academicobgyn.com Report : Visit Site


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    The description :the blogcast for the academic ob/gyn physician...

    This report updates in 05-Aug-2018

Created Date:2006-10-13
Changed Date:2017-10-12

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academic ob/gyn the blogcast for the academic ob/gyn physician home academic ob/gyn podcast why double coverage is a scam july 22, 2018 nicholas fogelson leave a comment you have just gotten a job offer that includes health insurance. you’re lucky enough that your spouse has great family insurance already, but hey that health insurance is going to cover the cracks in the deductible and co-insurance, so you feel great about that double coverage as you sign your contract. well, you just got scammed. that is, double coverage is a scam, and you would have been far better off negotiating a higher salary in return for not getting insurance. here’s why: let’s say policy a has a deductible of $1000 and 75% coinsurance up to an out of pocket max of $3000. policy b is identical, with a deductible of $1000 and 75% coinsurance up to an out of pocket max of $3000. so you get $500 in healthcare. it costs you $500 because neither policy pays up to the first $500 (for simplicity let’s ignore the no-deductible services some policies offer) then you have a surgery that costs $5000. the first policy pays $4000 on this ($5000 minus the $500 deductible that was left, and then 75% of the remaining $2000 on your out of pocket max, plus everything over that). so that leave’s you with a $1000 bill. that bill gets submitted to your second policy, which also has a $1000 deductible. so you still have $500 to satisfy there, and so the second policy pays you $500, or if you’re unlucky in how they interpret the secondary coverage, $375. so policy 1 pays $4000, and policy 2 pays $375 to $500. this has always seemed wrong to me. if you have two life insurance and you die, your family gets paid twice. but if you have two health insurance policies and you get sick, you only get paid once, or maybe once and a little more. so if one policy is at more risk than the other, the employer that buys the second policy must pay less for the double coverage policy, right? no they don’t. they have to pay full freight for both policies. that’s where the scam is. double coverage is way less coverage than the single coverage policy, but both policies are priced the same. this is a product of the fact that large employers are forced to make insurance offerings for their entire population even though that offering may be of substantially less value to some employers than others. but there is a way to solve this. just turn down insurance if you are offered double coverage. then tell your prospective employer that by turning down insurance, you are saving them $8 grand a year and ask for $8000 more in salary, or more vacation, or whatever other concession you want. for them it costs the same, but for you its of dramatically greater value. when you get that value, squirrel a bit of it away for unpaid healthcare costs. if you’re lucky and don’t need it, you just have more money. if you do need the healthcare, you can get the value that would have been paid by the double coverage with a fraction of the money. share this: email facebook linkedin twitter google whatsapp like this: like loading... categories: business of medicine on high volume gynecologic surgery, and how to pick a surgeon for your hysterectomy january 31, 2018 nicholas fogelson 1 comment if you had a serious issue with your knee and needed a surgeon to repair it, how would go about picking that surgeon? if you were like most people, you would find the most experienced and best surgeon in your area, at least within whatever in surance network you might belong to. and that would make sense, as the experience level of your surgeon is a strong predictor of outcomes, including complications of surgery. so you would assume that this would be similar for all types of surgery, correct? people of reasonable means will seek out the best and most experienced surgeon for whatever type of surgery they need, whether it be neurosurgery, bowel surgery, or in this case, gynecologic surgery. the troubling thing is that in the case of gynecologic surgery, that would be wrong. in fact, the majority of gynecologic surgery in this country is performed by relatively inexperienced surgeons who research would suggest will have a higher rate of complications than more experienced surgeons. read more… share this: email facebook linkedin twitter google whatsapp like this: like loading... categories: gynecology , rants and raves , surgery why don’t doctors do their tubals in the most reversible way? november 8, 2017 nicholas fogelson 4 comments syndicated from tubal reversal northwest nicholas fogelson, md as physicians that spend time helping women to restore fertility after a previous sterilization surgery, one is often left to ponder why some physicians who perform sterilizations do it in a way that makes it very difficult to reverse, when the don’t have to do that. specifically, there are techniques to very effectively cause permanent tubal sterilization while still preserving most of the fallopian tube and making a reversal highly likely to succeed. there are also ways of causing tubal sterility that will leave so little healthy tube that a reversal is much more difficult. so wouldn’t it make sense to do the former? it would seem so, but many surgeons don’t do this. it really comes down to how obstetricians are trained. we are trained that a sterilization surgery is permanent, and as such any sort of effort to make it more “reversible” would be a betrayal of the very reason we are doing the procedure. that is, is the woman wanted a reversible method of birth control, she could get an iud or use oral contraceptives instead of having a permanent sterilization surgery. there is also the thought that somehow doing a more reversible tubal sterilization would decrease the effectiveness of that surgery, and further be a betrayal of the original purpose of the surgery. the reality though, is that all of this is wrong. first of all, it is a fact that many women who have sterilization surgery decide later in their life that they would like their fertility restored and to have another child. this is particularly true when women have their children when they are still quite young. in many cases a woman who has had two or three children by her early twenties feels certain she never wants another child, and has a sterilization. at the time it makes sense and she feels sure about her decision. fast forward ten years, she is a different person than she was when she made the decision, perhaps married to a new partner, and feels like she would like another child. this just happens so frequently that we have to realize that while a tubal sterilization is “permanent”, its possible that reversal will be desired one day. as such, wouldn’t it make sense to do it in a way that is reversible as possible? second, some may be concerned that by doing a more reversible tubal sterilization, it would be less effective. this is just wrong, and the data doesn’t bear this out. in fact, many physicians use a technique that is both the least reversible and the most likely to fail. that makes no sense, but its true. there are two techniques that are optimal for creating the most successful sterilization that is also the most reversible. the key thing is the amount of tube that is destroyed in the sterilization, as success rates in reversal are high related to how much tube is left to bring back together in the reversal surgery. the most effective and reversible techniques are 1) a partial salpingectomy that removes a minimal piece of tube from each side (i.e. 1-1.5 cm of tube) or 2) the use of a filschie clip, which destroys less than centimeter of fallopian tube. both of these are associated with less than 1% failure rate over 10 years, and as long as minimal tube is removed has a high likelihood of being reversible if such a procedure is required. a third option is a falope ring, which can be used to remove a small amount of tube, though it can also remove more tube and is technique dependent. th

