent studies have shown that these disorders may be undiagnosed or under-treated.
-Screening systems, treatment guidelines and provider education in primary care are necessary but not sufficient steps to ensure a difference in outcomes.
-Collaborative and stepped care has been shown to achieve outcomes that are better than “usual care”.
There is the opportunity for quality improvement of care within the primary care and specialty behavioral healthcare settings: Studies have shown that many people with depression stop taking their medications before the minimal time required to effectively treat an episode of depression. Patients at Group Health Cooperative who initiated medications for depression with their primary care physician and received targeted stepped up care and relapse prevention support were significantly more likely to adhere to adequate dosages of medication and to demonstrate a greater decrease in depressive symptoms.
Application of research findings such as these through adoption of evidence-based practices in both primary care and specialty behavioral health (BH) settings will result in better outcomes for consumers.
With the publication of Priority Areas for National Action: Transforming Health Care Quality, the Institute of Medicine’s 2003 follow up to Crossing the Quality Chasm: A New Health System for the 21st Century, a major opportunity and challenge has appeared for the public mental health system.
The Quality Chasm recommended the systematic identification of priority areas for national quality improvement; Priority Areas proposes twenty areas for transforming health care nationally. Included in this list are major depression (screening and treatment) and severe and persistent mental illness (focus on treatment in the public sector).
Their inclusion as priority areas, as well as the findings in the Interim Report from the President’s New Freedom Commission on Mental Health, with its observation that the system is “fragmented and in disarray-not from lack of commitment and skill of those who deliver care, but from underlying structural, financing and organizational problems” suggests that the time for new strategies is at hand.
Many people being served by public behavioral health services need better access to primary care: A rationale less frequently articulated for integration is that the specialty BH system, especially the public sector focusing on the severe and persistent mentally ill adult population (SPMI) and seriously emotionally disturbed (SED) children, serves a disabled consumer population with healthcare needs that are frequently under-addressed due to difficulties in obtaining medical services.
Most state Medicaid waivers related to coverage for physical healthcare have focused on enrollment of the TANF population into Medicaid managed care plans, leaving the disabled Medicaid population unable to adequately access care, or in better situations, reliant on “safety net” providers-community health centers (CHCs) or county delivered health services.
Community health centers serve people who need better access to behavioral healthcare. These “safety net” providers serve a broader scope of patients than just the Medicaid population. But many states have implemented mental health Medicaid waivers that focus the public mental health system on the SPMI/SED and Medicaid populations, with minimal levels of support for non-SPMI/SED or uninsured populations. Often there is not a good match of target populations between the two systems. If the Medicaid mental health program also has a highly managed service authorization and payment methodology, there may be additional barriers to reimbursement for mental health services.
This has led to frustration for “safety net” healthcare providers because they have difficulty obtaining behavioral health services for their non-SPMI/SED or uninsured patients. In a recent survey of CHC medical directors, 80% indicated that cost is the main barrier to behavioral health care for their uninsured populations. The recent financing and development of behavioral health services in CHCs addresses this frustration and is just the latest in a series of efforts to acknowledge that a large proportion of the population gets their behavioral health services in primary care.
Because behavioral health clinicians are a resource for assisting people with all types of chronic health conditions: Yet another reason for integration is the potential contribution of BH clinicians regarding behavioral and lifestyle change: providing interventions targeted at better management of chronic disease, supporting and “leveraging” the time of primary care providers through disease management programs.
Disease management activities focus on several areas: early identification of populations at-risk for costly chronic disease (e.g., asthma, diabetes), care interventions that utilize evidence-based practices, education-intensive orientations that focus on both patient and provider, care management and a coordinated approach across multidisciplinary treatment teams, and a method for systematic data collection that measures clinical and cost-effectiveness. Large organized healthcare systems, such as Northern California Kaiser-Permanente, implement their major disease management programs with specifically assigned nurses as care managers and educators.
However, many physicians in individual or group practices do not have access to this level of support unless they are in the network of a health plan with active disease management programs. In markets where primary care and multi-specialty groups have accepted accelerated risk, disease management approaches will be especially value-added.
We are in a time of significant public policy activity regarding financing of the national healthcare system and the uninsured population. As we approach the 40th anniversary of the founding of the community mental health center movement, the dialogue has returned us to our public health beginnings-serving the needs of a population.
The Health Resources and Services Administration (HRSA) Primary Care Integration Initiative is currently being implemented across the country. The HRSA initiative includes: identification of system issues related to integration and the development of related strategies; development of a service manual for CHC behavioral health services; development of BH intervention models for CHCs; and grants for establishing BH services in existing CHCs.
Newly funded CHC sites will be expected to provide dental, mental health and substance abuse services, either directly or by subcontract arrangements. CHCs are in the process of decision making about building their own BH services or contracting for BH services, as they prepare their grant applications. (The NCCBH website, www.nccbh.org, has a Primary Care Integration Resource Center with more details about the HRSA process.)
