Mom’s allergy doctor isn’t shy about telling me what he thinks–about anything. The other day, after Mom’s appointment, the doctor and I had a candid discussion about Medicare. I tell ya, it was an eye opener.
Since Daddy died and Mom lost most of her vision, I’ve been handling her business, including her medical bills. Between Medicare and her supplemental insurance, she’s in great shape. She never has to pay a penny beyond the premiums on her supplement. For the elderly, this is how it should be. They’ve done their time, paid their dues, and their lives should be considerably easier during their retirement years.
But I’ve looked at the cavernous discrepancy between what the medical charges are and what Medicare actually pays.
The doctor drove the point home last week.
Mom went in for her annual breathing test to see whether her meds were still effective for her asthma and for her damaged lungs. The first test is without meds, the second is with. For both tests, she breathes into a tube that feeds into a machine which measures her lung capacity. The tube and mouth cover are disposable plastic–which makes great sense. Ya don’t want to be sticking something in your mouth that has been resting in someone else’s, right?
So, she breathes into the tube which measures her capacity, then she inhales her medicine (also through a tube), and returns to the machine. She has a nurse attending her all the way. So, just based on what I know, that’s at least one tube and mouthpiece (at a cost of approximately $9.00), one machine (which, according to the doctor, was $37,000), one dose of Albuterol or its equivalent (possibly a sample from a pharm. rep. so maybe it doesn’t count), one nurse, and one doctor, all housed in a rented office fully operational with water, air conditioning, electricity, office and medical equipment and supplies, and staffed with a host of professionals expecting paychecks at regular intervals.
How much does Medicare pay for this procedure? Six dollars.
If it wasn’t for his patients with regular insurance, the doctor couldn’t afford to keep his practice open. I think I mentioned once before having to find a family doctor for Mom and how difficult that was since more and more doctors are refusing Medicare patients. According to the allergist, there isn’t a single dermatologist in the area that takes Medicare–fine for them, since they don’t have a high percentage of elderly patients. But urologists do. The Bryan/College Station area has a team of three urologists operating out of one office. Medicare patients make up 80% of their practice. The allergist told me they were considering closing their practice–they’ll decide after November 6. At one point, Mom’s oncologist told me his office continually ran in the red. There is no money in medicine, according to him.
The dilemma facing most doctors–the entire medical community–is how to stay in business, how to treat patients, in the face of diminishing funds.
Politically, there are two strategies to deal with this mess. One is to increase taxes, the other is to work internally to put a stop to fraudulent abuse of the system. Then there’s the whole movement to do a Medicare-like cradle-to-grave plan for the entire nation. A newspaper editor actually told me how excited she is about a nationwide healthcare plan because “it is the responsibility of those who ‘have’ to take care of those who ‘have not.'” Funny thing is, I don’t have any trouble with that statement. That’s why I support certain charities. I’m just wondering what it is in the federal government’s track record with managing funds of any kind that says they’re qualified and capable of running such an extensive system without driving the entire medical industry to extinction.
I rarely write this kind of post. In fact, I have gone through my blog and deleted every political/social-issue post I’ve ever written. In spite of my tough-gal facade, I do not like conflict. I despise election years when the hatred between proponents of the two ideologies is palpable. I hate the lies that are broadcast, and more, I hate the fact that so many of them are believed as truth. I am heartbroken at how little understanding many in this nation exhibit. I don’t like it when things are so twisted that to disagree with someone makes a person a racist, to disagree with a proposed remedy indicates a desire to doom those poor people the remedy is to help to their destructive fates. I hate it all.
But I will go out on a limb and say this: The federal government has shown itself incapable of effectively running Medicare–not to mention Medicaid and VA medical benefits. It has been fiscally irresponsible dealing with the healthcare of a small portion of the American population. What on earth makes anyone think it can handle the healthcare of the entire nation?
Several years into it, and this blog still refuses to be categorized. It's eclectic and includes everything from writing posts to snippets from my ordinary life. 
Linda W. Yezak 
Amen, sister. We deal with Medicare too – and it’s amazing how many docs don’t take it because of the pittance they pay.
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From what I understand, it’s going to get worse. I have two pre-existing conditions. By the time I’m old enough for Medicare, it won’t be there–but it won’t matter. There won’t be any doctors who take it anyway, and if the feds try to force docs to take it, there may not be any doctors at all.
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When the health care reform is fully operational in 2019, many doctors will receive only 80% of what Medicaid pays now, with more people qualified for Medicaid. So they’ll have a card that says they have insurance but not enough doctors to provide basic health care, especially in sub-specialties that are expensive. I appreciate your post here.
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That’s the way I see it going, Olivia. Scary, isn’t it? Thanks for you comment.
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Hi,
We have governmental controlled healthcare in Germany. Does it do the job? NO!
More and more working people are running to private insurances and only the people who are a part of the social welfare system or who have families with lots of children or people who work in lower paid jobs have the governmental insurance. The money is taken out of your paycheck every month. Does it cover all the medical expenses? NO! In fact, if you are under the governmental plan, you may end up paying twice as much, because they don’t cover everything, and I could go on and on.
Conclusion, the worst thing that could ever happen in any society is handling the control of your healthcare over to the government to determine, the doctors you see, and the care you receive. It is the beginning of a third class system that builds up a bureaucracy that needs to be paid for. George Orwell lives again and the Animal Farm continues. 🙂 (Had to put that last line in.)
Ciao,
Patricia
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I’ll never know why so much trust is put in governments. It’s not like they have a stellar record–any of them.
Yeah, I like your reference to George Orwell . . .
