Cash Only Health Care

Physicians are more strained than ever before to stay in business and are searching for new models to help them succeed. Physicians’ offices spend between up to $30 billion dollars a year in administrative overhead trying to get paid by insurance companies. Due to the increased burden of administrative overhead and cuts in payments for services, many physicians are weighing the benefits of cash-only practices — meaning they would stop accepting any form of insurance and leave patients to seek reimbursement from insurance companies themselves. Cash only is a type of payment where the patient’s own resources pay for the care. It is contract between the patient and the physician. Individuals pay for care with personal funds, health saving accounts, and other funds. Cash only is the basis upon which the healthcare financing system began. Patients paid physicians a fee-for-service. In its purest sense, the Cash Only model includes only the physician and patient in the exchange of compensation for medical care provided. Over the years as healthcare financing arrangements have changed, entities paying a fee-for-service includes all payers-public and private. Recently, the healthcare industry has referred to physician practices that do not accept health insurance as cash-only practices or Cash only offices. Cash only vastly reduces the traditional overhead expenses by not having to bill and abide by contractual requirements of third party payers. There are already millions of Americans who cannot afford private health insurance and have Medicaid coverage. Others self-insure due to their financial resources being such that they can pay out-of-pocket for their medical expenses.

Urticaria

Urticaria, or hives, is a skin condition commonly caused by an allergic reaction, characterized by raised red skin wheals (welts). Hives are a skin-disease--itis or --uredo. Wheals from urticaria can appear anywhere on the body, including the face, lips, tongue, throat and ears. The wheals may vary in size from about 5 mm (0.2 inches) in diameter to the size of a dinner plate; they typically itch severely, sting or burn, and often have a pale border. Direct contact with an allergic substance or an immune response to food or some other allergen, causes urticaria, but it also appears for other reasons, notably emotional stress or innocent events, such as mere rubbing or exposure to cold.

Gastric Band Revision

After gastric band surgery, patients may need gastric band revision surgery for a number of reasons. A laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable silicone device that a surgeon wraps around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. The lap band could slip down, leading to a slow chronic condition or an acute condition requiring emergency surgery. Both circumstances ultimately lead to the gastric band not functioning the way it should. While each circumstance is different, treating these issues may require removing the lap band, repositioning the lap band or replacing the lap band all together. Removing the lap band obviously opens the door for potential weight regain. Gastric band erosion is another possible complication of lap band surgery. Lap band erosion occurs when the lap band burns a hole in the stomach, rendering the lap band ineffective. Patients may vomit blood as the first signal of lap band erosion. The most frequent symptom of lap band erosion is an infection around the site of the port. Due to erosion caused by the lap band, saliva leaks through the hole in the stomach and flows along the lap band tubing, causing the tissue under the skin of the lap band port to become infected. Gastric band revision treatment requires removing the lap band, resulting in no further weight loss surgery and a high likelihood of weight regain. The lap band may simply fail to produce the desired results and require revision bariatric surgery. Lap band is a restrictive weight loss surgery and some patients may not have the metabolism needed to lose weight with the lap band. Other patients may not be able to eat in the new prescribed way to achieve success after lap band placement. Gastric banding is the least invasive surgery of the bariatric kind. A gastric band surgical procedure using laparoscopic methods results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures. The patient can continue to absorb nutrients from food normally. Gastric bands are made entirely of biocompatible materials, so they are able to remain in the body without causing harm. However, not all patients are suitable for laparoscopy. Patients who are extremely obese, who have had previous abdominal surgery, or have complicating medical problems may require the open approach.