“After losing my mother to breast cancer 17 years prior to my diagnosis, I was determined to take control of my health and, ultimately, my life,” says Wyre-Daugherty, a 43-year-old Decatur, Georgia, resident. “It was necessary for me to research my condition, get clarity from medical professionals, understand my options, and pray for direction.”

Your doctor’s office can be intimidating. The various degrees on the wall and the doctor’s pressed, white coat might set you on edge. But visits don’t have to be a daunting experience. Our experts’ advice can help you become a more vocal and informed patient.

Educate yourself about your illness. Because her mother had experienced breast cancer, Wyre-Daugherty knew she had to research the disease not only for herself, but for her children—Kierra, 17, Keenan, 14, and Chanel, 9. Websites for the American Cancer Society (cancer.org), Breastcancer.org, and WebMD (webmd.com) were her main sources of information. She thought of specific questions for her doctor and jotted them in a notebook she kept in her purse. “First, educate yourself about the ailment.  Then, write down all of the questions and take them into the exam room with you,” says Kevin Flynn, president of HealthCare Advocates Inc., an organization that assists consumers with problems regarding healthcare.

Schedule your appointment at an optimal time. You want to have your doctor’s undivided attention to get your questions answered in what often is a 10- to 15-minute visit for routine checkups. Dr. Janet Bivens, owner of Kendrick Family Practice in Atlanta, says it’s generally best to be the first appointment of the morning, the first after lunch, or the last of the day. Trisha Torrey, author of You Bet Your Life! The 10 Mistakes Every Patient Makes—How to Fix Them to Get the Health Care You Deserve (Langdon Street Press; $16.95), offers another suggestion: “Avoid the days around holidays and weekends.” Medical personnel may not be as focused on patients during those times.

Form a partnership. The nature of the doctor–patient relationship has changed over the last 20 years. Under the old model, doctors told patients what to do and they did it—no questions asked. “The new model is a partnership,” says Bivens. That partnership should be mutually respectful.

Never allow a doctor or other healthcare professional to make you feel rushed.

Ask questions. Ask all the questions you have for the doctor. If the doctor leaves the exam room, or if all your queries haven’t been sufficiently answered, kindly ask the doctor to call you when he or she isn’t busy. If you find it difficult to ask questions, ask a more assertive family member or friend to accompany you during visits. It’s important for you to understand your illness. Your doctor shouldn’t feel threatened by your probing questions. Because a lot of the terminology in Wyre-Daugherty’s treatment was complex, she asked pointed questions during each visit. The Patient Advocate Foundation encourages patients to have a prepared list of questions such as the following:

• What is the goal of my treatment?
• What are my treatment options?
• What is your experience treating this disease?
• How often will I receive treatment?

“Making a list can be a useful tool to help your visit go more smoothly, but keep in mind that your doctor has a limited amount of time to spend with you and you should address your most important concerns first,” advises Bivens.

Assert yourself when necessary. Wyre-Daugherty took control of her health and insurance. When her first oncologist did not meet her needs (she says the doctor always appeared rushed, interrupted their appointments to talk to others, and was not very understanding), she found a second one through a cancer support group “buddy” referral.  When her insurance company initially declined to cover a $3,500 test, she made several calls to the insurer to get the test covered.

Your doctor is a service provider you have selected to help you get well. Your insurance company gets paid to properly insure you. “Being direct, but clear, about your needs is imperative as you resolve the issues you may face,” says Erin Moaratty, chief of external communications for the Patient Advocate Foundation. “However, it’s important that you don’t come across as rude or argumentative.”

Know your insurance coverage. It’s important to read and understand your health insurance policy. Ask your health insurer or employer to explain it to you. Like Wyre-Daugherty, don’t back down if a provider does not initially authorize certain expensive diagnostic tests, new drugs, procedures, or specialist referrals. If you need assistance, contact organizations such as HealthCare Advocates Inc. or Patient Advocate Foundation. “Following your insurance policy requirements will help you contain your out-of-pocket expenses,” says Moaratty. “Make sure you review the explanation of benefits after you receive treatment to ensure proper payment is being made.”