URL analysis for academicobgyn.com


https://academicobgyn.com/category/research-methodology/
https://api.whatsapp.com/send?text=on%20high%20volume%20gynecologic%20surgery%2c%20and%20how%20to%20pick%20a%20surgeon%20for%20your%20hysterectomy%20https%3a%2f%2facademicobgyn.com%2f2018%2f01%2f31%2fon-high-volume-gynecologic-surgery-and-how-to-pick-a-surgeon-for-your-hysterectomy%2f
http://www.xianguo.com/subscribe.php?url=https://academicobgyn.com/feed/
https://academicobgyn.com/2017/10/03/academic-obgyn-cases-large-abdominal-wall-endometrioma-with-mesh-reconstruction/
https://academicobgyn.com/2017/08/24/why-healthcare-is-so-expensive-part-5-pharma-gone-wild/
https://academicobgyn.com/category/journal-articles/bmj/
https://academicobgyn.com/2018/01/31/on-high-volume-gynecologic-surgery-and-how-to-pick-a-surgeon-for-your-hysterectomy/?share=email
https://academicobgyn.com/category/medical-student-silliness/
https://academicobgyn.com/category/gyn-oncology/
https://academicobgyn.com/2017/10/19/obamacare-the-uncanny-valley-of-healthcare/?share=email
https://academicobgyn.com/category/acog-acm/
https://academicobgyn.com/category/rants-and-raves/
https://academicobgyn.com/2017/08/24/why-healthcare-is-so-expensive-part-5-pharma-gone-wild/?share=google-plus-1
https://academicobgyn.com/category/infectious-disease/
https://academicobgyn.com/page/2/

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Domain Name: ACADEMICOBGYN.COM
Registry Domain ID: 630782932_DOMAIN_COM-VRSN
Registrar WHOIS Server: whois.tucows.com
Registrar URL: http://www.tucowsdomains.com
Updated Date: 2017-10-12T09:07:42Z
Creation Date: 2006-10-13T06:47:08Z
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