Cigna Medical Power Of Attorney: Fill & Download for Free

Americans do have universal health care. Any American is free to exercise, drink plenty of pure water, eat only nutritious foods, meditate, seek good supportive friendships, and care for his or her health in every other way.Oh, you meant universal MEDICAL care?Well, Americans are also entitled to walk into any emergency room and be seen and evaluated. If they are in labor or have a serious medical condition, the hospital must treat them until stabilized without regard to cost. This rule is stringently enforced and hospitals can lose their license if they don't comply.An American also can visit any medical practitioner who agrees to see him or her. The patient only has to provide a means of payment or have the payment discounted or waived by the practitioner.Unfortunately, CMS prohibits providers from discounting their fees, for anyone, by more than 15% for cash payment. This arbitrary amount is an example of law by regulation, by the way. I know, because an administrative judge’s ruling transformed me into a felon instantly.Insurance companies, however, are allowed to demand and receive discounts of 20%, 60%, sometimes even 100% for certain services, and it is perfectly legal. They use their bargaining monopoly power to drive their own fee schedules down to the lowest price point they can achieve and still meet state standards for numbers of each type of practitioner they are required by law to have in their network. So Aetna, Cigna, and Blue Cross are effectively receiving charity that should be given to the poor. This also ramps up the pressure on practitioners to see as many patients as possible per hour so as to stay ahead of their overhead.In the meantime, both private insurers and the public programs (Medicare and Medicaid, which comprise more than half of US medical spending) have escalated the dire and sadistic game of “prove to us why we should pay you,” that administrative costs are the greatest portion of medical payments by far. (See chart).People who think the US needs “Medicare for all” are oblivious to the fact that many practitioners treat Medicare patients at a loss. They also seem unaware that the perverse regulatory incentives baked into Medicare were the primary tumor of the bureaucratic metastatic cancer which is eating the American medical system from the inside out.Countries with government-provided medical care for anyone who wants it, normally also have a thriving free market in treatment for those who can't or don't want to wait, or who are denied care by the government system. That is the thing that Americans do NOT have. The frustrating part is, most Americans don't even know it.At this point, the administrators and insurers and billing companies and compliance consultants and healthcare policy analysts and attorneys who benefit from the status quo are so much richer and more powerful than anyone who actually takes care of patients that Congress is completely in their thrall.And THAT is why the USA has the most expensive, inefficient, and inequitable medical care system in the world and can't seem to do anything about it.

At 78, I have gathered up a few thoughts about this. It will be hard to keep it short.I list them as they come to mind:1. Get healthcare literate and take control of your health.If you are 40 and living in a western culture, especially the U.S., there is a good chance that your lifestyle has done some damage to your long-term health. That is unless you are one of the few outliers that have lived a disciplined life of good diet, exercise, low/no stress, and have chosen to understand how your biology works and how best to treat it.I grew up in an era in the 50s and 60s where our health habits were marginal at best. We lacked the knowledge, awareness, and access to the healthy living information that we have today. I smoked for 18 years until age 37. In the 1950′s, it was considered healthy and promoted by doctors, dentists, and movie stars. Diet was built around meat and potatoes. Although I’ve been a gym rat for 40+ years since then, I didn’t pay attention to my diet and continued on the S-A-D (Standard American Diet) until into my late 50s.At age 73, a routine heart scan revealed I was in the high-risk category for cardiovascular disease with significant artery calcification. I’m lucky. Mine appears to be distributed because subsequent echo and nuclear stress tests showed normal blood flow. My six-day-a-week exercise program continues and I have radically reduced my intake of meat, dairy, and C-R-A-P (calorie-rich-and-processed), the major components of our S-A-D still today.My point is that if you are living a normal American lifestyle, you are likely too sedentary, eating badly, stressed out, and have a 65% chance of being overweight, 25% of being obese. You may be one of the 50% of our American population that is pre-diabetic and one of the 70% that don’t know it.We know all we need to know to take full advantage of our birthright of good health. But, as a society, we choose to continue to remain naive about how our bodies and minds work and choose to abuse our immune system with poor health habits, failing to appreciate the slow, insidious damage that is being done until, often, it is too late to stop or reverse.Consider a few important facts:We have a food industry that doesn’t give a rip about your health and a healthcare industry that doesn’t care what you eat.Our antiquated healthcare system does not spawn practitioners that know or care about nutrition. They are trained in “cure” (as in drug it or cut it out) and not “prevention.” That’s on us.It’s also important to understand that the bio-pharmaceutical world is not built with your good health in mind, although they would lead you to believe it They don’t have a solution or a drug for “healthy.” The pharmaceutical industry would collapse if everybody took care of themselves. It’s built on the cure concept, in alignment with the similarly trained physician community.Once I understood how my biology worked at the cellular level, I began to change up many things in my life: increased my exercise, changed my diet, and radically reduced stress in my life. My recommended source to kickstart that awareness is the best-selling, transformational book “Younger Next Year: Live Strong, Fit, and Sexy - Until You’re 80 and Beyond.”The authors convinced me that I inherited a magnificent immune system of some 35 trillion cells that works 24x7 to keep me healthy. It doesn’t ask for much to do its job and will reward me if I follow the simple guidelines of what it needs i.e. good glucose, oxygen, fewer harmful stress hormones in my bloodstream, and rest.Knowledge is power, especially in protecting your health. Take charge on your own, be distrustful of a profit-driven medical, pharmaceutical, and food industry to be doing what is right for your optimal health. Believe me, they are not.2. Discover/rediscover your strengths and talents.You are likely a product of the 20th-century linear-life model that looks like this:You were squeezed into a learn-earn-retire model built on conformity and heavy cultural expectations: getta degree; getta job; getta wife, house, kids, two cars and a golden retriever; get title; getta 401K; getta gold watch.Here’s where that has ended up for many:I’ll confess to having drunk this 20–40–20 Koolaid, spending 35 years operating outside my essence and my deepest talents and strengths in the corporate world building someone else’s dream and doing the “normal” accumulation and conformity thing. While I did OK, it took separation from that and a venture into my own business to slowly begin to reveal that I was wired for something different.I ignored several personal/psychological assessments and personal experiences that were telling me that my core strengths were in learning, writing, teaching, speaking.I’ve arrived where I need to be, but late in my life. So my suggestion is to start, or restart, thinking about what you are really, really good at, what you really, really enjoy doing, and what the world needs and ask yourself if that fits what you are doing now. If not, it’s a good time to start thinking of where you can best use your talents, skills, and experience and fill that hole that I’ll call “lack of purpose.”3.Plan for a “third-age” with a sense of purpose.The level of disengaged employees in the workplace is at an all-time high. Few people enter their careers with a solid grasp of what their deepest core talents, strengths, and desires are. Or if they had a sense of what those were, they entered the system that our culture expects of them where those innate inner drivers get shuttled to the background in favor of accumulation and conformity, meeting cultural expectations.For many, these drivers never resurface. And they plod on through an unexciting, unmotivating career with the expectation of reaching that nirvana stage called “retirement” mostly unaware of the downsides of that decision.This sense of “lack of purpose or meaning” tends to surface at mid-life, usually in the 40s and 50s when one faces the reality of more days behind than ahead and struggles with questions like “Why am I here?”; “What will be my legacy, what footprint will I leave?”; “Is it really true that the number of people that will attend my funeral will largely be determined by the weather?”AT 40, I suggest it’s a time for serious reflection on where you are, how that aligns with your deepest desires and talents and begin to think in terms of a “third age” and what you want it to look like. And 40 certainly isn’t too early to start. That “third age” is the period between end-of-career and/or end-of-parenting and true old age where we come full circle back to full dependency.That period today is extending for many, to as much as 30–40 years. That’s a long time to function without purpose which is where many in the self-indulgent retirement model find themselves discovering that 30 years bingo, bridge, and boche ball isn’t healthy or fulfilling.Fortunately, we are seeing a rising tide of mid-lifers beginning to grasp the importance of a plan for the third-age that involves continued work, contribution, and sense of purpose as opposed to the traditional narcissistic, self-indulgent, consumer-only concept of retirement.One of my favorite “virtual coaches” is Dan Sullivan of Strategic Coach. He boldly states that people die early for three primary reasons:No moneyNo friendsNo purpose4. Get rid of the mental junk. Never stop learning.By 40, you’ve been exposed to - perhaps succumbed to - many harmful, life-inhibiting myths and messages. Such as, I will automatically lose cognitive ability as I age. Or, my DNA is my destiny. Or traditional, leisure-based retirement is good for my health. Or work in older age is harmful. Or my creativity declines as I age. Or that physical decline is automatic and irreversible.It’s a long list of disproved messages that we allow to entrench in our minds, much of it junk that holds us back. Ignore them - go the other directionWe’re learning that our creative powers don’t diminish as we age unless we allow it. They may slow, but we can build brain power and create as well as when we