PREPARED PATIENT BLOG

Patients and experts explore what it takes to find good health care and make the most of it.

Trudy Lieberman, a journalist for more than 40 years, is an adjunct associate professor of public health at Hunter College in New York City. She had a long career at Consumer Reports specializing in insurance, health care, health care financing and long-term care. She is a longtime contributor to the Columbia Journalism Review and blogs for its website, CJR.org, about media coverage of health care, Social Security and retirement. As a William Ziff Fellow at the Center for Advancing Health, she contributes regularly to the Prepared Patient Blog. Follow her on twitter @Trudy_Lieberman.


Has Patient-Centered Health Care Run Amok?

Trudy Lieberman | July 22, 2014
In the late 1990s, when the Institute of Medicine released their landmark Quality Chasm report saying that patients "should be given the necessary information and the opportunity to exercise the degree of control they choose over health care decisions that affect them," I don't think this is what they had in mind...

What's Wrong With Health Insurance Policies That Cover Less?

Trudy Lieberman | July 9, 2014
Insurance companies and a group of senators headed by Alaska Democrat Mark Begich think they have a great idea for getting more young people to sign up for health insurance...

Seamless Health Insurance Coverage Still Illusory

Trudy Lieberman | June 30, 2014
For ages we've all known that the U.S. health insurance system works splendidly for those who have good employer-provided coverage, slide smoothly into Medicare when the time comes and seldom get sick. But evidence is beginning to trickle in that this seamless pathway for some people who've signed up for Obamacare insurance may be more illusory than real...

Beware Those 'Average' Premium Increases – or Decreases!

Trudy Lieberman | June 24, 2014
Never before have I seen such intense interest from the press about health insurance rates, normally considered a snoozer of a story. For the public, this may be a good thing. If the stories are done well, consumers might learn something about the mix of factors that go into determining the premiums they will pay. But in the last couple of weeks, some stories have been downright misleading...

Pushing Back Against the High Price of Prescriptions

Trudy Lieberman | June 17, 2014
Are we finally doing something about the high prices of prescription drugs? Maybe. At the end of May, the Washington-based National Coalition on Health Care launched "Sustainable Rx Pricing," a campaign to "spark a national dialogue" about the high cost of drugs. Will it work?

Stop Expecting Antibiotics to Be Handed Out Routinely: Here's Why

Trudy Lieberman | June 10, 2014
For years, my colleagues on the Prepared Patient site have preached the importance of being an advocate for your own care. And they've noted that at times it is necessary to push back against doctors' recommendations if a suggested treatment does not seem right. I just returned from a visit to the U.K., which drove home the importance of that advice...

Who Needs a Doctor These Days?

Trudy Lieberman | May 6, 2014
Are insurance companies making more decisions about the health care you receive? I received a letter from Aetna, my Medicare supplement insurance carrier, advertising a pitch for getting "started on a healthier lifestyle." "Because of your health history, we think you might benefit from joining our program," the letter read. Annoyed, I called the insurer...

Calorie Disclosures Might Actually Improve Health

Trudy Lieberman | April 29, 2014
I've long been a skeptic when it comes to disclosing information about how doctors practice medicine, how hospitals treat patients and what both doctors and hospitals charge for their services. But I'm dropping my skepticism about disclosing calories in food. We've been conditioned to think of some foods as healthier than others. Only labels will reveal the truth...

Insurers Reap Rewards of Medicare Advantage Plans

Trudy Lieberman | April 22, 2014
A couple weeks ago, the Obama administration handed sellers of Medicare Advantage plans an increase in government payments for next year. While this may seem like a good thing for the 16 million beneficiaries who have MA plans, it may not be good for Medicare as a whole.

The Medicaid Gap Hits Home

Trudy Lieberman | April 8, 2014
A few days before the recent deadline for Obamacare sign-ups, I visited with one of the exchange navigators in Colorado, a state that expanded its Medicaid program and is working hard to enroll uninsured residents. This visit got me thinking of the millions of other people who live in states where they can't get access to Obamacare because they are too poor and yet are also not eligible for Medicaid...

The Dilemma of Canceled Insurance Policies

Trudy Lieberman | March 18, 2014
By now it's hardly a secret that insurance companies have canceled the policies of millions of Americans whose old coverage did not comply with new benefit requirements of the Affordable Care Act. But after hearing all the backlash and requiring people to buy newer and, in the eyes of ACA supporters, better policies, the administration took another U-turn and changed the rules once again...

Look Who's Coming Between You and Your Doctor

Trudy Lieberman | March 11, 2014
Opponents of health care reform, especially those who resist moving to a single payer system like Canada’s, have often used a very powerful argument to sway public opinion. Any significant changes, they warn, to America's private insurance system would mean that the government will come between patients and their doctors by making decisions about the care Americans receive. But what if it's not the government that is inserting itself between you and your doctor?

Obamacare Websites: Not Just a .Gov Problem

Trudy Lieberman | March 4, 2014
Shoppers searching the Internet for health insurance coverage can be forgiven if they are confused.

