ACA and diabetes screening guidelines; medical tourism is risky business
Q: I'm using the health-care exchange in New York state, and my plan won't cover diabetes screening at my doctor's office because the government recommendations say I'm not at risk. I'm 38, and everybody in my family, including me, is overweight. My mom and grandmother have diabetes! Don't you think I am at risk? - Angela C., Corning, New York
A: Angela, clearly you're at risk for prediabetes or even full-blown Type 2 diabetes. So, we did some research and found that in Corning, you can go to the Guthrie Corning Hospital for a free diabetes screening and a free nutrition class. Fortunately, there are lots of places around the country, such as hospitals and pharmacies, that offer free screening for Type 2 diabetes.
But why doesn't every health-care exchange plan encourage screening for prediabetes and diabetes? We think we have the answer.
According to a study done by researchers at Northwestern University Feinberg School of Medicine, the United States Preventive Services Task Force issued a recommendation that diabetes screening be done only on folks ages 40 to 70. Under the Affordable Care Act, "all services recommended by the USPSTF must be fully covered by insurers." Not recommended? Not necessarily covered. And that's why, say the researchers, more than half of the people at high risk (those younger than 40 or older than 70), especially folks who are in racial or ethnic minorities, no longer qualify for screening. We say a big "BOO!" to the USPSTF for this oversight.
In the U.S., 14 percent of the overall population has diabetes, and 38 percent has prediabetes. So to lower future health-care costs and prevent further sickness, these guidelines need revision to reflect current data, not just past (and out-of-date) studies.
And in the meantime, if you're diagnosed with prediabetes or Type 2, get proactive: Work with a diabetes educator, nutritionist and your doc to adopt a lifestyle (physical activity, healthful nutrition, stress reduction) that will keep you healthy. And remember, it's easier to prevent chronic illnesses like Type 2 diabetes than to reverse them.
Q: I'm thinking about finding a place to get plastic surgery that is less expensive than in the states. Is there a way to find a reputable practice? - Sharon G., Seattle
A: You're talking about medical tourism - and that's not something we advise! Up to 750,000 U.S. residents travel abroad for care annually, and cosmetic surgery, dentistry and heart surgery are the most commonly sought-after procedures. Unfortunately, it can be risky business, especially if you let price and a fancy brochure become the deciding factors!
It's sometimes hard for people to grasp how well-regulated and safe our medical care is compared with that in many parts of the world. The Centers for Disease Control and Prevention says that when you go abroad for cheaper care:
1. You may face communication problems that can lead to medical misunderstandings.
2. In many places, doctors reuse needles and have other unsafe injection practices.
3. Medications may be counterfeit or of poor quality.
4. The blood supply may be from paid donors, upping the risk of transmission of infections, including HIV.
5. Resistant bacteria may be more common than in the U.S.
Just recently, the CDC released a report on 21 people from six states who traveled to the Dominican Republic for cosmetic surgery in five facilities there. They all were infected with rapidly growing mycobacteria, and many (92 percent from one clinic) required corrective surgery and (78 percent from that same clinic) a three-month-long course of antibiotics to recover.
That's why going abroad for cheaper care isn't a smart move. But if you opt for it anyway, thoroughly check the qualifications of the doctors and the credentials of the facility. Take copies of your medical records and medications, and make sure an English speaker is onboard. Get copies of your medical records before you return home, and be aware that health-care insurers here sometimes refuse to cover treatment for complications incurred abroad.
Distributed by King Features Syndicate, Inc.
Read more http://cdn.kingfeatures.com/rss/feed/editorial/index.php?content=YouDocQ_20160807