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.

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 w