'Me' Versus 'We' in Obamacare

Trudy Lieberman | February 25, 2014
The Obama administration and Affordable Care Act supporters have not bothered to explain how the law includes cross-subsidization, missing an opportunity to talk about the "we" aspects of the law. As one 58-year-old woman put it: "The chances of me having a child at this age is zero. Why do I have to pay an additional $5,000 a year for coverage that I will never, ever need?" Here's how it works...

Backlash Against Narrow Provider Networks Begins

Trudy Lieberman | February 18, 2014
Seniors are starting to realize that fewer doctors and hospitals may be available to them if they select a Medicare Advantage plan. Restricting these choices – in theory – is a way to control the price of health care. There's just one problem: Consumers still want to choose their doctors or stick with the ones they've got...

Why Low-Income Seniors Fail to Get Help Paying for Health Care

Trudy Lieberman | February 11, 2014
A couple weeks ago, the Medicare Rights Center, a well-known New York-based advocacy group, released a report card showing that seniors on Medicare are struggling to pay for their health care. This finding brings up an important question: Why aren't seniors using the variety of state and federal programs that have been set up to help people in this situation?

Do Patients Care How Much Money Their Doctors Make?

Trudy Lieberman | January 28, 2014
I am all for transparency when it comes to health care. So when Medicare announced a few weeks ago that it would begin to tell the public how much doctors are paid to treat Medicare patients, my first thought was "hooray." Still, I keep returning to the question: What will the data do for the average person?...

Tiered Insurance Networks: Complicating Obamacare or Controlling Costs?

Trudy Lieberman | January 21, 2014
Last fall, a Pennsylvania woman, frustrated by the snags and snafus of healthcare.gov, turned to the website of Independence Blue Cross, the biggest insurance carrier in Southeastern Pennsylvania, to make sense of her health insurance choices...

Why Does Our Health Care Cost So Much?

Trudy Lieberman | January 8, 2014
We know that the U.S. has the most expensive health care in the world. But beyond noting that dubious achievement, we seldom ask why...

Is Shopping for an Exchange Policy an Impossible Task?

Trudy Lieberman | December 18, 2013
Last week at a New York City meeting of the Association of Health Care Journalists, Elisabeth Benjamin, a vice president of the Community Service Society, tried to explain the New York health insurance exchange to a group of skeptical journalists who had more than a passing familiarity with the topic...

Where, Oh Where Are Those Insurance Summaries for Consumers?

Trudy Lieberman | December 3, 2013
Buying health insurance through the state shopping exchanges was supposed to be a breeze — like buying an airline ticket from Travelocity. But it isn’t, and the reason why has nothing to do with the technical glitches of HealthCare.gov...

Reducing Obesity: It Takes a Village

Trudy Lieberman | November 20, 2013
During my recent visit to Canada, I had a chance to meet obesity expert and medical director of Canada's Bariatric Medicine Institute, Dr. Yoni Freedhoff. What he had to say was somewhat surprising...

The Great Canadian Experiment to House the Homeless

Trudy Lieberman | November 13, 2013
At Home/Chez Soi, a Canadian program for the mentally ill, is built on the concept that providing housing is the first order of business. An approach that reinforces the truism that good health is more than swallowing the latest wonder drug.

This Doctor Treats Poverty Like a Disease

Trudy Lieberman | November 6, 2013
What would you think if your doctor handed you a prescription that recommended filing your tax returns or applying for food stamps instead of the usual medicines for high blood pressure or diabetes...

The Latest on the Usefulness of Hospital Ratings

Trudy Lieberman | October 30, 2013
On Monday, Charlie Ornstein of Pro Publica provided the latest word on the usefulness of hospital ratings, an issue that seems never to disappear despite the growing body of work that raises questions about the methodology used to create them, their conflicts of interest with sponsors, and most importantly, their usefulness to the public.

Choosing an Exchange Policy: What's the Rush?

Trudy Lieberman | October 2, 2013
Will all the White House messages, the stream of breathless Twitter updates on the number of hits and enrollments, and the press hype surrounding opening day send the uninsured public into panic mode?

Low Premiums, Narrow Networks and the Ideal of Consumer Choice

Trudy Lieberman | September 18, 2013
We want to have choices about the health care we get and who provides it. Many of us think we have that now...

The Consumer's Ongoing Dilemma: Making Sense of Hospital Prices

Trudy Lieberman | September 10, 2013
Hospital charges are essentially like car sticker prices. Insurers use them as a starting point to negotiate what they actually will pay providers on their policyholders' behalf.

Political Football Season Starts for Medicare

Trudy Lieberman | August 28, 2013
It’s the silly season again for Medicare. It comes around whenever a political campaign is about to begin as it is for next year’s mid-term elections….Politicians love to play ball with benefits for seniors.

The Meaning of Another Obamacare Delay

Trudy Lieberman | August 21, 2013
The media has discovered another delay in another provision of Obamacare, and the new delay affects consumers’ pocketbooks directly...

Who’s Left Out of Obamacare?

Trudy Lieberman | August 14, 2013
The main purpose of health reform, the president said at his press conference last Friday, was to provide health insurance to people at affordable rates…Whether that coverage will be affordable or comprehensive for families remains to be seen.

Can You Choose Your Doctor? Well, Yes and No

Trudy Lieberman | July 23, 2013
The specter of loss of choice and freedom to select the doctor you want haunts again. This time it’s being raised on the airwaves with an ad from Americans for Prosperity…

Who Wins or Loses from the Delay in the Employer Health Insurance Mandate?

