My dad is 73, diabetic and on Medicare.  But there are problems with the Medicare system, even though it has faithfully paid for my dad’s numerous doctor’s visits, surgeries, and a litany of medications each month.  Some doctors do take advantage of the system to try to make more money.  For example, my dad was diagnosed with diabetes just after retiring, ironically on the same day that he took out a supplemental insurance policy.  Because he signed the forms at noon and his blood sugar results came back at 4 pm, it was not a pre-existing condition and thus it’s been covered. 

He started having vision problems from the diabetes, and the local eye doctor had dad coming in every other week to be evaluated.  However, here’s what makes my blood boil, he would only examine ONE eye each visit.  So he’d look at the left eye the first visit of the month, the right eye the second visit, and so on.  So when my dad started saying that his other eye was getting a bit blurry too, the doctor ignored him and said he’d check it at the next visit.  By the time the next visit came, it was too late and now my dad is legally blind.  This doctor was scamming the system, trying to make as much money as possible while completely ignoring the best interests of my dad’s health, his patient.  So much for "first, do no harm."  His financial interests were more important than his Hippocratic oath.  And I know this is true because I was there once when he refused to look at both eyes.  I let him have it, and he did as I asked/ demanded.  I could do this because I’m a well educated woman with a science background and couldn’t be placated with platitudes.  My dad, however, deferred to the doctor’s authority- to his own detriment.

Once I convinced my dad to switch doctors, it was too late to save much of his vision so now he has only 2% of his peripheral vision in one eye.  He’s 100% blind in the other.  There’s no guarantee that this wouldn’t have happened regardless, but the gall of that doctor just astounds me.  His current eye doctor only sees him once per year, or whenever he has a problem.  They will always work him in on the same day if he’s having a problem, and the doctor actually spends time with us explaining what’s going on.  My dad gets far more care from his annual visit now than he did with bi-monthly visits with the other quack doctor, but Medicare is paying 1/24th as much for this vastly improved care.  If all doctors were as honest and conscientious as dad’s current doctor, we wouldn’t be in this mess.

So just like in everything, there are those who take advantage and those who don’t.  We just need to find a system that punishes those who try to scam the system and regard the dedicated, hard-working doctors who just want to help others.

Liz Peek - thank you for asking all of us to join in on this Medicare subject.  I have been on Medicare for some time, as has my husband.  Of the 25 employees we have here on the Plantation - 15 are on medicare.  So, you might say we are all getting up there.  Medicare has worked for us - I’ve had three surgeries -my husband one.  We have had no problems.  Good doctors, good medical care.  My employees are quite happy with their coverage.  We also supply other insurance for our employees as a backup.  I can’t understand anyone not supplying proper insurance for the people who work for them.  Seems strange. 

 I hope Medicare exists until I go to my great reward.  I also hope someone up there in Washington will investigate any fraud that exists in this program.  I personally do not know anyone who has a horror story to tell - I’m sure there are some out there.  I hope, instead of cutting this program they will investigate the over-spending and cash back payments that are reported. 

I still say if we investigate the problems with all insurance programs there might not be a need to change anything.   

Important links: 

http://findarticles.com/p/articles/mi_m0815/is_6_33/ai_n27506744/

http://blogs.consumerreports.org/health/health_reform/

http://www.ssa.gov/history/pdf/ThirtyYearsPopulation.pdf

If anyone in the USA believes that for-profit insurance companies do not control physicians, and hospitals, they need to study business, and ask, “What is the difference between a for-profit corporation and a non-profit corporation?”  In short, the bottom line is always the goal in the for-profit sector and should be: how to increase profits to stockholders, paying the salaries of board members vs in NGOs board members/trustees are rarely paid even an honorarium, and there are NO investors/stock holders to be paid - all funds must move out to serve the NGOs stated, and mandated mission per their Charter.

The father of four children will not be told that his medication will cost over $30,000.00 a month, and the operation he needs to live another six months will cost $150,000 more than his insurance plans covers (that is reality—and something that even his loving children cannot change). That in turn, controls the man’s doctors!

re "about Medicare or other government-sponsored health-care programs. "

 Medicaid in Texas is a MESS, because the state sub-contracted it out to a for-profit "insurance company," with the gate-keepers who are not medically-licensed, like other such ‘keepers,’ and they are hiding behind a term that smacks of the state’s DHHS - only a slightly dissimilar term.

People who are very ill have told me that "Medicaid called on the phone and said I had to stop using the … " a device ordered by his doctor, etc. which terrified the patient. It’s common now in Texas, and the protest hearings are stacking up.

It’s intersting that Medicaid comes from funds out of US taxpayers to the states from the federal goverment, yet each state may administer it without federal oversite. NO GOOD.

OTOH, it is crucial for infants, children, expectant mothers, and seniors or disabled - but no state should ever move federal tax dollars into a for-profit for adminstering the funds, much less interefere in a doctor’s written orders by contacting the patient! (In the cases we’ve heard about in TX, Medicaid refused to talk to the patients’ physicians.)

http://www.nytimes.com/interactive/2009/09/17/sports/20090917-cowboys.html?th&emc=th

As long as America has football, even if the new stadium is too small to play a game in it, what else could the citizens POSSIBLY need?

I have posted this in places, but I think it is a really important article to read.  I applaud Kathleen Sebellius and Eric Holder for pursuing medicare fraud.  I think it is of primary focus for the president’s health care plans, as well as lower military spending as in reducing the missile shield for Eastern Europe.

 Dozens arrested in Medicare fraud busts across US

I am 66 and on Medicare and Medicaid.  I did a lot of research on this subject before I turned 65.  Keeping it simple: Medicare is federal and Medicaid is state.  Medicaid varies a bit from state to state and is only available based on income (mine is quite low).  For those who do not qualify for Medicaid, a supplement is necessary for Medicare Part B does not adequately cover medical expenses.  For medical treatment Medicare and Medicaid are just fine and I was very thankful for this when I had a nasty fall, literally breaking my foot from my ankle, required two surgeries in three months.

However, there is no preventive care (because there is no money in it, let’s be honest).  I must pay for annual physicals, for instance.  There is also no provision for dental care or eyeglasses.  Since dental care is very directly related to heart problems in particular, and since not being able to see is related to any number of problems, these are obvious flaws.  Dentures are very costly and without adequate dental care, a necessity that many people (me included) would have to do without.  I struggle to make my small income cover regular dental hygienist’s visits (for me, that is three times a year at a cost of about $125 per visit).

Now about cost savings.  I’ll use my own example.  I monitored the charges from my accident very carefully.  Just in my one case alone I found a doctor who not only billed twice, but who billed for things he had not done.  I found a CNA who was on the hospital payroll billing $700 for the five minutes she was in my room.  The hospital charges were astronomical.  And I questioned my doctor on every visit and procedure so as to avoid duplications.  I found that it is very important that we monitor our care, challenge our doctors, be advocates for our own health.  I also alerted Medicare to the spurious claims.

Between the pay-for-service that allows unscrupulous medical personnel to scam the system and doctors’ justifiable fears of malpractice suits, billions of dollars are misspent every year.  There really are cost savings to be had.  If preventive care were added to the paid services, the cost savings would be incredible.

I am quite happy with Medicare overall, but there is certainly more than enough evidence for serious health care reform.  And it troubles me that Medicare really will bankrupt our country without serious reform.  Just follow the money and a solution will be evident.