In the aftermath of the swine flu epidemic, which seems to be over (knock on wood), the brainiacs who do epidemiology are trying to figure why we had no traditional flu season.

The good news is that the flu threat has subsided and public consciousness about hand-washing is probably at an all-time high. It seems everywhere you look you see those signs encouraging you to wash your hands for a full 20 seconds with hot water and soap or some antibacterial goop.

Meanwhile, there's a new technology that uses plasma gas (like in your TV) to thoroughly disinfect and clean hands without water in four seconds flat. The best guess is that it would initially cost $100 for a device like this. Best of all, this technology seems to kill drug-resistant super-germs.

There's a race to get this plasma device into medical centers, with 50 groups working on the project. Once perfected, this kind of thing will eventually be available for consumers, likely even at a cheaper price point than $100 a pop.

Clark has heard you loud and clear that you don't want him doing politics on the show. So here's something that touches on politics that he'll strive to do in a multi-partisan manner.

The American people have said "no" to the Democrats' vision of health care reform. With Massachusetts as a proxy, the nation spoke and said it cares more about the economy and jobs than health care. How else to explain this ultra-liberal state electing a conservative Republican?

While the Democrats seem to be in a parallel universe, the GOP isn't faring much better on the issue of health care reform. Lamar Alexander's talking points on health care have been just that -- talking points that it sounds like someone told him to say because they'd sound good on TV.

In short, Clark has been frustrated to no end with both parties on health care. He thinks they're both lost in the wilderness.

The truth is we need market-based health care where we are the decision makers responsible for choosing the level of coverage we want to purchase. It's empty rhetoric to say "health care for all" and not do anything to empower us with access to make informed decisions.

To that end, Clark wants to tell you about ZocDoc.com, a new website that allows you to locate doctors by specialty and what kind of insurance they accept. You can also read user-generated reviews of doctors and make an appointment instantly online with their office.

ZocDoc.com is only available in Washington, D.C., New York and San Francisco at this time.

Watching TV or sitting in front of a computer for extended periods can kill you, according to the results of a new study in Circulation: Journal of the American Heart Association.

The six-year study by Australian researchers found that watching four or more hours of TV per day is associated with an 11 percent increased risk of death in general, and an 18 percent greater risk of death from cardiovascular disease in particular.

Many Americans watch that much TV but won't admit it.

When you dig into the findings, you see that even those who exercise regularly still have a higher mortality rate if you're passively sitting while watching TV or using the computer. Ultimately, the study is about sitting on your rear end for too long. TV is not the killer, it's the sedentary hours that typically accompany it.

To combat the dangers of sedentary jobs, Dr. James Levine of the Mayo Clinic has developed the Walkstation. The Walkstation allows you to walk slowly at 1.5 miles per hour on a treadmill that's equipped like an office desk. That's a speed that's slow enough that you won't be winded during conversation.

Clark himself has long stood while doing his job. When he owned a travel agency, he held standing meetings because he believed they were more efficient. He also does his radio show on his feet because he's a jitterbug.

So why not watch TV this way? You don't need a Walkstation to do that at home; a simple treadmill going at 1.5 miles per hour will suffice.

Looking for affordable heart surgery? You may soon be able to travel to the Caribbean for a procedure priced at a discount of 50 percent or more.

The Wall Street Journal reports that an Indian doctor named Devi Shetty has revolutionized the field with his economy of scale. With Shetty's setup, an open heart surgery costs $2,000 instead of the $20,000 or $40,000 it might in the United States.

Shetty now plans to open a new 2,000-room cardiac facility in the Cayman Islands.

The good doctor can crank out such cheap prices because he and his staff only handle heart surgery; that's the sole kind of procedure they do.

The benefit of this approach is twofold. First, it ensures a high-level of expertise among the doctors. Second, the high volume garners discounts from medical supply houses, which further lowers the cost. Shetty's model is so efficient that The Wall Street Journal has called him the "Henry Ford of heart surgery."

In capitalism, the most efficient provider wins. Why should it not be the same in medicine?

Meanwhile, there's a new website to comparison shop for health care. PriceDoc.com even allows you to name your own price and see if any doctors will meet it. It's another example of free market principles at work in medical care.

Earlier this week, Clark's revealed how sick his wife had become after developing complications from the H1N1 virus. Today, he wants to sound a note of calm after clearly agitating listeners.

Here are several stats from the Centers for Disease Control that are important to know:

• Some 22 million Americans are believed to have cycled through swine flu so far.

• Of that number, 3,900 people have died. Every single death is a tragedy, but the incidence of death is a very small number mathematically speaking in comparison to the number of cases.

• 100,000 people have gotten sick enough to be hospitalized. Of that number, a third have been kids.

• 96 percent of people who are hospitalized with the swine flu survive.

• About three-quarters of those who die of swine flu have an underlying medical condition.

So the message here is don't ignore the swine flu, but don't panic either. While not perfect, our medical care in the United States is excellent still. When Clark's wife was hospitalized, nobody at the nurse's station was turning away the uninsured. Everybody got great care regardless of income.

For those in high-risk groups -- children under age 2, people with pre-existing medical conditions and pregnant women -- it's probably wise to get vaccinated. But again, the choice is entirely yours.

Sad news for the Howard family as Clark's wife is recovering after a nasty bout with the H1N1 virus. For most people, swine flu manifests itself with nausea, fever, chills and other common flu symptoms for about a week.

But Lane developed bacterial pneumonia and had to be hospitalized for five days. She also sustained some liver damage that will hopefully prove to be temporary. Now she's out of the hospital and has a multi-week recovery ahead of her.

Through the process, Lane was worried about their 4-year-old son who would be susceptible for serious illness because of his asthma. The Howards still can't find a shot for him; normally children his age would get the mist, but his asthma makes him ineligible.

Pregnant women, children under 2 and people with underlying health conditions are in the prime group of those who should get vaccinated.

Meanwhile, Clark also has asthma and was forced by his doctor to get the shot. Watch the penny-pincher get his shot!

Everyone has to make their own decision about getting vaccinated. But after seeing how sick his wife was, Clark has a new appreciation for getting the shot.

The Wall Street Journal reports that the American Cancer Society questions the relative value of screening for breast and prostate cancer, which are the two most common types of cancer.

However, Clark wants to caution you not to get the wrong message from this new development. Screenings are valuable, but it's what you do with the information that's even more important.

Clark, for example, discovered that he has early stage prostate cancer. Yet he has around a 46 percent chance of never needing any treatment for his particular disease profile. But when he tells people he hasn't had treatment, they freak out. So often in our culture, diagnosis equals treatment. But it's not done that way all over the world, particularly in Europe.

There is some basic wisdom Clark can share that doesn't change:

• Get tested.
• Don't panic.
• Read medical journals so you can be the manager of your own health.
• Act -- don't react -- based on what you find.

Health care reform -- that word "reform" tests well among focus groups, much like "new and improved" -- is moving along with a little GOP support, but it's still generally a Democratic initiative.

Our health care system is broken. We spend more on health care per capita than any other country and have shorter lifespans to show for it. We have a "crisis" -- another overused word. But how we deal with the problem is as important as recognizing that we have one.

A big government solution to the problem is not the right direction in Clark's mind.

As a nation, we either get health care from a large employer; by working for government; or through Medicare/Medicaid based on age or income. It's an ad hoc system that doesn't recognize that we don't stay loyal to one employer for a lifetime anymore. So the very presumptions made by our health care system are based on a prior era.

What we need is more affordability and availability to purchase health coverage. Of course, Clark is painting a simplified picture. But there's too much emphasis on how complicated everything is, with hundreds of pages in bills floating around Congress that nobody understands because we're adding onto a broken system instead of doing a fresh start.

This is not a red vs. blue issue. Both parties have failed to lead and serve the American people on the health care issue. What we need is an individual market, with vouchers for those of lower income. And yet the free market is obviously not the answer to everything; just witness the bank-led financial meltdown. So you need a cop on the beat. Clark believes that cop for health care should be a public/private commission that would draw up standard health policies.

Most importantly, we have to remove health care from the grip of big business, big government and big insurance.

Are you among the two-thirds of Americans who takes dietary supplements -- as in vitamins, herbal products or those miracle remedies you see on bad late night TV?

Clark himself takes two chewable vitamins everyday. Executive producer Christa takes certain supplements such as magnesium. Associate producer Joel, however, doesn't take any supplements.

A recent Dow Jones report suggested people can experience kidney failure and liver failure because the contents of some dietary supplements are not regulated closely enough. A survey from the National Institute of Diabetes finds that roughly 10 percent of people with liver problems developed them from taking herbal remedies.

Another word of caution: Be sure to tell your doctor about any dietary supplements you take. That information will help him or her be aware of any possible drug interactions with prescriptions you may be taking.

There's a big fight about whether or not the feds should have stricter standards for dietary supplements. There is essentially no oversight of what goes into dietary supplements. The closest thing to any kind of oversight is an accredited body called the United States Pharmacopeia (USP).

So in essence, this is the Wild West and you've got to be careful with what you put in your body -- especially with the claims you see on late-night TV. Clark is stunned by the number of ads he sees for what he'll euphemistically call "evening activities." Know that you are being conned by the actors. The product may not harm you, but it will harm your wallet.

Clark has been a longtime fan of nurse-in-a-box facilities. These facilities are typically located in pharmacies, discount stores or supermarkets, and they offer the services of a nurse practitioner who administers basic medical care.

Customers love these kinds of "store within a store" operations because they're open 7 days a week for extended hours. They also offer a cheaper alternative to the emergency room.

But what's the quality of care you actually receive at a nurse-in-a-box facility?

The September issue of the Annals of Internal Medicine published a study with the following surprising results:

"Overall costs of care for episodes initiated at retail clinics were substantially lower than those of matched episodes initiated at physician offices, urgent care centers and emergency departments. ($110 vs. $166, $156, and $570, respectively)"

And this conclusion statement:

"Retail clinics provide less costly treatment than physician offices or urgent care centers for 3 common illnesses, with no apparent adverse effect on quality of care or delivery of preventive care."

That last phrase -- "with no apparent adverse effect on quality of care or delivery of preventive care" -- says it all.

We are three years away from traditional incandescent bulbs being banned in the United States. As of Sept. 1, new European Union rules made it illegal for many Europeans to buy a traditional bulb -- except for those that were still on the shelf.

Will the new crime du jour become smuggling traditional bulbs into the EU?

The International Herald Tribune reports that Germans were panicked about the Sept. 1 regulation and have been stockpiling traditional bulbs. Meanwhile, other European countries reacted to the ban with a shrug of the shoulders. So much of our behaviors and reactions are culturally influenced!

Compact fluorescent lights are one of the new options for lighting available in the United States. CFLs use a quarter of the energy of traditional bulbs and can put $80/year back in your pocket.

One reason people haven't embraced CFLs, however, is the fuss over their mercury content. But it's negligible compared to a traditional thermometer -- something in the range of one-four hundredth. You can also recycle CFLs at Home Depot stores across the country.

When traditional bulbs are banned stateside, halogens may be good compromise for some people.

Meanwhile, in totally unrelated news, Clark's 10-year-old daughter had possibly come down with swine flu, though it wasn't officially diagnosed. She had fever as high as 102.6 degrees, chills, nausea, cough, lethargy and didn't want fluids.

Yet it was nothing to panic over. She made a full recovery. Those who have contracted the H1N1 strain vs. the number who have actually died from it indicate that this is a mild strain compared to other influenza outbreaks. Of course, Clark realizes that's little comfort if you have actually lost someone to swine flu.

But he wants to emphasize that swine flu is generally not a death sentence.

Elderly people are one group you might expect to contract H1N1 that generally hasn't. The thinking now is that they may have been exposed to a similar flu early in life and have some level of immunity.

Pregnant women, however, should not take this outbreak lightly. The warnings from the CDC are very clear on this.

Editor's note: What follows is Clark's own address on health care reform, ahead of President Obama's planned speech before a joint session of Congress.

Hear Clark's Address: Listen Now | Right-Click to Download

"Madam Speaker, Mr. Vice President, members of Congress and the most beautiful First Lady in the history of the United States (Clark's wife Lane), I want to address you about health care reform and what I want you to put on my desk to sign into law.

For months, there have been angry words and both sides of the aisle have been talking past each other. But tonight I propose we go to a health care system that we can afford and that will allow market forces to finally enter health care in the United States.

We must address head-on that the federal government deficits we are running are not sustainable. The commitments to seniors with Medicare and the impoverished with Medicaid are not sustainable. We can not afford as a federal government to provide for the health care of the citizenry. It's just not possible.

In addition, our current system is based largely on luck. Either you're lucky enough to work for an employer that provides health coverage or you unlucky enough to be self-employed, work for a smaller employer or have a pre-existing condition that makes you a pariah for insurers.

