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Question of the Day | 09/21/2009 5:00 am

Among women you know on Medicare, has the program worked well/been successful?

© Shutterstock
Joan Ganz Cooney

Joan Ganz Cooney | 09/21/2009 12:00 am

Joan Ganz Cooney: Medicare Is Going to Bankrupt the Country

I have private insurance but I assume most people are happy with Medicare. The problem is that it is going to bankrupt the country. It is a fee-for-service insurance plan, which provides motivation to doctors to do a lot of unnecessary tests. Unless it is reformed soon to run more like the Mayo Clinic, for example, there will eventually be drastic changes.

Joan Juliet Buck

Joan Juliet Buck | 09/21/2009 12:00 am

Joan Juliet Buck on Medicare

I have no idea.
Liz Smith

Liz Smith | 09/21/2009 12:00 am

Liz Smith on Medicare: The Pros and Cons

Most of the women I am friends with are already on Medicare and they seem to be coping quite well in using this great mechanism. This doesn’t say, however, that if we don’t want to go bankrupt we better improve the system. I want to give President Obama’s ideas a chance to do that.

42 Reader Comments (so far…) Sign In or Register to comment

Diana T
Medicare has always worked well for me and my friends and family on it.  And, also, kudos to the people that help you sign up.  It was quick and easy…
By Diana T on 09/21/2009 4:28 pm
Lee Harrison
I think the trick to making Medicare work for a person is having supplemental insurance.  My dad, who is retired military, has TriCare for Life which picks up everything Medicare doesn’t.  He can get his scripts at Navy Med…so those are nearly free. 
By Lee Harrison on 09/21/2009 6:29 pm
C jay

Lee, TriCare is well known to be the Cadiallac of health care coverage. Don’t miss this very excellent progam on healthcare reform, and he includes TriCare.

http://www.c-span.org/Watch/Media/2009/09/18/HP/A/23360/NPC+Lucheon+Address+by+Mayo+Clinic+CEO+Dr+Denis+Cortese.aspx

By C jay on 09/21/2009 11:41 pm
Lee Harrison

C jay,

Thanks for the link…you’re right…an excellent talk which makes more sense than anything I’ve heard coming out of DC.  In the case of my parents, and now just my father, TriCare turned them into cash cows.  The expensive testing they both have had over the years boggles the mind.  I’ve never been sure if the doctors are getting some kind of kickback from the tests or if they are just covering their butts.  But I doubt they would have me, with my limited insurance, have the same tests at the same frequency.

Anyway, my point was Medicare works well…if the patient has a "Cadillac" supplemental plan.  The doctor speaking said the same thing in different words.

By Lee Harrison on 09/22/2009 2:53 pm
Katharine Gray

Seems to me from the above comments that *Medicare works just fine* BUT I have a supplemental policy.   I suppose from some evil insurance company.   What is not mentioned is the huge cost Medicare is to the taxpayers (yes just like social security you give part of your paycheck to the government to fund it)  and that rumor is, it is about to go bankrupt…just like social security.   I know the person who posed this question wanted us all to have an *AHA* moment (Medicare is government healthcare and it works just fine so obviously government health care is a good thing).  My question is if Medicare is so great why are so many seniors seeking out *supplemental insurance plans*?    And let me tell you…if you have to go into a nursing home due to a broken hip or other reasons, Medicare covers about 90 days of that.  AND the beds are limited.   IF you have private insurance for nursing home care you can pretty much choose your facility.  IF you have only Medicare, you are stuck with the urine halls.  If that.    What saved MY mother in her last years was a private insurance policy providing nursing home care (she was demented and needed constant supervision which no one in our family could provide without giving up our own very necessary jobs and of course we could not afford the cost of private nursing care f or her).    Medicare is a good fallback for the elderly.  But, assuming things stay the same, I will NOT choose to rely solely on Medicare to provide my health needs when I am elderly. If the Supreme Court says social security is not a *right* and Congress can stop it or limit it when they choose, what does that mean for Medicare or any government program.  I would prefer to buy my coverage from a company I can at least sue if they do me wrong, rather from the government who can cut me off at any moment for any and no reason.  And, make no mistake, the extra taxes you will pay for this program will probably equal or exceed the amount you will pay for private coverage. 

I heard today of a Rasmussen poll where 42% of UNINSURED Americans do not support the health care reforms put forth by Congress.   While this is not a majority, of course, it does strike me that if 42% of the people this program is supposed to benefit say they don’t want it….and the uninsured comprise about 15% of the population….more than a very large majority of Americans do not think that health care needs reform.  

 

  

By Katharine Gray on 09/21/2009 10:37 pm
C jay

Katharine, I have been watching the economics of the Supplement plans, and its noting they do not cover very much, and they don’t  - and all have to cover the same amount, all insurance companies, for each Plan. Their fees are vastly different, though.

I do carry mine through State Farm, which has always had all my other "hard" insurance - autos, home, liability, etc. so I get a discount, but AARP’s was way higher! ;0))

I’m going to drop the Suppment based on what I’ve read. It’s quite a bit of $ I can use in other places, and really, adding it up montly, their payout is less than my premium. Frankly, they can’t get blood out of turnip, either - if I run into debt over healthcare, at this point, too bad. Breastcancer did that to me - I paid everything including my savings, those years.

