By Nancy Dickenson

Our country’s health-care system is in crisis. An estimated 45 million Americans do not have health insurance and many who do have coverage are underinsured. Health-care costs are growing rapidly, and the system is becoming ever more complex to navigate. It’s not surprising that when it comes to finding quality health care and paying for it, many of us need help. To ensure the well-being, perhaps even the survival, of ourselves and those we love, we must become informed health-care consumers.

So where can you find help? A new book, “How to Get the Health Care You Want: The Savvy Consumer’s Guide to Navigating the Health Care System” (1 Life Press, 2007), is a good place to start. Author Laura Casey, a professional patient advocate, draws on both personal and professional experience to provide the tools needed to be an effective communicator within the health-care system.

She believes that people need to advocate for themselves or find someone who will do it for them. Some sources of low-cost or free advocates cited in the book include company employee assistance programs, local social service agencies and clergy.

Excellent features of this book are formulas readers can use to analyze the quality of their health-care experiences. These formulas assess such things as “lost lifetime” costs and anxiety levels before assigning a “care index.” These tools can help readers quantify and evaluate all the aspects of their health-care interactions, from making the appointment to physician communication and waiting time. Another chapter carefully explains health-care insurance, helping readers understand the complex web that is paying for health care. Yet another chapter discusses ways to find a competent physician or allied health provider. It includes information explaining the meaning of titles, degrees and credentials, as well as criteria to help match patient to appropriate provider.

This book stresses that good health care is available for those who can assert themselves and express their needs and expectations well. This is a worthwhile tool for all who are health-care consumers.

People with chronic diseases and disabilities are at a distinct disadvantage when it comes to obtaining the health care they need. The cost of health insurance coverage continues to escalate, even among those whose employers offer group plans. For those with a pre-existing condition, insurers often refuse to cover at all, or, if they do cover, they severely restrict that coverage.

The new book “Health Insurance Resources: A Guide for People with Chronic Disease and Disability” (Demos, 2007, 2nd ed.), by Dorothy E. Northrop, Stephen Cooper and Kimberley Calder, is an excellent resource for those with chronic conditions who face insurance challenges.

In slightly more than 200 pages, this book covers a lot of ground. It features chapters on managed care and indemnity plans, Medicare, Medicaid, Social Security disability insurance, along with information about an alphabet soup of acronyms: ERISA, HIPAA and COBRA, all laws that ensure health-care rights. The book provides listings of resources, including contact information for insurance companies, pharmaceutical assistance programs and state programs for children’s health insurance. The book is an invaluable resource for those with chronic conditions and for health-care professionals, helping to increase understanding of the health-care system, including their responsibilities and entitlements.

People who are self-employed or do not have an employer-sponsored group insurance plan face challenges when it comes to obtaining health-care insurance. Economist Paul Zane Pilzer, author of “The New Health Insurance Solution: How to Get Cheaper, Better Coverage without a Traditional Employer Plan” (John Wiley & Sons, 2007), has some answers.

The book begins with an executive summary outlining the author’s two basic solutions for health-care coverage. First, he believes that most healthy people under age 60 should purchase individual or family health insurance policies themselves. Second, he advocates participation in Health Savings Accounts (HSAs), whether it comes via an employer-provided group plan or an individually purchased policy.

The rest of the book provides details supporting these assertions. Readers learn about their legal rights to health insurance through ERISA, COBRA and HIPAA and how to buy their own low-cost health insurance plan. The best options for those with good company plans are outlined, as well. There is advice on what to do if a family member has a significant health issue, how to get affordable medical care when you are over 55 and how to save money on prescription drugs.

The second section of the book is aimed at business owners. It describes how they can economically provide coverage to their employees, primarily through HSAs and HRAs (Health Reimbursement Arrangements).

For those concerned with the ability to obtain and maintain adequate health-care coverage, the new health insurance solution offers some intriguing options. It takes complex financial concepts and makes them easy to understand. The author is clearly enthusiastic about his subject and confident about his opinions. Readers need to consider carefully their individual situations and learn as much as they can before making any financial commitments based solely on the book.

Nancy Dickenson is a librarian at the Stanford Health Library. Branches are located at the Stanford Shopping Center near Bloomingdales’, on the third floor of Stanford Hospital and on the main level of Stanford’s new Cancer Center. For more information, call the Health Library at 725-8400 or e-mail mailto:healthlibrary@stanfordmed.org.