Employer provided health care was an accident of history. It only exists because of a move by employers some 50 years ago to provide health care as a back-door way to give raises during the days of wage price controls -- when the feds said that employers couldn't give pay raises.

Unfortunately, it's grown into an unsustainable haphazard system. If you go back 50 years, an employee would be a "lifer" at a job and there was a reciprocal relationship between employer and employee. Today it doesn't work like that. Employers add or subtract employees at will and we pick up and move as we see fit.

But many times someone may have an illness and can't leave an employer because of health coverage. We need a new system to address the fact that we don't stay put for a long time. We need to move away from centralization of health care from government or employers.

We also need to introduce the marketplace. How can this be done? We need to create an individual health insurance market where each individual in each family buys his or her own coverage. We can't allow employers to be the sole source of safe venue for coverage, but instead have to create an insurance market based on the principles of standardized policies.

Insurers will be allowed to charge what they wish based on age/sex, but we need standard policies you can pick and choose from.

Choice is the key to driving smart decisions. Some like the structure of an HMO, some like the freedom of a traditional fee-for-service plan. Others want an in-between option like a PPO with a list of cheap in-network providers and more costly out-of-network ones. Yet others, such as entrepreneurs, love HSAs, where you take a high-deductible health insurance plan and you are essentially your own insurer for routine things.

We should allow Americans to choose from all 4 options, but the coverage should be standardized across all insurance companies so consumers can comparison shop.

Not everybody should have to buy the same HMO or the same PPO coverage. I think there should be 3 levels of choice in each -- 3 different HMOs, 3 PPOs, 3 traditional plans and 3 HSAs, each with different levels of coverage.

For example, a basic plan would provide only generics medications and no experimental treatments. Each level would have different care for you. But you would have the choice of what you want to buy.

If an employer wants to subsidize the health care with a voucher, that's fine, but you would still be in control of the purchase. So even if you left your employer, you would still have insurance.

If someone chooses not to buy insurance, that's fine too. If you do become ill, you'll be barred from buying coverage for 24 months. Otherwise, the healthy would never buy until they're sick.

The moral choice is so key here. If we rely on government or an employer to decide what coverage is good for us, we give them the power of life and death over us. But if we make our own choice, then it puts us in control and eliminates the moral dilemma of will we tax ourselves more to provide more coverage or tax less to provide less coverage.

And for those without means, both sides of the aisle seem to agree on a voucher system that would scale back as the level of income rises. I think that's a reasonable option. But I can tell you that we can not solve the cost issue with health care, without having a collision with morality, if we do not put the patient in charge. That's the key.

You must be the person who decides what coverage you want, what coverage you choose not to buy and who you buy it from. It's that simple. Health care costs account for one-sixth of our economy and we have to get control of that one-sixth, but at the same time provide true power back where it belongs -- with the American people. Thank you very much."

Whole Foods CEO John Mackey has created controversy with an op-ed piece he penned for The Wall Street Journal.

Before we go any further, it's important to note that Mackey and Clark are not the same person. Yet so many of the positions Mackey takes in his piece mirror Clark's stances. Like Clark, the CEO recognizes that our problem is not having a true free-market driven solution to the healthcare quandary.

Right now, health insurance is very confusing. It's not easy to make an individual decision based on cost. Mackey would clean-sheet the whole model and go to a system of individual purchase decisions. You would get your healthcare from the free market, not necessarily from your employer as so many of us do.

For this idea and others, Mackey has set off a firestorm. There is now a Facebook page with 30,000 members (at last check) who are part of the Boycott Whole Foods movement. And in the Northeast, people are picketing the CEO outside of stores.

Clark would not normally shop at "Whole Paycheck," as he derisively calls it because of the chain's high prices. But the idea of boycotting Whole Foods because you don't like the position of the CEO is silly.

Normally, CEOs hide behind layers of corporate lingo and bureaucracy to disguise their feelings. Clark thinks it's refreshing to hear one actually take a stand for something he believes in passionately.

When all is said and done, the idea of adding additional obligations on taxpayers to foot the healthcare reform bill -- especially when we can't pay our existing bills -- is reckless, dangerous and not possible.

New changes in medicine promise to help millions stick to treatment regimens more efficiently thanks to improved delivery systems.

For example, Wired Science reports that a new breed of contact lens is being developed that can time-release medication directly to your eye.

This breakthrough is expected to help glaucoma patients, who routinely skip their eye drops almost 60% of the time -- even though doing so can lead to blindness.

When it comes to skipping medication, Clark himself confesses to never having completed a 10-day cycle of antibiotics in all of the 15 or so times they have been prescribed to him. The reason? He's just too flaky to remember.

Interestingly, the contact lens solution wouldn't be one that would help Clark either. His blink reflex is too strong to allow his eye to hold a contact lens, as he discovered early in his TV days when a news director wanted to get him out of glasses on-camera but couldn't!

In May, Clark told you that an advisory panel was being convened by the FDA to address the question of how to label products that contain acetaminophen.

Well, that panel has come back and recommended a ban on Percocet and Vicodin, which combine narcotics with acetaminophen. Exactly what the FDA will do with this recommendation remains unclear.

Acetaminophen is the active ingredient in a seemingly benign dose of Tylenol. However, the dangers of liver failure and death associated with unintended large doses of acetaminophen are well documented.

It's particularly dangerous when you have flu symptoms and take a cold remedy that contains acetaminophen (such as Nyquil, for example) with a couple of Tylenol in addition to that. The combo can be truly deadly. In fact, acetaminophen is the leading cause of liver failure.

So be alert and wary of the problem with medications that have acetaminophen in them.

Tylenol may get a black box warning as a result of the panel's recommendations. Know that the people at Tylenol are not in any way trying to harm the public. It's just one of those things where they built a famous name brand around a substance that now has a big, red target on it.

Summer's here -- Think you don't need sunscreen? Think again!

New stats show that only 1 in 4 men wear sunscreen when they're exposed for 4 hours or more. With women, it's a little less than half who will wear sunscreen. The real danger, however, comes when the parents of young children don't apply sunscreen to their kids.

Sunscreen does not have to be expensive. Clark always buys his at the dollar store, though one staffer on the show spent $22 on a bottle. Another spent $7.

When buying sunscreen, be sure to select one that's at least 15 SPF. You can go as high as 30; any higher than that probably won't be any more effective.

The key is to apply tons of the stuff and reapply as needed, especially after the pool or ocean -- even if it says it is waterproof.

Meanwhile, Christa warned people about the dangers of getting too much sun exposure on their arms and face while driving around in their cars. She uses a moisturizer with a built-in SPF 15 level of sunscreen protection.

Earlier this month, Clark informed you about the dangers of liver failure and death associated with unintended large doses of acetaminophen.

According to The Boston Globe, a new FDA report calls for more stringent label warnings on acetaminophen products -- the most popular of which is Tylenol.

The real danger comes when you have flu symptoms and take a cold remedy that contains acetaminophen, plus a couple of Tylenol in addition to that. The combo can be truly deadly. In fact, acetaminophen is the leading cause of liver failure.

Of course, you can always protect yourself by simply taking ibuprofen or aspirin instead. But if those options don't appeal to you, Clark has another suggestion.

A traditional dose of Tylenol is 325 mg. For marketing reasons, however, almost all acetaminophen is 500 mg per pill and it's marketed as "extra strength." So you might want to consider switching back to regular strength tablets.

And if you have an inventory of "extra strength" tablets in your medicine cabinet, be sure to only take one pill at a time instead of two.

Since I first told you about my prostate cancer after my January diagnosis, I have been overwhelmed by the well wishes, prayers and suggestions that I have received from thousands of kind people.

As anyone who has or had cancer can tell you, it is a journey. Today, I want to let you know where I am in the journey.

Have you heard about the dangers that can result from taking acetaminophen after several days of fasting -- as you might if you had a particularly nasty flu?

Clark learned about this little-known threat when he was seated on a plane next to 2 lawyers from a firm named Toliver & Gainer. Both attorneys were actively involved in a pharmaceutical product liability case pertaining to acetaminophen.

For those of you who don't know, acetaminophen is the generic name of Tylenol. It's also an active ingredient in a variety of cold and cough medications.

Earlier this week, the FDA announced that it will now compel Tylenol to issue a stronger label warning about the possibility of severe liver damage resulting from acetaminophen.

Attorney William "Gil" Gainer called into the show while Clark was speaking on the topic. According to Gainer, the real problem is that when you haven't eaten for several days because of a stomach virus, a flu or even a dental operation, you're at risk of liver damage or failure even when taking recommended doses of acetaminophen.

It's important to note that his opinion differs from that of the FDA. But as Gainer explained, under normal conditions, you have enzymes in your liver that help remove toxins produced by the acetaminophen. However, once you go anywhere from 5 to 7 days without eating, those enzymes no longer work effectively.

Gainer also revealed that acetaminophen is now the No. 1 cause of liver failure in the United States. For more information on this topic, see his firm's blog.

As a safer alternative to acetaminophen, Gainer suggests either ibuprofen or aspirin. If you're prone to ulcers, you may need a buffered aspirin to protect your stomach.

Worried about the swine flu? Clark wants to set a little perspective to calm your fears.

Back in 1918, there was a brutal influenza that followed on the tail end of World War I. At the time, 1 in 3 people on Earth got the flu. The best estimates suggest that it ultimately killed twice as many people as World War I.

The only other precedent in human history had been the Black Plague during the medieval era.

There were no medications available to treat the flu epidemic of 1918. Nor was there any real ability to do lab work and verify what illness someone had. But today we have all these capabilities.

Rewind a few days to Sunday and very few people had heard about swine flu. Suddenly, the news about it is all over the place today. There's a dangerous middle ground between having no knowledge on one hand and having constant coverage on the other hand. Remember, TV producers want to tease you to watch the next segment with headlines that can trigger fear.

So Clark's advice is to chill for now. Know that our nation will take precautions as necessary and we're in better shape than we might have been in a different era.

And when all this is over, the deals in the travel market to areas that people are afraid to visit will be amazing.

Walgreen's has introduced an amazing new plan to provide free health care to the unemployed.

For the rest of 2009, they'll offer routine treatment and tests for nada to those who are laid off via their Take Care clinics. This offer does not cover prescriptions.

The clinics, which are staffed by nurse practitioners, normally charge $59 for a visit. Walgreen's has no idea what the response will be. The demand may even overwhelm the operations at their 340 clinics across the country.

But compare the spirit of Walgreen's offer to what you find in the hospital business. Sometimes it seems hospital administrators work overtime figuring out how to not treat the uninsured and the unemployed.

Clark likens the Take Care clinic initiative to Miracle on 34th Street with abbreviated banker's hours: 11 a.m. - 3 p.m. on Monday through Friday.

Sometimes the real innovation comes from outside of an industry. Walgreen's and the entire "nurse in a box" field is taking on traditional medicine. After all, there's no reason why we shouldn't have a price list at the doctor's office like you do at a nurse in a box.

There just hasn't been enough competitive pressure…until now.

Several years ago, Clark told you about how Geisinger Health System infuriated insurance and medicine people alike with a very innovative idea.

This Pennsylvania medical provider decided they would offer a 90-day warranty on elective heart surgery procedures. If anything went wrong during that period, the patient's return visits would be free.

Clark was ecstatic when Geisinger announced their policy. Now several years later, it's clear that their idea worked. Heart patients are doing much better at Geisinger, and the provider has been able to cut costs at its surgery centers by 15%.

How did they achieve that 15% drop in surgery costs? They took a cue from airline pilots. Before a flight, pilots in the cockpit go through an extensive pre-flight checklist to make sure every system is functioning and all procedures are being followed. They treat the airplane as a system.

Medicine, however, operates as a fiefdom, where things are non-systematized and everyone does their own thing. Geisinger's innovation involved coming up with a set of 40 procedural steps.

Their system, called Proven Care, has to be run through and check-marked before any patient can undergo heart surgery. It even includes steps to deal with the trouble-prone arena of making sure that medication is properly administered after the operation.

But the fact that this is revolutionary in medicine is just silly. This kind of systemization is what well-run businesses routinely have in place.

For example, the fatality rate on U.S. aircrafts is so low because of the emphasis on systematic safety. In the recent Buffalo crash, investigators are focusing on whether or not pilot safety procedures were properly followed. Therein they expect to find the likely leading cause of the crash.

Geisinger has reduced the fatality rate to zero -- not a single in-hospital death -- since implementing Proven Care. When they started, only 59% of patients were getting good systematic treatment. Now it's 100%.

According to The Washington Post, Proven Care has been so successful that Geisinger is now extending the 90-day warranty to other procedures, such as hip replacements and cataract surgery.

We all have a right to expect accountability from our medical providers.

Two recent tragedies -- the killing of 4 police officers in Oakland, Calif., and the sudden death of actress Natasha Richardson following a minor skiing accident -- have brought about a renewed call for organ donation from Clark.

