Child Health Plus Health Insurance Renewal: Fill & Download for Free

A bit of stress. A bit of impostor syndrome. A bit of embarras du choix.Let’s back up a bit.To my own surprise, I am working a lot. I was never a person who thought I was going to be working a lot when I was in med school. In fact, my dream was to graduate, find some part time work and work at most 3 days a week. I didn’t understand what I was going to do with all the money physicians made in the US. What was the point, when I was going to leave it all behind anyway?In my last year of residency, I started having more ambitious financial goals. I didn’t intend to live lavishly. But what if, I asked myself, I earned so much more than I immediately needed that I could save and invest to enable myself to retire in 15 years? The proposition seemed attractive in the extreme. I could find myself retired at age 48 or so and devote my time to writing, playing tennis, learning to cook new meals, reading, playing video games, traveling, and whatever else would strike my fancy. I would be financially independent and young!As I earned more money, something else changed. I couldn’t fathom putting so much money away when my parents were barely making ends meet. What if I retired early, only to be despondent at the thought that my parents had died in indigence while I was too busy putting money away to help them? I couldn’t do it. So I offered them a retirement package: housing costs plus a generous stipend every month. That, plus helping other family members here and there, meant that pretty soon, I was spending upwards of $5K a month on my family. At this point, I had two options:Make my retirement goals less ambitious.Work more and seek career advancement opportunities.I took the latter course. Soon enough, instead of working 35 hours a week, I was working 50 hours a week, sometimes a bit more. This has been good for my net worth, but not so much for my stress levels. It’s harder to exercise and get enough sleep when you work more. Drinking wine—sangria in my case—also becomes more appealing. I’ve hardly become an alcoholic. But when you used to drink once every few months, buying a bottle of wine every month or every 2–3 weeks feels like you’re drinking way too much. It also doesn’t help you keep your weight down.So, I decided to reevaluate my situation. What if I spent a bit of money to reduce my stress levels? One of the puzzling aspects of modern medicine is that you spend twice as much time charting as you do seeing patients. And the vast majority of what you chart is repetitive, mind-numbingly boring stuff that you could train a child to do. After moving to Oregon, I decided that I would get a scribe, someone to follow me as I do my rounds and type while I see patients. This could save me 3 to 4 hours a day. I found a renewed sense of urgency after Chadwick Boseman’s death a few days ago. And yesterday, I finally posted an ad on Indeed.First, I agonized over how much to pay.The average pay in my area is $13-$15.5 or so per hour. I knew I wanted to pay more than that, but how much more?Housing isn’t cheap in Eugene, and I’m not starving. What’s more, it wouldn’t be a full time position, maybe 25–30 hours per week. Shouldn’t I offer someone enough money that they could live on it, especially since it wouldn’t come with health insurance? Would $20/hour be exorbitant?On the other hand, a case could be made that this wasn’t a charity venture. The services I am paying for have a certain value. Was I just trying to make a point by overpaying? And if that was the case, why not just go all out? Why not offer health insurance and, say, $25/hr?That seemed a bit too much. In the end, I decided to go with $18/hr. It was solidly above market, high enough that I could be sure to attract enough applications, but not so high that it would make a significant dent in my budget if my number of patients dropped for some reason.Then, I started agonizing over how to choose people to interview. 27 people have applied in about 24 hours!Some were easy to eliminate. There was a small test on the website that took 5 minutes to complete. It was about familiarity with electronic health records. Lots of people couldn’t be bothered to even attempt it. I’ve eliminated all but one of them.Other things were harder to answer: was I uncomfortable with the idea of an employee older than myself?I hate bossing people around. I’m almost apologetic when I ask my nurses to do something. Or I will merely mention that something needs to be done. I have a hard time saying: “hey, you, do this!” or “I need you to do this.”I grew up in a culture where one owes deference to elders. I’ve never quite been able to shake this off. I have a really hard time commanding my elders to do something.Is that a reason to eliminate people? No. It is not. I had to be conscious of it. But what if at the end, all the finalists were younger than me? Would that meant that I had found other plausible reasons to weed out older applicants? Too hard to think about. I hope