Health Care Happenings

         How are you doing?

         Christmas is 2 days away.

How would you answer the following right about now?   Yes/No

1. Do you forget to laugh—No ho ho ho?                                ___ ___

2. When little things go wrong, does it ruin your day?            ___ ___

3. Do you constantly feel exhausted?                                      ___ ___

4. Do you hate it when the plan changes?                               ___ ___

5. Do you feel worried, nervous in your mind or body?             ___ ___

Did I miss a question that fits you better?

      Wishing you and your family a happy and stress-free holiday!

As a “grey area” reserve, I am thankful for one of MOAA’s significant legislative victories in this year’s defense bill.

Although authorized to begin on Oct. 1, 2009, TRICARE benefit changes typically take a year or so to implement so we anticipate seeing the tentatively named “TRICARE Retired Reserve” coverage by late summer or early fall 2010 as announced by TRICARE Officials earlier this week.

The retired reserve health care benefit will be provided under TRICARE Standard and Extra, similar to TRICARE Reserve Select (TRS) but it differs in that it requires premiums equaling the full cost of the program; whereas, TRS premiums are 28% of the cost. We won’t know the exact cost of the premiums until the program rules are posted in the federal register.

What we do know is that the “grey-area” retiree will pay the retiree cost share/deductible and fall under the retiree catastrophic cap of $3000/family per FY. Additionally, they will be able to enroll as member only or member and immediate family.

We’ll keep you posted - so standby for further updates as we receive them!

Humm, thought I’d catch up on some reading while at the gym—so I pulled out my TRICARE Health Matters Newsletter, Issue 7: 2009 issue.

It was a pretty quick read and I flipped through the pages in short order. But when I got to the last page, for some reason, the box in the upper right hand corner of the back page spoke to me.

It said:

TRICARE
An Excellent Value
• Generous coverage
• Superior health care
• Decisions health driven, not insurance driven
• High satisfaction with care
• Low out-of-pocket costs
• Easy access

I struggled some with these words. Do you?

Humm, look forward to hearing your thoughts on “TRICARE—An Excellent Value”—Any after thoughts?

“What’s Up Doc”  Part IV Answer:
          Last week’s symptom:       Headaches and/or ringing or aching ears, plus aching back, neck, and/or teeth

          The Doctor Says: Migraines or an ear disorder

          But It Could Be: Temporomandibular joint syndrome—when the joint connecting your jaw and skull becomes inflamed

So why is it so difficult to get a straight answer when you go see your doctor?

This month’s Redbook Magazine points to an alarming statistic from the National Patient Safety Foundation that says, “about 40% of all mistakes that medical doctors make are misdiagnoses” – the article also talks about the four diseases we’ve been discussing these last few weeks.

There are a number of factors contributing to this statistic, including the fact that many conditions have similar symptoms or can be detected only with certain tests that your doctor may consider unnecessary, or because your doctor is confident in the diagnose based on his or her experience, just to name a few.

What this statistic highlights for me is just how critical it is to be fully engaged in my own health care. Not just being aware of what’s going on with my body, but also knowing the right questions to ask my physician when I notice something wrong.

The article suggests that by being aware of conditions that might present confusing symptoms then you can ask the right questions to prevent or fix an error by your doctor.

My take-way in reading the article? A little patient education can go a long way in helping me get a straight answer from my Doc—and, it might just Save My Life!

Are you ready for “What’s Up Doc” Part IV?   You get to diagnosis a condition I give you and I’ll let you know the answer the following week.

Last week’s symptom:      Sadness plus fatigue, weight gain, insomnia, and/or muscle aches or stiffness

You’re Diagnoses:
• Depression
• Narrow down the possibilities:
        - Depression  –>  (sadness plus fatigue, weight gain, insomnia.)
        - Consider symptoms above and you may have:
                  * Chronic Fatigue Syndrome  –>   (muscle aches or stiffness.)
        - You as the physician with little time to see this patient must also  consider this first before pulling your prescription pad:
                   * Patient History?  Soldier, veteran, family member.  What medications is this patient currently taking? What doctors are seeing this patient?  Is this patient having a medication reaction to possibly an anti-cholesterol drug?
        - This case screams of drug reaction and the patient should physically bring to you all medications he is taking for a review. Giving this patient a script for an antidepressant is not the answer.
        - In the dawn of socialized medicine, patient teaching is the key to protect your patients. Bless you for taking time out of your busy schedule to be their teacher.
• My initial reaction would be depression based on the symptoms described, though the insomnia may be the ‘mcguffin’ since I recall that the opposite (lethargic, always drowsy/sleepy) is an indicator of depression. You are tricky, René! Can’t wait to see the answer.  
• Mood disorder, probably clinical depression, rule out bi-polar, rule out fibromyalgia syndrome.

The Answer:
          The Doctor Says:      Depression
          But It Could Be:        Hypothyroidism (Webster’s Definition: deficient activity of the thyroid gland; also: a resultant bodily condition characterized by lowered metabolic rate and general loss of vigor)

You all are good! You were spot on with ‘Depression.’ YOU ROCK!

          Now, for Symptom 4:      Headaches and/or ringing or aching ears, plus aching  back, neck, and/or teeth
          Your Diagnosis Is: ???????

Come back next week—same time next Wednesday, same place for the answer.   I’ll tell you more about what’s behind the answers these last few weeks.   See you then!

As you can imagine, MOAA is getting a lot of mail from members on every conceivable aspect of the national health reform debate, ranging from suspicions about the motives of politicians on one side or the other, to specific aspects of the plan that might affect them personally, to larger philosophical issues of what the country and taxpayers should be responsible for and what they can afford.

Any way you cut it, this issue is a big deal.  But it covers so much territory  (four bills of 1,000+ pages each so far, with more to come) that it’s nearly impossible to track every detail and chase down all the various assertions and allegations if doing that isn’t your full-time job.

And with MOAA’s limited staff, there’s no way we can assign anyone to spend 100% of their time on national health care reform.  So we have to focus our efforts to deliver the best value for our members’ dues buck.

On Monday, MOAA President VADM Norb Ryan sent a personal message to the membership to articulate MOAA’s priorities in this area.

That message also included a link to our Aug 7 Legislative Update item covering our latest assessment of the initiative’s potential implications for TRICARE beneficiaries under 65 and for TRICARE For Life beneficiaries over 65.

But there’s still a long way to go in the process, and we urge our members to protect their interests by using MOAA’s national health reform alert to inform their legislators of their views.