At the same time that HRSA is putting new BH resources into CHCs, reports are emerging from many states indicating that the public mental health system is funded at somewhere around half the level that is needed. In the private sector, the relentless downward pressure on behavioral health PMPMs has also reduced overall system resources, shifting cost from the private sector to the public sector.
Reports such as these were released prior to the current fiscal crisis in state Medicaid programs; rather than addressing the shortfalls, there are significant new reductions in BH services in many states. And, the implementation of managed care methods for Medicaid have made it difficult for some community based BH providers to continue to enact their mission of serving the needs of the population, regardless of ability to pay.
The implications for system-wide duplication and competition for the scarce resources of BH staff and funding, as well as the opportunity to improve consumer access to both health and behavioral healthcare services, suggests that collaboration is a priority at the national, state and local levels. Good public policy will work at sustaining, supporting and requiring collaboration between the two “safety net” systems of community mental health centers and community health centers.
The conceptual model proposed in this paper can become the basis for HRSA grantees to work with their partners in the public mental health system to fully define working relationships and collaboration on behalf of consumers of care.
In summary, the reasons for integration are grounded in the desire to improve access to both primary care and behavioral health services; ensure that there are evidence-based practices as well as consistent communication and coordination of clinical activities (especially medication management-a key concern of consumers) among the providers serving any single individual; wed the skill sets of primary care physicians and BH clinicians in order to better manage chronic health issues; and, participate in and shape the public policy debate regarding how services should be organized, delivered and financed in ways that ensure that needs of public sector SPMI/SED consumers and the broader community alike are met.
Benedict
Why Pursue Mental Health Integration?
It is the right thing to do: The NCCBH vision statement provides the foundation for our work: We are committed to creating and sustaining healthy and secure communities, achieved through a system that holds the needs of consumers paramount, regardless of their ability to pay.
Vital to this commitment is a network of organizations and advocates promoting services of unparalleled value.
NCCBH members primarily serve public sector consumers, those with severe and persistent mental illness or serious emotional disturbance-the needs of this population are often overlooked in primary care and integration planning. We must assure that their needs as well as the needs of the broader community are appropriately addressed.
Many people in the broader community now receive their behavioral healthcare in a primary care setting, and the gap between the medical and behavioral healthcare systems must be bridged: As noted by Robin Dea and many other commentators, there is:
“evidence that many, if not most, people coming into primary care are being treated for psychosocial problems, not organically based medical disease . . . evidence of medical cost offsets from treating behavioral health problems presenting as physical health problems in the primary care setting . . . the assumption that if adequate detection of early stage psychiatric illness took place in primary care, there would be some prevention of patients going to more severe episodes of major psychiatric illnesses . . . and primary care is where most people who have behavioral health problems are in fact seen.”
Some of the important findings from the research field include:
-The Epidemiologic Catchment Area (ECA) Study and articles based on this survey data, reported the finding that about 50% of care for common mental disorders was delivered in general medical settings. However, many subsequent studies have shown that these disorders may be undiagnosed or under-treated.
-Screening systems, treatment guidelines and provider education in primary care are necessary but not sufficient steps to ensure a difference in outcomes.
-Collaborative and stepped care has been shown to achieve outcomes that are better than “usual care”.
There is the opportunity for quality improvement of care within the primary care and specialty behavioral healthcare settings: Studies have shown that many people with depression stop taking their medications before the minimal time required to effectively treat an episode of depression. Patients at Group Health Cooperative who initiated medications for depression with their primary care physician and received targeted stepped up care and relapse prevention support were significantly more likely to adhere to adequate dosages of medication and to demonstrate a greater decrease in depressive symptoms.
Application of research findings such as these through adoption of evidence-based practices in both primary care and specialty behavioral health (BH) settings will result in better outcomes for consumers.
With the publication of Priority Areas for National Action: Transforming Health Care Quality, the Institute of Medicine’s 2003 follow up to Crossing the Quality Chasm: A New Health System for the 21st Century, a major opportunity and challenge has appeared for the public mental health system.
The Quality Chasm recommended the systematic identification of priority areas for national quality improvement; Priority Areas proposes twenty areas for transforming health care nationally. Included in this list are major depression (screening and treatment) and severe and persistent mental illness (focus on treatment in the public sector).
Their inclusion as priority areas, as well as the findings in the Interim Report from the President’s New Freedom Commission on Mental Health, with its observation that the system is “fragmented and in disarray-not from lack of commitment and skill of those who deliver care, but from underlying structural, financing and organizational problems” suggests that the time for new strategies is at hand.
Many people being served by public behavioral health services need better access to primary care: A rationale less frequently articulated for integration is that the specialty BH system, especially the public sector focusing on the severe and persistent mentally ill adult population (SPMI) and seriously emotionally disturbed (SED) children, serves a disabled consumer population with healthcare needs that are frequently under-addressed due to difficulties in obtaining medical services.
Most state Medicaid waivers related to coverage for physical healthcare have focused on enrollment of the TANF population into Medicaid managed care plans, leaving the disabled Medicaid population unable to adequately access care, or in better situations, reliant on “safety net” providers-community health centers (CHCs) or county delivered health services.