In the case of the police officers, one officer named John Hege was an organ donor. Now his heart, kidneys and liver are giving the gift of life to four individuals that Hege never knew in life.

Think about the tragic irony of 4 people being shot to death and 4 others having another chance at life simply because of organ donation.

Meanwhile, Richardson had a freak accident on a beginner's bunny slope while skiing. Unfortunately, she was not wearing a helmet. The actress died of a brain injury shortly afterward. Once again, her family made a medical donation of her organs.

Clark understands that some people have religious objections to organ donation...but for everyone else, if you are interested in donating, you can visit OrganDonor.gov to learn how it works. Once you've decided to make the commitment, be sure to tell your family and loved ones so that they know your wishes.

It's a chance to provide life for someone from beyond the grave.

The back-breaking costs of healthcare can be a real frustration for entrepreneurs and other small business people.

Insurers have traditionally engaged in the risk management business by charging massive premiums and excluding people with certain conditions. In essence, they only make coverage available to the healthy.

Nearly 50 million people don't have coverage because of access or affordability issues.

Back in 2000, Clark had heated arguments with the industry's chief lobbyist Karen Ignagni on the air. During an off-air conversation, he later told her that if the industry doesn't fix what's broke, we're going to wind up with socialized medicine.

Here we are 9 years later and the Obama administration is proposing a government insurance plan for anybody at any age that does not have coverage.

Is it any wonder the insurers are now saying they would consider phasing out high premiums for people with medical problems? Duh.

We have this silly system where you buy subsidized healthcare from your insurer. That was great when you worked for one employer your entire life, but the typical employee today works for 15 or 20 companies on average through the years.

Isn't it somewhat idiotic to get coverage through your employer when your employer changes so often?

Healthcare should be bought just like auto insurance or homeowner's insurance. For those who can't afford it, Clark believes that vouchers are perfectly reasonable.

He's also long advocated that coverage be standardized. In the consumer champ's ideal world, there would be just 12 health plans offered to everyone: 3 HMOs, 3 PPOs, 3 HSAs and 3 of the traditional 80/20 splits. Every insurer would have to sell identical plans. That way you could switch to another insurer's HMO plan No. 2 if your insurer's HMO plan No. 2 is too costly.

But no matter whether we go the socialized medicine route or we keep it privatized, we still have a nagging problem. We spend roughly twice what any other wealthy industrial nation does per capita.

Our system heavily compensates transactional-based medicine -- such as doing a procedure or surgery -- instead of the actual act of diagnosing. The only insurer that's an exception to the rule here is Kaiser Permanente.

The result of our system's set up is that we frightfully over-treat. Yet we have a shorter lifespan to show for it than other Western nations.

So far Clark hasn't heard anyone talking about making healthcare truly affordable. And the only way to get there is to end the transaction-based model.

In fact, the penny-pincher would be happy to serve as health care "emperor" for our nation and set up a free enterprise medical system to stave off socialism!

Since the late '80s/early '90s, Clark has been receiving calls from people in dispute with their health insurers about "reasonable and customary" charges. This is a tactic used by insurers to shift costs away from themselves and onto consumers.

Say, for example, your doctor bills your insurer $100 for a procedure. Typically, the insurer might cover 80% and you would pay 20% after meeting a deductible. But using the guise of "reasonable and customary" charges, the insurer goes back to the doctor and says it's only reasonable for him or her to have charged $50 for the procedure. Suddenly, the insurer is only paying $40 (80% of $50) and you get stuck picking up the remaining $60 tab.

In a massive conflict of interest, insurers were actually using an internal database to calculate what level of reimbursement they would give out-of-network providers for reasonable and customary charges. A new settlement between UnitedHealth and the state of New York, however, will change all that.

Under the settlement, UnitedHealth will pay $50 million to build a more transparent database. In a predictable move, the company admitted no wrongdoing whatsoever.

If you're locked in an ongoing dispute with your insurer, Clark advises the following: Go to other doctors in your area and ask them what they would charge for the procedure in question. That will build a consensus to show that the charge should be closer to what your doctor says instead of what your insurer says -- and that gives you leverage to negotiate.

Hospitals across America are doing covert "wallet biopsies" to deny life-saving treatment for patients, according to BusinessWeek. This is even happening to those patients who have insurance!

In a wallet biopsy, the hospital takes a separately purchased health credit report and then factors in your income, insurance and level of debt. The goal is to gain a profitability index score on you so they can determine how to handle your individual case.

If your index score is too low -- meaning that your insurer is unlikely to pay and you're unlikely to meet your out-of-pocket expenses -- they won't treat you, according to BusinessWeek.

But there is a way to fight back. Many hospitals have non-profit status, which means that they receive massive subsidies from taxpayers in return for the promise to provide charitable care. Have a family member go directly to the hospital's administrator and threaten to challenge their tax-exempt status if they're not providing care to you.

Meanwhile, new figures show that the instance of cancer has had its first recorded drop ever. Let's hope this is a turning point and not just a statistical aberration.

Clark is going to make a lot of people unhappy as he picks on yet another herbal remedy in the dietary supplement arena.

Now, the consumer champ acknowledges that there's no solution for the common cold, so he doesn't want to negate the possibility that herbs can be effective. But as he and his wife were told while recently seeing the doctor at Duke University Medical Center, science knows only relatively little about the mysteries of the human body.

Airborne Health Inc. has paid $7 million to settle multiple lawsuits in 32 states and the District of Columbia over alleged false product claims. Airborne makes a nasal spray used by travelers that is said to prevent viruses and bacteria from entering the body.

Clark's advice? Treat any claims about alternative medicines with a grain of salt. It's common for companies to make unverifiable claims about their products because they're not subject to FDA scrutiny.

Traditional chain drugstores devote a lot of shelf space to herbal remedies. But it's not because they're necessarily known to be effective; it's because they're capitalists and they want to make money on popular products.

So you've got to be your own cop on the beat. Remember, the first rule of medicine is "Do no harm." Be careful out there!

Certain pharmacies in New England are now using robots to fill prescriptions!

The Boston Globe reports that 1.5 million people are harmed every year by getting the wrong prescription. Think about it: Handwritten scripts can easily be misread by the pharmacist, and pharmacists themselves are overworked and may inadvertently make an error when filling a script.

Automated machines, however, eliminate the chance of human error. They can be programmed to dispense up to 200 of the most commonly filled scripts, according to the article, at a rate of 134 scripts/hour. That's more than 2 scripts a minute, and it frees up pharmacists to do more face-to-face consultations with their customers.

A new report from the American Heart Association suggests that obese and overweight children can have the arteries of a middle-aged person. That in turn can put them in danger of having heart disease or a stroke in their 20s!

There are many reasons why children are packing on the pounds. For one, the calorie count is way up for kids. But it's not just fast food that's to blame. When Clark gets a Happy Meal for his son, it comes with the option of apple slices instead of fries. Many restaurants are likewise offering healthy choices.

There's also the issue of lack of exercise. Kids used to just play all the time outside, but today it seems like they're being carted around from one structured activity to the next. It's our responsibility as parents to see that our kids are active. Clark often brings his children to a soccer field to play -- even though he's not very good at the game.

Meanwhile, in a separate health-related development, Phillips has come up with an intelligent pill. The so-called "iPill" contains a microprocessor in it that can release medication at a specific spot in the GI tract. The goal is to eliminate the "chemo phenomenon," where you make a person's whole body sick just to target illness in one part of the body.

The iPill contains a wireless transmitter that senses acidity and body temperature to determine where to pinpoint the medication. Some of its expected uses will be for colon cancer treatment and GI tract disorders -- if Phillips can convince the pharmaceutical companies to buy into the technology.

The San Francisco Chronicle has a simple English explanation of the iPill. The real shocker so far is that the cost is $1,000 per pill. Once it's in mass production, however, that price would come down to about $10 per pill. Talk about the economy of scale!

The trend of employers opening up medical offices on-site for their employees isn't exactly new. After all, Clark recalls working for IBM in the '70s and visiting an in-house doctor. But The Wall Street Journal now reports that companies like Toyota, Walt Disney and Intel have opened full-service doctor's offices with a large range of medical equipment at their locations.

This can save the employer a fortune. Illnesses can be caught early, making for less absenteeism, and employees don't have to take time away from the job to run out for medical treatment.

Clark vividly recalls his encounter with the doctor at IBM even after all these years. As soon as he walked in, the doctor remarked, "So, I hear you like double cheeseburgers." The penny-pincher's reputation as a lover of fast food obviously preceded him. Later, the doctor drew a picture of 2 double cheeseburgers and crossed one out -- in an effort to convince Clark he had to stop eating fast food. Did he listen? No way!

Have you ever had an MRI, CAT scan or other radiological test? The use of such tests has surged by 50% in the last 5 years. They're potentially life-saving tests. But they're also over-prescribed by doctors who are afraid of being hit with a malpractice suit for not running the tests. This is also known as "defensive medicine."

To complicate matters, the big insurers are now using RBMs -- radiology benefits managers -- to assess whether they want to cover the procedures or not. A Wall Street Journal reporter found case after case where an insurer would pre-certify a radiological test and then, after the fact, turn around and deny payment based on the recommendation of their RBMs.

So what can you do? Before you proceed with any radiological test, get approval in writing -- even if pre-authorization isn't necessary. Don't settle for approval over the phone; you must get it in writing.

If you've already had a test done, and you're getting a referral to another doctor who is suggesting another test, take your films with you instead of undergoing a duplicate test.

So often, it takes an outside force to generate change. Take the business of medicine in the United States, for example. It's been stagnant for too long, and it doesn't really work for patients or doctors.

But a new change is being driven by nurse practitioners. They're the ones who brought us "nurse-in-a-box" practices that are open 7 days a week with extended hours for basic medical care. That means shorter wait periods. You'll typically find these practices in big box retailers, drug stores and supermarkets.

The nurse-in-a-box practices are upfront about their pricing, with brochures or charts that detail every service along with the actual price -- much like a menu at a restaurant. In addition, they keep records electronically. Clark laughs whenever he's at a traditional doctor's office and has to fill out a piece of paper on a clipboard. Come on, people, this is 2008!

This is a great example of medicine responding to the free market -- though it's not a knock on doctors. You have to realize that our system is set up with medical school being so expensive that young doctors can't afford to go into general practice. So the nurse practitioners serve a very valuable function.

However, there is one major problem with the nurse-in-a-box practices. There's no continuity of care. They won't know your medical history like a primary care doctor would.

The Kansas City Star reports that primary care doctors are feeling the loss of revenue from nurse-in-a-box practices and making some adjustments. They're offering better access, including evening and weekend hours. One practice saw a big increase in both patients and profits as a result of the changes, according to the paper.

Clark is beyond angry about the FDA's actions regarding children's cold remedies. Here's the scoop: For years, the drug companies have been making big bank selling children's versions of their OTC cold and flu remedies for adults. The industry has been allowed to set its own labeling standards for the safe age to give children such medications.

6 years of age is the scientifically accepted demarcation age when it's safe to give a child an OTC cold or flu remedy. But the industry got labeling that suggests it's safe to dispense the medication when a child is 4. That's a complete lie, and it remains unsupported by any science to Clark's knowledge.

Prior to age 6, the only thing you should be giving your child for cold or flu symptoms is ibuprofen or acetaminophen -- unless, of course, you hear differently from your pediatrician or nurse practitioner. Do not allow the FDA's false labeling to sway you. They were bought by dirty money on this one.

Clark's love of Zenni Optical -- the ultra-cheap online retailer of glasses -- recently caused a little marital discord between the penny-pincher and his wife.

When the couple's 9-year-old daughter Stephanie needed glasses, his wife Lane wanted to go to Costco. Clark nearly had a coronary as he looked at the frames Stephi liked -- they were $80! He quickly suggested Zenni, prompting Lane to blow her top and tell him not to be so cheap. (Editor's note: That's the clean version of her diatribe!)

So they reached a compromise: Stephi got the Costco frames, but also got a spare pair from Zenni for $19. It turns out that she likes the Zenni frames better than the Costco ones!

Listeners, however, haven't always embraced Zenni. The company grinds their glasses in communist China, starting at $8/pair with shipping costs of $4.95. Some listeners have been particularly upset that there's been no service after the sale. Zenni is all about the price -- not the customer service.

In 2002, Clark slipped a disc in his back and needed invasive surgery that involved being cut open, a lengthy recovery period and a huge scar. But that kind of thing may be going the way of the dodo.

You've heard of less invasive surgeries of the arthroscopic and lathroscopic varieties, right? Well, doctors are now working on going in down your throat and using robotic equipment to take out your gall bladder, appendix or what have you through your mouth. This new technique is done under general anesthesia. Doctors can also go in (and out) through other body openings to do other procedures.

The Washington Post reports that so far there have been no major complications with this new technique. There's no more need for scarring and cutting. Surgery that was previously an in-patient procedure -- necessitating many days of hospital recovery -- can now be done as an out-patient service. But Clark sure doesn't want to be a guinea pig when it comes to this kind of stuff!