Trudy Lieberman | July 10, 2013
It’s hard to say it was a surprise last week that the Obama administration delayed implementation of the employer mandate — that pillar of health reform requiring employers with more than 50 employees to provide health insurance or else pay a fine.

It’s Medicare Versus Medical Supplier in Controlling Costs

Trudy Lieberman | June 25, 2013
On July 1, Medicare begins a second round of competitive bidding for medical equipment and supplies, such as diabetes testing strips that beneficiaries use to check their blood sugar levels. There’s nothing remarkable about any of this except that the industry is fighting to make sure that competitive bidding does not happen...

Cheap Insurance Premiums Come at a Price

Trudy Lieberman | June 18, 2013
Yesterday the blog of WIFR-TV in Rockford, Illinois, featured a small story about community groups in the state applying for federal grants to help educate customers coming to the new health exchange in October.

Are Health Insurance Rates Going Up or Down — A Cautionary Tale?

Trudy Lieberman | June 12, 2013
Will consumers buying coverage in the new state shopping exchanges find lower or higher rates? On one side are those who say the newly insured will see lower premiums for coverage.

Do Corporate Wellness Programs Work?

Trudy Lieberman | June 5, 2013
On a recent trip to Lincoln, NE, I visited Lincoln Industries, a company that makes chrome trims for Harley-Davidson motorcycles. I was curious about the firm’s award-winning wellness program, especially since more employers are penalizing workers by making them pay more for their health insurance if they fail to meet certain health goals.

Rehabilitating the Image of the Emergency Room

Trudy Lieberman | May 29, 2013
Maligned over the last decade as places to avoid because of the price of the care they delivered, last week’s release of a study by the RAND Corporation goes a long way toward improving the image of hospital emergency rooms.

Rationing Medications

Trudy Lieberman | May 15, 2013
In America, the conventional wisdom is that we don't ration health care. But we do, and there's no better example than patients rationing themselves when it comes to the medicines they take.

Are We Finally Getting Closer to Price Transparency?

Trudy Lieberman | May 8, 2013
The revelations by the Centers for Medicare and Medicaid Services on Wednesday that hospitals vary widely in what they “charge” for the same procedure—sometimes as much as 10 or 20 times more than Medicare reimburses—confirms what health policy wonks have known for a long time. There’s no consistency in pricing for health care services…

Is “Guaranteed Coverage for Life” in the Cards for Medicare Seniors?

Trudy Lieberman | May 1, 2013
A few days ago, Empire Blue Cross Blue Shield sent me one of those Medigap sales brochures that seniors usually expect during the fall open enrollment season.

Is Health Care One Gigantic Consumer Problem?

Trudy Lieberman | April 23, 2013
One could easily make a case that health care is today’s biggest consumer problem—not unlike those that sparked the consumer movement of the 1960s and 70s. Back then, consumer issues centered on problems with using credit, buying cars and home improvement services, and obtaining the best price for food, appliances, and just about every other new-fangled and expensive product that sprang from the post-war economy.

How the President’s Medicare Proposals Affect Seniors’ Pocketbooks

Trudy Lieberman | April 16, 2013
The president’s budget proposals released last week call for more seniors to pay more money for their Medicare benefits. While the president’s plan to require beneficiaries to pay higher premiums came as no surprise to Washington insiders, it probably was to people who will feel the pinch.

Is Health Insurance Sticker Shock for Real?

Trudy Lieberman | April 9, 2013
Wherever you turn, there are complaints about health insurance rates. A Pennsylvania woman tells me her monthly premium will soon be $100 more than it used to be. A New Yorker finds the premium for retiree coverage rising 24 percent...

Whatever Happened to Underuse of Medical Services?

Trudy Lieberman | April 2, 2013
Twelve years ago, in its landmark study Crossing the Quality Chasm, the Institute of Medicine (IOM) found that “the health care industry is plagued with overutilization of services, underutilization of services, and errors in health care practice.” In simple English, the IOM reported that health care was riddled with overuse, underuse and misuse of medical services.

Making Seniors on Medicare Have More Skin in the Game

Trudy Lieberman | March 26, 2013
The movement is growing, it seems, for making people who rely on Medicare have more skin-in-the-game. In the minds of some, seniors and the disabled pay too little for their health care and their Medicare benefits…

A Disconnect: What Hospitals Want You to Know vs. What You Should Know

Trudy Lieberman | March 19, 2013
The Association of Health Care Journalists (AHCJ) is making hospital inspection reports from the Centers for Medicare and Medicaid Services available at AHCJ’s new website www.Hospitalinspections.org. The site is not perfect, and there’s a lot of missing information, but still it provides some information about hospitals that has been lacking and offers a basis for asking questions.

Patient-Centered Care: It’s All in the Details

Trudy Lieberman | March 12, 2013
Having had one eye surgery a few months ago, I knew what to look for. But my patient experience was much different this time and made me aware of how many places in the chain of care where mistakes can occur.

Those Confusing EOBs…Once Again!

Trudy Lieberman | February 27, 2013
Let’s face it. Despite all the rhetoric about health care transparency, most health care providers really don’t want patients to know the price of their products and services.