were younger. So, don’t buy the line that says senescence is automatic. It isn’t.We start dying slowly when we allow our dreams and desires to fade in the face of the myths about aging.Henry Ford had it right: “Anyone who stops learning is old, whether twenty or eighty. Anyone who keeps learning today is young. The greatest thing in life is to keep your mind young. "5. Get strong, stay strong. Aerobic exercise should be keystone in your lifestyle. Optimally, from age 40 forward, your week should include six-days-a-week of aerobic exercise of 30 minutes or more with your heart rate in an aerobic zone of 220 minus your age x .65 and .85.But it shouldn’t stop there. It’s vital to have a strength training component along with your aerobic exercise - at least two days a week.Here’s why. Beginning in our mid-30s, our bodies begin to lose muscle mass at a gradually accelerating pace. The clinical name for the condition is sarcopenia and it really accelerates when we reach our 50s and ends up becoming one of the major causes of early frailty and premature death in our culture unless compensated for. The only antidote is strength-training - there are no drugs to effectively treat sarcopenia/loss of muscle mass.Failure to compensate for loss of muscle mass is a major contributor to the “live short and die long” referenced above. Falls and broken hips, which are major contributors to early frailty and premature deaths, are a consequence of lost muscle mass.Get a gym membership (if they are able to come back after COVID) or build an at-home gym (here’s a photo of my current in-home set up - treadmill, upright bike, Bowflex, weight-bench and assorted free-weights).Get with a trainer to get started properly and to avoid early injury that may discourage you from staying with the program. Put heavy emphasis on your core - a key to avoid falls later on and for avoiding back problems as you age.6. Rethink retirement. If you are part of the Euro-American culture, you are likely convinced that retirement is an entitlement and a nirvanic end-goal filled with exotic travel, golden sunsets, and total freedom. And it can be all that but at the risk of experiencing some of the subtle, hidden downsides of a self-indulgent, leisure-based retirement.There is an encouraging, but slow, shift taking place in our awareness of the downsides of the traditional, off-the-cliff, labor-to-leisure retirement model that we have cherished for decades and is so effectively marketed by the financial services industry.Part of it is because we know so much more about what comprises good health and the growing awareness that our biology offers us only two choices, regardless of age: growth or decay. There are many aspects of the traditional retirement model that violate that biological principle and can accelerate our physical and mental decline.Historically, there has been a tendency for retirees to become more sedentary and move less. Satisfying the dream of spending less time in the kitchen promotes a lifestyle of eating out more where food content is less healthy - 30–40% higher calorie content and generally heavy in sugar, salt, fat. Netflix, voice-activated remotes, and the Laz-y-boy become increasingly tempting. Continued learning diminishes.Social isolation is a major concern post-retirement and is said to be equivalent to smoking 15 cigarettes a day.The new trend for this “third age” is away from self-indulgent, leisure-based retirement and more toward continuing to stay engaged with work of some sort, be it volunteer, part-time, full-time, or by starting a new business. The largest number of new businesses over the last decade or so have been starting by folks over 50.In my coaching practice with folks over 50, I encourage them to consider their third age as a time to strive toward achieving a balanced lifestyle of labor, leisure and learning.I believe it is a healthier formula and can lead to “living longer and dying shorter” versus our current predominant “live short, die long” model.7. Connect and commit. A recent random survey by Cigna revealed that nearly half of those surveyed “sometimes or always feel alone” and that 40% “feel their relationships are not meaningful and that they feel isolated.”These are alarming numbers because of the health and mental health risk associated with social isolation and loneliness. AARP recently revealed that the health risk of prolonged isolation is equivalent to smoking 15 cigarettes a day.There is substantial evidence that social isolation and loneliness increases the risk of early death. Social isolation is a threat as many retirees exit from the work environment and lose the major part of their social life. They often find themselves without much of a social network outside of that environment.We are wired to connect, to be in community.Let me wrap by quoting Chris Crowley, co-author of the aforementioned book “Younger Next Year.” As a successful attorney, he offers up the following which I feel is golden advice for a 40-something that is considering “what’s next.”“It was nuts to immerse myself so completely in my old professional life before retirement. In particular, it was foolish not to have other hobbies, communities and commitment - things I care about and people who care about me- when my work life ended. If you’re going to do well in this country, you have to make a massive commitment to your job. No question about it. But don’t make your job your only commitment, because it will go away. You need to get a life that will last a lifetime. It makes sense to start on that project as early as you can. Today would be good.”