Share your health history. It’s important to be honest with your doctor—even about herbal or alternative treatments you may be using. Your doctor will give you forms to fill out to detail your medical history.  Additionally, Bivens suggests setting up an account on HealthVault (healthvault.com). Your medical records, imaging films, test results, doctor’s appointments, and even your children’s immunization records are kept in a central location that doctors can access with your approval. “HealthVault is a secure account you can use to view and track your health information online. You document your history, your medications, allergies, family history, blood pressure, and blood sugar readings. If you are ever in an emergency room in another state, the doctors can readily access important information,” she says.

Overcome the race, gender, and age bias. HealthCare Advocates offers several tips for African American, female, and older patients, three groups that experience healthcare disparities. If you feel you’re getting substandard care, you can file a complaint with your state’s board of medical licensure and the facility’s peer review panel. If possible, carefully consider the facility in which you are being treated. “For routine care, seek a professional practice and not a teaching hospital,” says Flynn. “While you can try, you cannot ensure that your doctor will listen to you. If you feel that you’re being treated like a child, you should seek a new doctor. Having confidence in your doctor is a large part of the medicine.” For complex ailments, Flynn says teaching hospitals are best because they often have access to the latest tools to fight illnesses.

Get a second (or third) opinion. Wyre-Daugherty found peace with her second oncologist. After suffering side effects (acute nausea, weight loss, and uncontrollable itching) of eight rounds of chemotherapy, she became cancer-free in July 2007. If you’re going through a major illness, you want a doctor who calms you in a soothing environment. There are other reasons to seek a second opinion. “If a doctor prescribes any form of long-term treatment, then a second opinion is called for,” says Torrey. “If a patient is being treated but the treatment isn’t working, then it’s time for a second opinion. If the two opinions are not the same, then it’s worthwhile to get a third opinion.”

Negotiate the bill. If you are uninsured or underinsured, you can still be empowered in your healthcare. You can ask your doctor for a discount such as the Medicare rate. Many doctors will reduce their prices for self-paying patients. Depending on your situation, apply for Medicaid. (While income is a qualifying factor, it is not the only criteria used. Research your state’s guidelines to see if you qualify.) If you are denied Medicaid, some hospitals will offer financial assistance. Also ask about drug replacement programs. Financial grants are available from disease-specific organizations such as Patient Advocate Foundation’s Co-Pay Relief (866-512-3861; copays.org), its National Underinsured Resource Directory (patientadvocate.org/help4u.php), and its Colorectal CareLine Financial Assistance Fund (866-657-8634; colorectalcareline.org). The Colorectal CareLine Financial Assistance Fund provides one-time $400 grants to individuals who have a diagnosis of colorectal cancer and make $75,000 or less annually. Co-pay relief programs can also help cover some medicines. Contact the Patient Advocate Foundation (patientadvocate.org) for strategies to help reduce or eliminate your out-of-pocket expenses.

Simple steps for small business owners (Image: Thinkstock)

As part of my weekly segment on Warren Ballentine’s Truth Fighters radio show,  we have discussed and will continue to review over the next month the best ways to empower our audience given the current environment.  I told him one of the areas that continues to be a a major focus for our editors has been entrepreneurship. And for good reason: According to the recently released data from the U.S. Census Bureau’s Survey of Business Owners: Black-Owned Businesses: 2007, the number of firms owned by African Americans increased by a whopping 60.5% to 1.9 million, more than triple the national rate of 18%. Over that same period, the report stated that black-owned businesses showed an increase in revenues of 55.1% to $137.5 billion.

Although Census data — the survey is conducted every five years — does not include the growth of black businesses since the brunt of the Great Recession, it is a good bet that there has been more business creation and self-employment out of necessity. That doesn’t mean that the same challenges of gaining contracts and financing hasn’t continued to serve as an anathema for black firms. One way for African American entrepreneurs to get a leg up on the competition or find new business strategies and  funding sources is by registering for the BLACK ENTERPRISE Entrepreneurs Conference + Expo hosted by Nationwide and held in Atlanta from May 22-25. Our theme,  Rethink:Business, gives you an idea of the type of information you will receive during the course of that event.

