Our health care is system is changing dramatically. To help ThirdAgers understand what the new health care bill means to all of us, we spoke to Dr. Joel Brill who has had decades of experience in developing strategies for value-based medical management. He is board certified in internal medicine and gastroenterology, and has practiced for over two decades in California and Arizona. He is also the chair of the Practice Management and Economics Committee for the American Gastroenterological Association.
ThirdAge: How can people be savvy medical consumers in these changing times?
Dr. Brill: First of all by asking questions. When a treatment or a test is prescribed a patient really needs to ask his doctor is this the best treatment. Is this test a repeat of a test I have had before? Are there other possible treatments? He or she really should try to be an informed consumer. That doesnt mean googling everything but primarily asking those questions. Make a list of questions or bring a friend to help you ask them if you get flustered or confused. You know in medical school we were taught to pause before we left the examining room to see if a patient had one more question. And when they did , it usually was the most important question they wanted to ask.
ThirdAge: What do you think are the biggest problems with medical care today?Dr. Brill: It is a problem about the balance between cost and value. As things get more restricted we have to be concerned if we are losing value when we take a meat cleaver to costs. Of course you do not want patients to have unnecessary tests. But sometimes having a test done at first may cost more but may save money in the long run.ThirdAge: How do you feel about the new health care bill?Dr. Brill: I dont work for the government but I do know health care costs were going up and up and were getting unaffordable for a lot of small businesses. If this can bring down insurance premiums for small businesses and make our small businesses more competitive that is good. And being able to address the question of the uninsured and being able to keep kids on their parents insurance to 26 thats all good as well.But at the same time the new focus on costs may not be helpful to patients. And there could be a stifling in innovation. Looking at developments in medical technology we may find that for the first time ever we will have to go overseas to find the latest innovative treatments. ThirdAge: What should people on Medicare know about the changes?Dr. Brill: There is an increase in preventative services so people will get screening tests which could allow for earlier treatment. Closing the doughnut hole in drug costs make medications more available for those with chronic conditions. And there is now counseling available so that drug regimens can be monitored. Thats very valuable.
But what is bad is that Congress has refused to deal with the schedule that sets the fees for doctors in the Medicare program? The fees are set after doctors decide whether or not to participate. Subsequently, it is getting harder and harder to find doctors who decide to participate. As more and more boomers get on Medicare there may be fewer and fewer doctors who will take them as Medicare patients. This is especially a problem in urban centers like New York City. ThirdAge: What do you think is the most important to stay healthy as you age?Dr.Brill: Eat right, exercise, drink in moderation, enjoy life. As we are talking I am walking my dog. I try to enjoy every day, enjoy my family, travel, meet new people, and learn new things. Thirdage: What is the medical breakthrough you envision in the next few years?Dr. Brill: The cure for cancer. A vaccine, in truth, multiple vaccines. That would be my hope. About the author: Myrna Blyth is the former editor of Ladies Home Journal and the founder of More Magazine. She is the author of four books including the New York Times bestseller Spin Sisters.
