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Guiding your journey through illness ....

In This Issue
Understanding Palliative Care
The Fine Print of Your Insurance Policy
Food Science - Part 1
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National Association of Healthcare Advocacy Consultants

Second Annual Conference

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November 2010

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Volume 1 Issue 2 September 2010
Dear Colleagues and Friends,
Welcome to the September issue of "Patient Navigator News" with articles to help you become your own best advocate and give you new perspectives on the healthcare system.

Patient Navigator's mission is to bring health care and life care together through advocacy, education and a patient-centered approach to solving problems and overcoming obstacles in the health care system.

We welcome feedback at Patient Navigator or by email.

Sincerely,
Elisabeth Schuler Russell
Founder and President
Patient Navigator, LLC
Guiding your journey through illness ....
Understanding Palliative Care
Many people mistakenly believe that choosing to accept palliative care, especially for cancer treatment, means that the patient is giving up. This is a common but unfortunate misconception.

Palliative care focuses on pain relief and other measures intended to improve a patient's quality of life. A groundbreaking study published August 18 by the New England Journal of Medicine showed that lung cancer patients getting palliative care from the start reported less depression and happier lives as measured on scales for pain, nausea, mobility, worry and other problems. Moreover, even though substantially fewer of them opted for aggressive chemotherapy as their illnesses worsened, they typically lived almost three months longer than the group getting standard oncology care.

We at Patient Navigator have seen first-hand that pain management and palliative care options are woefully misunderstood by medical practitioners and patients alike. In last year's health care debate, any discussion of palliative care to support patients was cast by opponents as "death panels" and euthanasia. Doctors lost an opportunity to educate patients about important choices available to them.

To learn more about end-of-life issues in the American medical system, we highly recommend the August 2, 2010 essay in The New Yorker by Dr. Atul Gawande entitled Letting Go. National Public Radio's Diane Rehm on August 24 hosted an informative and insightful program entitled "New Studies on Palliative Care." With a distinguished panel of guests and lucid conversation, you will learn a great deal by listening.

Our blog post The Face of Pain will direct you to more resources on pain management and palliative care. People living with chronic pain can also get information from the American Chronic Pain Association. Let's hope this study sparks an informed debate about pain management and the possibilities for help from palliative care.
The Fine Print of Your Insurance Policy
Have you actually read the coverage and benefits documents provided by your health insurer? Most of us only refer to them them only if we need something out of the ordinary or have purchased a new policy.

Implementation by insurance companies of this year's Affordable Care Act (health reform) will be confusing. It will be up to each of us to stay informed. Don't assume the insurance companies will necessarily make any changes easy to discern.

Here is one example. In 2008, Congress passed the Mental Health Parity and Addiction Equity Act (this law actually pre-dates health care reform). As of January 1, 2010, the law basically requires the equal treatment of mental health and physical health benefits. Group health insurance plans are prohibited from restricting access to mental health care by limiting benefits and requiring higher patient costs than those that apply to general medical or surgical benefits.

In 2010, we started hearing from clients about mental health claims that were being denied, although the providers and diagnostic codes had not changed. We assumed this was a mistake, but then discovered that the insurer had imposed a pre-authorization requirement for services that in the past had not required pre-authorization (although there had been an annual limit on visits which was now lifted to comply with the law). In addition, the insurer authorized services only with certain providers.

This came as a great surprise to the policyholders who did not recall being notified of this new pre-authorization requirement. Since they had not obtained pre-authorization, they were out-of-pocket several thousand dollars. When we reviewed their coverage document, we found notification of this change, but not highlighted in a way they would notice.

The moral of this story: Learn the vocabulary, read your policies thoroughly and watch out for changes you might not expect.

Check out the Government's new website designed to help all us understand the new laws. It's a pretty good starting point.
Food Science - Part 1
Food science is a field gaining prominence among patients with chronic diseases, nutritional imbalances or cancer who want to attack their disease and boost their immune systems. They are asking for nutritional guidance along with their doctors' prescribed treatments.

We begin this month a series that will focus on the science and research of nutrition to help you become more informed about food choices. One easy way to start learning more is by reading Michael Pollan's book In Defense of Food: An Eater's Manifesto.

First, some context. Before World War II, food additives, food colorings, food preservatives, packaging preservatives, artificial flavorings, artificial sweeteners, trans fats, artificial fats, xeno-estrogens, pesticides and herbicides were not omnipresent in the food we ate. Since then, food products using these artificial ingredients have often crowded out high nutrient whole foods we might otherwise be eating. (The influence of agribusiness and food lobbies on this trend will be the subject of future column).

The presence of these toxins in our foods for the past 70 years, and the related deficiencies they have created, has coincided with an increase in many types of cancer, obesity, diabetes, Alzheimer's disease, autism, ADHD, fibromyalgia, food allergies, food sensitivities and psychological conditions such as dementia, depression and chronic fatigue. This list of research studies only begins to address the topic.

Eliminating these artificial ingredients and eating nutrient dense, disease fighting foods when dealing with any illness can unburden the body, and supply extra nutrients to build strong systems capable of fighting disease.

Source: Notes from a lecture by John Bagnulo MPH, PhD., at the Center for Mind-Body Medicine's Food as Medicine Forum, Washington, DC. May 2010.

You can visit the Center for Mind Body Medicine's Food as Medicine site to learn more about this education and training program.


Next month: The six problems with the current American diet and what to do about them.

Guest "Food for Health" Columnist Deborah Roney holds a degree in biology and received her certification from the Food as Medicine program at the Center for Mind-Body Medicine in Washington, D.C. in May 2010.