not.How much do I care about formal education. Between a person with an associate’s degree and more relevant experience and one with a bachelor’s degree but less relevant experience, whom would I choose?The former would require less training. Who cares how educated someone is? Isn’t the best proof of true education the demonstrated ability to do a given task?The latter would perhaps bring a greater command of the language. I use a lot of elevated diction in my notes. It’s not on purpose; it’s just the way I write. Wouldn’t it be valuable to have someone like an English major on board, assuming they had some vague familiarity with anatomy?How much should I let go of things I could find by googling someone? Like, if someone had lost their license for being intoxicated on the job, should I give them a chance? What if there were other, equally qualified applicants with less tarnished records?I’ve eliminated 20 applicants. I have 7 promising candidates. I can’t give everyone a job. I kind of feel bad about it. Not my fault. Nothing to do about it. It makes me sad that I can’t make all of these people happy.My finalists are all women. Is that evidence of anti-male bias? Truth be told, there were many more female than male applicants. But how is it that none of the males made it through? I had good reasons each time: poorly phrased sentences, failure to take the Electronic Health Records test, irrelevant experience, etc. Still, was I imagining from the start that this job would go to a woman?Some of you have always known me as a physician. I haven’t. I still can’t quite believe I am where I am today sometimes. And there is a voice in my head that tells me that I have no right to be here judging people on their qualifications. I ignore it, and it doesn’t actually prevent me from doing anything, but it’s there.I’ve winnowed the field further to 5 candidates as I was typing this. 3 of them are really good! Of the 2 others, one has healthcare experience but nothing super close to medical scribing, and one of them has relevant experience but didn’t bother taking the 5 minute test!The scribe will be my employee, not the hospital’s. I’ll need to find a way to get her credentialed, so she can have a badge and log on to the computer system. I will also have to run payroll. This is so bizarre.Anyway, that’s my life. I’ve done it again. I’ve succeeded in staying up past my bedtime. I had a good excuse, but tomorrow is going to be a Ruthless day: not only am I discharging a patient named Ruth, but I’m discharging 4 patients, which means that I’ll have to admit at least 3 if I don’t want the census to drop too low. And that, my friends, is my life!

Well of course it can.How could the US possibly be so inept or corrupt that it can’t do what every one of the green countries on this map do:The truth is the US healthcare system is horrendously inefficient, and much more expensive per person than any other. All of these countries have universal healthcare. Except the US. So which one is the outlier in terms of spending.Oh, and if you think all this money buys better health outcomes, I’m sorry to disappoint you. Here’s life expectancy by country.Here’s infant mortality:Here’s maternal mortality:Other measures of healthcare outcomes show similar results.It’s worth looking at Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care for a comparison of the healthcare systems of 11 developed, wealthy countries. It should not be a surprise that the US comes out at #11 out of 11 for equity and #11 for access. What may be more surprising is that it comes out #10 for administrative efficiency (only France is worse). I thought the free market was supposed to be efficient? Unfortunately, healthcare isn’t a free market. It’s been known for 55 years that it cannot be a free market (Uncertainty and the welfare economics of medical care. 1963, by Nobel Laureate Kenneth Arrow), so trying to make it one will never work. But the saddest result of the Mirror Mirror study is that the US comes out #11 out of 11 for health care outcomes, too.So now you can believe one of two things:There’s something magic about the US that means that its healthcare simply must produce worse outcomes and cost twice as much per person, even though only 7 of 8 Americans are insured (Millions more Americans were uninsured in 2017); or(gee, this is going to be hard to hear) maybe, just maybe, the way the US healthcare system works, based on private insurance paid for by employers or individuals or both (except for the 1 in 8 Americans with no health insurance), plus a 5.8% tax on income for Medicare (You don’t think your employer just eats the 2.9% he pays for your Medicare, do you? That comes out of your income, too.) is not actually a cost effective system and doesn’t actually produce good outcomes.Americans tend to have a disdainful view of healthcare in other countries, but the truth is many countries’ healthcare systems provide outcomes at least as good as the US overall, and a great many do so for less than half of what the US spends.