Columns & Blogs
Rebates coming if ACA stays
Paul Gionfriddo writes that if Affordable Care Act stays in place, a lot of consumers will get rebates from insurers, including more than 325,000 in Florida.
Hazing doesn’t typify FAMU band
Ennis Leon Jacobs Jr., a former member of the Florida A&M Marching 100, writes that the only future that the school's marching band can have is one where no tolerance for hazing exists.
Health policy hasn’t made many strides in past 25 years
Paul Gionfriddo writes that presidents and presidential candidates have long taken confused and confusing positions on health policy. And Obama and Romney are no different.
Myth-busting her own disease
Andrea Torres, chronicling her breast cancer experiences, writes that the rumors, e-mails and bogus stories about causes, miracle cures and treatments are often overwhelming but nothing a "delete" button can't handle.
Floridians don’t care about innocence; they want retribution
Columnist Fred Grimm says Florida's shameful record of sending innocent men to prison should make citizens wary of the death penalty. It doesn't.
Hazing’s not going to go away as long as we tolerate it
Columnist Andrew J. Skerritt writes that state hazing statutes tie the hands of state's attorneys and police, keeping them from prosecuting thugs as the murderous bullies they are.
Out of tragedy, girl’s legacy shines
Sue Carlton writes that after something went horribly wrong during a routine tonsillectomy, the parents of Carly Jane Liptak make sure her memory lives on.
End stigma, increase hope for mental illness
Bob Sharpe, CEO and president of the Florida Council for Community Mental Health, writes that mental illness can happen to anyone, so ending stigma and increasing access to care will help ensure that we all have the opportunity to lead productive and fulfilling lives.
Keep trying for ALF reform
The executive director of Families for Better Care writes that the need for reform in the assisted-living industry remains, even though legislators and the governor let it die during the 2012 session.
Many VA patients face delays in mental health care
Paul Gionfriddo writes that where veterans’ mental health is concerned, playing catch-up seems to be the norm at the Veterans Administration. And for William Hamilton, his treatment never seemed to catch up with his disease.
Republicans denounce ‘Obamacare,’ but disagree on alternatives
Joe Paduda writes that now that there's a real possibility that the Supreme Court will overturn some or all of the health law, there's pressure on the GOP to come up with its own plan. But that could be tough.
Look for ‘Monkey Law’ to make its way to FL
Given their recent history, columnist Fred Grimm writes, Florida lawmakers are likely to embrace an anti-evolution law similar to the one enacted in Tennessee.
The face of gun owners is changing
John Romano writes that chances are, someone in your neighborhood carries a gun. And the number of people with a concealed weapon permit is rising, many more of them women.
‘Suspicion-less drug testing’ gets 2 thumbs down
Sue Carlton writes that Gov. Scott thought it a great idea to make people who apply for welfare pee in a cup to prove they were worthy of aid. Well, two judges have decided that it's an unnecessary intrusion
Scott pays lip service to good causes, then yanks funding
Frank Cerabino writes that Gov. Scott has a strange way of supporting causes like rape-crisis centers: He cuts their funds.
Controlling health costs will be ever more painful
Joe Paduda writes that he change from the easily-gamed "usual and customary" system to one based on Medicare is appropriate and necessary. Yes, it's also painful.
Public-health spending: big bang for the bucks
Health consultant Paul Gionfriddo writes that half of the improvement in U.S. mortality rates in recent decades is linked to public-health spending, yet 95% of the dollars in the system go elsewhere.
Simple solution to health care: Never get sick
David Plazas writes that health-care woes seem to be on everyone's mind, regardless of party affiliation. The common ground -- the system is broken as is and needs fixing.
Media rushes to judge Zimmerman
Lloyd Brown writes that the media has tried and convicted and George Zimmerman before it was even determined whether a crime had occurred in the shooting death of teenager Trayvon Martin. The time for pontificating will come after the facts are revealed in court.
AIDS isn’t nearly as under control as we might think
Paul Gionfriddo writes that the message of a friend who died of AIDS has resonated with him over the years. He said it didn't matter how he got the disease. What matters is what we can do to prevent others from getting it. And we have not done nearly enough.
The rules in FL: Scared? Shoot
Frank Cerabino writes that U.S. troops in war zones need to obey the military's rules of engagement. In Florida? Not so much.
Prescription-drug addiction: a national crisis
Workers' compensation expert Joe Paduda, a speaker at this week's National Rx Drug Abuse Summit in Orlando, says no other national health issue has as much potential impact on society.
Get rid of mandate; it forces us into broken system
Pierre Tristam, editor of FlaglerLive, writes that the answer to America's health-insurance crisis is to expand Medicare to all.
Even Texas has a saner gun policy than Florida
Columnist Beth Kassab says that even Texas shows a lot more prudence in requiring training for those who apply for concealed weapons permits. In Florida, it's all about convenience. In fact, you can mail-order your license without even setting foot in the Sunshine State.