Buying Health Care from a Boutique

Trudy Lieberman | February 20, 2013
Somehow, I don’t think of money-back guarantees when I think about going to the doctor. Yet as textbook marketing principles creep into health care, a few medical providers are beginning to look like sellers of toothpaste and detergents.

Does the U.S. Get Value for Its Health Care Dollars? – Part 2

Trudy Lieberman | February 13, 2013
It turns out Japan has much to teach us about improving health…In many ways, Japan scores much higher than the U.S. when it comes to the health of its population.

Getting Your Operation at a Cut-Rate Surgery Center

Trudy Lieberman | January 29, 2013
Consumerism in health care is coming to mean patients must shop around for the best price — for a doctor’s visit, Cipro, health insurance and maybe even your next operation.

Does the U.S. Get Value for Its Health Care Dollars?

Trudy Lieberman | January 23, 2013
It’s hardly a secret that the U.S. is spending close to 18 percent of its GDP (or $8,362 per person) on health care — more than any other country. So it’s fair to ask exactly what we’re getting for our money.

What the Next Fiscal Showdown Has to Do with Health Care

Trudy Lieberman | January 16, 2013
The New Year'??s Day deal between the White House and Republicans postponed the long-awaited debate over cutting Social Security and Medicare. But in the next few weeks, Beltway talk will again turn to slicing these interrelated social insurance programs.

Hospitals Under the Microscope: Another Way to Check Out Your Hospital

Trudy Lieberman | January 8, 2013
The nation'??s hospitals are now officially on notice that the federal government is looking closely at the kind of care they give'??so closely that Medicare will be giving them a financial bonus or a penalty depending on how well they do.

Is Raising the Age for Medicare Benefits a Good Idea?

Trudy Lieberman | December 18, 2012
The twists and turns of recent political conversations over the federal deficit have explored a variety of changes to Medicare. The most likely ones are raising the eligibility age for benefits to 67 from 65.

The Government Wants Seniors Out of Bad Medicare Plans

Trudy Lieberman | December 5, 2012
Even though open enrollment closes this week for some 47 million seniors who can change their Medicare coverage arrangements for next year, the federal government is extending the deadline for certain people. Who are the lucky ones?

When I Rated My Doctor

Trudy Lieberman | November 29, 2012
Recently, I spent some time answering the questions on one of those CAHPS surveys for doctors. CAHPS stands for Consumer Assessment of Healthcare Providers and Systems, and these days hospitals ask patients to use them to review not only their hospital experience but their experience with their doctors as well.

When it's Time to Drop Your Medicare Advantage Plan

Trudy Lieberman | November 20, 2012
Currently, Medicare Advantage sellers are engaged in heavy marketing due to the MA open enrollment period that ends on December 7th. The ads don't say much but give enough clues to tip you off that you must ask lots of questions and dig deep to find out what you're getting.

When You Really Learn about Hospital Infections

Trudy Lieberman | November 13, 2012
One of the greatest risks I faced from surgery to repair a macular hole in my eye was from a hospital acquired infection. But when I tried to find data on the performance of various hospitals in New York City, there were no ratings for Manhattan Eye, Ear & Throat where I would have my surgery.

100 Million Without Dental Care

Trudy Lieberman | November 12, 2012
Every year, over 100 million Americans don’t go to the dentist because they can’t afford it, leaving many in pain. How can people pay for dental care?

A Bogus Mass Mailing about Medicare That Just Won't Die

Trudy Lieberman | October 18, 2012
Last week, the health care and political pollster Humphrey Taylor received a scary email about rising Medicare premiums from a friend. He was skeptical and wanted to know what I thought. It turns out I knew a great deal and had seen a similar version a few months ago.

Do Seniors Want So Many Medicare Choices?

Trudy Lieberman | October 2, 2012
Seniors need more Medicare choices, or do they? The answer depends, of course, on who'??s doing the asking.

What Patients Really Need to Know about Hospitals

Trudy Lieberman | September 27, 2012
If you want to know if restaurant food is safe, there's help. Just look at the signs in the window'?¦There are similar government inspection reports for hospitals, but you won't see them on the front door or any place else in the hospital, for that matter.

Trolling for Insurance Prospects on Twitter

Trudy Lieberman | September 18, 2012
Selling health insurance on Twitter? Yes indeed. Not long ago a simple tweet about a blog called Medicare Made Clear alerted me to this new way to find sales prospects for Medicare Advantage Plans and Medigap policies

Are Patient Ratings a Good Guide to a Good Hospital?

Trudy Lieberman | September 11, 2012
After writing about trying to choose the best hospital for my upcoming cataract surgery, I wondered if a few quality measures might offer a clue or two about how to better honcho some of my care, like the one that asks hospital patients if a nurse explained medications given to them. Since many ratings schemes rely on patient satisfaction data collected by the government, I decided to explore further.

Can You Really Choose the Best Hospital?

Trudy Lieberman | August 28, 2012
After learning recently that I may need cataract surgery, it was time for me to check out the hospitals where that procedure might take place.

Seniors Will Be Paying More for Their Health Care

Trudy Lieberman | August 13, 2012
I was reminded of a conversation I had a few years back with Marilyn Moon '?¦.. The best advice she gave for people not yet on Medicare was to '??Save, Save, Save'?? because even with Medicare, seniors would be paying more for their coverage and for their health care. Moon was right.

