Ask the Expert

Americans - Rushing to Find Health Insurance This Spring

Charles R. Keating

Author, "The U.S. Healthcare System" , Family Practitioner (1968-1997)

Each week we welcome a professional from the insurance or medical industry to discuss non-biased, real issues that affect middle-income Americans. The designated topic for discussion is posted ahead of time and each week millions of Americans are given the unique opportunity to ask questions pertaining to that topic. You are encouraged to e-mail us with any question you would like answered by that week's 'expert'.

This week our 'Ask the Expert' professional is Charles R. Keating, M.D.,ABFPA, an advocate of health insurance socialism, and former family doctor for over 30 years.  He has written numerous articles for the Associated Press, as well as lobbied for patients' rights both on and off the congressional floor. He joins us today from his home in Sunnyvale, CA. A father of three children, Charles and his wife Beverly currently chair three health advocacy organizations.

Editor's Note: moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

Saturday, June 19, 2004 | Updated 10:02 a.m. PST

Arlington, Va.:
I'm a 20 year old student from University of Wisconsin. I got kicked off my parents' health insurance last year and haven't had any since. First off, what would you recommend for someone like me?

C. Keating: Being dropped from a parent's insurance, especially this time of year, can either be a 'fly-by' experience, or a 'must have'. As adults, you must be responsible for your actions and justly so, you have taken on the next step towards fiduciary responsibility. Whether acquiring a short-term plan, or permanent health insurance, you must take into consideration one thing: the fact that you are becoming more responsible for your own actions. Take into consideration the following article: Playing Without a Net, as written by Lisa Barrett Mann of the Washington Post. If I were you, I would choose a more permanent solution for your health care needs. You're young, healthy (I'm assuming), and risky (I'm also assuming). You'll have trouble later on if you choose a short term plan now and decide to convert to a long term plan later because you will have to endure the obstacles of underwriting. 1 down, 15 to go. Let's move on now.


Washington, D.C.: Hi, I'm a 25 yr old male, with a 22 yr old wife who is pregnant. My question is, what kind of health care insurance would you recommend we purchase? I heard we were uninsurable from all of those agents - because my wife Mandy is pregnant.

C. Keating: Yes, rarely will a carrier pay pregnancy related claims 'during-the-fact'. Which is why it is always a sound idea to have health insurance beforehand. You will need to either acquire Medi-Cal (I believe that is what you guys have there in California right?) or wait until after the baby is born to purchase health insurance. As a doctor, it was always tough for me to take care of patients who were pregnant and had no health insurance. Our system is not the best out there - but we deal with what we're dealt.


Loma Linda, Calif.: What would you recommend - short term or permanent health insurance?

I am undecided.

C. Keating: Please read above. I'm an advocate for permanent health insurance. The premium difference is hardly noticeable - in many cases, it ends up being cheaper. The underwriting involved (pulling up the M.I.B., investigating claims, checking previous medical history) is the deterrent here. No silver bullet is going to pierce a determined graduate seeking health insurance.


Burbank, Calif.: I broker my finger, I think, and bruised up my leg pretty bad when I fell attempting to 'grind' a rail. I have no health insurance but was wondering if you knew of any free places to receive treatment. Else I will have to pay the bill - and I'm afraid it will get expensive. What should I do doc?

C. Keating: If you haven't gone to the doctor yet, I would do so right now. You allow yourself to walk around with broken bones you're asking for trouble. Not only skeletal problems but you may actually be hurting your body even more by not receiving medical treatment. In terms of getting health insurance now, most policies have a clause stating the fact that they won't pay claims on pre-existing conditions for at least 6 months, from the effective fate. You will have to shop around and find, for yourself, a good plan to cover you in the meantime.


Baton Rouge, LA.: I'm worried Dr. Keating. I purchased some health insurance last month and finally went to go see see my doctor, and my dentist. They made me feel comfortable - I have an HMO plan. In any case, I found out that I had Hepatitis C - and they think that I got it from my boyfriend. How should I approach him about it without pointing fingers?