Make the call, write the note…it’s not too late
Columnist Jan Glidewell writes honestly about his too-long separation from his son and his re-connection at the hour of his son's brave last stand in the fight against cancer.
Anna was homeless, mentally ill. So she was a nuisance.
Health consultant Paul Gionfriddo writes a moving column about a woman who tried to get help from three emergency rooms on the day of her death. Her epitaph could read: "See? I told you I was sick."
Scott’s remarks on health law are rated false
Gov. Rick Scott, like many other Republicans, is calling the Affordable Care Act a "job-killer." There is no evidence for his claim.
Law profs offer opposing views on health law
Two constitutional law scholars, Elizabeth Price Foley of Florida International University and Franita Tolson of Florida State University, offer opposing views on the Affordable Care Act. (Click headline for Foley, click here for Tolson.)
It’s not about the ‘hoodie’
Columnist Leonard Pitts Jr. writes that while many questions remain unanswered about the death of Trayvon Martin, his death stems from our culture's assumption that all young black males are dangerous.
Health law helps families like this
Vanessa Mishkit, a nurse in Tampa, tells in a video what it’s like to go up against insurance companies on behalf of her child.
60-Plus’ TV ad on Medicare distorts facts
PolitiFact looked at the commercial that stars Pat Boone railing against "Obamacare," and says it is so misleading it earns the lowest possible rating.
The Marketing of Rachel Hoffman
Radio host Larry Golbom says those who want to legalize drugs have air-brushed the flaws from the young woman who was killed while serving as an informant.
Legislature stole some vital Health Dept. functions
Columnist Paul Gionfriddo says one of the divisions that disappeared is the one that would handle the crisis and clean-up if there were an accident at a nuclear plant.
No more payouts: Smokers should know the risks
Columnist Gary Stein has no patience with dying smokers who sue the tobacco companies.
Stand your ground on pit-bull ban, Miami-Dade
Steven Kurlander writes that, like pythons overpopulating the Everglades, lifting the longtime ban on pit bulls in Miami-Dade County would endanger safety.
Senate DOH bill isn’t much better than House’s version
Consumer health activist Richard Polangin says that while the Senate's version of the Department of Health reorganization isn't as bad as the House's, that's not saying much.
Horror on I-75 could have been prevented
Remember four years ago, when fog and smoke combined to kill four and injure 38 on I-4? FAMU Assistant Professor Andrew Skerritt says that lesson was ignored.
Public health will be crippled if Rep. Hudson has his way
Health consumer advocate Richard Polangin says the Department of Health reorganization bill will strip funding away from vital disease-fighting efforts.
Florida victory on health law would have unintended effect
Health consultant Paul Gionfriddo writes that if Florida wins its suit against the health law, which expands insurance through individual and state action, a federal system will be more likely down the road.
Medicaid growth ‘will bankrupt our state’
Liz Dudek, secretary of Florida's Agency for Health Care Administration, argues that Medicaid's method of paying hospitals must change.
Democrats’ Medicare warning called ‘biggest lie’ of 2011
Florida-based PolitiFact says its "Lie of the Year" goes to Democrats for grossly exaggerating the impact of a proposed Medicare voucher program. This is the third year in a row that the big lie involved health politics.
Grandma and the Big Bad SGR
Florida medical groups are encouraging members to share a video with patients that explains the Medicare "SGR" pay cut for physicians in extremely simple terms.
Saddest city? Give me a break
Columnist Robert Trigaux pokes fun at Men's Health magazine for proclaiming St. Petersburg the nation's saddest city, closely followed by a bunch of other Florida towns, based on suicide rates and anti-depressant use.
Homeless kids abound in Disney’s shadow
Scott Maxwell says CBS' 60 minutes show on Florida's hordes of homeless children showed the dark side of embracing a cheap-wage economy.
Solution to cost crisis: Pay some doctors NOT to practice
David Kibbe and Brian Klepper write that Instead of trying to reform the whole system, let’s root out the bad apples and create a "physician fallow" program.
JJ. was a kid worth saving, but how?
Columnist Sue Carlton remembers when a fifth-grader accused of armed robbery was given a second chance to turn around, in a new family. It should have worked. Why didn't it?
Health district rejects free land, buys $4M parcel
Stacey Singer questions why the taxpayer-funded Palm Beach County Health Care District turned down free land for the state's nursing home and bought a $4 million property owned by the district's real-estate agent.
Environmentalists win victory on fertilizer bans
Nursing-home care at risk
Backing away from the MRSA crisis
Health care reform package a major step forward for U.S.
Florida KidCare is key to kids’ health, our state’s future
Keep hope alive: Fund cancer research
Brit says: Congratulations on health reform! About time
Why does Florida allow pseudoscience?