How Retirement Income Relates To Health Care

Trudy Lieberman | August 7, 2012
If you don't have enough money for retirement, from income and assets, you probably are going to have trouble paying for medical care.

In the Medical Market Place—Another Way to Pay for Dental Care

Trudy Lieberman | July 30, 2012
Across the country some 200 dentists have begun selling a package of basic dental services with a membership plan similar to those offered by big retailers like Costco and Sam's Club.

After the ACA Ruling---What's next for Employer-Based Health Plans?

Trudy Lieberman | July 16, 2012
Buzz about the recent Supreme Court's health reform decision has hovered mostly over the individual mandate---the requirement that everyone carry health insurance---and over push back on Medicaid expansion....But what about the 160 million Americans who have coverage from their employers?

Selling Dental Services Like Chevrolets

Trudy Lieberman | June 27, 2012
Mailers from a New York City dentist piqued my interest last week offering zero percent financing ' the same come-on that car manufacturers have used for years to entice you to buy Chevys and Toyotas.

Do Hospital Ratings Matter?

Trudy Lieberman | June 18, 2012
Another hospital report card showed up last week adding to the pile of ratings already available. A few years ago there were more than one hundred offered by various for-profit and not-for-profit businesses and government agencies. The newest one is the Hospital Safety Score report card from the Leapfrog Group...

More Confusion about Those Insurance EOBs. This Time from Medicare

Trudy Lieberman | June 6, 2012
People have a right to receive in plain language a summary of what doctors bill, what insurers pay and how much they themselves must pay.

'Death Panels': Beliefs and Disbeliefs in Health Care

Trudy Lieberman | May 23, 2012
Virginia was particularly concerned that she would not get medical treatment after she turns 75. She had heard at that age, 'they send you a letter. They are going to start sending you literature on death.'

Selling Screening Tests

Trudy Lieberman | May 8, 2012
A few weeks ago, a letter arrived from the Life Line Screening company enticing me to come in for a 'simple, potentially lifesaving screening' to assess my risk for strokes and other vascular diseases.

What to Do About Long-Term Care Insurance

Trudy Lieberman | April 17, 2012
The decision to buy long-term-care insurance and how long to keep it is among the toughest people make as health-care consumers. The product is difficult to buy'confusing, complicated, and costly.

The Supreme Court's Health Care Decision and Your Pocketbook

Trudy Lieberman | April 5, 2012
Last week's drama at the Supreme Court and most of the media coverage that followed omitted crucial information: how a decision either upholding or junking the Affordable Care Act (ACA) will affect ordinary Americans. Because the health reform law is not well understood by most people, it's worth recapping what might happen.

Medicare Games: When Is a Stay in the Hospital Really a Stay?

Trudy Lieberman | March 21, 2012
If you or a family member is on Medicare, you would assume that if they are in the hospital their care would be covered under Medicare's Part A hospital benefit. Right? Well, not always.

Hospital Games: Luring Patients to the ER

Trudy Lieberman | March 6, 2012
You may have seen the billboards or gotten a message on your smartphone: Come to our emergency room; our waits are short.

The Government Meets the Jolly Green Giant

Trudy Lieberman | February 21, 2012
Labels describing key features of health insurance policies will become a reality this fall fulfilling a provision of the health reform law that called for more disclosure and transparency. The idea was to copy the labeling for food products'

Health Care's Curtain of Secrecy

Trudy Lieberman | February 14, 2012
I'm skeptical that price transparency about health services will make the health care market more competitive, more honest, or less dysfunctional. After all, health care simply does not work like other markets.

What Consumers Don't Know About Their Health Insurance

Trudy Lieberman | February 7, 2012
On a chilly New York day, a sales agent for UnitedHealthcare stood on a noisy street corner in Spanish Harlem pushing Medicare Advantage (MA) plans. He was engaging in table marketing a way to snag new customers, converts from other MA plans, he hoped.

Cash Rewards from Your Health Plan

Trudy Lieberman | January 30, 2012
Harvard Pilgrim Health Care has moved deeper into the business of transforming health care into a commodity governed by the rules of the marketplace. Plan members can get cash rewards'.if they use facilities for outpatient medical procedures and diagnostic testing recommended by the health plan, not their doctors.

Revisiting Those Explanations of Benefits

Trudy Lieberman | January 19, 2012
Katie Ryan-Anderson, a health reporter at the Jamestown Sun in Jamestown, North Dakota, had a question. What did all that gobbledygook on the Explanation of Benefits (EOBs) from Blue Cross Blue Shield of North Dakota mean?

Who Gets Preventive Care?

Trudy Lieberman | December 19, 2011
Who doesn't think preventive health care is important? Probably nobody if you ask this question abstractly. But when it comes to getting it - well that's a different matter.

Patient Engagement: Expert Trudy Lieberman Talks About Challenges

Trudy Lieberman | November 7, 2011
This interview with Trudy Lieberman is the ninth and final of a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

Health Reform's First Casualty

Trudy Lieberman | October 27, 2011
The Obama administration has dealt a mighty blow to one part of the health reform law by effectively killing off the CLASS Act, which was to be a baby step in the development of a national program to pay for long-term care.