 

By C jay on 09/21/2009 11:45 pm
C jay

Medicare’s weakest link in it’s very strong chain is it’s sub-contractors, approved by the last administration — it sub-contracted out the DME (durable medical equipment), and the Medicare Advantage and Medicare Plus Plans to FOR-PROFIT INSURANCE COMPANIES. That is where the Medicare money is going, friends. If this would be stopped, and all for-profit health care vendors (who are *NOT medically-licensed professionals), the money would very EASILY be there for our nation’s health care as we all appear to want it to be, in all forms mentioned on this site, and across the nation.

I am disabled, and the only time I have a problem is with the DME aspect, which is sub-contracted out to CIGNA!), or the *health care vendors! I have nearly died, literally, because I could not access care in my region, so had to fly out of state for not only care but to receive the equipment I needed to live. No big deal - it’s merely AIR needed by a polio-affected diaphragm. Many of us end up chronic ventilitory failure - from Polio. It’s a terrifying situation, and the most painful things I have ever gone though (and I had cancer twice).

Just a horrid is that if we are given most anesthesics, most pain killers, most "relaxants" for medical procedures, they affect our muscles, and we cannot breathe, often ending up in respiratory failure (over something most doctors know NOT what) - but pain meds for Polio survivors can rarely be used without judicious physician who knows how to help us - few do!

And, it’s just happened to me, again! From an accident, I have 3 broken bones in the one leg that works since I was 10 years old (in spite of a perfect bone density scan in August). A local vendor my doctor faxed order to after receiving the x-ray reports - no, 2 vendors in the past 4 days — have said "Medicare won’t cover a brace for your leg - you don’t need one if you use a powerchair!" My DOCTOR ordered it after x-rays showed where the fractures are. Each moment that these bone are not supported, may remove the only limb I have left to mobilize, transfer, MOVE. These are not medically-licensed people - they’re salespeople! Just like those who deliver oxygen and supplies to people in their homes!

Did those vendors call CMS? NO! If you remember the Spring 2008 uproar over Congress implementing "Competetive Bidding" for anyone selling durable medical equipment and supplies to Medicare Beneficiaries - which all non-profits must do - put products OUT for bids. (It was about time Congress insisted on bids! We the people are paying retail price for all durable medical equipment that is leased to people in their homes, etc - and worse, the rental fees vendors charge CMS or the patients is about 10%/month of retail value!) - on and on it goes, along with the uproar against HEALTHCARE REFORM. Now, do you see why the uproar is going on and WHO is doing the roaring?

Well, hell erupted in DC, with thousands of bids floating in from all over the planet (that was the fault of DHHS for not holding "Pre-bid Conferences" to qualify bidders, first - I’ve done that job!).

Worse, the for-profit vendors, primarily those hawking oxygen supplies et al to people at home (imagine what the profit margin is on that!!!!!!!!) and the lobbying groups they hired, gave "grants" to respiratory NGOs to fly-in their members, and patients on oxygen, etc. to DC to protest COMPETIVE BIDDING, and they brainwashed the victims with "the government is going to take away your oxygen."

I was told that by people I was with in a DC hotel near the capitol, the oxygen vendors were in the airports around the US that week, ‘helping’ people who used oxygen, oh soooo nice! In elevators - even in the Rotunda) people on O2 stopped me and warned me over and over again (I use a powerchair but have to HOLD my ventilator b/c I cannot get both from the local vendors - but the kids on Medicaid can get these chairs from ‘those’ vendor - quick money from the States!).

No matter what I told them to give them THE TRUTH, it did NO good. Their COPD, Emphysema, and other non-profits had told them what "was going to happen" if the government got away "with this."

This was PROPAGANDA, just like "Pulling the plug on Grandma." However, it’s happening now, and has been the past 10 years in America - WITHOUT healthcare reform!

By C jay on 09/21/2009 11:36 pm
Lynn Marie

On a nice note—when I became ill at 43 I had to use forearm crutches to walk. I went to the Medical store and the manager told me I wasn’t covered. He then told me to wait and he went in the back room.He came out with a pair of forearm crutches.Adjusted them for me—showed me how to use them.Then he told me—these are the best crutches I have here-He gave them to me FREE-I swear there was a tear in his eye and I knew somewhere in his life someone he loved must have endured sufferring/illness. I of course thanked him profusely and now understood why his smallcompany has stayed open for over 30 years.

When I got to the car I cried my eyes out! Not because I had to use crutches to walk—-but that someone had touched my life with their compassion and kindness—no one had been nice to me for a long time.

