How to Decrease Your Healthcare Costs in the Upcoming Year

Hello. This show is brought to you by the Channel of Health, and this is the show where you can be informed and empowered about all sorts of healthcare issues that are important to you. I'm your host, Dr. Valda Crowder. You can call me Dr. V. I've been a board certified emergency medicine physician. I've treated patients across four pandemics, one mass shooting, and a category four hurricane. So rest assured you are in good hands. We've got a really big topic today to cover. And that is basically, you know, how can we decrease our health care costs in the upcoming year? You know, at the end of the Carl Nelson show, they were talking about uh the NFL. Uh, there's a lot of NFL players who'll be retiring this year, and they will also struggle in retirement um to actually figure out how to get their health insurance. The Obamacare subsidies will be expiring, assuming that there's nothing that occurs in Congress in the next uh 10 to 20 days. That is gonna leave about 5 million Americans uninsured this year, and there'll be about three to four million every year after that that will become uh uninsured. And the consequence of that is really, really important because for every 5 million people that are uninsured, about 55,000 Americans die a year because of the lack of insurance. Lastly, there may be some of you out there that have a New Year's resolution related to health and wellness uh that you want to actually uh see actualized uh this year. And so, you know, with all of this, I kind of wanted to talk about how do you actually decrease your health care costs in the upcoming year, and how do you get the most bang for your buck for the money that you do spend. So the first thing that I wanted to start out talking about was, you know, a health care cost that all of us experience, which is prescription medications. And, you know, at one time or another, we've all had to go to the pharmacy, pick up a prescription for either ourselves or a family member or a friend, and sometimes been hit with a surprise as far as how much the medication cost. So I want to really talk about what sort of things are going on uh to decrease health care costs, and what sort of options and things can you do when you have this experience. So, one of the things that I want to talk about is that the Biden administration, before they left office, actually passed a uh a law that allowed Medicare to negotiate uh pricing. And that negotiated pricing took place and started, became in effect as of January 1st. And what they did was they looked at the 10 most common drugs that are used uh primarily by uh folks that are on Medicare. Um, and the drugs that they picked are the following. Uh they picked Eloquis, which thins out your blood and prevents blood clots, uh, Genuvia, Jardiance, and Farsiga, all three of those medications are used for diabetes. Uh they also looked at Zorelto, which also thins out your blood, um, entresto, uh, which is used for heart failure, embril, which is used for autoimmune diseases, uh, things like uh rheumatoid arthritis, um, Stellara, which is used for inflammatory conditions, and then Novolog, which is uh you know a type of uh insulin. So these 10 medications, what they actually did was they allowed Medicare to negotiate the pricing. Um, the discount um is 40 to 80 percent on non-generic medications. So this is a very, very significant discount. So this actually tells you how much we had actually been overpaying for medications, that they could actually discount the medications 40 to 80 percent, and I'm sure the pharmaceutical companies are still making money. Um, this um is for Medicare, uh, people on Medicare. However, usually what happens is the commercial insurers will also then actually say we want the same pricing as Medicare, and normally it will follow that the um that the um Medic that the commercial uh insurance will also uh have the same rates. Um the other thing that the Biden administration did before they left is they decreased um out-of-pocket expenses for Medicare and capped it at$2,100. So the most you should have to pay in 2026 is$2,100 for any sort of uh medications if you are on Medicare. So now what happened after the Biden administration? So the Trump administration actually decided to add 15 other medications to that list of 10 medications. So these reductions in prices are not going to occur until next year, 2027. So there will be a discount on uh Janumet, Ozempic, Rebelsis, Rogovi, Trigenta, which are all diabetes and weight management drugs, uh Trilogy, which is for COPD, Zitandi for prostate cancer, uh Puma, which is for multiple myeloma, Caposi, sarcoma, uh eyebrans for breast cancer, uh ovae for pulmonary fibrosis, uh lenses for irritable bowel syndrome, uh QLens for leukemia, osteto for uh Huntington's disease, uh Brio ellipta, which is for asthma COPD, um, and also Vrailar for bipolar and um schizophrenia, uh, and OTESLA which will be for psoriasis andor psoriatic arthritis. It is expected that the discounts for these medications, because of the negotiation with Medicare, will be similar in the 40 to 80 percent uh percentage range. So um significant reductions coming up for those medications. Um, I think that, you know, there are still people who are on other medications and need to get some help. And so we're gonna talk a little bit about all of that. What the health is happening, that's a real question. And it's also the name of my new podcast where you can literally get life-changing advice. What the health is happening is where I give you the inside scoop on all healthcare matters, and it empowers you with information on everything that you need to know about healthcare and important medical updates. What the health is happening is your dose of medical reality with myself, Dr. V, and some of my friends from the front lines of healthcare. It is a podcast. If you don't know how to actually download a podcast, ask a younger person in your family. They'll show you immediately. And you can download, subscribe, and comment. All right, let's take some questions that we have actually had. Um, I have a question from Jennifer uh in Bowie. And Jennifer says, Um, I've heard of commercials like Good RX and people talk about coupons. Is this really a thing? Um, does this really exist and how do you actually get it? So this is really important. So if you actually go to pick up a medication or um and you go to the pharmacy and it is higher than what you thought, um, you can actually um ask them for a good RX coupon. The good RX coupons are usually sitting right by the cash register. Um, and you can ask them what is the good RX price. The other thing is that the manufacturer of that particular medication may also have a coupon. So sometimes you can ask the pharmacist, are there any coupons online for this? Sometimes they'll stop and look for you, sometimes they'll tell you, um, here's the manufacturer, the manufacturer is, let's say, Merck or Johnson Johnson. You can uh take a look. Um, those coupons are different for different people, like they'll say this coupon is for someone who's on Medicare, this coupon's for someone who's uninsured. So you want to make sure you get the coupon that's right for your particular situation. All right, we've got a call on line one. Carol? Carol, can you hear me?