How you can be a better patient
Obama’s private doctor army? Really?
Elder-care housing must improve ratings to compete
Health care bill of rights needed
A child’s life could depend on you
‘We are the people’s health care system’
Strength through advocacy
Health law will be costly for Floridians
Medicare recipients know they’ll pay
McCollum exaggerates Medicaid burden
Price, politics propel GOP rush to transform Medicaid
At end of life, somebody decides, but are they right?
Priest was protected, not the children
How the health-care law will affect you
State workers wear a bull’s eye
Don’t hurt those with kidney disease
Greer scandal shows GOP cares about coverage: their own
Heath reform galvanizes both left and right
Mica-Kosmas duel on health care legislation
Red light or green light for traffic cameras?
Pay cuts to doctors will hurt seniors
FDA policies threaten innovative drugs
AARP explains its support of health-reform bill
GOP, condemn the violence
Florida tried to reform health care and flopped
Looking for humor in the health-care debate
Newt should know better
Health reform has champs, chumps
When will we know if health reform worked?
Taking health care reform to next step
How much is that lawsuit costing Florida?
He has a healthy interest in our votes
This bill is truly bad
Medicare was bitterly opposed at first
McCollum’s health-care suit: savvy or risky?
Health bill scores A- on cost containment
Grayson makes cable TV host look like a fool
Diabetes Alert Day: Are you at risk?
Legislature eyes Medicaid Reform, Part B
Florida’s coming Medicaid crisis
Nelson’s stunt to woo seniors flops
Medicare will be stronger
Gays want to be heard? pack heat
Medicaid managed care fails to deliver
Health-care debate lurches to a bizarre conclusion
Uninsured? Here’s some advice
Dear Marty:
I am sorry to hear that you are facing such serious health issues without the aid of insurance. I have been in your shoes in terms of no health insurance. I also have faced life-threatening illness and have long-term chronic autoimmune and other health issues. I am not a doctor or nurse, but I can offer you some advice as a 50-plus-years consumer of healthcare services.
I have never had much luck relying on doctors' offices or hospitals sharing medical records in a timely manner. I found it better not to rely on my doctors or hospitals to communicate with each other.
Use your Health Information Portability and Accountability Act (HIPAA) rights. I find it better to go to the hospital or doctor's office and request a copy of all doctor's notes, lab results, and X-rays, CT scans, and MRI written reports and actual scans, images and films on CD. Yes, this does take time away from your life and paid work, but better to have a future life than not.
Hospitals and doctors are required by federal law to provide you the copies of your medical records, although it may cost you up to a $1 per page. You can always sort through the records and get only the pages you want copied. If nothing else, at least get copies of the lab results and other test reports. If they will not provide them, open your laptop, if you have one, and begin filing a HIPAA complaint while you are chatting with them. Specifically ask the person refusing you for his/her full name. That or something similar usually results in positive action.
Next, scan all the hard-copy reports and save them to your computer; that way you will always have a copy of the records available. I also copy any CD files to my computer. Most often doctors will not want to look at the actual films, scans, or images, but it is always good to have them on hand along with a hard copy of any results or reports when you go to the doctor. This way, you can share the information with any doctor without waiting on some clerk to fax the information or someone on the receiving end to actually find the faxed information and give it to someone who can do something about it. It will get you treatment faster.
Sure, it does not cost you anything to have a doctor or hospital send records directly to another doctor or hospital, but you will wait a long time, become extremely frustrated, and the appropriate doctors and/or hospitals may never receive the information.
I cannot tell you exactly how many times doctors who were suppose to receive information, never actually received it. My guesstimate is 90 percent to 95 percent of the time my various doctors, labs, and hospitals failed to achieve communication with each other. But, I was a Girl Scout and learned early to always be prepared, so I have copies of my latest test results in hand when I walk into any doctors' offices.
Of course, a national electronic medical records system that all doctors, hospitals, insurance companies, and patients could access would save millions in health-care costs for patients, and the healthcare and insurance industries, too, but our free marketplace, our penchant for privacy, andfear will likely never let it happen.
Any way, I also strongly suggest you go to the pathology lab that did your biopsy and obtain a copy of the actual tissue slides to take with you to the Moffitt Cancer Center, so you can get a second opinion. All you have to give the hospital pathology clerk is the name of a doctor to whom you are taking the slides. Any doctor's name will do; the clerk will not check it unless the slides are not returned. Even then, I do not think anyone checks.
However, do call the lab in advance, so they can get the slides ready for you. You will still have to wait while the clerk finds them, but the clerk may tell you to come back if you have not called in advance. If you called ahead, they usually do not make you make a second trip.
