Health Care Choices for Today's Consumer: Guide to Quality and Cost, Revised and Expanded

by Families USA Foundation; Editor: Marc S. Miller

• ISBN13: 9780471170907
• ISBN10: 0471170909
• Edition: Revised
• Format: Paperback
• Copyright: 1997-07-01
• Publisher: Wiley

Summary

"Admirable . . . clearly written, well organized . . . easy and helpful." -Washington Post"This is the surefire guide to making critical decisions about your family's health." -Dr. J. Larry Brown, Professor of Nutrition and Health Policy School of Nutrition, Tufts University"The array of choices and decisions facing consumers in health care today is incredibly complicated. Families USA has taken on the challenge of making this complex world accessible to the most important person in the process: the consumer. They've succeeded brilliantly!" -Dick Davidson, President, American Hospital Association.Now completely revised and expanded, this indispensable reference provides in-depth, up-to-the-minute coverage of major health care issues to help you make crucial choices for you and your family. Packed with vital facts and figures, illuminating advice, and invaluable tips, Health Care Choices for Today's Consumer includes: New chapters on men's health as well as prescription and over-the-counter drugs The latest on health care finance, managed care, alternative medicine, and wellness programs Updated financial, legal, and insurance information Important details on such topics as consumer rights, primary care, mental health, medications, hospitals, and physicians.

Author Biography

FAMILIES USA FOUNDATION (Washington, D.C.) is a national nonprofit organization dedicated to ensuring that consumers are given a voice in shaping the U.S. health care system. It has 135,000 members. MARC S. MILLER, Ph.D., is the Director of Families USA's Health Care Choices project.