Yes, I can't.

Oh, Kashiba. Can you hear me? Yes, I can. Kashiba, I'm sorry.

Yes. I have a question regarding, you know, how to talk to your doctor to some extent. Well, I had uh I've got sense in my heart.

Okay.

And um I have done some a little bit of research and books about um cholesterol studies. Um my doctor is when I went back to him. I guess my blood pressure was elevated and he was concerned about my uh cholesterol. But what I've been reading about is is that all that all that all those statins have an effect upon you. I've got some short-term memory loss of been having that for months now, taking all these statin drugs. Um do you for your patients, do you are there alternatives to statin drugs? No. My doctor told me that no, there weren't any alternatives, but there has to be something other than um you know, increasing blood pressure medicine and increasing statin drugs too.

Right. Do you know what statin you're on?

Rosevastin um let's see how is it pronounced? Roseovastatin. Calcium.

Yes, yes, okay. Alrighty. So a couple of things. So when it comes to your cholesterol and your cholesterol being elevated, um there are it's the if the bad cholesterol is elevated.

My good cholesterol is is is um is is elevated too. I mean it's so that makes it.

So that means so it means you're so you have basically um an elevation of your total cholesterol as well.

Yes.

Right.

So um good cholesterol is is is is elevated.

Mm-hmm. So you're so you're the so so when you talk about the good cholesterol, that's your high density. Yeah, that's your HDL. That's the high density lipoprotein. So you you want that to be elevated.

Yes.

Right, okay, so so you have that that's elevated and that's great. So what you have is you have an elevation of your LDL, which is the bad cholesterol.

Yes.

Okay. Do you know whether or not your triglycerides are elevated?

You know, I I don't know. Well, he just was concerned about the cholesterol.

Right.

Should I be asking him about my triglycerides?

Yes. Right. So so let me tell you, one of the things that we're finding out now, and I don't know, you know, the age of your physician, but I'm just telling you, one of the things that we're we used to not think that triglycerides were important. And we have now found that triglycerides are actually a very important component along with your H HDL and LDL. Um, and so I would ask about triglycerides, because if you have an elevated triglycerides and an elevated LDL, that may be a different approach than if you just had elevated LDL only. Okay. So ask about um uh ask about uh triglycerides. And I bet you he it's probably on the it's probably on the profile. So one of the things that can actually make a difference though, since we know you have elevated LDL, one of the things that can actually really make a difference are what we call like soluble fibers. So these are things like oats, barley, beans, lentils, chickpeas. These things actually really make a difference and can lower your LDL by about you know, eight eight to fifteen percent.

