Op/Ed: A Health Savings Account Could Save Your Life

AddThis Social Bookmark Button

In a lawsuit against Aetna for denial of benefits which the patient alleges "almost killed him," Aetna's medical director admitted under oath that he never looked at patients' medical records when deciding whether to approve or deny care.

Concomitant with the flow chart revolution, patients complain that when barely a nanosecond has passed since the physician's first "hello,” they are handed a DNR (Do Not Resuscitate) form. Reasoning that the State cannot be held responsible for its determination-of-death laws, because doctors have "broad and legitimate discretion" to end patients' life support.

We dread the day when "algo-medicine" devoid of human emotion, intuition, or instinct will say Sell! (to the mortician) when the patient hits 70? Buy! if the baby has no problems discerned on prenatal ultrasound?

Algo-Trading /Algo-Medical Treatment

Some pundits blamed algorithmic trading for the stock market's recent wild ride. "Algo-trading" relies on computers programmed to follow defined instructions for placing trades. For example, the computer buys 50 shares of stock when its 50-day moving average goes above the 200-day moving average. Period. Algo-trading was popularized as a systematic approach that removes human emotion, intuition, or instinct from the transaction.


Beltway Insider: Trump Talks 2020; Mueller Pushes Onward to Jared, Ivanka; Hicks Out; Syria’s Civil War; Nor’Easter


Advanced medical algorithms are becoming the next best thing. Their intended purpose is to improve and standardize decisions made in the delivery of medical care, enabling multiple levels of health care practitioners to use the same "thought" process.

A medical algorithm can be a list of risk factors for various conditions, such as heart disease, or a simple calculation such as BMI (body mass index) utilizing height and weight to determine ideal numbers. Many algorithms are flowcharts with a binary decision tree: if BMI is greater than 25, do this; if not, do that.

Newer algorithms based on machine learning, a form of artificial intelligence that simulates how humans learn, can analyze and diagnose radiology images or pathology slides or predict the actual risk of developing certain conditions.

Some of these advances are extraordinary and will likely add to our medical armamentarium. But they do not exist in a vacuum. Concomitant with the flow chart revolution, patients complain that when barely a nanosecond has passed since the physician's first "hello," they are handed a DNR form.

Are Patients Deemed Viable or Useless Before

Yes, it is a good thing for a physician to know about a patient's desires at what could be the end of his life. But it is unsettling when the 35 year-old "provider" cheerfully encourages a patient to fill out the form, crowing that she signed her DNR form.

The patient is thinking, "you'll feel a lot different about it at 65 than you do now." Unfortunately in today's healthcare delivery factories, when illness strikes "your” doctor may be a previously unknown-to-your hospitalist whose sole knowledge about you, the human being, is lab tests, x-rays, findings on physical exam, and a form you signed 10 years ago. Your family relationships, religious views, and the like are not his purview. When death is actually walking down your street you want to know and trust those in charge of your life.

In a recent case, a toddler was declared brain dead by one hospital, but apparently showed signs of life. His mother sought but failed to stop the removal of her child from life support. After the plug was pulled, she challenged the constitutionality of California's Determination of Death Act which effectively takes away life-and-death decisions from parents.

The Act provides that a person is dead when, in accordance with accepted medical standards, either the body or the brain has irreversible cessation of all function. A federal court dismissed the case, reasoning that the State cannot be held responsible for its determination-of-death laws, because doctors have "broad and legitimate discretion" to end patients' life support.

Less obvious but nonetheless devastating, is the power Medicare, Medicaid, and insurers exercise over life and death through pre-authorizations and denials of claims. In a lawsuit against Aetna for denial of benefits which the patient alleges "almost killed him," Aetna's medical director admitted under oath that he never looked at patients' medical records when deciding whether to approve or deny care.

If physicians have the power over life and death, "if you like your doctor, you can keep your doctor" takes on added significance as more states adopt physician-assisted suicide laws. Even in Belgium where euthanasia is legal, its proponents are increasingly uncomfortable with the speedy approval of psychiatric patients' requests to die. Discomfort turned to outrage when a dementia patient was euthanized when there was no evidence that the patient had asked to die.

As independent physicians we want to use the best advances to help our patients but we do not want medicine to devolve into paint-by-the-numbers. We dread the day when "algo-medicine" devoid of human emotion, intuition, or instinct will say Sell! (to the mortician) when the patient hits 70? Buy! if the baby has no problems discerned on prenatal ultrasound?


Op/Ed: Is it Really Our Job to Save the Addict


If you want to ensure that your doctor has your back, run – don't walk to a direct primary care practice (DPC). Tell your congresspersons to add the 1-page Primary Care Enhancement Act (HR 365 / S 1358) to upcoming "must pass" legislation. This will allow patients to use Health Savings Accounts (HSAs) to pay for DPC. Your life could depend on it.

 

Bio: Dr. Singleton is a board-certified anesthesiologist. She is also a Board-of-Directors member and President-elect of the Association of American Physicians and Surgeons (AAPS). She graduated from Stanford and earned her MD at UCSF Medical School.  Dr. Singleton completed 2 years of Surgery residency at UCSF, then her Anesthesia residency at Harvard's Beth Israel Hospital. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law.  She interned at the National Health Law Project and practiced insurance and health law.  She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers.