Are you an entrepreneur looking for some power moves to expand your business? Click here for 10 tips that can give you the edge you need.

Photo by Scott Council

For three years, Bola Oyeyipo-Ajumobi has participated in her company’s flexible spending account program to purchase contact lens solution, a blood pressure machine, allergy medicine, and cough medicine for her 3-year-old and 6-month-old children. She typically contributes between $500 and $1,000 a year, and has saved an estimated $200 each year that she’s participated. But as of Jan.1, a new provision under the Affordable Care Act prevents employees from getting reimbursed for purchases of over-the-counter medications without a prescription.

“It will be a hassle, because when my child has a cold, I just want to pick up something quickly,” says Oyeyipo-Ajumobi, 34. As a result of the new rules, she reduced her contribution to $250 and stocked up on cold medicine. The new stipulation also applies to employees who hold health savings accounts, health reimbursement arrangements, and Archer medical savings accounts.

FSA participation benefits employees because the money they contribute to their plans isn’t taxed as income. These accounts helped to offset the 30% rise in yearly out-of-pocket health costs Americans paid between 2001 and 2006, according to HealthReform.gov.

The Affordable Care Act will soon be effecting another change: capping the amount that can be deposited into FSAs at $2,500 per employee, down from the current $5,000. But this change doesn’t go into effect until 2013.

For now, here’s what you should be aware of:

• Over-the-counter drugs that now require a prescription for participants to be reimbursed include allergy and sinus medications, pain relievers, and nutritional supplements.

• Non-prescription items still eligible for reimbursement include birth control products, reading eyeglasses, and diabetic supplies like insulin. Fortunately for Oyeyipo-Ajumobi, contact lens solution is still an eligible item. For a full list, go to IRS.gov and search for Publication 502, Medical and Dental Expenses. You can also still use your FSA to pay co-payments and co-insurance deductibles.

• You’ll need to keep a copy of your prescription along with your receipts when you submit your claim for reimbursement, says Sara Taylor, a benefits consultant at Aon Hewitt, a human resources consulting firm.

• If your FSA plan provides a debit card, as of Jan. 1 you cannot use it to buy over-the-counter drugs. Your card can still be used to purchase medical care items, such as bandages, that are not medicine or drugs.

• According to the IRS, 2010 FSA participants can be reimbursed for eligible purchases made through March 15 if their employer allows a grace period. The only exception is that over-the-counter medications must have a prescription if they were purchased on or after Jan. 1. If you purchased the medication before Jan. 1 and have not submitted your claim for reimbursement, you can do so up to March 15.

• Plan ahead and think about the pharmaceuticals you’d usually buy. “When you see your doctor, discuss the need for prescriptions rather than calling six weeks later for a prescription for aspirin,” says Dr. Michael Bihari, a health insurance guide at About.com.

• If you purchase ineligible items using another type of health savings account, like an HSA or Archer MSA, those medical expenses will be included in your gross income and be subjected to an additional tax of 20%.

In his State of the Union Address, President Obama sought to rally the nation as he mapped out his bold plan to “win the future.” Asserting that “the rules have changed,” he said America will achieve the next level of greatness through industrial innovation, improving the public education system, rebuilding the nation’s infrastructure and deficit reduction through shrinking government and a five-year spending freeze, among other measures.

The centerpiece of his speech before the jam-packed chamber focused on making American industry more competitive with nations such as China and India—those countries that have invested heavily in research and new technologies. He issued a challenge to America’s scientists and engineers to invent new clean energy technologies, calling for 80 percent of the nation’s electricity to come from sources like wind, solar, nuclear, clean coal and natural gas by 2035, as well as ensure that the US is the first country to produce 1 million advanced technology vehicles on its roads.

“Half a century ago, when the Soviets beat us into space with the launch of a satellite called Sputnik¸ we had no idea how we’d beat them to the moon,” Obama said, recalling the incident that shocked the government into creating the space program. “After investing in better research and education, we didn’t just surpass the Soviets; we unleashed a wave of innovation that created new industries and millions of new jobs. This is our generation’s Sputnik moment.”