It seems to me to be particularly important for you to get these slides since one doctor told you the biopsy showed necrotic (or dead) tissue. It probably just means they got dead kidney tissue in the biopsy rather than cancer cells from the tumor. Oops! You might want to argue with the doctor who did the biopsy about how much your bill should be if they did not actually get tissue from the tumor. Such problems are hardly uncommon.
One of my several health horror stories I share with you as an example is the last biopsy I had done in 2004 at Tallahassee Memorial Hospital. The pathology report came back stating I had "mild fatty liver disease," but they could "not rule out Wilson's disease." The local gastroenterologist believed that report and offered me medication usually prescribed for neurological pain and told me to stop drinking alcohol. Since, at that time, I only drank about one glass of wine a year, that was not particularly a hardship for me and I refused the pain medicine prescription. I had been living with the pain on and off for more than five years and did not consider it the major issue. Nothing they offered resolved the problem of my consistently, abnormally elevated liver enzymes for the previous five years. I did stop drinking my one glass of wine a year, though, not that it had any effect on the liver enzymes.
In the interim, I went to www.medlineplus.gov to learn that Wilson's disease is a copper deficiency. You usually are born with it and without treatment die from it at an early age. Since I was already 50+, it did not seem possible that it would even be considered as a diagnosis on the pathology report. Next, I went to my primary care doctor and asked him to refer me to Mayo Clinic for a second opinion. Of course, I had health insurance at the time -- Mayo would not take me without it.
Not only was I not anywhere close to having Wilson's disease, I also did not have fatty liver disease. The head Mayo pathologist and the liver specialist looked at the actual tissue slides I brought them and both said all they saw was trace evidence of inflammation. The treatments for these diverse diagnoses from two sources are vastly different. Therefore, I strongly recommend you get a second opinion about your kidney CT and biopsy if you can afford it.
It took a couple of years after my liver biopsy before a rheumatologist in Gainesville put me on a disease-modifying drug to reduce inflammation. Within a few months, my abnormal liver enzymes finally returned to normal and have been normal for the past four years. I am grateful to the Mayo Clinic team who correctly read the slides and to my rheumatologist who got me on the right treatment.
I had all these problems when I did have insurance, and I do not envy you your lack thereof.
Eleven plus years ago, when I was rushed to a teaching hospital in acute renal failure and was later determined to have the frequently fatal toxic shock, I had no insurance. Well, that is not exactly true . . . I had COBRA insurance, but they refused to cover me because I had moved out of their coverage area, so the hospital considered me an uninsured patient. I had to spend a year and hire a lawyer to make the insurance company pay the $30,000 hospital bill . . . but that is another story.
The point is that during my first five-day stay in the hospital, I think I was treated somewhat differently. There was nothing I could pinpoint, but it was the way some of the staff interacted with me that seemed different. The hospital also released me sooner than some of my doctors would have liked, because I did not have health insurance. Of course, I was back in the hospital a week later when my new policy under my new employer had finally kicked in.
But, the new insurance company had the hospital release me again after only three days, even though my doctor had scheduled me for in-hospital debridement of necrotized tissue. That is when they take a scalpel and scrape the dead tissue off your infected skin, in this case both my legs. I did that treatment on an outpatient basis, several times a week for three weeks. I had to use a walker because I was re-learning how to walk again, and use handicap bus services to and from the hospital because I could not drive my manual transmission car or drive under the influence of the pain medicine they had to give me. The insurance company apparently thought that exposing my already infected legs to those environmental challenges was the most cost-effective means for quick healing. I was very lucky to have a job after I returned to work part-time two months after I went into the hospital the first time.
While I had problems both with and without insurance, I would strongly suggest you check out the federal website https://www.pcip.gov, which will get you information about health insurance for people with pre-existing conditions.
Since I know freelance writers do not make a lot of money, you also should apply for Medicaid online at http://www.dcf.state.fl.us/programs/access/ as soon as possible, if you have not done so already. I would not wait for the social worker at Moffitt Cancer Center to help you -- the process takes awhile and you can get it started with the online application.
I know this may not be what you wanted to hear, but it is better to face reality and take charge of your health care now. If you wait, things will only get worse. You have to stay on top of your doctors and medical records.
Ask questions. If your questions are not answered to your satisfaction, call the doctor back. When you get a referral, ask how long it will be before you hear from the new doctor or hospital. If you do not hear from the new team within a week, call them and keep asking for someone who can help you. If you get flack, ask for a supervisor. If you know the name of the doctor you will be seeing, asked to speak with the doctor's nurse.
Also, check the phone book or the web for are any health advocates in your area. Some work for non-profit organizations and may not charge you a fee. They can help you navigate the health system. You also might try contacting the American Cancer Society and/or the National Kidney Foundation, because they also may be able to provide you some support and help you navigate the system.
I wish you much luck and better health. In the interim, I will keep you in my prayers.
Best regards,
C.A. Alexander, Tallahassee
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