(This chart is a bit old; the US now spends more than $10,000 per person on healthcare.)To provide universal health insurance, the US would only need to cut per capita spending by 1/8. If it just lowered its spending to the level of the 2nd highest spender, Switzerland, it would save more than that. And that neglects the money it would save by covering everyone; for example, by saving hundreds of thousands of bankruptcies per year and by having people treated promptly by GPs, rather than waiting until a problem is acute and going to the emergency room, costing many times as much.The truth is, the US system could be much more efficient. The first two of the top 6 Reasons Healthcare Is So Expensive in the U.S. could easily fixed by adopting a single payer system. The top reason is administrative inefficiency, mostly stemming from the insurance claim process. Because there are so many insurance companies and so many different policies, every hospital, doctor’s office, and insurance company must maintain an army of staff to handle the burden. The oft-quoted example is the 1300 billing clerks that Duke University Hospital must employ for only 900 hospital beds. A hospital in most countries would only need a handful of staff, because the claim process is streamlined. There are about 900,000 hospital beds in the US; if Duke University Hospital is typical, that would mean 1.3 million administrative staff in the country doing work that should only take a few thousand.The second reason US healthcare is so expensive is drug prices; American pay several times as much for the same drugs as people in countries that bargain with the pharmaceutical companies for lower prices. Given that the US spends $450 billion per year on drugs (Topic: Pharmaceutical Industry in the U.S.), it could save $300 billion per year if it could bargain prices down by 2/3. After all, big Pharma has one of the highest profit margins of any industry (and no, it doesn’t use that to develop new drugs; it spends more on marketing, and much of the research it does do is into marginal changes to existing drugs to allow them to renew the patent).The third cause of high health spending is defensive medicine: unnecessary tests performed for fear of litigation. This could be fixed with tort reform, but also note that universal healthcare means that there is no need to sue to cover medical costs of medical errors. In any case, defensive medicine isn’t working: Medical error is the the third leading cause of death in the US.The fourth, fifth and sixth reasons US healthcare is so expensive come down to for-profit healthcare, high salaries, and overuse of specialists.All of these things could be fixed, bringing US health spending into line with other developed countries. And covering everyone. And saving around $1 trillion per year (based on lowering US health spending to the level of the 3rd highest in the world, saving $3154 per capita per year).Really, the question isn’t whether the US can afford to implement universal healthcare. The question is how long it can afford not to fix its system. Look back at that second chart, and think about the drag on the economy of the trillion dollars wasted every year. That’s 5% of the economy wasted, and rising. With no end in sight.

we have chosen 10 policies since they stand superior on certain parameters, such as eligibility, uniqueness of features, coverage, affordability, limits and exclusions.list of plans with their respective benefits:1.Max Bupa-Health companion individualRefill BenefitAnimal Bite VaccinationDirect Claim SettlementLong-Term Policy BenefitHospital Cash Benefit2.Royal Sundaram-Lifeline supremeSum Insured Re-LoadSecond Opinion BenefitEmergency Domestic Evacuation ExpensesPre-Hospitalization and Post-Hospitalization ChargesOrgan Transplant Cover3.Aditya Birla-DiamondCancer Hospitalization BoosterAny room upgradeSum Insured Reload BenefitPre-Hospitalization and Post-Hospitalization CoverageUnlimited sum Insured Reload4.Religare-NCB super premiumAutomatic Recharge of Sum InsuredLifelong RenewabilityNo Claim Bonus SuperEveryday Care BenefitDomestic Air Ambulance Cover5.Star-Family Health OptimaAuto Recharge BenefitCompassionate TravelRepatriation of Mortal RemainsRoad Traffic Accident CoverRestoration of Amount Insured6.Cigna TTK-Prohealth PlusEnhanced Sum InsuredRestoration BenefitHealth Maintenance BenefitCritical Illness Expert OpinionMaternity Expenses7.Apollo Munich-Optima RestoreRestore BenefitStay Active BenefitMultiplier BenefitE-opinionAdditional Cover for Critical Illness8.HDFC ERGO-Health Suraksha Gold RegainZero Sub-limitsMaternity BenefitRegain BenefitCumulative BonusCoverage Basis9.Universal Sompo-PrivilegeNo Medical ScreeningSpecialist ConsultationConvalescence BenefitMother & Child Care BenefitRestore Benefit10.Star- Senior Citizen Red CarpetNo Medical ScreeningPre-existing Illness CoverMedical Consultation CoverSub-limitsHassle-free Claim Settlementhope you will be able to take your best pick. Do let us know your experience!