“We know what it takes to compete for the jobs and industries of our time. We need to out-innovate, out-educate and out-build the rest of the world,” he continued. “We have to make America the best place on Earth to do business”

But the President has immediate concerns. Although he recounted the economic and financial progress of a nation that was on the financial brink two years ago—the stock market’s strong performance, rising corporate earnings and sustained GDP growth—the administration wrestles with how to put millions to work and reducing the country’s 1.3 trillion budget deficit.

The speech was chock full of initiatives, offering programs that would be embraced by progressives such as ending tax breaks for wealthy Americans and policies favored by conservatives, such as a 12-month reorganization of government. In fact, Obama said he was open to improve healthcare reform by “mak[ing] care better or more affordable”—a measure the Republican-controlled House voted to repeal this week.

“It was a delicate balance of trying to tell some of the Democratic base some of the things that they wanted to hear, such as the elimination of the 2% of the richest Americans getting tax breaks, and at the same time he was also trying to send up an olive branch to the other side. It’s a delicate balance,” says Rep. Emanuel Cleaver II (D-Missouri). “He made the point that he wants to be the president of the entire country and he needs the Republicans’ help to do it.”

From his conservative vantage point, Allen West (R-Florida) says: “[President Obama] talked about some things we’d heard two years ago, such as our vetoing a bill with any earmarks. Starting right off we saw that he didn’t do that with the stimulus package. It was interesting to hear him sound like a conservative on some points and at other points he sounded like the same president of the last two years.”

Citing the shooting of Rep. Gabby Giffords, he also used the speech to urge Democrats and Republicans to seek common ground and put American concerns before partisan infighting. In fact, the Arizona incident and renewed focus on incivility of political discourse led to a number of Democrats and GOP legislators to “date,” sitting together instead of a splitting the chamber along partisan lines.

“This simple recognition won’t usher a new era of cooperation,” the President said. “What comes out of this moment will not be whether we can sit together tonight but whether we can work together tomorrow.”

–Additional reporting by Joyce Jones

Be sure to read this related content…

• What Do You Want Obama to Say Tonight?
• Rescuing Communities of Color
• House Republicans Pass Healthcare Repeal

The state of the union is an annual occasion in which a president receives more unsolicited advice than he cares for or, for that matter, could ever use. Republicans want him to propose specific and wide-ranging budget cuts to address the deficit; some hope he will embrace their effort to repeal healthcare reform legislation. Supporters of gun control hope he will point to recent shootings as a reason to enact some reforms. Anti-war activists want to know when the U.S. will permanently leave the Middle East. BlackEnterprise.com asked some African American leaders to also weigh in. Here’s what they had to say:

“The State of the Union will provide the opportunity for President Obama to lay out his plan for getting Americans back to work, and continuing to move this country forward. More specifically, I would like to hear about ways to recapture our industrial base where thousands of jobs could be created. Together we’ve achieved monumental accomplishments, but there is still much work to be done. I am also interested in hearing him expound on opportunities for the most vulnerable Americans. Too often they’re left out of the equation. I’m positive the President will deliver an excellent State of the Union address.”

—Congressional Black Caucus Chairman Emanuel Cleaver, II (D-Missouri)

“I think that he needs to return to many of the themes that he campaigned on: restoring U.S. competitiveness, investing in green technology, investing in education and improving the quality of schools because they’re long-term solutions to the problems that we have. We’ve got massive numbers of unemployed people with no prospect that they’ll be reemployed immediately so something has to be done to address that, particularly for African Americans in urban areas, Hispanics and large sectors of the general population.

It’s not likely that Congress will continue to extend unemployment, yet those people will still be unemployed. So more creative kinds of strategies need to be developed, such as a national service program in exchange for both unemployment compensation and some type of earnings, as well as a focus on retraining and other educational programs that will begin to address the high levels of unemployment that we’re going to encounter for the next five to ten years.