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Linda, it sounds like we are in agreement. Every system the government has opted to run is a colossal failure. I could list them, but we’ve probably all seen the list, beginning with the Post Office and not ending with Social Security. I take exception to only one statement you made. That those who “have”, have the responsibility to help those who “have not.” It applies to those who “have not” for reasons beyond their control. It does not apply to those who “have not” because they “work not.” And they are multiplying at an alarming rate. And will continue to do so as long as the “haves” are forced to support them. Worse yet, some of us who are considered to be on the “have” side don’t really HAVE that much. But we are not of the nature to take from others as long as we are able to keep our heads above water.
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Oh, I agree with you about the difference between “have not” and “work not.” After eight years of working in the food bank, I’ve seen the difference. The first client I registered swore he didn’t have an income–not a single penny from work or government. When I asked him for ID, he pulled it out of his wallet. Right behind it was his casino card to the Isle of Capris. I’ll never forget it.
But don’t get me started . . .
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Wow, I had no idea the discrepancy was that much. Goes to show once again that privately operated businesses are inevitably superior to anything outsourced by the government.
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Honey, if I were your age again, I’d start sinking funds into a health account aside from having independent insurance. And I’d make the account sacrosanct–never to be touched, no matter what, until it’s needed for health issues. Co-pays and deductibles can wipe a person out. I know. During the worst of my Crohn’s, after six surgeries in three years, I had to sell the bulk of my personal assets to make the medical payments, and we had insurance. You never know what’s going to hit, so it’s always best to be prepared.
So says Mama Linda. End of lecture. 😀
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This is the result of the Washington pols eyeing those tempting $$$ amassing from our Social Security monies, which we and our employers so obliging pumped into the system all these many years. Left alone to do what they were supposed to do, those monies would have provided a decent monthly paycheck for all plus a healthy Medicare system. Makes one want to pull every hair out of ones head, doesn’t it? Let’s hope it will make millions upon millions of voters feel the same and have a different kind of “change” in November.
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That is so true, Pat. They couldn’t keep their hands out of the till–and why should we be surprised? I remember during my first year of political awareness–sometime in the ’70s, I think–the government voted themselves a 300% pay raise. A bunch of folks who were only supposed to be compensated for their time are now salaried for life, with the power to increase their income. Yeah, if I think about it too long, I’d be snatching myself bald-headed.
I dread the time between now and Nov. 6. But I can’t wait for Nov. 7.
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All I can do is sigh and agree! {sigh}
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Heavy, sad, sigh. I know what you mean.
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Amen!! I was talking to one of my son’s nurses today about Obamacare, and how scared I am that it will be able to sink its teeth more deeply into our current system. I’m scared TO DEATH that his doctors (and he has several on his case!) will decide to stop practicing. Since he has a rare disease, it’ll make it that much harder to treat him because the experts could be gone…
The only things the government can do well is build an interstate system and run our military. Look at the post office–it’s even failing! They should stay out of everything else. I’m getting more and more libertarian as I get older, and getting more and more of secessionist tendencies, too (it’s almost scary to think what I may be like in just 20 years!)
Nov. 7 can’t come soon enough… I just hope America makes a better decision than they did 4 years ago.
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It’s such a scary time. I hope we make a better choice in November too.
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I agree with you as well, Linda. Our country is becoming a scary place. And you are so right, if you disagree with some, you are a hateful, non-compassionate person. Our founding fathers decreed our country should have a small federal government, not the monster we have now. Too many just want “theirs” and they don’t care about anyone else, and I am afraid it is a pandemic. All we can do is vote our conscious – and pray.
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Yes, our country is becoming a scary place. I hate to think of what we’re leaving our kids and grandkids. Vote and pray.
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Linda, thank you for this post, and for your blog! I’m 53, have no health insurance, and God has blessed me with 2 autoimmune diseases: Ulcerative Colitis, and Lupus. (I say the “blessed” with no sarcasm intended. I have learned much about trusting Him through this, and am certain He will heal me as soon as His good purpose is fulfilled.)
People are typically shocked to learn that I have opposed Obamacare from the beginning. But my hope is in the Lord–not the federal government. What shocks me is that anyone, whether of the Household of Faith or not, could possibly look at the track record of our gov’t and have faith in that!
Our doc is a friend for whom I once worked (nursing and billing), and his oldest son is also a physician. Doc’s son couldn’t find a job as a family physician when he finished his residency, and this was okay, since he and his wife are moving to Africa as medical missionaries.
But–Internists are practically unavailable as the move to specialize becomes more and more prevalent.
A federal health-care system will end all this…in ending medical practice, and with it good medical care, as we’ve known it in this nation. I’m a bit perplexed as to why one should place her trust in Romney, after his massive bungling of gov’t health care in Massachusetts. Often I think when we vote for a president, we can either choose A or…A. I believe the move to socialize the country will, eventually, take place. We can, and should, try to hold off the inevitable as long as possible, and save as much money as we can, but when all is said and done without faith in the Lord to care for us we have nothing.
Just some “old lady thoughts”. 🙂 Thanks again.
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Fortunately, Romney doesn’t support doing for the nation what he did to the Mass. health care system, but healthcare isn’t the only reason I prefer him over the incumbent.
I imagine you’re right, though, about our inevitable move to socialism. For reasons beyond my comprehension, European-style socialism is attractive these days, and the idea of achieving the American dream by working for it has gone by the wayside. These days, redistributing the wealth to keep everyone at the same level of poverty is more appealing than having the ability to get ahead through hard work, frugal living, and wise investments.
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