Beans.

Beans, yes. Any sort of what we call soluble fiber. So oats, barley, like some people have uh an oat or barley cereal, right? Then they have made they'll have beans or lentils for um, you know, as a soup or something. Um chickpeas is basically hummus.

Okay, I'll get some hummus.

Right. So those are things that can actually the other thing that can really make a difference is having eating more fatty fish with omega-3s. So that's like salmon. Omega three. Yeah, or you can take an omega-3. Did he you need it? You should definitely be on an omega-3 supplement. Are you on an omega-3 supplement?

Um, I'm on um is that uh D3?

Is that no. No, so so no, so vitamin D three is completely different. That is for your immune system. So omega-3 is actually for your um for your um for your heart health. So you get omega-3 from like um, you get D3, which you're taking, that's from sunlight. Omega-3 you get from salmon, sardines, those sorts of fish. So they're they they recommend that if you have an elevated LDL, that you actually have two a minimum of two servings of that a week.

Two servings per week.

Two servings per week, yeah. Right? So those would be the things that would actually really, really make uh make a difference. I'm gonna um what I can do is I if you if you want to get a really good omega 3, you can email me at DRV at channel of health.

Slow down. Yep. D-R-V at channelofhealth.org.

So D likeen David, channelofhealth.org.

Wait a minute. DRV as in the Dr.

V.

Victor.

Yep, yep, D likeen David. Yep, D like and David, R like and Ralph, V like and vegetable. Channel of health.org. Yep, at channelofhealth.org, and I will get you a good omega 3. Because you want a medical grade omega three, because you already have stents, and you you know, you know three stents. Yeah, yeah, yeah, yeah.

Is that the reason why I just have to have these statin drugs?

Yes, because because the the so so the next step after stents is having to have bypass surgery.

Oh, okay. You don't want to, you know, that's like a whole but the only alternative is the statins, even though they they're they're talking about the statins cause memory problems.

No, I I just gave you the st the the now I'm not saying don't get off of what your doctor told you to do. Make the dietary changes first. Okay? Okay. So so take those soluble fibers and the omega-3s, take that first. And then with the dietary changes, your uh LDL should go down by 10 or 15%, and then as it goes down, you're you can consult with your physician, and then he can slowly wean you off of those statins. But you have to make the dietary, you have to stay on the prescription medication that he's given you and make the dietary changes while you're on it.

Okay.

Okay.

Okay.

All right. All right, great, Kushiba.

Well, thank you very much for your help.

You're welcome. You're welcome. Send me an email, I'll make sure you get a good omega-3.

All right.