Health Reform Loopholes

Trudy Lieberman | October 13, 2011
A couple weeks ago I walked the streets of Lincoln, Nebraska, talking to men and women about whether they thought Washington was listening to their economic concerns. Jeff Melichar manages his family's Phillips 66 gas station on the city's main street, and one of his big financial problems happens to be health insurance.

Cigna's New Ad Campaign Aims to Snag New Customers

Trudy Lieberman | September 27, 2011
Cigna launched a $25 million 'GO YOU' national branding campaign last week signaling that they are gearing up for tons of new customers as health reform rolls towards 2014. That new business will come from the millions of Americans now uninsured who will start getting government subsidies as an encouragement to buy health insurance coverage.

Turning 65: A Medicare Snafu

Trudy Lieberman | September 13, 2011
I didn't expect to write a sequel to my seven-part series about signing up for Medicare. Just when I thought I was on the program, and all was fine, it wasn't. After I submitted two bills for routine exams, I learned Medicare would not cover them as my primary carrier. That threw me into a tizzy. All my years of reporting about the program taught me that once you retire Medicare is primary.

Health Insurance, Meet the Jolly Green Giant

Trudy Lieberman | August 31, 2011
It's official now. The government has proposed that descriptions of health insurance policies will resemble those nutritional labels on canned and packaged foods'the ones you look at to find out how much sodium there is in Birds Eye peas versus the A&P brand.

When the Insurance Company Says 'No'

Trudy Lieberman | August 12, 2011
Blue Cross just advised a twenty-six-year old woman I know that it will cut off payments for the physical therapy that was making it possible for her to sit at a keyboard for eleven hours a day. Her thirty sessions were up.

Hit by the Fine Print: Three Ways the Debt Deal Could Hurt Seniors on Medicare

Trudy Lieberman | August 2, 2011
Medicare turned 46 last week, but instead of celebrating its major accomplishment ' keeping millions of older Americans healthy ' it finds itself under siege.

Drug Labeling Inside the Box

Trudy Lieberman | July 20, 2011
Reading those lengthy package inserts about the medicines you're taking is a bit like eating peas. You know they are good for you, but your gut says 'yuck.' So odds are you don't bother with all that teensy-tiny fine print, but just take the medicine and hope for the best.

Turning 65: Medicare's Future and Me

Trudy Lieberman | July 14, 2011
I once thought that when I signed up for Medicare, I would never again have to worry about paying for health care. But I will. Medicare's future shape and substance is uncertain.

Turning 65: Making the Choice

Trudy Lieberman | June 21, 2011
Even though I have written about Medicare for many years, it wasn't until I actually went through the process of selecting an option to cover Medicare's gaps that I realized seniors have an extraordinarily difficult, if not impossible, task. You can't make a perfect decision because so much depends on your future medical needs and no one can predict those with certainty.

Turning 65: Finding a Medicare Advantage Plan

Trudy Lieberman | June 6, 2011
Ah, those Medicare Advantage (MA) plans! The government can't seem to decide if it loves or hates them. On the one hand, when I tried to learn about my options, there was much more MA plan information available from the government than for traditional Medigap policies. So it seemed like I was being encouraged to select an MA plan.

Turning 65: Finding a Prescription Drug Plan

Trudy Lieberman | May 23, 2011
If I were to choose a Medigap policy to supplement my basic Medicare coverage, I would still have to buy a separate plan for prescription drugs, since Medigap sellers can't include drug benefits in those policies.

Turning 65: Finding a Medigap Policy

Trudy Lieberman | May 12, 2011
The first step after reading my collection of Medicare Advantage, prescription drug, and Medigap sales brochures was to find a way to fill in core Medicare coverage gaps'the deductibles for hospital stays and doctor care and the coinsurance for physician visits, lab tests, and hospital outpatient treatment that could really leave me with an unwelcome bill. I would have to pay 20 percent of those bills if I didn't have supplemental coverage.

Turning 65: The Sellers Were After Me

Trudy Lieberman | April 28, 2011
Even before I officially signed up for Medicare, sellers of Medicare Advantage plans, prescription drug benefits and Medigap policies began stuffing my mailbox with marketing brochures and lead cards'the kind that ask for your name and address and tell you that a salesperson will call if you return the card. Since the first of the year, I have received five lead cards asking for personal information, four solicitations for Medicare Advantage plans, two for stand-alone drug plans and three for Medigap insurance.

Turning 65: It Was Time for Medicare

Trudy Lieberman | April 11, 2011
This is the first in a series of posts that examine the process of signing up for Medicare, navigating its rules, choosing supplemental coverage and planning for health care in a program with a very uncertain future.

How Code Creep Boosts the Price of Health Care

Trudy Lieberman | March 22, 2011
About 30 years ago I had my first run-in with code creep. A urologist I had visited for a garden-variety urinary tract infection billed $400 to determine that this was what I had. The price seemed excessive, and then I looked at the bill. The good doctor has 'unbundled' his services. He charged for every single thing he did'inserting a catheter, taking a urine sample, writing a prescription and finally adding a fee for a general office visit. I had thought all those things were part of the office visit. I protested. He reduced his charges, and I never went back.