CLARKONOMICS: Both the National Association of Insurance Commissioners and IMS Health have reports out that suggest Americans are not filling prescriptions and not going to the doctor because they're financially stretched. When it comes to a choice between filling a prescription and filling up the gas tank, people are opting for the latter.

Medicine is going through a messy transition. Employer-provided healthcare can cost your employer a fortune. Many smaller businesses have discontinued it, while larger businesses have shifted more of the premium cost to the consumer.

So what can you do? Wal-Mart and other retailers have $4 prescriptions for a variety of generic drugs. Print out the list and take it with you to your doctor so he or she can try to write you an affordable script.

Also, you can try using a nurse-in-a-box as an alternative to a standard office visit. You'll find these "mini-offices" staffed by nurse practitioners at supermarkets, drug stores, discounters, etc. Their prices point tends to be around $59 for a visit.

Clark is a big fan of consumer-driven medical care. But consumer-driven medical care does not mean ignoring your health because you can't afford it.

Back in the '90s, Clark first talked about breakthrough laser technology being developed for the dentistry field. He went for a cleaning shortly after and discovered his dentist was very upset with him. Several other customers heard Clark on the air and were already asking about the laser! It turns out the technology is very expensive, but it eliminates most of the discomfort for common dental procedures.

USA Today now reports that less than 10% of dentists use laser technology. Yet if people become aware of the laser, they'll ask for it and dentists may comply just to seize market share. Dentists also would be able to charge more for laser services.

Clark has an old filling that he needs replaced. Why should he go the Novocain route when he can have the laser instead? There's even a special laser for root canals that reduces discomfort and the time you're in the chair by 30 minutes.

Laser could be a very promising option for people who take care of their teeth. But 1 out of 3 people don't get dental care in the United States. We're a developed country, yet we have people with rotting teeth! Clark thinks one possible solution would be to allow dental techs to do a special 2-year program that certifies them for basic dental procedures. Such a plan has already been enacted in Alaska.

Clark recently discussed how he was furious over kangaroo court arbitrations in the corporate world. Many banks force customers into these joke arbitrations that are worthy of a banana republic. Of course, the financial institutions routinely select arbitrators that rule in their favor.

Days after his initial comments, The Wall Street Journal did a story about nursing homes that harm or kill people through negligence. Surviving family members have no recourse because they signed mandatory arbitration clauses when they were admitting their loved ones. It's getting to the point that nursing homes have no incentive to not kill people; there's nothing families can do after the fact.

The Wall Street Journal is not exactly a bleeding heart liberal publication, but they're very angry over this. So what can you do to protect yourself before you put a loved one in a nursing home? They suggest you carefully vet the admission contract and see if you can opt out of the mandatory arbitration clause. If you can't avoid it, try writing the following next to the clause: "I'm signing this because I was told that I have to." That creates the possibility that you can potentially get out of mandatory arbitration in the event your loved one is harmed or killed while in their care. The thing with the banks was bad enough, but it's a whole different story if they kill your mama.

Last year, Clark told you that nursing homes were using multiple holding companies behind the scenes to limit their liability. There are a lot of things going on in this industry that are unacceptable in a decent society, according to Clark. Interestingly, the demand for beds in nursing homes has been far lower than what demographers anticipated. That's because more families are choosing in-home care options for their elders. You need to feel confident about who's caring for your senior loved ones.

Doctors are being squeezed between what they're paid from insurers and what they're paid from Medicare/Medicaid. The reality is that doctors often make no money or even lose money when they see you. So they're shifting their practices to reflect the free market.

For example, take the field of dermatology. If you have a suspicious mole, you may wait months for an appointment if you're an insurance customer. But if you're willing to pay cash for cosmetic dermatology, you can usually be seen in 24-48 hours.

The New York Times reports that dermatologists and laser-eye surgeons are even building separate waiting rooms for cash customers. They're rolling out the red carpet with fancy furniture, free lattes and more. Contrast that with the ratty furniture and long-expired magazines that fill traditional waiting rooms for insured customers.

The doctors are not bad guys; they're simply business people. You can't blame them for wanting to put food on the table. It's the current health insurance system that deserves your ire.

The latest stats from the Center for Disease Control show emergency rooms visits are up. Some 120 million of us visited the ER in 2006 -- the last year for which records are available.

Historically, the ER has been for uninsured people. But today, a very large numbers of insured individuals are making the trek -- even for non-emergency conditions in the middle of the day.

What's going on? Well, many people no longer have primary care doctors. So they just go to the hospital. Not a good idea. The wait is very long and you have to be assessed in triage; there's no "first come, first serve" service. The visits are also massively expensive even with insurance.

If you do have insurance, you'd be better off taking the time to pick a primary care doctor. This also allows for continuity of care and easy follow-up visits.

But most people won't get around to selecting a primary care doc. That's why there are alternatives like "nurse-in-a-boxes," which can be found at supermarkets, drug stores, Wal-Marts, etc. Nurse-in-a-boxes usually have a price list so you know how much you'll pay to be seen by a nurse practitioner.

Another alternative comes in the form of Doctor of Nursing Practice programs being offered at some 200 schools. These doctoral-level programs require nurses to take the same qualifying exam as a doctor. Clark loves that the marketplace is developing an answer to the primary care crunch.

There is a scandal that's broken in a very unlikely place -- the Journal of the American Medical Association. Some doctors have been selling their names to be fake front people on articles running in medical journals. Merck ran 72 different fake medical review articles touting Vioxx, with endorsements from respected physicians. The doctors got $2,500 to sell their souls. It was never disclosed that they were paid for the use of their names. This is a true scandal because Vioxx actually harmed people. It amazes Clark that doctors allowed their reputations to be sullied for a relative pittance. So when you see an ad on TV for a hot new drug, you have to realize that it's just propaganda. Many times a generic or over-the-counter drug would work just as well.

In another disturbing trend, some medications are so expensive that they're being classified as Tier 4 drugs by the insurance companies. The new classification has priced low-income Medicare patients out of the market. The real tragedy is that T4 pricing has been applied to medications for chronic conditions like cancer. Clark wonders about the ethics behind the decision to reclassify a drug as T4.

Since the '90s, Clark has been talking about medical tourism as an option for non-emergency and cosmetic surgery. Americans can go overseas for a procedure and pay 20 cents on the dollar (or less) to be treated by Western-trained staff and a private nurse in modern facilities.

US News & World Report recently ran a cover story on the medical tourism trend. Shortly after that, The Wall Street Journal retorted by saying the trend is overhyped and nobody's doing it.

For once, Clark has to disagree with his "girlfriend." The reality is that many Americans lack adequate insurance coverage and/or have huge co-pays, so going overseas is a viable alternative.

While there are some inconveniences in going far away for care, the cost differences can be ginormous. (That's a technical term!) For example, a hip replacement that may run you $60K here might be between $12K and $15K overseas.

If you are considering medical tourism, how can you be sure an overseas facility is any good? Check with the Joint Commission International to see who's accredited.

Yes, medical tourism is controversial, but people need care and some can't afford it under our system. Two providers in Southern California -- Health Net and Blue Shield -- have provisions for treatment in Mexico that can save 40 percent on insurance premiums. Meanwhile, dental care in Costa Rica can be one-fifth the cost we pay here.

When you have a medical procedure, a bill is generated, the insurer pays a negotiated amount and you have your co-pay. That should be the end of the story. But right now there's a fight in California about who gets stuck with the tab. Doctors and hospitals are furious that they bill one amount, yet the insurers come back saying they'll only pay a fraction of it.

In the push and pull, the weakest player here is the consumer. The doctors and hospitals are trying to pass unpaid costs off to the patient through a practice known as "balance billing." Clark has no idea how this fight will go in the Golden State, but he'll keep you updated.

The real solution here would be for customers to know the cost of medical care before a procedure and shop accordingly. But we're nowhere near this being the case.

The Society of Actuaries finds that paying for healthcare is the No. 1 concern of workers, cited by 70% of people. Right now there's a stalemate with employers, medical providers and consumers all hating the system. The only ones who like the system are the insurers.

The problem is we don't have a marketplace where insurers are required to practice normal capitalism. Clark has long been an advocate of vouchers for healthcare. Insurers would then have to compete for everyone's business and there wouldn't be exclusions for pre-existing conditions. This is not a justification for universal healthcare; it's just a call for healthcare vouchers.

Healthcare is a hot button issue for voters in '08. But both parties are stuck in a prior decade with their views. We need to move into the future and vouchers might be one way to get the job done.

Nationally syndicated columnist David Lazarus is among the people upset about the marketing of prescription drugs on TV. Clark gets a kick out of those highly produced commercials where you see a vibrant young woman or man who explains how they were falling apart until they took that magic pill being advertised. These kinds of commercials always end with an upbeat announcer telling you about the dangerous side effects of the drug.

Doctors are put in a very difficult spot when patients come in with self-diagnoses and request a drug they've seen on TV. Unfortunately, doctors can only spend about 4-6 minutes with each patient because of managed care. That means it's difficult for them to explain at length why another medication might be better. If they try, they sometimes wind up making the patient angry because they're giving pushback. But seeing a 60-second commercial doesn't give you a medical degree like a real doctor.

Commercial speech -- like the kind in pharmaceutical TV commercials -- has a lower standard of protection than other speech under our Constitution. So Clark thinks it's not unreasonable to require that medications shouldn't be advertised until after they've been in the marketplace for 5 years and we have a clear understanding of the side-effects. That would prevent the slew of litigation that sometimes follows when a drug harms people after being prematurely rushed to market.

We often hear about how people are uninsured, but we don't hear about how they're underinsured. A lot of people have coverage, but it may only be minimal for some procedures. Figuring out what's covered and what's not is like reading hieroglyphics.

Smart Money magazine reports that consumers can really benefit by negotiating upfront for non-emergency care. The classic example of this is an uninsured pregnancy. The list price can be as much as 900% above what an insurance company can negotiate. The key is to negotiate beforehand; after the fact, you'll have no recourse.

Consumers need to know that the price difference from hospital to hospital is all over the map. So Clark's advice is negotiate, negotiate, negotiate. About two-thirds of people who haggle do get a lower price.

Whenever Clark gives this advice, medical professionals get hot under the collar. They often allege that he's turning medicine into Wal-Mart. But they need to understand that medicine is the only thing we buy that we don't know the cost of until after consumption. Doctors also need to know that a customer with a cash payment represents more money in their pocket than a negotiated insurance claim.

Clark recalls that before the "dot bomb" era, there were a lot of websites offering Internet price shopping and bidding services for medical care. They all went bust in the tech crash, but their time is coming again as consumers take on a larger portion of health costs. Having the ability to shop based on price makes perfect sense to Clark.

As Clark's mom has aged, she's been struggling with diminished hearing ability. But this problem is not just limited to seniors. The younger iPod generation will probably suffer premature hearing loss because the device's in-ear buds really tax your hearing. In many countries, there's a volume limiter on the iPod and its competitors. Not so in the United States. When Clark is at the gym, two-thirds of the people there have iPods or iPod Shuffles. They play them so loud that he can make out the song the guy on the next machine is listening to while exercising!

Many young and old people alike are very self-conscious about wearing hearing aids. So there's been a lot of time and money spent by companies trying to develop invisible hearing devices that are comfortable to wear. Clark recently found out about a hearing device called the Lyric that is implanted into the ear canal. The device works for months at a time and then has to be replaced. Installation must be done by a professional, and they actually use a powerful magnet to pop the Lyric out and change it; you can't take it out yourself. So far the Lyric is only available at stores in California, New Jersey and Florida, though it's not a cheap option. You pay an annual subscription fee of $2,500. But if that money means someone who hasn't been able to hear well can hear again, isn't that worth it?

There is a scandal that's broken in a very unlikely place -- the Journal of the American Medical Association. Some doctors have been selling their names to be fake front people on articles running in medical journals. Merck ran 72 different fake medical review articles touting Vioxx, with endorsements from respected physicians. The doctors got $2,500 to sell their souls. It was never disclosed that they were paid for the use of their names. This is a true scandal because Vioxx actually harmed people. It amazes Clark that doctors allowed their reputations to be sullied for a relative pittance. So when you see an ad on TV for a hot new drug, you have to realize that it's just propaganda. Many times a generic or over-the-counter drug would work just as well.

In another disturbing trend, some medications are so expensive that they're being classified as Tier 4 drugs by the insurance companies. The new classification has priced low-income Medicare patients out of the market. The real tragedy is that T4 pricing has been applied to medications for chronic conditions like cancer. Clark wonders about the ethics behind the decision to reclassify a drug as T4. Be sure to let him know what you think by voting in the latest poll.

Should you list your Social Security number on a medical form? Clark does not. Medical record numbers have replaced Social Security number on insurance cards in an effort to stop ID theft. Why would you open yourself up to it again?