C. Keating: Hepatitis C is a condition that occurs when blood or body fluids from an infected person enters the body of a person who is not infected - it is also spread through sharing needles or "works" when "shooting" drugs. Persons at risk for HCV infection might also be at risk for infection with HBV (Hepatitis B) or HIV. If your boyfriend is indeed a carrier, I would highly suggest getting him treated and quarantined right away. I recommend a treatment called Interferon - a very effective treatment against Hepatitis C - it has an effective cure rate of about 25%. Consult with your family doctor about the possible side effects of this drug - it is also licensed for treatment of AIDS-related Kaposi's Sarcoma and genital warts. There is no shame in curing Hepatitis C - which is why I feel there is no shame in approaching your boyfriend - the main thing here is to find the 'source' and quarantine this 'source' right away. If you haven't heard, an outbreak of AIDS in the porn industry has halted productions nationwide!


Madison, WI.: I'm 5'2, 278 lbs, and I want to get obesity surgery. I would like to staple gun my stomach, or do something that will force me to eat less. I read an article about Carnie Wilson, who lost 150 lbs after her gastric-bypass surgery in 1999. She's absolutely beautiful now! I remember when I used to listen to the Wilson Philips. What do you recommend? I need advice, big time. I'm tired of being large, overweight, tired, just plain 'fat'. I need a lift in life, and I feel this may be just it.

C. Keating: Morbid obesity affects people in many ways - not just physically. Depression soon follows. Diabetes and gout, as well as heart attacks are very common as well. I remember the whole Gastric-Banding procedure done on Carnie Wilson - she's absolutely stunning today. The magic of medicine! In fact, to go beyond that, it saved her life - and made her beautiful outside as well. The bariatric surgery society estimates that, on average, nearly 400 procedures will be performed every day this year. Doctors are becoming more strict with who they consider to be the perfect candidate for gastric-banding surgery. Many have witnessed what overeating does to a post-gastric-banded patient - throwing up. In many ways, make sure you investigate the potential hazards of gastric banding. Hope that answers your question.


Lansing, MI.: I heard the FDA rejected the nonprescription morning-after-pill. First off, I'm not going to start with the whole women's rights thing. However, I really feel Bush and his government are putting politics before science in rejecting over-the-counter sales of morning-after birth control. I feel there should be easier access to these kinds of drugs - which in fact will prevent many from leaving high school early because they made a 'mistake'. What is your take on this and where do you see these types of drug sales going in a couple of years? Any hope in sight?

C. Keating: As I recall, the FDA was going to reconvene and discuss the possibility of reinstating, or approving nonprescription morning-after pills. I'll tell you one thing for sure, never in my 30 years did I realize how much of an issue this was until now. Back in the 70's, people were usually satisfied with having kids early in life. Not much to do during the Vietnam era - life was more family oriented, especially with much of the population going overseas to fight in the war. Five states however, all access for women to buy morning-after pills from certain pharmacists without a prescription. These states include California, Washington, Alaska, Hawaii, and New Mexico. If a woman already is pregnant, morning after pills have no effect.


Princeton, NJ.: Read in the news something about Lyme disease climbing to its highest level on record. Doesn't Lyme disease originate from ticks? What is it - attacks of the ticks now?!

C. Keating: Ticks and me are not friends. We are enemies - bitter enemies. I used to treat a lot of deer hunters who acquired Lyme disease, or were bitten by ticks that just refused to let go of their prey, us humans. Growing populations of deer that support deer ticks, as well as more homes being built in wooded areas are contributing to the rise in the national 'Lyme Disease' rate. If untreated, the disease can cause joint swelling and brain inflammation. Moral of the story here - stay away from the woods if you can right now.


Silver Spring, MD.: Attack of the cicadas - help!

C. Keating: Is this a joke? Yes, every 17 years they come out to haunt us, and this spring/summer is going to be quite loud and eventful. Just keep your dogs away from them, they tend to choke on the exoskeletons when swallowing the darn things. I sure hope I'm allowed to say 'darn'. Cicadas make good delicatessens for many as well - taste like shrimp if you ask me. I use'm for bait some times when going fishing. Apart from that, the males and females will have a mating fest this season. It will be loud. And afterwards, silence. What a life.


Salt Lake City, UT.: Graduating this Spring - where do I get health insurance?

C. Keating: Wow, surprised you'd come onto eNetInsurance and ask that question.


C. Keating: Gotta go, friends. Thanks, as always, for your questions and take good care, stay strong. Til next week...Goodbye!

Submit your questions for next week's expert, Dr. Margaret Samuels, a Gastric-Banding surgeon, who will be answering your questions regarding "Obesity and You".

Check back next week for the answers to your questions.

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