By Lynn Marie on 09/25/2009 8:29 pm
Lizzie R.
We have Medicare, which has been an excellent program for us, and being military we have TriCareForLife as our secondary. However, none of this will cover us for any long-term issues, so we also have Long Term Care insurance. We have had it since we were younger  and the premiums are high. It is something you hope you never have to use, but will cover us in case we get a debilitating illness & require  long term nursing home care. I’d hate to have to be placed on Medicaid & be warehoused in some substandard facility if that ever happened without this insurance protection.
By Lizzie R. on 09/22/2009 12:53 pm
Kaye Marano

Has anyone had any recent treatment through Medicare and learned about the new "co-insurance" deal?  I believe they must have passed this in the middle of the night, and it has gotten zero attention.  Most Medicare recipients don’t learn about it, until they start getting billed.  My mom was recently treated for breast cancer, and that’s when we learned.  She carries supplemental insurance, that she pays for, that used to cover the 20%, that medicare did not.  However, now, Medicare demands the patient pay 10%, and the secondary insurance can only pick up 10%.  Now my Mom has the same high secondary premiums, with half the coverage… thanks Medicare!  The result is thousands of dollars in bills, for her cancer treatment, that previously would have been picked up by her secondary insurance. 

I would really love to hear someone in the media addressing this change to Medicare.  Seniors no longer have the coverage they think they do, and most aren’t unaware of it.

By Kaye Marano on 09/22/2009 2:29 pm
Jackie Childress

It is the only way my mother has access to medical care, period. Thus far, it has worked out beautifully for her and, since I always go with her to her doctor’s appointments and, since I am her advocate, there are no unnecessary tests, etc, that are ordered for her. Everything she’s had done has been necessary and without medicare, she would not be able to afford her medications or the necessary tests she’s had to undergo.

Our perspective is different, however, because we’re originally from Spain which has a much better healthcare system than we have here. Nobody goes bankrupt in Spain because of a necessary medical procedure or treatment. No one has to decide between paying bills or paying for medication. Everyone is covered, equally.

Without medicare and without healthcare reform as well as a public option to keep insurance companies honest, many more than the 46 million uninsured we have today would go without access to medical care.

By Jackie Childress on 09/22/2009 4:53 pm
Lynn Marie

I am  100% Disabled and have Medicare as my medical.

I pay 20% of all my medical bills-most tests-Md visits.

I go to what ever Md I choose.

I had ByPass Cardiac Surgery and it covered 80% of it -some of the other money was paid by a Hospital fund-the rest I paid off in time.

The problem I do have with medicare is they do not cover teeth or glasses.

I guess it is not important to them that people can see clearly(reduce falls/accidents)

or if we can eat.(dental diseases,choking)

Right now I am sitting here with a mouth full of teeth that are completely rotten-

they are brown=

they stink-

some are broken off

-my gums are red-swollen

and they bleed most of the time.

I am also in tremendous pain.

I contacted medicare they will not cover dental-even when it is caused by a ”disease process”

I watch TV shows with women getting ”white bright” treatments and I cry.

It costs $8,000 for them to pull all my teeth-because I still have so many.

I also need trifocals and have visual problems from a medication they were giving me that caused me to lose peripheral vision in both eyes.

My Mouth and my Eyes are both directly linked to my disease…..

I guess when I get sepsis they will put me in the cardiac unit at the hospital then.

It will cost a lot more and I could lose my life.

Right now I use listerene everyday trying to ward off germs-I cannot brush my teeth they hurt so bad.

I basically eat mush for food!

I use $dollar store glasses to read with.

So I work my whole life from the day I am 16-raise my son alone without childsupport or welfare-put myself through college/nursing school-still working!

I spent my whole life caring for other with my whole heart and soul….and still this is how it all ends up?

I do get a disability check for which I am grateful and I did work for.

Nothing else-except the pharmacy program which I guess is going to stop if Obama has his way …

The Pharmacy Plan sent me a letter today saying if Obamas Plan goes through they are shutting down.

I thought it was bold of them but I guess they are giving us all fair warning from the state run program.

I have almost 900$ in prescription-all generic except one.

I live with my elderly mother now for financial reason etc..

Soon I may be living in a box by the side of the road?

and who will care?

Obama?

By Lynn Marie on 09/22/2009 7:29 pm
Lindy Finestein
I am new to Medicare but was surprised to learn that my husband and I are both forced to use Aetna Medicare.  Apparently our state made a deal with them.  Now we have to not only find doctors who will take Medicare but also Aetna.  A pain in the neck.  We have two supplemental insurances but the deal there is, if Medicare says NO, they say NO to things they covered before we were on Medicare.  One physical for the rest of your life?  Hard to believe.  We were living in a dream world with our two insurance companies during our working years.  Fortunately, we are both healthy.
By Lindy Finestein on 09/23/2009 6:20 am
Lynn Marie
wow got quiet here—sometimes the truth is hard to handle—had to start a whole to blog to continue…..
By Lynn Marie on 09/24/2009 8:46 pm
Edith Wagner

Health care? simple: take Medicare, add obstetrics and pediatrics and voila! the public option. What is all the talk about? The system is in place: use it! Everything is negotiable: lots of ways to cut costs: the rest of us have to do it to stay alive. 

I’m 71, own my own business, will always have to work, cannot afford to retire and thank gawd for Medicare. I was always frugal but am having to take that to new heights so wish the medical care establishment would do the same.  How many more MRI machines do we need if all of them are not in constant use?

By Edith Wagner on 09/25/2009 9:54 am