A Wall Street Journal reporter recently found that some hospitals now require Social Security numbers at registration. The facilities then quietly run your credit using an outside source that gives a proprietary rating to gauge your likelihood to pay for service. Some hospitals are even turning away urgent but non-emergency patients deemed to be credit risks. Unfortunately, many hospitals doing this are non-profit facilities that have a duty and mission to provide care to those who can't pay. So they get non-profit status, but they ignore their core values.

Your credit can help or hurt you in so many ways. Think about this: Clark recently froze his credit. Does that mean he might be temporarily denied service until his records can be thawed?

Economics have forced medical students to abandon primary care. The costs of medical school and the current health insurance system mean that everyone wants to be a specialist. Clark believes that nurse practitioners and physician assistants are the answer to the shortage of primary care doctors -- and the looming shortage of pediatricians. Clark recently read in the Personal Journal about a new program called Doctor of Nursing Practice that's being offered at 200 schools. This doctoral-level program requires nurses to take the same qualifying exam as a doctor. Clark loves that the marketplace is developing an answer to the primary care crunch.

There's often a gatekeeper at your doctor's office that won't let you talk to the doctor. They'll make an appointment for you, but they won't let you speak directly to him or her over the phone. After all, doctors don't get paid to just talk, right? Well, now Aetna and Cigna are reimbursing doctors for online virtual visits. You can chat directly with your doctor over the Internet. This creates a market incentive and saves the insurers a ton of money. The fees they disburse for online appointments are less than they'd pay out for an actual visit. Meanwhile, the CDC reports that visits to the doctor are up 20% over the last 5 years. With fewer general practitioners than ever, that's a train-wreck waiting to happen. Clark has long advocated for nurse-in-a-box practices to alleviate the crunch.

The Los Angeles Times recently published a list of the 10 top issues that doctors are most asked about during Internet visits. Not as much fun as a Letterman list, but here goes: No. 1 medications; No.2 sinus problems; No. 3 back problems; No. 4 colds and flu; No. 5 test results; No. 6 coughs; No. 7 follow-up on surgery or another procedure; No. 8 headaches; No. 9 fevers; and No. 10 asthma.

Clark has been a longtime advocate of nurse-in-a-box practices, but they're not doing well financially. Several have actually had to close their doors. The idea is still being germinated and needs time to be perfected. Walgreen's and CVS don't care if these in-store practices are lucrative or not; they just like that people are more likely to fill prescriptions inside their stores when there's a nurse practitioner present. Now Wal-Mart is starting a new initiative that has doctors upset because they're aligning with medical centers around the country for new nurse-in-a-box practices. The Wal-Mart facilities will refer patients out to the medical centers if someone is too ill to be seen in-store. Wal-Mart is also partnering with one urgent care chain owned by AOL's Steve Case in a couple hundred markets.

The nurse-in-a-box trend provides an advantage to the American people that's not being discussed: More than half of the clients are uninsured. That means your neighborhood nurse-in-a-box helps de-clutter the emergency room at your local hospital, allowing people with real medical emergencies to be seen faster. This pressure valve release is all to the good, according to Clark. He knows doctors will be alarmist about somebody dying at a nurse-in-a-box. But medicine involves educated hunches -- it is part art, part science. It's just as ridiculous to expect perfection from doctors as it is to expect it from a nurse practitioner. One out of every 6 dollars goes to medical care in our economy. That's by far the highest in the world. Nurse-in-a-boxes will not be the solution to what ails healthcare, but they will relieve some of the pressure on the system.

Recently there was a story that got huge media coverage about the long waits in hospital emergency rooms. Those in dire or critical condition endure waits that are up 40 percent over the last 7 years. The wait time for heart attack victims is up 300 percent! It's as if the emergency rooms have had a nervous breakdown because they're a catch-all for the uninsured, the urgent care patients and those who have been critically injured in accidents. Triage nurses have to see everyone, play traffic cop and hope they don't make a fatal error.

Clark recalls taking his wife to an emergency room once. The triage nurse seemed to hate her job and had no eye contact with Clark or his wife while she was taking vitals. Suddenly, she hit the code blue button and people swarmed in, put Clark's wife on a gurney and rushed her down the hall. That was a situation where triage actually worked. But it's not working in a lot of instances. Nurse-in-a-box clinics can help alleviate the emergency room crunch. Clark's 2-year-old son was sick this past weekend. On Saturday, he took him to a nurse-in-a-box practice and for $59 he was seen, evaluated, treated and they were on their way. The nurse practitioner wanted to see him again the next day because it couldn't wait until Monday when Clark's regular pediatrician was in. The follow-up was free! Not every nurse-in-a-box has free follow-ups, but this one did to encourage continuity of care. Clark's executive producer Christa originally turned him on to this specific nurse-in-a-box practice. She's been there about 8-10 times with her 2 children.

Doctors have been upset with Clark for advocating nurse-in-a-box practices. But so far medicine has failed to come up with an alternative to see people on an urgent, non-emergency basis. So this is what the marketplace has devised. If doctors are upset, they need to find a way to encourage more of their ranks to go into primary care to alleviate the crunch. Primary care docs are the unsung heroes of medicine. They make far less than if they're specialists and have far higher patient loads. Clark thinks we need a nurse-in-a-box in every hospital (like in the TV drama Grey's Anatomy) where triage can funnel people who are not truly emergencies.

Since the late 1980s, Clark has thought it's crazy that medications can only be dispensed when a doctor writes a prescription. Many other countries have their pharmacists write scripts and dispense the medication. The FDA is now considering adopting a similar policy. We're not talking highly addictive things like Vicodin or Oxycontin here; we're talking about two-week cycles of antibiotics and other relatively benign medications. Clark loves this idea. Doctors are already overworked and in short supply. Because pharmacists are very well-trained and knowledgeable about medications, it's almost a no-brainer to allow them to pick up some of the slack. The Los Angeles Times reports that Kaiser Permanente pharmacists already have the authority to write and fill their own scripts.

Pharmacists are a vastly underutilized resource. To treat them like clericals who just fill prescriptions isn't Clark Smart. The numbers of primary care doctors are down 50 percent, so empowering pharmacists to write prescriptions is one possible solution to the shortage. Clark knows doctors will be up in arms about his feelings on this issue, so he's ready for the fallout on the Clark Stinks forum! On a related noted, Minnesota has banned pharmaceutical sales reps from giving free gifts and meals to doctors. These kinds of sales practices subtly influence the brand choices doctors make when they write prescriptions. Now The New York Times reports that the pharmaceutical companies have come up with yet another tactic to influence the selection of scripts; they're wooing nurses and office managers since they can't get to the doctors anymore!

Navigating the healthcare maze can be an exhausting process if you or your family members are sick. Employers are starting to understand this and make healthcare advocates available to their employees as a free benefit. Healthcare advocates are usually former medical professionals who help people get what they need from the medical system. Right now about 3,000 employers offer healthcare advocate access. But very few workers even know they're entitled to such a benefit. Clark thinks of the healthcare advocacy phenomenon like he does expeditors. When you live in a city, sometimes you can hire an expeditor who knows the right people to contact to expedite any request. In the same way, healthcare advocates can assist you in getting to doctors and certain facilities that you might not be able to get into on your own. Of course, it goes without saying that healthcare should not be this difficult. Yet that's the reality. Healthcare spending accounts for 1 in every 6 dollars in our economy and it's not slowing down anytime soon.

When Clark goes to Europe, he often gets dragged into museums to look at paintings. Much of the Renaissance art he sees depicts people who are slightly chunky because that was the sign of health and wealth at that point in history. It turns out that people from that era may have been on to something. Today our culture believes that being a stick figure is healthy and having some meat on your bones means that you're unhealthy. But the latest health findings from the Centers for Disease Control show that being slightly overweight when you're under 30 doesn't raise your risk of cancer and heart disease. In fact, it can even lessen your risk of death from some illnesses. The findings of the study were revealed in the Journal of the American Medical Association. Bear in mind that some scientists think these findings are faulty, so this not a green light for you to get a little chunky. Take any health advice with a grain of salt—or salt substitute because everyone's so sodium conscious these days!

Clark has to go to the doctor for a second opinion on a medical condition. When he made the appointment, he was told he'd have to bring a copy of his test results from his other doctor or have them faxed. Isn't it bonkers that in 2007 were still passing medical records around like it's the 19th century? We waste so much labor and time in the United States with how we process medical information. Clark previously talked about Revolution Health, a company that's been trying to update the process. Now Microsoft is spending a lot of money to bring medical record handling into the 21st century. Why is it that with all of our modern equipment we're still doing things by hand? There's no reason why Clark can't have a test and leave the doctor's office with an e-version of his results or password-protected results. The problem is that there's no financial incentive for doctors to modernize the way they process medical records. The insurance companies don't give them extra money for having e-files for all their patients. So Microsoft is also trying to come up with a system that would save doctors money. We'll keep you updated on their progress.

Not very long ago, Clark mentioned that people from the United States are now going to Mexico for dental care. That discussion sparked some unfriendly response. Now London's Financial Times has done a report about the medical tourism trend. People are going overseas to Thailand and India to save money on surgeries. The number of Americans going overseas is rising 20 percent per year, according to the report. The savings can be extraordinary -- up to 75 percent. The big question is, "What kind of care will you get overseas?" While the quality does vary, many third-world countries have first-rate hospitals that cater to foreigners. The Financial Times reports that Singapore is the best place to go for overseas medical care that is roughly equal to American care. You'll still save substantial amounts there -- up to 50 percent off -- and have a private nurse for 24 hours a day. While Clark admits that he is a medical idiot, he does believe that if you are grappling with the cost issue alone you should consider this option. There are now medical tourism businesses that handle accommodations, finding doctors and all the other logistics of getting care abroad.

More and more baby boomers are experiencing premature hearing loss from exposure to loud sounds. The unfortunate thing is that many of them may be freaked out by hearing aids and are not willing to use them. Clark knows someone who's slightly younger than himself who has enjoyed loud music all her life. Finally it got to the point that she couldn't hear conversation clearly. When she finally decided to get a hearing aid, it dramatically improved her life.

There are many kinds of hearing aids and many different price ranges from really inexpensive to several thousand dollars per ear! Clark has earned the ire of a lot of professional audiologists who hate him for telling people to go to hunting shops and buy devices for hunters that are essentially hearing aids. You'll pay a few hundred dollars -- a fraction of the cost you'd pay to get one from an audiologist. The audiologists complain that someone could mask a problem that may need serious medical treatment by getting such a hearing aid. So there's a definite caveat to Clark's advice. He once got one of his relatives a cheap hunter's hearing aid. His relative was as unhappy with the cheap one as she was with the one that cost thousands of dollars. There's obviously no magic bullet here. Clark remembers the days when there used to be a disposable hearing aid device called the SongBird that retailed for $49. Unfortunately it's no longer on the market. But if you travel overseas you'll find that hearing aids aren't regulated by the government. So that you means you can go to a drug store and buy one over the counter for a fraction of the cost you'd pay in the United States.

The healthcare question is a big one among presidential candidates. There's no one right answer to this question, but Clark knows that he doesn't like the idea of government-provided healthcare. If you ask the Europeans or Canadians who have government-sponsored health benefits they'll tell you they love it -- until they get sick and run into all the hassles associated with it. In our own way, we've moved closer to a parallel system. A recent report about the dermatology industry found that patients who want Botox -- which is not covered under insurance -- are seen much quicker than people who have a mole that may be cancerous. Why does this happen? Because the doctor's expenses to see the patient with the mole will barely be covered by an insurance company -- and the doctor's office will have to fight tooth and nail for whatever money the doc gets. But people coming in for Botox pay cash upfront. So the free market kicks in and the doctors treat those patients who will reward them the most financially. Now there's a trend among doctors who offer Botox, Lasik and other cash-only, uninsurable services to offer "no no no" plans: no payment, no interest and no down payment.

The cost of prescriptions has been in the news a lot lately. Regional supermarket chain Publix is now giving away select generic antibiotics to drum up business for its in-store pharmacies. Clark recently had a funny prescription story related to his ongoing sinus infection. The doctor first put him on a generic antibiotic that cost $8 for 20 pills. But when the infection didn't go away, the doctor wrote a new prescription that cost more than $120 for 10 pills at a warehouse club -- and he's still not cured! Meanwhile, his 8-year-old daughter needed a liquid prescription that ran $225. Clark jokes that he had it filled and then didn't eat for four days! The best advice here is to ask your pharmacist what your prescription is going to cost before you buy it. If it's too expensive, call your doctor's office and see if they can write a prescription for an alternate drug that's more affordable.