Will Medical Bankruptcy Be a Ghost of the Past?

Trudy Lieberman | March 15, 2011
During the health care debates, didn't you hear the president repeatedly tell the crowds that reform would mean that people would no longer be forced into bankruptcy because of illness? Insuring people who previously had no insurance does give them a cushion of protection and will mean that some of them will avoid bankruptcy court'but not all.

How the Cost of Health Care Creeps Up and Up

Trudy Lieberman | March 1, 2011
In a previous post, I talked about what happens when a radiology practice goes digital for mammography, even though there's scant evidence that more-expensive digital is better than cheaper film for detecting cancer in older women. Yet the higher-priced costly procedure is winning out. That's pretty much the norm for U.S. health care, for instance, when ThinPrep replaced the conventional method for doing Pap smears. I used to pay $9 for the test; the one I had last summer cost $250.

Vanishing Health Care Choices

Trudy Lieberman | February 16, 2011
Ask someone what he or she remembers Obama promising during the great health reform debates, and the response might be: 'We can keep the insurance we have.' The president did offer assurances that there would be no socialized medicine with the government dictating where you could go for care. He did not mention, though, that many insured people already have little say in what kind of coverage they get and who can treat them.

The Dilemma of Digital Mammography

Trudy Lieberman | February 7, 2011
The rapid changeover from traditional mammography'pictures taken with film'to the new digital imaging technology poses a thorny dilemma for women, especially those over 65. The scientific evidence suggests that digital mammography does not improve the detection of breast cancer in older women.

Those Clever Drug Companies, Again

Trudy Lieberman | January 27, 2011
If prizes were given for ingenious marketing, drug companies would win top honors. Like most businesses, they want to expand markets'that means getting you to buy more drugs whether you need them or not. Their appetite for finding new ways of doing that is insatiable.

Selling Sickness

Trudy Lieberman | January 21, 2011
Someone I know who is just over 65 received an unlikely solicitation'from The Scooter Store located in New Braunfels, Texas, on Independence Drive no less. The outside of the envelope promised a free personal mobility assessment. This person is totally mobile and hardly needs a scooter.

Assessing Risk: Medicare Advantage vs. Medigap vs. Drug Coverage Only

Trudy Lieberman | December 22, 2010
As Medicare's open enrollment season draws to a close, it's a good bet that seniors are still sifting through all those brochures and flyers that have come in the mail the last several weeks. My husband received 22. Here's a simple rule to make the sifting go a little faster.

Mini-Med Policies: Is the Government Telling Us Something We Don't Already Know?

Trudy Lieberman | December 17, 2010
The new health reform bureaucracy at the U.S. Department of Health and Human Services has announced that it will now require employers, health insurers and union welfare benefit funds to disclose to policy holders that the health insurance they have may not be real health insurance at all. They now have to tell us if their coverage does not meet minimum benefit standards required by law and by how much they fall short. So those who have mini-med policies will now get a notice telling them that their policies cover very little. As if people don't already know.

Finding a Medigap Policy on the Web? Better Think Twice

Trudy Lieberman | December 10, 2010
Oh, those clever insurance agents, always on the prowl for new customers. This time they are using the current period of open enrollment for Medicare to snag customers for other insurance products'products that consumers may not need or want.

Assessing Your Risk: Buying a Policy That Doesn't Cover Much

Trudy Lieberman | December 2, 2010
My friend Ariane Canas, a New York City hairdresser, was eager to tell me about a new health insurance policy she had come across. It was cheap very cheap as such coverage goes. I knew that she and her husband, who is also self-employed, had gotten a notice this fall from their current carrier advising of a 33 percent rate increase.

Does Long-Term Care Insurance Have a Future?

Trudy Lieberman | November 23, 2010
The decision by Metropolitan Life to stop selling long-term care (LTC) insurance once again calls into question the viability of that product as a way to pay for nursing home, assisted living and home care needed by the growing number of elders. MetLife was a solid company'big and reputable, with a knack for selling policies to workers whose employers offered the coverage as an extra benefit. It was a name that people trusted in an industry characterized by many small sellers, some of whom became insolvent.

Doctors and Their Speaking Fees

Trudy Lieberman | November 11, 2010
Would you keep using a doctor who collected $300,000 or even $300 in speaking fees from drug companies for saying a good word about their products? That's the question the non-profit, investigative journalism outfit ProPublica is inviting thousands of patients to ponder.

What You Need to Know About Your Health Insurance Policy

Trudy Lieberman | October 29, 2010
Federal and state government officials and their opponents in the insurance industry have been busy as beavers these days chewing on that perennially vexing problem: how to disclose insurance information so consumers will be wise shoppers. Since we have a market-based model of health insurance, that's not a frivolous question. What works best, what doesn't, and what do consumers acting as shoppers really care about?

How Useful Is the Government's Hospital Compare Web Site?

Trudy Lieberman | October 22, 2010
Well, what do you know? Another study surfaced this week raising more questions about the usefulness of the information on the federal government's Hospital Compare web site, just at a time when most of us are thinking about choosing new health plans for next year. For some time now, the standard advice has been to look at all available data for the doctors and hospitals in the plans you are considering. That has meant heading to the Medicare Web site and its Hospital Compare data set.