Community health centers serve people who need better access to behavioral healthcare. These “safety net” providers serve a broader scope of patients than just the Medicaid population. But many states have implemented mental health Medicaid waivers that focus the public mental health system on the SPMI/SED and Medicaid populations, with minimal levels of support for non-SPMI/SED or uninsured populations. Often there is not a good match of target populations between the two systems. If the Medicaid mental health program also has a highly managed service authorization and payment methodology, there may be additional barriers to reimbursement for mental health services.
This has led to frustration for “safety net” healthcare providers because they have difficulty obtaining behavioral health services for their non-SPMI/SED or uninsured patients. In a recent survey of CHC medical directors, 80% indicated that cost is the main barrier to behavioral health care for their uninsured populations. The recent financing and development of behavioral health services in CHCs addresses this frustration and is just the latest in a series of efforts to acknowledge that a large proportion of the population gets their behavioral health services in primary care.
Because behavioral health clinicians are a resource for assisting people with all types of chronic health conditions: Yet another reason for integration is the potential contribution of BH clinicians regarding behavioral and lifestyle change: providing interventions targeted at better management of chronic disease, supporting and “leveraging” the time of primary care providers through disease management programs.
Disease management activities focus on several areas: early identification of populations at-risk for costly chronic disease (e.g., asthma, diabetes), care interventions that utilize evidence-based practices, education-intensive orientations that focus on both patient and provider, care management and a coordinated approach across multidisciplinary treatment teams, and a method for systematic data collection that measures clinical and cost-effectiveness. Large organized healthcare systems, such as Northern California Kaiser-Permanente, implement their major disease management programs with specifically assigned nurses as care managers and educators.
However, many physicians in individual or group practices do not have access to this level of support unless they are in the network of a health plan with active disease management programs. In markets where primary care and multi-specialty groups have accepted accelerated risk, disease management approaches will be especially value-added.
We are in a time of significant public policy activity regarding financing of the national healthcare system and the uninsured population. As we approach the 40th anniversary of the founding of the community mental health center movement, the dialogue has returned us to our public health beginnings-serving the needs of a population.
The Health Resources and Services Administration (HRSA) Primary Care Integration Initiative is currently being implemented across the country. The HRSA initiative includes: identification of system issues related to integration and the development of related strategies; development of a service manual for CHC behavioral health services; development of BH intervention models for CHCs; and grants for establishing BH services in existing CHCs.
Newly funded CHC sites will be expected to provide dental, mental health and substance abuse services, either directly or by subcontract arrangements. CHCs are in the process of decision making about building their own BH services or contracting for BH services, as they prepare their grant applications. (The NCCBH website, www.nccbh.org, has a Primary Care Integration Resource Center with more details about the HRSA process.)
At the same time that HRSA is putting new BH resources into CHCs, reports are emerging from many states indicating that the public mental health system is funded at somewhere around half the level that is needed. In the private sector, the relentless downward pressure on behavioral health PMPMs has also reduced overall system resources, shifting cost from the private sector to the public sector.
Reports such as these were released prior to the current fiscal crisis in state Medicaid programs; rather than addressing the shortfalls, there are significant new reductions in BH services in many states. And, the implementation of managed care methods for Medicaid have made it difficult for some community based BH providers to continue to enact their mission of serving the needs of the population, regardless of ability to pay.
The implications for system-wide duplication and competition for the scarce resources of BH staff and funding, as well as the opportunity to improve consumer access to both health and behavioral healthcare services, suggests that collaboration is a priority at the national, state and local levels. Good public policy will work at sustaining, supporting and requiring collaboration between the two “safety net” systems of community mental health centers and community health centers.
The conceptual model proposed in this paper can become the basis for HRSA grantees to work with their partners in the public mental health system to fully define working relationships and collaboration on behalf of consumers of care.
In summary, the reasons for integration are grounded in the desire to improve access to both primary care and behavioral health services; ensure that there are evidence-based practices as well as consistent communication and coordination of clinical activities (especially medication management-a key concern of consumers) among the providers serving any single individual; wed the skill sets of primary care physicians and BH clinicians in order to better manage chronic health issues; and, participate in and shape the public policy debate regarding how services should be organized, delivered and financed in ways that ensure that needs of public sector SPMI/SED consumers and the broader community alike are met.
Benedict
May
10
dancingsnow asked:
I’ve been feeding her fancy feast together with dry food for 4 years but now I note that there’s by product in it and I’m not comfortable with it any more and I switched her to wellness can food, but she never ever eats it. What do I do? Any better tasted can food that is of high quality and holistic? Thanks.
Horace
I’ve been feeding her fancy feast together with dry food for 4 years but now I note that there’s by product in it and I’m not comfortable with it any more and I switched her to wellness can food, but she never ever eats it. What do I do? Any better tasted can food that is of high quality and holistic? Thanks.
Horace