Clark recently read that 60 percent of all prescriptions being filled are generic now. The New York Times reported that a number of brand name drugs are going generic in the next two years, which is throwing BigPharma into a tailspin. One company is laying off 5,000 people because a blockbuster brand name drug is set to go generic. The consumer is set to save a bundle when this trend heats up. Discount stores have already been getting into the action with Kmart doing a three-month supply of some medicines for $15, and Wal Mart doing its own $4 deal. Other consumer-driven shifts in the medical field can be seen in new websites that let you rate a doctor online. Forbes reports that RateMDs.com is one of the most popular. Some doctors who have bad bedside manner are getting their feelings hurt because patients are acting as consumers and rating them. Clark loves that patients are seizing the power to rate their medical providers, and he thinks it's especially important to vet your doctor when you get a referral to a specialist.

Have you heard about American retirees moving to Mexico, Costa Rica, Guatemala and Panama because their social security checks go so much further abroad? This is a trend among healthy seniors, but now families who can't afford to pay for senior nursing care are taking a cue and outsourcing their elderly parents! Clark wants to clearly state that he's not endorsing this practice; he only wants to bring awareness to it. India is one of the hot spots for this new trend. The Chicago Tribune recently ran a story about Indian nursing homes that are built to Western standards. The article profiled a man that sent his parents -- an 89-year-old mom with advanced Parkinson's and a 93-year-old dad with Alzheimer's -- to India. The cost is about $15 per day -- a tremendous savings over the facilities we have here. For that price, the mom gets massages, physical therapy and 24-hour staffing for any need, while the dad has a fulltime personal assistant and a cook. Their cost of living is so inexpensive that it only eats up two-thirds of their social security checks. Compare that to nursing home fees in metro Chicago, where the cheapest one is $6,600 per month. Again, Clark is not recommending that you ship your parents off to India when they can't care for themselves. He's just noticing that so much has changed these days with medical tourism, seniors living abroad, etc. The real disadvantage is that you can't visit your parents too often because the cost of flying to see them is prohibitive.

About two years ago, Clark first started talking about clinics where you can go to see a medical professional without an appointment. Big retail chains like Wal-Mart and Target sometimes have such places on premises. What you usually do is speak with a nurse practitioner, not an actual doctor. But they're affordable and a good choice if you have a very routine medical concern. The drugstores chains have also jumped on the idea of these in-store clinics because they help create an instant market for their own pharmacy counters. The latest development now is that Wal-Mart has announced plans to establish 2,000 of these "doc-in-a-box" practices in its stores.

Clark loves the idea of having a one-stop shop option in the medical field. Up until now, the medical profession has been very slow to embrace change in the marketplace. That's why the healthcare experience for the average American includes going to the doctor's office across town, getting a handwritten prescription and then running all the way back across town to the pharmacy just to wait to have it filled. That's a very inefficient process that's not customer friendly. This new wave of in-store clinics promises to help shake up the medical field. And because they take up very little real estate in a retail store, Clark believes they're the wave of the future. Whether it's a good or bad future remains to be seen; at the very least, the clinics will help alleviate the crunch in hospital emergency rooms.

Not very long ago, Clark mentioned that people from the United States are now going to Mexico for dental care. That discussion sparked some unfriendly response. Now London's Financial Times has done a report about the medical tourism trend. People are going overseas to Thailand and India to save money on surgeries. The number of Americans going overseas is rising 20 percent per year, according to the report. The savings can be extraordinary -- up to 75 percent. The big question is, "What kind of care will you get overseas?" While the quality does vary, many third-world countries have first-rate hospitals that cater to foreigners. The Financial Times reports that Singapore is the best place to go for overseas medical care that is roughly equal to American care. You'll still save substantial amounts there -- up to 50 percent off -- and have a private nurse for 24 hours a day. While Clark admits that he is a medical idiot, he does believe that if you are grappling with the cost issue alone you should consider this option. There are now medical tourism businesses that handle accommodations, finding doctors and all the other logistics of getting care abroad. Be sure to vote in our new poll when you visit our homepage and tell us what you think about this emerging trend!

Medical care is now taking a turn and becoming more market oriented. Some Pennsylvania hospitals are starting to guarantee surgeries in their hospitals. That means that the hospital pays for further problems after surgeries. Mystery shopping services are also springing up that rate the care received at hospitals. They are rated just like any other retail business. People under 30 overwhelmingly want monopoly government health care because of the hardships they have had to endure in the medical industry today. Clark thinks that this is hard to stomach though and that the private system works best. Frustration with medical care, especially with health insurance. The state of Massachusetts actually requires individuals to have health care. If you want a more dysfunctional system, let the government run it.

One hospital system is now beginning to guarantee their work for 90 days. This is amazing that in medicine some are now beginning to stand behind what they do. Why hasn’t this been done until now you may ask? Well, medicine has always been considered different from other industries that must focus on customer satisfaction. Having warranties with a surgery is something we shouldn’t be surprised of, we should be surprised if they are not offering it. This kind of creative thinking in the medical industry could revolutionize it.

Do you remember when doctors used to make house calls? There is one California organization that is reverting back to the old house call system. They are saving money doing it too! The one size fits all plans just don’t work and are wasting an awful amount of taxpayer money. These creative, outside of the box ideas are the types of things that are going to change our outdated health system. It is very similar to our school system that is a one size fits all mold. One system doesn’t work equally for all.

Clark is a big fan of the “minute clinics” that are popping up in grocery stores and department stores. They provide quick, efficient service and they cost less than a visit to an actual doctor’s office. There is a shortage of primary care doctors these days, in part because they’ve been crushed financially by insurance companies. In fact, in the beach area where Clark has a vacation home, pediatricians have refused to take on any new patients. More often, doctors are going into specialties because it’s the only way they can make real money. So, we’re headed for a time when the point of contact is going to be a nurse or nurse practitioner. Speaking of, Harris did a survey of the “nurse-in-a-box” clinics, and 90 percent of people are happy with the care. Some people worry about the quality of care from a nurse. But people who’ve actually seen a nurse at one of the clinics are overwhelmingly happy with the care.

About 50 million Americans are without healthcare and many of those who do pay exorbitant fees for mediocre care. In part, that’s because employers have been providing health care to employees. Companies get a huge tax break if they do this, but there is no incentive to watch what is spent or to encourage personal responsibility on the part of employees. It’s the typical thought: I don’t care how much it costs because I’m not paying. But as a country we are. That’s why Clark is thrilled that President Bush will address health care in his State of the Union address tonight. We are headed toward socialized medicine and it needs to stop for the well being of the country. Clark would like to see people buying their own health care policies, much like they do with their cars and homes. Then we’d be more careful about what we spend. Employers and government need to stay out of it.

This time of year, people choose whether to contribute to their 401k plans and pick what kind of health plan in which to enroll. With all those choices, how do you know which plan to pick? One annual report known as The Health Competence Survey found that more than half of people are in shell shock over the cost of coverage next year. People are seeing such large increases in health care costs that they are going to reduce the amount they contribute to their 401k plans. That is unfortunate, but it’s a sign of the times. So, when looking at jobs these days, consider health care, bonuses and other benefits. Typically, an employee only thinks of salary. But health care is huge these days. One alternative is a high-deductible health plans. Clark thinks these are great for people who own their own businesses and for contract workers. HSA plans are another option that Clark supports. Many people don’t have money saved, so paying the big out of pocket costs is not realistic. But for others it could be a great idea. For more on HSAs, click here.

We spend $1 out of every $6 on health care in the United States. That’s much higher than any other wealthy country in the world. Yet, we have lower life expectancies than dozens of countries out there. Where does the problem lie? A professor at MIT looked into the subject and found that most of the money was going to hospitals, doctors and pharmaceutical companies. It happens because we don’t act like consumers when it comes to our health care. Instead of asking what something costs, we just care about what the co-payment is. HSAs will help curb this way of thinking, in Clark’s opinion. Health savings accounts require that we monitor what we spend because of the way they are structured. We don’t know if these will have an affect, but Clark sure hopes so. We must change how each of us views our responsibility if we want the health care system to improve.

Steve Case, the creator of AOL, is fed up with our health care system and is speaking out about the changes we need. He’s not the only one. The problem is that the power is in the hands of just a few mega insurance companies who mistreat doctors and their patients. So what are the alternatives? Retailers are leading the way in innovation with the in-store clinics that are popping up all over the country. The clinics have one of the following: a doctor, a nurse or a physician’s assistant. The cost for patients is much less because overhead is next to nothing. The store benefits because patients usually fill their prescriptions in the store. One mini-clinic mogul has opened 16 mini-clinics in retail stores and plans to open 1,400 total. Minute Clinic is another chain with lots of stores where a visit is just $49. There is no follow through on care with these places. But, most of that is up to us to do.

When you get sick and need medical care, how do you know if you’re being charged a fair price? You don’t because we have never had open pricing in the medical industry in the United States. It’s been kept a secret and people are kept in the dark. In every other phase of our capitalist system, you can ask what something costs and get the answer, which is called “transparency in pricing.” As a result, people don’t get procedures because they’re afraid they can’t afford it. The good news is that the Feds are about to change all of that. Thanks to the advent of HSAs, which require that people pay for medical care themselves, prices of procedures will be posted. They will be available at the Medicare Web site, medicare.gov. So, for non- emergency care, you can see what a procedure costs and negotiate the price beforehand. Barron’s magazine published a related story recently about the need for this kind of change and Clark agrees 100 percent.

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In other medical news, Harvard medical school is now requiring doctors to walk in the shoes of their patients. Part of the training required for doctors is to go through the same hoops to get help and sit in waiting rooms. Clark thinks it’s brilliant. People are customers, not patients and should be treated with good service.

A new report out shows that Americans have set an all-time high on medical expenses, with 16 percent of our nation’s output going to health care. That means that one of every six dollars we spend is siphoned off into medical insurance, hospital care, doctor visits and the like. Our medical expenses are increasing at three times the rate of inflation, which is not sustainable if we’re to compete with other countries. In another silly move, Maryland passed a law that requires Wal-Mart to spend a certain amount on every employee. It completely misses the point that our employers should not be providing our health care. That is one of the reasons why we’re spending so much on health care. Did you know that more than half of the health care provided in our country is being paid for by government? Another large chunk is provided by companies. Neither one makes sense. Choosing your own policy and the coverage you want is much more cost effective. To expect your employer or the government to take care of your health care is not only antiquated but it’s just not smart.

Clark has talked in the past about medical tourism and the trend of traveling to other countries for cheaper medical procedures. People often travel to India or Thailand for surgeries that cost about three quarters of the cost in America. People who do this often have their own private nurse 24 hours a day and the care is impeccable. As a result, insurance companies in California are setting up Mexican HMOs. For non-emergency care, residents of southern California can go to Mexico to see a doctor. The plans cost about half what it costs in the States. Now, if you had to go to the hospital for an emergency, you go to your nearby hospital. But for everything else, a plan that normally costs $600 would cost $300. Blue Shield of California has one called “Access Baja,” for example. Clark is all for people going to Mexico or Thailand for medical care and to Canada for their prescriptions. Eventually, it will force American companies to reduce its medical costs, which would benefit many citizens and keep the business in our country.

Wal-Mart has taken a lot of heat for having many of its workers on state assistance programs for health care. Many Wal-Mart employees don’t have health coverage for Wal-Mart because it’s so expensive and because they make so little that qualify for state assistance. As a result, the company has gotten a black eye in the public view. In response, the company is trying out a new low-cost health care plan that is basically like an HSA. It will cost between $10 and $25 a month, with a $1,000 deductible per year. It gets more complicated after a year, but that is the general idea. About 50 million people in the country have no health coverage. When those people get care, people who have insurance end up paying for it. So, offering reduced options to lower income people is a good idea. Another provider known as “Mega Insurance” uses green, yellow and red stickers for its doctors. The green doctors treat for very little out of pocket expenses, while red doctors charge a lot. It keeps the responsibility with the patient, so consumers make informed decisions based on care and cost.

What do you do if you’re an independent contractor with a company and you need health coverage? Well, a number of large companies have come up with the idea to create limited low-cost health benefits for part timers and contractors. The group is called the HR Policy Association, and there are 250 of the nation’s largest employers involved. The first companies have now started launching their programs and that speaks to the need to buy individual health coverage en masse. The idea is that your premium is based on your age and gender. And, people in the plan get to speak to an advice nurse before they actually go in to see a doctor. There are a number of price levels, depending on how much coverage you want. It will eventually be available in most states, and Clark hopes this kind of insurance becomes the standard way health care is distributed. Our health car system is in need of serious help right now, and we need to figure how to make it easier for people to get it. Kaiser Permanente has a system similar to this that puts people in five different tiers based on age and gender. Why are large employers doing this? It will ultimately lead to lower insurance costs for corporate America. So, it benefits you and them.

Clark has transitioned from a group health insurance plan, to an individual plan and then back to a group plan again. Knowing how to chart those seas can be very difficult because the system is constantly changing. It’s been a frustration for listeners, but Clark has a new outlet for you from Georgetown University. The university has put together a printable online guide for you to navigate the health insurance industry. It’s called HealthInsuranceInfo.net, and it has a state-by-state guide. The guide answers questions including what your rights are when switching from one company to another, when you start an individual plan and what is covered under you plan. Check it out!

