GWY for Health Care provides hundreds of concrete steps consumers can and should take to get better access to care, find the highest-quality doctors and care facilities, and learn how to pay less for better care.
The book includes research-based advice on how to take care of yourself and your family before care is required and how to assemble your own personal and professional health care teams. For the 90 percent of Americans who are covered by some form of health insurance, the book provides detailed help in understanding how to use health insurance, including how to talk to your insurer, how to avoid rejected claims, and how to fight back against adverse coverage decisions.
Throughout, it shares the stories of innovative businesses and entrepreneurs who are already finding better and cheaper ways to provide health care. It also shares the stories of courageous health care heroes who explain how they refused to settle for unacceptable care and high prices.
PART ONE: HEALTH INSURANCE BASICS
Health Insurance: Friend and Foe
Heroes I The Health Navigator—Brian Lehrschall
Employers Get to Work on Health Care
The Affordable Care Act and Other Health Plans
Heroes II The Insurance Claims Expert—Marsha Meytlis
Medicare Coverage, Costs, and Concerns
Medicaid: A Program Everyone May Need
PART TWO: YOUR HEALTH CARE TEAM
Heroes III The Letter Writer—Julie Greenwood
Your Personal Health Plan
Your Personal Care Team
Heroes IV The Social Media Maven—Julie Croner
Your Professional Care Team
What Quality Looks Like
Heroes V The Patient Advocate—Karen Moore
PART THREE: NEW HEALTH CARE CHOICES
Unneeded and Misdiagnosed Care
When You’re in Control, and When You’re Not
Heroes VI The Warrior Mother—Cynthia Buness
Shopping for Health Care
Getting and Paying for Drugs
Heroes VII The Warrior Daughter—Areta Buness
How To Fight Back
When Consumers Make the Call
Afterword: Through the Pandemic Looking Glass
Countless people are proving that consumers can beat the system, that superior care at reasonable prices is possible, and that we don’t have to accept the status quo. They are a different breed of health care hero than the caregivers who manned the front lines during the heights of the pandemic. But they are heroes nonetheless. . . . These heroes shop for the best deal and pore over health quality ratings. They appeal rejections of their insurance claims. They fight the government about which treatments and drugs are approved and the rules for how insurers help pay for them. They don’t accept defeat or walk away—they speak up; they kick and scratch; they sue! Their stories illustrate an evolving movement involving thousands of organizations and millions of engaged patients and consumers. View them not as the end of the transformation story. There will be more heroes and disrupters appearing each day.