Table of Contents

Foreword: A Message from Families USA	xv	(2)
Philippe Villers, President
Acknowledgments	xvii
Part One: Getting Started	1	(38)
1. A User's Guide to Health Care Choices for Today's Consumer	3	(6)
Marc S. Miller, Ph.D.
Partnerships and Good Health	5	(1)
A Look Ahead	6	(3)
2. Healthy Living	9	(14)
Rena Convissor
Audrey Chang
Practicing Good Health	11	(2)
Prevention Principles	12	(1)
Challenges across the Life Span	13	(4)
Childhood	14	(1)
Adolescence	14	(1)
Adulthood	15	(1)
Old Age	16	(1)
Chronic Conditions	17	(2)
Changing Behavior	17	(2)
Taking Charge of Your Health	19	(4)
Managing Your Own Care	19	(4)
3. Consumer Rights	23	(16)
George J. Annas
Informed Consent	24	(4)
Consent Must Be Competent and Voluntary	26	(1)
The Consent Form	27	(1)
Your Right to Emergency Treatment	28	(1)
The Hospital Emergency Department	28	(1)
Your Right to Your Medical Records	29	(3)
What Your Record Shouldn't Contain	30	(1)
Why Read Your Medical Record?	31	(1)
The (Limited) Right to Privacy	31	(1)
Enforcing Your Rights	32	(7)
The Patient-Rights Advocate	32	(1)
Complaining to the Licensing Board	33	(1)
Medical Malpractice and Informed Consent	34	(1)
Proving Malpractice	35	(4)
Part Two: The Heart of the Matter	39	(96)
4. Health Insurance: Managing Managed Care	41	(28)
Nancy Turnbull
This Thing Called "Managed Care"	43	(8)
Traditional Insurance vs. Managed Care	44	(2)
The Varieties of Managed Care	46	(2)
Other Options for Medical Insurance	48	(3)
Choosing a Health Plan	51	(8)
Cost + Coverage = Your Choice	53	(1)
What Else Does the Plan Cover?	54	(1)
Your Choice of Providers	55	(2)
How Does the Plan Pay Primary Care Physicians?	57	(1)
What If You Leave Your Job or Move Away?	58	(1)
The Quality Question	59	(4)
Report Cards	62	(1)
When It's Time to Complain	63	(6)
File a Complaint or Grievance with the Health Plan	63	(1)
Talk to Your Employer or Benefits Department	64	(1)
Other Options for Complaints	64	(5)
5. Primary Care	69	(22)
Harriet Tolpin
What a Good Primary Care Provider Does	71	(4)
Life Work: Promoting Health and Preventing Disease	73	(2)
Who Provides Primary Care?	75	(4)
Physicians	75	(2)
Physician Assistants	77	(1)
Advanced Practice Nurses	78	(1)
Finding Primary Care	79	(3)
Private Practices	79	(1)
Community Health Centers	80	(1)
Managed Care and Primary Care	81	(1)
Choosing Your Primary Care Provider	82	(5)
Getting Started	82	(2)
The Try-Out	84	(2)
Forging the Partnership	86	(1)
Money Matters	87	(4)
Primary Care and Insurance	87	(1)
The Smart Consumer	88	(3)
6. Hospitals	91	(24)
Joseph Restuccia
Alan Labonte
Jeffrey Gelb
The Varieties of Hospitals	92	(3)
Teaching and Nonteaching Hospitals	93	(1)
Speciality and General Hospitals	93	(1)
For-Profit and Nonprofit Hospitals	94	(1)
Hospitals for Veterans and Their Families	94	(1)
Outpatient Care	95	(2)
The Emergency Room	95	(2)
Testing and Treatment: Hospital Clinics	97	(1)
Searching for Quality	97	(5)
Accreditation and Quality	98	(1)
Services, Staffing, and Quality	99	(2)
Patient-Centered Care: A Quality Perspective	101	(1)
Making a Choice	102	(3)
Check the Service: High-Quality Care	103	(1)
Check the Services: The Caring Hospital	104	(1)
Getting Recommendations	104	(1)
Building a Health Care Partnership	105	(5)
Your Role in the Partnership	106	(2)
Your Hospital Record	108	(1)
When Problems Arise	108	(2)
Money Matters	110	(5)
Price Questions	111	(1)
The Hospital Bill	112	(3)
7. Medications	115	(20)
Jeo Graedon
Teresa Graedon
Working with Health Care Providers	117	(2)
Understanding Your Medicine	117	(2)
The Types of Medications	119	(4)
Prescription Drugs	120	(1)
Over-the-Counter Medications	121	(1)
Herbal Remedies	122	(1)
Avoiding Drug Dangers	123	(5)
Interactions between Drugs	124	(1)
Durg and Food Interactions	125	(1)
Psychological Side Effects	126	(2)
Money Matters	128	(7)