Haute Tease

  • 21 AND OVER Review - Boys Gone Wild College Style

    AddThis Social Bookmark Button

    21 AND OVER, from Mandeville Films, Virgin Produced and Relativity Media, brings to the screen a boys gone wild college style sophomoric romp from Directors Jon Lucas and Scott Moore.

     
  • Fourth Hostage, Alan Henning, Beheaded by ISIS; Obama’s Impotent Foreign Policy Faulted

    AddThis Social Bookmark Button

    Alan Henning, a volunteer humanitarian worker and Muslim, the fourth hostage held by the terror group ISIS/ISIL has been executed by his captors according to global media agencies. He was kidnapped in Syria.

     
  • Celebrity Auction Benefits Juvenile Diabetes

    AddThis Social Bookmark Button

    Briggs and Riley, the manufacturer of Travelware, a high end innovated luggage design company, has teamed up with the Juvenile Diabetes Research Foundation of Long Island to raise money in the fight toward finding a cure for Juvenile Diabetes.

     
  • London, Paris Each Hit with Terror Attacks; Sixth Between Nations in last 90 days

    AddThis Social Bookmark Button

    The sixth Terror attack between the United Kingdom and France occurred on the Champs d'Elysees, in Paris, 24 hours after the fifth attack, both car-ram, occurred outside a Mosque in London early Monday morning, killing one.

     
  • It’s Spring! Past The Blahs Into The Blues

    AddThis Social Bookmark Button

    As the seasons change and we shed the winter wools it’s time to step outside our inoculated online I-Pad world and breathe!

     
  • Money News: Equity Estates - The Smart Alternative for Savvy, World Travelers

    AddThis Social Bookmark Button

    Equity Estates' Luxury Residence Fund offers investors a smart alternative for dream vacations while also making a sound financial investment. This private fund allows for the opportunity to own a portfolio of exceptional residences without the troubles of ownership.

     
  • For the Man with Everything – Fly Jets or Race at Indy with CXC Simulation Motion Pro II

    AddThis Social Bookmark Button

    Looking for the perfect gift for the man with everything? The quest for what to get Dad for Father’s Day? Well, there’s no need to search high and low for that special present. At a place where masculinity meets high-tech virtual realism, you’ll find CXC Simulations’ Motion Pro II.

     
  • Café Society Review – Woody Allen Hits a Four Star Homerun

    AddThis Social Bookmark Button

    Café Society, from Lionsgate and Amazon Studios, presents the newest film from quintessential New York director Woody Allen, who charms with a less neurotic and inviting bi-coastal look on The Golden Age, family, romance, love, choice and circumstance.

     
  • ISIS Claims Responsibility For Berlin Terror Attack that Killed 12 and Injured Dozens

    AddThis Social Bookmark Button

    A familiar and disconcerting pall hangs over Western Europe, the day after a lorry truck jumped the sidewalk and plowed through a Berlin Christmas Market, smashing wooden vendor stalls, and careening into holiday shoppers killing 12 and injuring 48.

     
  • “When Valentine’s Day Is Simply Not Enough:” Celebrate An Entire “Month Of Romance” In Cabo At The Exclusive Capella Pedregal

    AddThis Social Bookmark Button

    Cabo San Lucas – Cupid is flying in for an extended stay during the month of February at Capella Pedregal in Cabo, Mexico, as the stunning 96-room hideaway is heralding a “Month of Romance” with a range of delightful activities created especially for couples.

     
  • Simply Vietnamese Cooking Review – Easy to Follow Gourmet Recipes

    AddThis Social Bookmark Button

    Simply Vietnamese Cooking, presents more than one hundred delicious recipes, by Vietnamese cooking expert Nancie McDermott, in an easy to read and follow soft bound cookbook, which is the number eleven for the former Peace Corp volunteer.

     
  • Miss Bala Review - Compelling, Intense, A Wild Ride

    AddThis Social Bookmark Button

    Miss Bala, from Sony Pictures Entertainment, brings to the screen a wild, fast action, south of the border ride as a weekend with family turns into a life or death race as two rival cartels fight for dominance.

     
  • V Theater Las Vegas Review - Entertainment Aplenty

    AddThis Social Bookmark Button

    No matter how many times you’ve visited Vegas, no trip would be complete without taking in a show or two amidst the time you spend eating, gaming, clubbing, sunning and otherwise funing in Sin City.

     
  • CVNE Winery, of Rioja, Spain, Presents The Works of Sir Anthony Caro

    AddThis Social Bookmark Button

    CVNE (pronounced Coo-nay), a leading producer of Spanish wines from Rioja, will host 'Caro at CVNE' an exhibition of installation pieces, of renowned British artist Sir Anthony Caro,  throughout the historic winery grounds.

     
  • HL Las Vegas: Urban Turban Hires Chef Tarun Kapoor and Debuts New Menu

    AddThis Social Bookmark Button

    The Urban Turban has announced international-award winning Master Chef Tarun Kapoor, an award winning ingredient, as new executive chef at the dine-in restaurant on East Paradise and Urban Turban EXPRESS at The LINQ.

 

Login Form