The August edition of Premera’s “Washington Network News” explains to referring providers the requirements for a massage therapy prescription:

Referring provider’s offices can expedite treatment for members by including the following information on the prescription:

• Member/patient name
• Prescribing provider name
• Prescribing provider phone number
• Diagnosis (preferably ICD-9 code)
• Frequency of treatments (e.g. twice a week for three weeks) or number of visits including start and end date (e.g., six visits June 1-July 31)

Premera patients: Please make sure that the prescription from your doctor includes all of the information above.

I’ve been doing online publishing for quite a while now, at least 15 years, and am back at it with a new website, Office Fitness Tips. (Attention, massage clients: don’t worry, I’ll be doing this in the early morning, so you can still book appointments at your usual time.)

I have internalized so much of the technical, business, and creative arcana of web publishing that it sometimes helps to back away from the details and reflect on the purpose and potential of the medium.

How to Build a Successful Blog Business is a terrific e-book overview of the many aspects of building, promoting, and profitably operating a commercial blog. It’s a little daunting to see in one place all of the details that have to be attended to, but it’s also very helpful to have a mega-checklist of what it takes to make it as a serious blog publisher.

I’ve been so busy with my massage practice the past several years that my online ventures have mostly fizzled to this point. Office Fitness Tips integrates nicely with my massage practice, so I am confident that this effort should at least get a little traction.

This is the text of a speech I delivered at my Toastmasters group today. I have looked for a long time for a succinct description of the problems with our health-care system, couldn’t find one, and so I wrote this. It’s based in large part on T.R. Reid’s book, The Healing of America, but is also informed by numerous newspaper and magazine articles and other sources.

* * * * *

I donated blood yesterday, as millions of Americans regularly do. As I lay there sharing my blood, I thought about the irony of our situation here in America. We are generous, kind people and the world’s leading nation in many ways, yet we have created a health-care system that ranks 37th in the world, according to a survey by the World Health Organization.

I have taken a long, hard look at our health-care system, and I have concluded that it is barbaric. That’s a strong word, I know. I spent a lot of time thinking about it and reviewing dictionary definitions before I decided to use it. I’m not accusing anyone of being a barbarian, but I believe we have a health care system that is demonstrably barbaric.

One definition of barbaric is: crude, uncivilized, and brutal.

Crude

Our health care system is truly crude – unrefined. It is marked by logical inconsistencies and financial inefficiencies.

Unlike every other major industrialized nation, we have a piecemeal collection of different systems that treats vast swaths of our citizenry differently. Every other modern nation puts all of its citizens in the same system (by the way, this is how insurance is designed to work – by having everyone in the same pool, risk is spread equitably across the population). Here we have 4 pools: if you’re employed or able to buy your own health insurance, then you are covered much like folks in Germany, in a multi-payer, multi-provider system; if you are a veteran or a Native American on a reservation, then you are covered much like folks in the UK’s National Health Service, a single-payer system in which the doctors work for the government; if you are over age 65, then you are covered like folks in Canada’s system (from which we also got the name Medicare), a single-payer, multiple-provider system; if you are not covered, then you are in the heaven-help-us, please-don’t-let-me-get-sick, pay-as-you-go non-system. Every other modern country has one system for everyone.

Our system is incredibly inefficient. All you have to do is think about your last encounter with your insurance company to see this. But the data also show how inefficient our system is. The U.S. spends vastly more on health care than other countries – in both absolute and relative terms. More refined systems in other countries waste many fewer dollars on bureaucracy and administrative overhead and – more importantly – they deliver better health results. That #37 ranking in the WHO survey is just the tip of the iceberg – we rank poorly in virtually all comparisons of health-care outcomes.

Our awkwardly assembled and poorly managed health-care system is indeed crude.

Uncivilized

Our health care system is also demonstrably uncivilized. It is simply uncivil to treat each other the way we do.

We leave tens of millions of our fellow citizens uncovered (and this will remain true even after the current health-care reform bill is fully implemented). Universal coverage is the ideal in the modern world, and every other modern industrialized nation except ours has figured out a way to cover all of their citizens.

And here in the U.S., those who are covered have to fight their way through armies of insurance-industry minions who try to rescind coverage and deny care.

Leaving millions of our fellow citizens exposed to the whims of illness and injury, and then denying us care even when we are covered – that is truly uncivilized.

Brutal

Finally, our health-care system is brutal.

The upshot of our crude and uncivilized system is that tens of thousands of Americans die every year for lack of medical care (25,000 to 40,000, depending on the source). That’s like having a travesty on the scale of the 9/11 attacks unfolding each and every month. That shouldn’t happen anywhere at any time. And it simply doesn’t happen in other modern countries.

Also, about a million Americans are driven into bankruptcy every year due to unpaid medical bills, a situation that is also unheard of in other modern countries.

Killing tens of thousands and bankrupting a million people every year, our health care system is definitely brutal.

* * * * *

I’m not happy to deliver this news. Nor do I know how to fix this situation. Believe me, I would if I could.

Americans are not Barbarians. It’s a shame that we are saddled with such a barbaric system.

* * * * *

Clients often ask me where I get information on general health care issues. I read widely on health care, but these four sources account for the majority of my reading:

• The New York Times Health section – outstanding coverage of current health news. All of the reporters and columnists are, of course, excellent; I really appreciate Jane Brody’s reports on orthopedic medicine.
• WebMD – very good medical journalism, if a little overly conventional and unimaginative.
• The UC-Berkeley Wellness Letter – good old stodgy MDs covering a wide range of medical topics.
• Dr. Andrew Weil – disparaged by many in the medical world for his unconventional views, I think they’re just jealous of his success and his deep and eclectic knowledge of integrative medicine

This assortment gives me WebMD’s breadth of coveage, the NY Time’s depth, the UC-B Wellness Letter’s conventional coverage, and Andrew Weil’s unconventional take on things. If you have sources that you think I should be reading, please leave a comment below.

Forwarded from a friend:

Looking for a part time Licensed Massage Therapist for busy North Seattle Chiropractic Office. Team Member – Long Term Mondays and Wednesdays 8:30 AM- 6:00 PM. APPLY: mydoctor@abramschiropractic.com North Seattle – $25 per hour to start.

A nice group showed up for the noodle group lunch today. There were 16 of us, plus one infant, so we had to spread out a bit.

We’ve now been meeting for more than 12 years – yikes!

Mike passed his camera around, and everyone except Michael got snapped. Here’s a Flickr slide show of the pix:

As usual, I overate, gorging myself on the panang curry combo plate. Also as usual, the service at Jai Thai was great and the food yummy.

Seven couples attended my “Basic Swedish Massage for Couples and Pairs of Friends” class Saturday.

The weather was beautiful Saturday. It seems that every time I offer the class the weather is stunning, but they were a diligent, studious group and did a great job of focusing on the class.

Generally, I felt like the class went well (I’ll send my feedback e-mail to the class participants later today). I still tend to be a little more high-strung than I’d like at the start of the class, but once we settle into the demo and hands-on part of the class, I feel like I’m in my groove.

I still have a little work to do on the pacing of the class. I can easily get through most of the material in the allotted time, but I have had to go a few minutes past 5:00 each of the past two classes to cover the neck and head techniques. The curriculum hasn’t changed much over the past couple of years, but somehow I have ended up going long once in a while, instead of having a couple of minutes at the end for questions. It’s hard to predict exactly which issues will come up in class, so – even though I have refined my replies to the most common questions – I still have some work to do to be ready for any question.

The next class will be offered in Ballard Saturday, May 22, 2:00-5:00 p.m. Online registration is available at Brown Paper Tickets.