Drug Plans	128	(1)
Lower-Cost Prescriptions	128	(1)
Mail-Order Pharmacies	129	(1)
More Money-Saving Options	130	(5)
Part Three: Focussing on You	135	(116)
8. Parents as Health Care Consumers	137	(22)
Nora Wells
Primary Care for Children	138	(3)
Providers of Primary Care for Children	138	(1)
Choosing a Provider for Primary Care	139	(1)
The Factors to Consider	140	(1)
Your Role in the Partnership	141	(6)
Keep Records	142	(3)
Priority One: Immunizations	145	(1)
Children and Rights	146	(1)
Specialists for Children	147	(5)
The Specialists	148	(1)
Specialists and Hospitalization	149	(1)
Birthing Options	150	(1)
Cesarean Sections	151	(1)
Money Matters	152	(7)
Picking a Plan	152	(3)
Your Teenagers and Health Insurance	155	(4)
9. Women as Health Care Consumers	159	(28)
Martha Snyder Taggart
Building the Health Care Relationship	160	(3)
Continuity of Care	162	(1)
Counseling and Prevention	162	(1)
The Field of Providers Caring for Women	163	(4)
Family Physicians	163	(1)
Obstericians and Gynecologists ("Ob-Gyns")	164	(1)
Internists	165	(1)
Advanced Practice Nurses	165	(2)
Making Your Choice	167	(4)
Step 1: List Your Needs and Requirements	167	(1)
Step 2: Begin Your Search	168	(1)
Step 3: Interview Canditates	169	(2)
Step 4: Make a Decision	171	(1)
Women's Health throughout the Life Cycle	171	(5)
Young Womanhood: The Teen Years	172	(1)
Early Adulthood	173	(1)
Middle Age	174	(1)
The Later Years	175	(1)
Special Health Concerns of Women	176	(4)
Breast Cancer	177	(1)
Safe and Legal Abortion	178	(1)
Battering and Abuse	179	(1)
Insurance Issues for Women	180	(7)
How Women Are Faring under Managed Care	182	(5)
10. Men as Health Care Consumers	187	(18)
Jeffrey Kellog
Health Care for Men	188	(3)
Breaking the Silence	189	(1)
Finding the Right Doctor	189	(2)
Confronting the Top Killers of Men	191	(8)
Heart Disease	191	(2)
Cancer	193	(2)
Strokes	194	(1)
Lung Disease	195	(1)
Pneumonia and Influenza	195	(1)
Personal Injury and Violence-Related Deaths	196	(1)
Diabetes	197	(1)
HIV and Other Sexuallty Transmitted Diseases	198	(1)
Men's Mental Health	199	(6)
Therapy: A Vital Link	200	(1)
Fatherhood as a Health Issue	201	(4)
11. Elders as Health Care Consumers	205	(34)
Lou Glasse
Mal Schechter
Aging, Health, and Well-Being	208	(5)
Habits and Health	209	(1)
The Health Care Spectrum	210	(1)
Chronic Illness	211	(2)
Caregiving/Caregivers	213	(3)
Long Term Care and the Consumer	213	(3)
The Elements of Geriatric Care	216	(3)
The Geriatric Assessment	217	(1)
Geriatric Discharge Planning	218	(1)
Money Matters	219	(20)
Medicare	219	(1)
What Medicare Covers	220	(3)
What Medicare Costs	223	(3)
Beyond Medicare: Medigap and More	226	(2)
Medicare and HMOs	228	(5)
Insurance Assistance	233	(6)
12. On the Job: Health and the Workplace	239	(12)
Nancy Lessin
Laurie Stillman
Occupational Hazards and Your Rights	240	(2)
Your Rights to Workplace Hazard Informaion	241	(1)
Rights and Recourses	242	(1)
Getting Care	242	(3)
More Ways to Get Help	244	(1)
Controlling Hazards	245	(1)
Money Matters	245	(6)
More Sources of Compensation	247	(4)
Part Four: The Complete Package	251	(146)
13. Physician Specialists	253	(18)
June Ellen Mendelson
Choosing a Specialist	254	(5)
The Referral	255	(1)
Getting a Referral for Complex Care	256	(1)
Evaluating a Specialist	257	(1)
Certification Boards	258	(1)
Getting Good Specialist Care	259	(3)
Before Agreeing to Surgery	260	(1)
Second Opinions	261	(1)
Money Matters	262	(4)
Primary Means First	263	(1)
Judgement Calls	264	(1)
Physician Self-Referral and Unnecessary Tests	265	(1)
Who Does What	266	(5)
The Medical and Surgical Specialities	266	(5)
14. Mental Health	271	(20)
Cindy Brach
Gail K. Robinson
Choosing a Provider	273	(5)
Your Choice of Provider	275	(2)
Interviewing the Candidates	277	(1)
Reviewing the Options for Mental Health Services	278	(4)