About 60 percent of people who show up in emergency rooms don’t need to be there, according to one study. That doesn’t mean the people are not sick, but they do not have to go to an emergency room for care. When people show up who are not sick with emergencies, it crowds up the hospital and costs a ton of money. Instead, we need to open small clinics in stores where people can get quick medical care whenever they need it. Target has already started this trend in some cities. Now, one drugstore chain, CVS, and several supermarkets are also trying it out. It’s a continuation of the convenience trend in stores. So, why not have a doc-in-the-box, as well. It’s called “consumer driven health care,” and it makes a lot of sense.

Did you know that roughly one of every seven dollars spent in our country is siphoned off to the health care industry? That wouldn’t be so bad if the current medical system were more efficient. That inefficiency can cause enormous harm to our country and we need to fix it. One hospital in Seattle is trying to do just that. Virginia Mason Hospital was severely inefficient in its treatment of patients. Cancer patients, for example, were waiting up to 17 hours for chemotherapy treatments and care. So, the folks at Virginia Mason went to Japan to learn from one of the most efficient company in the world. They studied Toyota, which will soon be the world’s largest automaker. According to the Washington Post, the hospital moved the lab and exam room closer and opened private rooms for chemotherapy patients. It’s more like a business and it’s rubbing off on other hospitals. We need to reduce the cost of medicine while increasing the value of patient care, and these hospitals are doing something about it. Clark hopes more people adopt these smart, thoughtful business practices.

Mosquitoes are not just an annoyance anymore. They can carry tons of diseases and it’s hard to know what will protect you. Through the years, the Centers for Disease Control has said that the only guaranteed protectant is Deet. But people are reluctant to use Deet because it’s sticky and stinky. Well, the good news is that there are now some alternatives that have been approved by the CDC. An oil of lemon eucalyptus spray that is natural and smells much better than Deet is one of them. The other is a chemical known as “Picaridin.” Only 40 percent of people use mosquito repellent currently, so maybe more will start putting something on now that there are alternatives.

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The Centers for Disease Control is also involved in preventing colds from spreading. Colds spread most easily through our hands. We cough into our hands, trying to be polite. But then we shake hands with someone or touch others and pass on our germs. So, the CDC is now recommending that people cough into their elbow. It keeps germs at bay and still is polite.

A recent study published in the Journal of the American Medical Association (JAMA) shows us just how much pharmaceutical advertisements influence us and what happens in our doctor’s offices. The people in these commercials look like they’re having the time of their lives and are able to climb mountains and ski cross country at a moment’s notice. So, when we visit our doctors, we ask for the drugs that look like they will make us happy and healthy. Doctors are happy to oblige because it speeds up the office visit when patients know what they want and it keeps them satisfied. According to USA Today, doctors in more than 150 offices were told that at random times someone who wasn’t sick would visit them and ask for Paxil, a depression medication. The doctors knew what was happening up front, yet 55 percent of the time the doctor gave them the prescription with no questions asked. Drug companies love that this is happening because they’re selling all kinds of drugs and making money. Clark hopes doctors will take this news to heart and think twice before giving patients prescriptions when they may not be necessary.

One question we’ve failed to see during the controversy over the Terri Schiavo “right to life” case is what can WE do to prevent this from happening in our own families. Medical technology can allow keep people alive even though they are not really functioning. Teri, who is in a vegetative state, is in the middle of a debate between a group of people who want to keep her alive and another group who want to let her die peacefully. Her husband says she wouldn’t want to be kept alive in the condition she’s in and he says she expressed that to him. The problem is that her wishes were never written down. People should write exactly what they would like to happen in what’s called an “advance directive.” People should also appoint a messenger who will be the steward of that information and will deliver it to the appropriate parties if something happens. Clark does not want to be kept alive if machines must function for him. But you may feel very differently. That’s why it’s important to establish your wishes ahead of time. To find out more, check out the following sites: partnershipforcaring.org (provides specific advance directive forms for each state), agingwithdignity.org (offers details about its Five Wishes document), healthdirectives.org (charges $18 a year to scan directive documents and make wallet-sized cards specifying how medical providers can retrieve the documents from the website), and uslivingwillregistry.com (offers directive services for member hospitals).

It’s become very hard for individuals and small business owners to find affordable health insurance. But the warehouse clubs are starting to offer very viable solutions. Costco Wholesale, for example, is offering its own branded health insurance for small group. Because of the buying power Costco has, the company can offer group buying power and better rates for groups. We’re talking about real health insurance policies, not just some slip to go see a certain doctor. The San Francisco Chronicle also reports that Costco is going to offer individual policies. The company is going to start this in California only at first, but it will eventually branch out to other states if it’s successful. We’ll see if it works. If so, Clark expects warehouse clubs to start offering HSAs (health savings accounts). This could be a terrific thing for small businesses and for our health care system in general.

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In other medical news, Target is starting to set up “Minute Clinics,” where people can stop in and see a nurse practitioner for certain ailments. If the problem is more serious, the patient will be sent to an emergency room. But people shouldn’t have to go to the emergency room for a minor emergency and pay extreme amounts. The cost at the Minute Clinic will be between $25 and $75. So, Clark commends Target and the warehouse clubs for their efforts to help consumers.

The state of California now requires that hospitals publish price lists for services and medicines. It allows people to comparison shop because there are big differences from one hospital or another. Clark thinks it’s a great idea. The problem is that there are a number of “charity hospitals” that are mistreating people without insurance. Because they can claim themselves as a charity, they don’t have to pay the taxes. But, in return, they are supposed to provide charity care to poor patients. There are now lawsuits in 22 states against charity hospitals for this reason, according to the Washington Post. The suits state that these hospitals are trying to take people’s homes away for not paying the bills They also charge people without insurance much higher rates than those with insurance. In fact, the typical rate is 600 percent higher. It’s turning everything on its head in the health care industry. Hospitals should provide care to all people.

Americans pay more for health care than any other country. The ironic thing is that right now we rank with third world countries in terms of life span, infant mortality and other standardized measurements. Clark thinks we need standardized plans that are simple and easy to understand such as the Health Savings Accounts or HSAs. But right now most people only have insurance through their employer or extremely high individual insurance. And it’s causing people severe financial harm. According to Harvard University, about half of all bankruptcy filing are due to medical bills. Most of those people were middle class, had health insurance and owned their own homes. But the non-reimbursed portion of medical care put them into bankruptcy. Hospitals, labs and doctor’s offices should have a price list for patients so they know what they are getting into. We need capitalism and competition in health care to keep it affordable.

Clark believes strongly in organ donation. Some people don’t for religious reasons, and that is understandable. But if you have no real opinion or feeling about it, consider what you could do for someone else. You can donate so many parts of your body to science and you could possibly save a life. What if it were one of your family members or you who needed an organ desperately. Wouldn’t you want one to be available? To find out more about this, go to organdonor.gov or to unos.org. There are forms on these sites that you fill out to easily become an organ donor. It takes just minute to do, yet it could save a life.

Some hospitals have capped the number of hours a doctor can work in an emergency room. But in most medical centers, there is no cap on how many hours a doctor works on a shift. It’s sort of like a fraternity hazing its new pledges because older doctors think young interns must “pay their dues.” But overworking doctors can be very dangerous to patients. The New England Journal of Medicine found that the car accident rate doubles for doctors working 32 hours instead of 24 hours. They fall asleep behind the wheel because they are so tired. What does that say about the care patients are getting? About 3,000 doctors were followed for the survey, and Clark thinks that is proof that the traditions of the industry need to change. These are people dealing with life or death situations every day.

Tons of stories have been published about how sloppy care and treatment in hospitals has led to serious medical complications and even death. About 100,000 people die each year in hospitals because of medical mistakes. More than half of people who have been in hospitals recently are unhappy with the quality of health care they received. Yet, only one in nine people sue when something happens. Many just go away quietly. But research shows that people would rather trust the system and the doctors who treat them instead of suing the doctor or hospital. People know that doctors are not perfect and they make mistakes. In fact, patients are more appreciative when doctors come clean about what went wrong, according to research from the Wall Street Journal. What the public really wants is medical information, or “report cards,” about doctors and hospitals. The medical industry is frightened to no end by report cards, but there are lots of moves coming from corporate America to get them published and accessible. When it happens, you will be able to see how a particular facility has performed. Clark thinks we need to do something to help allay peoples’ fears. Doctors who fess up when they mess up help quite a bit, and we’d all be better off if that happened. But there are moves taking shape around the country to impose extreme non-economic damage caps. Doctors want to cap damages at a quarter of a million dollars. Clark sees that figure as too arbitrary, but he thinks there should be some cap that makes sense. Doctors should no longer be scared to treat people because their malpractice costs are too high, and patients should no longer be afraid to go to the hospital. Hopefully we can reach that goal.

You may have heard of Health Savings Accounts or HSAs but you’re not really sure what they are. It’s the Bush administration’s main initiative in the health care area and Clark really likes the idea. Right now, the health insurer and your employer are the customer, and you’re in third position. No one cares about you and you have no say in what you pay. But with an HSA, you get a trade-off. You get much lower premiums for health coverage, but you have to pay the first minimum $1,000 for coverage. The money you don’t spend, goes into a tax-free savings account known as an HAS. It earns money tax-free and is used tax free to pay for medical expenses. Now, if you see the doctor frequently, an HSA is not a good idea. But for many, it’s a huge improvement because you will be more conscious about how much you’re spending. Kaiser Permanente, one of the largest health care companies, is getting in on the HSA game early. The company is concerned about losing customers to individual HSA plans. So, as an experiment, the company is going to allow customers to buy an HSA plan through Kaiser. About one in four Kaiser members will be eligible. The premiums will be much lower, but the doctor visits will cost much more. It won’t be the typical $10 or $15 co-payment. It’s not the traditional Kaiser business model, but Clark congratulates them for trying something new. The market place will decide if it’s a good idea or not and we’ll keep you posted.

It’s the time of year to decide whether you’re going to participate in your company’s Flexible Spending Account (FSA), and the time of year to get your paperwork in if you already participate. If you’re not familiar with an FSA, it’s a medical benefit that mid-size and large-size companies offer to people who want to set aside money for medical expenses. It’s pre-tax money, and you can have two accounts. There are FSAs for your children or elderly relatives, which are known as a “dependent care” accounts. Then there are individual FSAs for you and your own medical care. They cover non-reimbursed medical expenses, including contact lenses, laser eye surgery, hearing aids, prescriptions, over-the-counter medicines and some co-payments. You have to fund each account separately, and the individual account will hold up to $3,000. With dependent care, babysitter costs and day care costs are eligible. It’s important that you underestimate how much you think you’ll spend. The reason is that if you don’t use it, you lose it. Clark put too much money in one of his account and forfeited about $400 last year. So, if you have money left to spend, look at the bills for which you haven’t been reimbursed. If you do, buy medicines or have an eye exam, and use it up. Also, keep in mind that FSAs are completely different than HSAs or health savings accounts. With those, you can carry the money forward. But with an FSA you cannot. So use it!

A big controversy has been brewing in California over Wal-Mart and its current health care policy. Residents claim Wal-Mart doesn’t play fair because it doesn’t offer health care coverage to all of its employees and taxpayers have the pick up the bill. An initiative currently on the state’s ballot asks residents whether Wal-Mart should be forced to provide health care to its workers. It’s really a microcosm of the nation’s frustration with our overall health care system. As the largest employer in the United States, Wal-Mart just happens to be a lightning rod for these issues. And it’s true that the company is not treating all of its workers the same. Less than half of the company’s employees have health care coverage. And, those who do have coverage must pay one-third of the cost of that care. But covering the health care costs of those who don’t have coverage is causing a huge stir in some states. In Georgia, taxpayers are forking out $10 million a year to insure the children of Wal-Mart employees. In North Carolina, roughly one-third of patients on Medicaid were Wal-Mart employees. And Washington has a huge out-of-pocket expense for non-covered Wal-Mart employees. Compare those statistics to Costco, which provides health coverage to 96 percent of employees. In addition, they pay only 8 percent of the cost, according to the New York Times. Clark doesn’t want to come down on Wal-Mart like others are doing. Our health care system, as a whole, is the problem. He thinks people should buy their own insurance, instead of getting it through an employer. That way we would care more about what we’re paying and our wages would most likely go up.