Revisiting Those Puzzling EOBs: New York Penalizes Aetna

Trudy Lieberman | October 14, 2010

The Medicare Sales Season Begins: As Always, Buyer Beware!

Trudy Lieberman | October 7, 2010

Adding an Adult Son or Daughter to Your Insurance

Trudy Lieberman | September 30, 2010

Matt Seeks Health Insurance, Part 2: The Runaround Continues

Trudy Lieberman | September 24, 2010

A New Way for Hospitals to Make a Little Extra'Tax the Sick

Trudy Lieberman | September 8, 2010
Dianne Cooper Bridges, a feisty health reform activist in Massachusetts, recently found herself in the hospital for a routine consultation with no tests or procedures. Because Bridges, a self-employed designer, refuses to buy the required health insurance in her state, she has no insurance and occasionally pays a fine. That means she shops carefully for medical care, which she pays for in cash. When she called the University of Massachusetts Memorial Medical Center and asked how much her consultation would be, the hospital quoted her a price between $100 and $200.

Matt Seeks Health Insurance: A Young Adult Falls Through the Cracks of Health Reform

Trudy Lieberman | August 26, 2010

Sorting Through the Indecipherable 'Explanation of Benefits' Is Becoming a Required Skill

Trudy Lieberman | August 16, 2010
A young friend showed me her Explanation of Benefits from Empire Blue Cross Blue Shield. "I don't really understand it," she said. This woman has a master's degree from the London School of Economics but couldn't comprehend what her insurance carrier was telling her...

More People Choosing Consumer-Directed Health Plans---Pitfalls and All

Trudy Lieberman | August 9, 2010

Keeping an Eye on Insurance Rate Hikes

Trudy Lieberman | July 29, 2010

Chicago Doctor Reveals Hidden Health Care Pricing'.

Trudy Lieberman | July 22, 2010

What Happens When an Insurance Company Misbehaves

Trudy Lieberman | July 12, 2010
When the Centers for Medicare and Medicaid Services (CMS) took the rare step this spring of kicking Fox Insurance out of the Medicare Part D drug benefit program, it pretty much went unnoticed. CMS went after Fox, admittedly small fry in the pool of insurers, and said they couldn't sell any more stand-alone prescription drug plans to seniors These plans are the kind that people buy to complement Medigap policies that don't offer any drug coverage.

Hospital Ratings: What Do They Really Mean?

Trudy Lieberman | June 29, 2010
From WHIO, a news talk radio station in Dayton, Ohio, comes word that four area hospitals rank in the top five percent nationally for emergency care. That is impressive, I guess. If you have an emergency, your chances of having a good outcome in one of them are probably pretty high. At least that's a reasonable assumption. The story went on to say that HealthGrades, the outfit that gives the awards, evaluates the hospitals based on their mortality rates for 11 of the most common conditions for patients needing emergency treatment. Furthermore, only 255 of the 4,900 acute care hospitals in the country got the award. A viewer might be doubly impressed.

Is Choosing a Health Plan Like Buying a Car or Canned Goods?

Trudy Lieberman | June 21, 2010
Do consumers buy health insurance like they buy canned peas? Or should they? That's the big question market place advocates have been trying to answer now for more than a decade. The government and others have thrown gobs of money at this vexing problem trying to figure out the best combination of stars, bars and other symbols that will catch the shopper's eye.

Some Honesty about Medicare Advantage Plans, Please

Trudy Lieberman | June 11, 2010
Obama administration officials and the president himself have been on the road selling the benefits of health reform.' The other day in Maryland the president was touting the $250 rebate sent this week to some three million Medicare beneficiaries whose prescription drug expenses have reached the infamous donut hole where there is no coverage.

What Happens When COBRA Disappears?

Trudy Lieberman | June 4, 2010
For thousands of laid-off Americans who have been relying on COBRA for their health insurance the past several months, Friday brought some bad news. In an effort to trim the deficit, the House voted to drop an extension of COBRA benefits that would have given displaced workers coverage until the end of the year. That would have cost the government nearly $8 billion. The Senate will vote on the issue next week.

Will You Be Helped by the New High-Risk Health Pools?

Trudy Lieberman | May 26, 2010
The new health reform law is what I like to call an 'over-the-line proposition' because undoubtedly, someone is going to be left out. ' What passed the Congress will not bring universal health coverage to America; nor does it assure that everyone is entitled to health care as a matter of right.' It simply adds more people to the current system by giving them subsidies to buy insurance they couldn't otherwise afford.' In such a system, there will always be people over the line'they won't qualify for this subsidy or that program either because the government limits its spending on them, or it wants to encourage people to use private insurance to keep those markets strong.

Can You Really Choose the Best?

Trudy Lieberman | April 29, 2010

How Safe Is Your Insurance, Really?

Trudy Lieberman | April 19, 2010
Throughout the long debate over health reform, the president told us if we liked the insurance we had, we could keep it.' No government would come between us and our health coverage!'

Not just about Mom and Dad's Health Insurance...

Trudy Lieberman | April 6, 2010
In the past two weeks I have visited two college campuses---one in Brooklyn and one in Wisconsin.' Large numbers of students turned out to hear about the new reform law and wanted to know what it meant for them.'