Aging Options

Lost in the Health Care Maze? It May Be Time to Bring in an Advocate

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“The health care bureaucracy is crippling. There are lots of layers to get to the right person. So you end up paying bills just because you’ve run out of energy.”

Those sobering words from a 62-year-old retired teacher in Washington, D.C., sum up the dilemma many patients find themselves in as they try to work through the complexities of our American health care system. We found this woman’s story, along with a potentially encouraging solution for her and thousands of other similarly bewildered patients, in this very recent article in the New York Times.

The article is titled, “Patient Advocates Help Navigate Health Care.” It describes a growing number of professionals who – for an hourly fee – help their clients with a whole host of problems related to their medical care. Besides deciphering complicated hospital bills, patient advocates can help coordinate care, do informal medical research, even accompany their clients on appointments. Some physicians, frustrated by the medical establishment, are now becoming patient advocates.

In the case of the schoolteacher mentioned above, as described in the New York Times, her surgery had gone badly and she had spent many months hospitalized. She and her husband became overwhelmed with the barrage of bills, some running up to 30 pages long! This woman finally turned to an advocate who examined her bills, looked for errors, and ultimately worked out a negotiated settlement with the hospital that saved the patient $10,000.

According to the Times, the profession of healthcare advocacy began some seven years ago. Today there are about 650 practitioners nationwide, a drop in the bucket when it comes to the need. But the number is growing fast. There’s now an organization, the Alliance of Professional Health Advocates, that provides a directory and professional standards for this burgeoning specialty. Courses in patient advocacy are being offered at more than 30 colleges and universities nationwide.  Still, as the article points out, there is currently no certification, and anyone can become a patient advocate, so a careful reference check is absolutely essential.

Why is this service on the rise? The Times article puts it this way: “The rise of this new cottage industry reflects not just the difficulties of navigating a complex health care system, but the unequal power relationships between providers and insurers on one side of the equation, and patients and families on the other.” It goes on to say that, even though many are trying to control medical costs, “the system is still driven by a pay for service model, which encourages excessive procedures and inflates prices.” Our health care system, it would seem, encourages buying more services, even unnecessary ones, not less – with little incentive to economize.

If you are experiencing the emotional nightmare of a complex health insurance problem, a patient advocate may be for you. But before you hire anyone, here are a few steps we strongly suggest. First, read the New York Times article for some perspective. Second, contact our office here at AgingOptions, because we can help you make a wise decision in this regard and give you some important questions to ask and qualifications to look for. Finally, as we so often say, if you’re approaching retirement age (or already there) you need a geriatrician as the cornerstone of your health care team. We can recommend several excellent geriatric physicians who will provide you with excellent professional care geared to the needs of seniors.

Oftentimes the best way to avoid a problem like the “medical maze” described in the Times is through careful planning. That’s definitely true for all aspects of retirement: with a well-conceived comprehensive plan in place you can look forward to a retirement that is fruitful and secure. We call this planning method LifePlanning – and to introduce you to the concept we invite you and a guest to attend a free LifePlanning Seminar where we’ll outline this exciting and unique approach that has made the future brighter for hundreds of our clients. Learn more by clicking on the Upcoming Events tab, where you’ll find dates, times and locations, and where you can register online. Or if you prefer, contact us during business hours and we’ll gladly answer your questions and handle your registration.

It will be our privilege to work with you!

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