But all of that is moot if there’s not some serious attempt to address the deficit. Obama needs to lay out a blueprint to get the deficit under control. You don’t want brutal and heartless cuts across the board, particularly to housing and other kinds of social programs that are going to severely hurt the middle class or lower-income families because those are the folks that are already hurting. But if he doesn’t lay out a blueprint, that’s what Republicans are going to start targeting.

There has been a lot of recognition that we need to support small businesses if we’re going to grow jobs, but no realistic plan to do that. Simply making money available for loans doesn’t solve the problem because at the same time there are tighter credit requirements and regulations so most small business owners don’t seek loans. These are the themes he needs to return to that got away from him after the campaign.”

—Dr. Thomas D. Boston, Georgia Tech economics professor; CEO, Euquant; and member, BE Board of Economists

“I want to hear that Obama takes the jobs commitment seriously and that he’s going to invest in infrastructure. He’s made a significant commitment to education, his investment in the stimulus package was big, and he has to continue that. But I think there’s an issue of education equity at the state level that only the states can address and I hope he charges them with the responsibility of finding more equitable ways to provide quality education for all. I really hope he deals with a defensive healthcare bill. He’s got to make that a strong centerpiece; people spent too much political capital on that. It is a civil and human rights issue of the first magnitude, as are jobs, so I hope he makes a vigorous defense of healthcare.

I think he’s got to deal with comprehensive immigration reform and I hope he makes that more of a national issue. It’s certainly a civil rights issue, both in terms of the anxieties that many Americans feel about the presence of the undocumented and what that means for the economy, but also for the future of the country.”

—Wade Henderson, president and CEO of The Leadership Conference on Civil and Human Rights and The Leadership Conference Education Fund

“There needs to be a removal of this uncertainty there has been for a long time in the business world: Where are we going? Are you willing to support businesses? How will you support businesses? How will you create jobs if you don’t support business enterprise?

Historically, jobs have come from small to mid-size businesses. More so than ever before we need that now because as a result of the recession, well-to-do companies have figured out that they don’t need as many people to get the same work done, and in many cases to get more work done. They’ve invested money in either intellectual property or hard assets that work faster. They’re doing more business but not creating any new jobs.

There needs to be some certainty regarding the tax rate on capital gains. If it’s going to stay at 15%, that gives folks a reason to invest in and grow their business, or sell and get out without having to worry about giving it all back. But if there’s that, there’s really no appetite to spend a lot to grow your business too quickly because you don’t expect to get a lot out of it.”

—Tilmon F. Brown, CEO, New Horizons Baking Co.

“Jobs, jobs, jobs, and a focus on high unemployment and urban communities. We’re certainly looking for the president to talk about long- and short-term solutions, such as training and retraining of workers and education. He has to lay out a strong case for an economic recovery that touches all people. State of the union addresses tend to touch on a wide range of issues, but this year we’re very focused. We’re looking for him to give a nod to targeted policies. People are looking to be inspired, which I know the president will do, but really to hear him talk about his commitment to jobs and ideas in areas like transportation infrastructure and green empowerment zones, but also how the disadvantaged can connect with those jobs.”

—Marc Morial, president and CEO, National Urban League

Feel free to share your thoughts on what you would like the President to discuss in his State of the Union Address tonight.

According to Majority Whip Eric Cantor (Virginia), the House will begin a two-step process that involves conducting oversight of the law and its impact on the nation’s economy and healthcare system and then develop new policies to improve healthcare “without bankrupting our country and taking away the healthcare that most Americans want and like.”

Yesterday the House voted to instruct the committees that have jurisdiction over healthcare to draft alternative legislation and Cantor also has pledged to “defund and delay” certain provisions in President Obama’s signature domestic legislation.

Some lawmakers, such as Congressional Black Caucus chairman Emanuel Cleaver of Missouri, fear that means reducing the budget for the Department of Health and Human Services, targeting line items that the agency needs to hire people to implement healthcare reforms in the states. He’s also concerned that Republicans will try to eliminate funding for community health centers in the mistaken belief that nobody cares about them.

“The rippling effect of not giving HHS sufficient dollars is going to be earth shattering,” Cleaver said. “Unemployment is somewhere around 15% in African American and Latino communities. If you close the health centers, all of the people who lost their jobs and their insurance would have no place to go except to indigent hospitals, which are reporting overload.”