How would you like it if you were a patient in an emergency room and the doctor is nodding off and rubbing his or her eyes while treating you? You probably wouldn’t like it. But doctors have always been made to work long hours when they are young or just starting out. Interns, especially, have to go through the fraternity-like process of earning their stripes in the hospital. Clark thinks it’s just plain dumb. It puts peoples’ lives in danger when doctors are expected to work 36 hours straight. That is the norm. Working a regular job for that long is difficult, but doing it in a life or death position is unacceptable. The state of New York put limits on how long doctors can work, and many people were furious about that . But a new study out from the New England Journal of Medicine showed that doctors working long hours make 36 percent more serious errors than those who worked regular hours. Among the errors were ordering the wrong prescriptions, making mistakes during invasive procedures, reading test results wrong and misdiagnosing patients. Doctors should not be subject to “hazing” like this because it is the patient who suffers.

Clark often says that there is no “debtor’s prison” in our country, meaning collection agencies can’t send you to jail if you owe money. But it’s not completely true. Hospitals can throw you in jail if you can’t pay their bills, and the worse part is that it’s completely legal. A recent article in Self magazine spotlights this critical issue, using the tragic story of a single woman and cancer patient who nearly lost her house because she couldn’t pay her medical bills. Sadly, the woman died a few years ago at 32 years old, and her family is still fighting to keep her home. The hospitals that treated her have put a lien on the condo in Northern Virginia, and, even after her death, they are not offering to help. People without insurance, and even some with insurance, can go broke very quickly if stricken with a serious illness. People in six states have been put in prison for not paying bills, and it has become big news on Capitol Hill. Should people pay bills they owe? Yes! But there are times when people need help, and these hospitals are non-profits. That means they take donations for charity and don’t have to pay tax on that money. So they can use that money to help patients who need it. The hospitals are out of line here! So it’s important for you to do your homework before you have any procedures. There are giant discrepancies in what hospitals charge for certain procedures. Doing your homework ahead of time is absolutely essential. Have a family member who can help you with the billing throughout your treatment. Having a billing advocate is also smart. These are people who charge by the hour to help you understand and negotiate your bills. There are also Web sites out there listing people who will represent your interests in hospital negotiations.

Doctors face a huge burden when it comes to medical malpractice insurance. Sometimes, the first $150,000 they earn each year goes toward insurance. As a result, doctors are now asking patients for donations to help pay for their insurance bills. They usually ask for $10 or $15 from each patient, and it’s working. People are sending in contributions. Some doctors were so successful with the letters that they are planning to do it again next year. Others are charging a surcharge for insurance that appears on patients’ bills. There is obviously something wrong with our health care system if doctors have to beg for money to pay for their insurance. Rates are so high because of all the malpractice lawsuits people have filed and won. Some states have set caps on the amount of money people can win in court for these malpractice cases. But most of these caps are unusually low. Setting the caps unrealistically low is just as unfair as setting no limit at all. We need to come up with a reasonable level of compensation and leave it at that.

Clark has had two surgeries in the past two years. He had hand surgery last year and the year before he needed back surgery. Both were pretty painful, but not nearly as painful as the bills he received in the mail after each one. Not only were the bills outrageously expensive, but they were also impossible to understand. It’s like trying to read hieroglyphics. According to Money Magazine, roughly 8 in 10 hospital bills have multiple errors. So, almost always the bill will be wrong, and it won’t be in your favor. It’s hard to blame hospitals for the mistakes because they are so difficult to run. So, do you just roll over and pay the bills? No way! First of all, Consumer Reports has a program online that helps you decode these bills. It’s at consumerreports.org. Also, document everything that goes on in the hospital. Keep a log of what goes on and ask a friend or relative to write down every medication you are taking and every procedure you have. Then when the time comes to get the bill, asked for it to be itemized. Then you can compare everything you have written down to everything on the list. It’s up to you to be on your toes in the hospital. You can also hire medical experts who will look over your bill. Two sites that help you with that are billadvocates.comand claims.org. So, do as much as you can yourself. If you need more help check out these sites.

Most people get health insurance from their employers these days. The problem is that with the increasing health care costs, employers are struggling to provide the same amount of coverage without increasing premiums too much. But employers are basically lost as far as what to do. At the same time, more people are losing their health care coverage. So, push has come to shove and people are choosing to "self insure." This is difficult if you have a major health care problem or emergency. Because of the high health care costs, one insurance company – Humana - went to a customer-driven system. Under this plan, employees are given a certain amount of money each year to use toward health care. After that money is used up, the employee pays out of pocket. Since the program started, employees have paid no co-payments or premiums under this plan, and Humana had a massive reduction in the cost of health care. Most companies experience a 10 to 12 percent increase in health care costs each year. But Humana only had a two percent jump when it put the employee in charge, according to Business Week. Clark is very psyched about HSAs or Health Savings Accounts, which are very similar to Humana's plan. You will probably start seeing them next year. A customer driven marketplace will reduce spending and therefore costs.

There are health care centers and surgical centers in existence that are performing procedures on people who are perfectly healthy. These centers are so desperate for money that they “rent” patients to have surgeries they don’t need so that the surgery centers can bill insurance companies for the money. In return, these patients are receiving money – usually a couple thousand dollars – or trips to vacation destinations. Insurance companies have paid out half a billion to these centers, which are practicing what’s being called “rent-a-patient programs.” On the other end of the spectrum, non-profit centers are treating patients like dirt because they don’t have insurance. We are in the early innings of figuring out how to fix out broken health care system, but this development is a clear sign that our system needs immediate help.

In college, Clark smoked two packs of cigarettes a day, and he now wonders what the effects are on his body. For the past 53 years, a British organization has been researching that exact question. The study found that if you quit by age 30 your body would repair itself well. If you quit by age 40, you may lose a few years or so of your life, but you will live nine years longer than someone who never quits. Think about living nine extra years with your family. Wouldn’t that be great! People who smoke are dying from lung cancer, throat cancer, and a number of cardiovascular diseases. The good news is that another recent study found that high school students are smoking at the lowest level of this generation. The cigarette companies want kids to smoke because that’s when a lot of life-long smokers start, but great advertising by anti-smoking campaigns have really paid off. High taxes on cigarettes have also helped people quit and live longer.

How would you like free unlimited long distance calling across the U.S. to Canada and across Western Europe? Think about it. Talk as much as you want at no cost. It’s the promise of a lingo.com, an offshoot of Primus. Lingo provides an unlimited Internet telephone connection and all of the extras for $20 a month. It tells you how much things are changing in the telephone business. For years, there been a huge fight on Capitol Hill over whether companies should be able to compete with the four dominant local phone companies. Verizon, BellSouth, SBC and Qwest don’t want and competition, so they’ve been fighting it tooth and nail. But these new-age companies have blown past all of that and have figured out that all it takes is two high-speed Internet connections. Check it out at lingo.com.

Clark had surgery on his hand recently, and his out-of-pocket expenses were actually not too bad. But sometimes these charges can get out of hand and very hard to understand. A woman featured recently in USA Today had this problem in the extreme. Her daughter needed knee surgery, so she went out and priced how much it would cost at various hospitals in the area. She got a quote for $4,200 from one hospital and her daughter went there for the surgery. But when the bill came in the mail, it was for about $25,000. She took the bill to the surgeon and asked what it all meant because it was so difficult to understand. Even he didn’t know. So, knowing that she had kept a log of everything that happened during the surgery, she met with hospital administrators about the cost of everything on the itemized bill. It turned out that about $20,000 of the charges were not legitimate. Only an additional $620 should have been charged. The good news is that in nearly every state there are now medical review specialists who decode hospital bills. For a bounty or for free, they will help you out. Consumer Reports has instructions on what to do step-by-step when enlisting one of these specialists. The magazine also found that the more money people have to lay out of pocket on their own, the more they pay attention to the bill. And usually errors are found on those bills. So, do your home. And, if it’s not a life or death emergency, get price quotes.

Some doctor practices around the country are getting very smart about providing medical care. They are offering discounted services for people who pay in cash. It’s because they want nothing to do with insurance anymore. Medical care is always a bargain between time and money. Insurance companies waste massive amounts of money every year on administrative tasks and claims processing. People are getting fed up with it. There is no “one size fits all” medical care system in our country, so Clark loves the innovation. The market is creating choice for you and that is great news.

Buying health insurance is no bargain these days. As a result, about one in six people have no health coverage. And, it’s easy to believe the junk faxes offering coverage for the entire family for just $89. For people who have lost a job or are self-employed, it’s really tough out there. But these companies are not going to cover you in a catastrophe because they are not insurance. And many of them are scams. These cards all claim that they will get you a special deal on medicines or services. But it’s hard to know which ones are legitimate and will actually give you a deal. So, if you’re going to try one out, you need to follow some important steps. First, make sure you ask for the actual provider name and ask what prices they offer on particular services. You need hard numbers. Don’t just accept it if they say they’ll give you 10 percent off services. That’s not enough information. Also, make sure the doctors are still accepting patients under the program. But most importantly, remember that these are not insurance plans. They are a way to get out of harm’s way for the time being. But they won’t help with the real difficult or complicated procedures.

Imagine if you walked into a store, and they refused to serve you. It’s going on in doctor’s offices across the country because they are afraid of getting sued for malpractice. Doctors don’t like being questioned about their actions and are so fearful of getting sued that they have built a Web site showing the names of anyone who has been a party to a malpractice suit. Doctors can subscribe to this site, doctorsknow.us, to check for your name. They have decided whether to treat patients as a result. It’s true that some people have taken advantage of malpractice suits and lawsuits in general, but Clark thinks this is a severe overreaction. Just because some people’s names are on this list does not mean they don’t deserve medical care.

People face a huge ripoff these days if they either have no health care insurance or if they have coverage with a provider that is out of town. When people seek treatment from a hospital, they are billed with “list prices” that the hospital claims that they can’t negotiate. But this isn’t true. The Department of Health and Human Services has directed all 4,800 hospitals in the United States to negotiate with patients on services. In the past, insurance companies have had different relationships with these hospitals. One insurer may have negotiated a deal with that hospital and, if you have that insurer, you are billed at 80 percent. Another person walks in with insurance that the hospital doesn’t recognize, and that person is billed at 100 percent. But now, that has all changed. If you’re in an MSA (Medical Savings Account) or you have no insurance at all, you can negotiate with that hospital. So how do you negotiate? You tell them you want to work out a payment plan based on the “medicare rate.” That is the target you are shooting for. Hospitals are bureaucratic organizations and they will try to bill you as much as they can. But you can work this in your favor.

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The main goal of a hospital is to make you well, right? But some hospitals have had serious problems and subsequently tragic consequences because the wrong medicine is administered to patients. There are so many people involved with the dispensation of prescriptions that there is huge room for error. As a result, the Department of Health and Human Services has issued a directive, requiring hospitals to use a bar code system for prescriptions. The doctor will write his or her prescription electronically, generating a bar code for each bottle. The bar code will match up with the patient, so the chances of the prescription harming someone are much lower. About 7,000 people die each year because they are given the wrong drugs. Let’s hope this helps. In addition, if you have elderly parents who take a lot of medications, you should monitor the medications they take.

One of the toughest things to deal with these days is the cost of medical care. A very large percentage of prescription medicines are never filled because people can’t afford them. Tests and lab procedures are also sometimes skipped because a lot of them are “out-of-pocket expenses.” According to the Journal of the American Medical Association, people often don’t follow through with their needs at the doctor’s office. Researchers for the study followed doctors and patients and talked to them about what happens in the doctor’s office. Two out of three patients have financial questions about what the doctor is recommending. But only 15 percent ever bring it up. They sit there and have a conversation in their heads. Listen up! If your doctor recommends something you should do and you can’t afford it, say it. About 90 percent of doctor’s now know they should consider a patient’s cost. But they’re busy running from patient to patient and it’s up to you to bring it up. What they’re prescribing may be what they think is best for you, but you should always ask for a generic medication. Also, some doctors may have samples they can offer you. If you don’t have the money, tell the doctor!

Clark has been getting a lot of calls from listeners about Health Savings Accounts or HSAs since Congress passed the law recently. These accounts are going to become a household name in the next few years, but right now they are very confusing. HSAs look at health care very differently. The idea is to make health care more of a patient-oriented system. Right now, you fill out medical forms and you might pay a co-payment or a percentage of the bill. And you have to check if your doctor or specialist is in your “network.” With HSAs, people are now “customers.” The first certain number of dollars come out of your pocket. After that, all the bills are paid by your health care plan. The idea is that you’ll try to think of a less expensive way to get care if you’re paying for it. If we’re spending someone else’s money, we don’t really care about it. With HSAs, your deductible could be as high as $2,600 or as low as $1,000. But the great thing is it’s up to you, and it’s tax free. And if you buy a policy that has a $1,500 deductible, you’re free to put $1,500 into it and it’s never taxed. HSAs will be available from large employers, small employers and the self-employed. It’s still very early in the HSA game, but we’ll keep you posted. There are some people who don’t like HSAs, of course. They think all of the money is being funneled to the rich. But, it’s better than our current system. Of all the economic output in the United States, 15 cents on every dollar goes to health care. That’s about 50 percent higher than any developed country. So, we are basically sapping our nation’s economic growth with the enormous amount of money going to health care.