Services for People with Severe Mental Illness	279	(2)
Hospitalization and Residential Alternatives	281	(1)
Money Matters	282	(4)
Insurance and Mental Health	283	(2)
If Your Insurance Doesn't Cover Mental Health	285	(1)
The Rights of Mental Patients	286	(5)
Discrimination	288	(3)
15. Long Term Care	291	(24)
Peggy Denker
What Is Long Term Care and Who Might Need It?	292	(1)
Getting Started	293	(4)
Question 1: What Kind of Care Is Needed?	293	(1)
Question 2: Who Will Provide the Care?	294	(1)
Question 3: Where Will Care Be Provided?	295	(1)
Question 4: What Will Care Cost?	296	(1)
Question 5: Who Will Pay for Care?	297	(1)
Finding Services	297	(7)
Assessment Services	298	(1)
Home-Care Services	299	(1)
Community-Based Care Services	300	(1)
Housing Options in the Community	301	(1)
Nursing-Home Services	302	(2)
Money Matters	304	(5)
Insurance for Long Term Care: Buyer Beware!	308	(1)
What Now? Assembling a Plan	309	(6)
16. Home Care	315	(16)
Anne P. Werner
James P. Firman
Getting Started	316	(3)
Who Provides Home Care?	316	(1)
Assessing Your Needs	317	(2)
Choosing the Right Providers	319	(4)
Assembling Information	320	(1)
The Job Offer	321	(2)
Managing Your Home Care	323	(2)
You and Your Home-Care Workers	324	(1)
How to Complain about Quality	325	(1)
Money Matters	325	(6)
Medicare	325	(1)
Medicaid	326	(1)
The Older Americans Act	327	(4)
17. Caring for Your Teeth	331	(18)
Robert Krughoff
What a Good Dentist Does	332	(4)
The Qualities to Seek	333	(1)
A Thorough Diagnosis	334	(1)
Explaning Your Choices	335	(1)
Obtaining Quality Treatment	336	(2)
Look...and Look Again	336	(2)
Your Safety	338	(1)
Fixing the Damage	338	(5)
Dental Implants	339	(1)
Bonding	340	(1)
Root-Canal Therapy	341	(1)
Dental Tips for Parents and Children	342	(1)
Money Matters	343	(6)
It's Your Record	344	(1)
Warranties	345	(1)
Insurance, Prepaid Dental Plans, and Dental HMOs	345	(1)
Dental School Clinics	346	(3)
18. Buying Eyeglasses and Contact Lenses	349	(16)
Robert Krughoff
The Eye Exam	350	(2)
The Choice: Glasses or Contacts	351	(1)
Buying Eyeglasses	352	(5)
Choosing Eyeglass Lenses and Features	355	(1)
Sunglasses	356	(1)
Buying Contact Lenses	357	(3)
Contact Lens Options	358	(1)
The Cost of Contact Lenses	359	(1)
Picking Up Your Glasses or Contacts	360	(5)
After You Go Home	361	(4)
19. Alternative Health Care	365	(16)
Nicolas P. Carballeira
A Short History	366	(3)
A Question of Balance	368	(1)
Who Does What	369	(5)
Ayurveda	369	(1)
Naturopathy	370	(1)
Chinese Medicine and Acupuncture	371	(1)
Homeopathy	372	(1)
Chiropractic	373	(1)
Biofeedback	373	(1)
Making a Choice	374	(2)
The Rules of the Game	375	(1)
Finding Local Alternative Providers	376	(1)
Money Matters	376	(5)
20. Death with Dignity	381	(16)
George J. Annas
Hospice Care	382	(4)
Money Matters	385	(1)
Pain and Medication	386	(1)
Saying No	386	(1)
Children and Parents	387	(1)
Planning Ahead	387	(5)
Living Wills	389	(1)
Durable Power of Attorney	390	(1)
Donating Your Organs	391	(1)
what Is Death?	392	(5)
Brain Death	393	(1)
Autopsies	394	(3)
Part Five: For Everyone's Health	397	(22)
21. Unreformed Health Care	399	(8)
Ron Pollack
Health Insecurity	400	(2)
Holes in the Net	402	(1)
The Active Consumer	403	(4)
22. Helping Yourself: A Guide to Self-Help Groups, Going Online, and General Resources for Health Care Consumers	407	(12)
Martha S. Grover
Mutual Assistance	409	(3)
A Remedy That Works	410	(1)
Finding a Self-Help Group	411	(1)
Computers and Self-Help	412	(5)
Bulletin Board Systems	413	(1)
Commercial Online Access	414	(1)
Health on the World Wide Web	414	(1)
Software Packages	415	(1)
Health Data Brokers	416	(1)
Finding Solutions	417	(2)
Appendix A: The Short List: Selected National Resources	419	(14)
Appendix B: Toll-Free Health Help	433	(6)
Appendix C: Emergency Health Care Phone Numbers	439	(2)
Glossary	441	(7)
Index	448