All righty. Next question is uh from Janice. Um, and again, if you want to join us, it's 1-800-450-7876. Next question is from Janice. What is the most common reason people go to the ER that could actually be handled at an urgent care or primary care office, and how much money could you choose by by choosing the right setting? So this is a really this is a really great question. So, so so this is a this difficult to answer this question because primary care offices and urgent care centers have different capabilities. So I tell people if you're dealing with something that's not emergent, so let's say um, you know, you you sprained your ankle and or you know, you injured your ankle, but you can still walk, or a cut, or something, something along that line that is that is relatively minor. If you're gonna go to an urgent care center rather than an emergency department, then you need to ask them do you can you guys handle? I fell and I cut my finger. Do you have the ability to do stitches? Do you have the ability to do uh x-rays? Different urgent care centers have different capabilities. When you look at something like, and I'm just gonna use an example, there's various uh CVS's minute clinics, they will have very, very low capabilities. So they almost are never outfitted with um, they almost never outfitted with x-ray, x-ray machines and usually are not staffed by folks that can actually suit your lacerations. Then you go to other urgent care centers and they have um all of that capability. So you kind of have to know, um, you kind of have to ask ahead of time if you're dealing with something that is emergent. Now, the other thing about urgent care centers is they are going to collect the copay up front. They do not have an obligation to see you no matter how much money you have. The emergency department, we have an obligation to see you, we do not collect any uh any money up front. So a lot of people will go to the emergency department because they may not have the money right then and there. And so um they'll get a bigger bill later, um, but they don't have to pay up front. Um, I will say this a lot of a lot of things that people mistakenly go to urgent cares for. If you are on a blood thinner and you fall and hit your head, you absolutely need to go to the emergency department. So I see a lot of people who go to urgent cares rather than going to the emergency department, and the urgent care will immediately send you over. So if you fall and hit your head and you're on a blood thinner, um you need to go on to uh the emergency department. One of the most preventable things that I see in the emergency department, if people are looking at decreasing their health care costs in the future, I always say, you know, one of the main things is don't get sick, right? So that's easier said than done. So, so but um what I actually see a lot of people do that is preventable are falls. So, you know, you really want to look at, you know, especially at night, um people get up, go to the bathroom, they've got something in the way, they've got a rug that they trip on, they've got, I don't know, clothes or hangers that they haven't put up. So just make sure at night when you go to bed that you know you can get up and get to the bathroom and traverse um uh cleanly to the emergency to the bathroom and back. Um it really does make a difference. A night light where people can actually, you know, where you can actually see. So falls are a big way to actually that a lot of people come to the emergency department, um, that they're just moving too fast. Um they should be using a cane or should be using a walker and don't want to use a cane and don't want to use a walker. Things like that often lead to some un some some emergency department visits that actually uh uh could be prevented. All right. I've got a question here from Mike, and Mike said, What is your advice for uninsured or underinsured patients who need emergency care? Are there financial assistance programs that they should know about before or right after their ER visit? So this is really this is really important. So a couple of things. One is that when you have an emergency, you should just go to the emergency department and get the care that you need because your health is the most important thing. You cannot pay any bills or deal with anything if you are disabled or having any sort of a problem. Most hospitals have a financial assistance program and you can ask about it, and they will often give you an application so that you can actually apply and see if you actually qualify. When you actually do qualify, many of those programs will apply not only to your emergency department visit, but for other things that you need moving forward in the future. Um, and so there are assistance programs that are only for that visit, and there are assistant programs that actually apply moving forward. The other thing is let's say you're out here and you already have a hospital bill, you didn't apply for the assistance, and they've been hounding you. You want to actually call them and actually either try to get a discount, like, okay, I'll pay this, but I need a 30% discount. Um, I can pay this bill, but I can only pay$100 a month. You can negotiate with the hospital. So don't be scared about negotiating with the hospital. The other thing is you can negotiate with your physician. Um, I know I had a situation where my dental insurance got changed. I didn't realize it got changed, so I wound up having this bill. I negotiated, hey, I'll pay you, you know, 60 cents on a dollar and just got got it got it gone. And so there are things that you can actually do like that. It's also very important when you go to see your physician that you let them know that you are struggling or Or uninsured. And so if they give you a prescription, you can ask them, is this prescription something that is going to cost a lot or is there something that is lower priced? Is this can I actually get this prescription filled as a generic? Um and so you want to make sure to um you want to make sure to ask those questions. All right, I've got a question from Cynthia. Uh it says, Why would the Republicans want to push so many people off health care when it's going to impact their constituents too? Who is benefiting from these changes? Oh, that's really simple. Um all of this is occurring so that we can provide tax breaks. Um tax tax breaks. This is all of this is occurring so that we have more money for tax breaks that are really benefiting more of the wealthy than anyone else. Um I would also say um a lot of this a lot of this is occurring um also so we have money for our military. So, you know, at the end of the day, we have to really look at um requiring our administration to actually value people. All right, we got a one call on one on line one. Do we have enough time to take it? Okay. I give you contact information. It's DRV, like David Ralph Victory, DRV at channelofhealth.org. Um, you can reach out to me. We also have a oral uh we also have an oral GLP one and medical grade supplements and anything that you really need. So just email me, tell you, tell me what you need, and I'll help you get it. All right, I want to thank you guys today. I hope that this show has been really helpful. I want people to know that moving into the new year, you do not have to be straddled with very high health care costs. There are things you can do. And the mission of the Channel of Health is to educate, inform, and empower all communities about pressing healthcare issues. I want to thank you for joining me today. Make sure to email me, and we will be back here next week.

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