Rep. Chaka Fattah (D-Pennsylvania), who sits on the House Appropriations Committee, called the repeal bill a charade and said that he doubts Republicans will be able to carry out their defunding threats.

“They may not fund certain things, but the Senate will. Then there will be a conference committee and if they want to produce a bill that the president will sign, they’re going to have to have the funding in there,” he said, adding that the GOP is overestimating its power.

“This notion that they can control one half of one-third of the federal government and dictate what’s going to happen isn’t going to work out,” he scoffed. “When we controlled it all we couldn’t dictate what was going to happen.”

When the final tally showed that the repeal legislation had passed, Republicans began cheering until they were quieted by Cantor, observed Maryland Rep. Elijah Cummings, ranking Democrat on the House Oversight and Government Reform Committee. He thinks that was a clear indication that the majority leader knows the bill is nothing to celebrate.

“With this vote, they’re saying 32 million people won’t be able to get healthcare. It’s up to us on the Democratic side to message this properly and tell the people what they’ve done,” said Cummings, who believes that the American public is in for a rude awakening once they realize that the majority is trying to withhold something from them.

“They’re trying to take away keeping your children on your policy until they’re 26, making sure a child with a pre-existing condition can get insured and contributions from the federal government to help small businesses address the issue of healthcare,” Cummings said. “All of these are very significant and the public’s attention will be much more focused because we’re talking about taking away something that they already had.”

But as even Minority Whip Steny Hoyer (D-Md.) acknowledged during his weekly press briefing, months after the bill was signed into law, his party has failed to successfully sell its benefits to the American public.

“None of us did a good enough job, because public opinion is divided and unsure of whether this legislation is going to be positive for them and their families,” Hoyer said. “About half are, and about half are not sure.” A Gallup poll taken earlier this month confirms his assertion and found that 46% of Americans want their representatives to repeal the legislation, 40% want it to stand, and 14% have no opinion.

To remind voters of what’s at stake, Democrats staged an elaborate mock hearing  that featured people from around the country, who shared tales of health-coverage woes. The Hispanic, Black and Asian Pacific American caucuses will hold a press conference today to discuss how the bill impacts their constituents.

The Obama administration also participated in the sales pitch. The Department of Health and Human Services released a report Tuesday that found that 50 to 129 million non-elderly Americans have a pre-existing condition, 25 million of whom are uninsured. Rescinding the provision that prohibits insurers from denying coverage to people with pre-existing conditions would severely limit their health care and coverage options and remove the ban on lifetime limits on benefits and restrictions on annual limits for benefits, the report said.

In a White House conference call with reporters, Garth Graham, M.D., HHS Deputy Secretary for Minority Health, said that a repeal would be particularly detrimental to African-Americans, who disproportionately suffer from pre-existing conditions and certain diseases. “The [reform] law contains more than 75 equity specific provisions that will help advance healthcare for minority communities across the board and for the African American community,” Graham said. In addition, the bill includes workforce provisions and incentives that would create a more diverse and culturally competent corps of healthcare givers who would practice in underserved urban and rural communities and research initiatives that would ensure that racial- and ethnic-minority issues are considered in the study of disease.

The conventional wisdom is that the Republican repeal is mostly symbolic and would never succeed in the Senate. During his weekly briefing with reporters, Majority Leader Eric Cantor (Virginia) challenged Senate Majority Leader Harry Reid (Nevada) to hold a vote on a similar measure to prove to the American public that it cannot be passed in the upper chamber. Either way, House GOP lawmakers have a Plan B.

“If we are unsuccessful in seeing the Senate take up the repeal bill and the president signing a repeal bill of ObamaCare, we’ll do everything we can to delay and defund the provisions of the bill so that we can get some discussion going on how we can replace it, and come together on the agreement that we can’t accept the status quo,” Cantor said.

Read more of our news and political coverage:

• What you can learn from…Obama’s White House Shake Up
• President Obama’s powerful speech honoring Arizona shooting victims
• Obama ends the year on a high
• 5 Tips for being an empowered patient