Medicare Revelations

I’m back.

Did you miss me?

My column has not appeared for the last eight weeks.

Life goes at a rapid pace but, for someone facing a major health crisis, the days are in slow motion.  Under such circumstances one realizes how fragile life is.

My husband and I have sacrificed in order to buy the kind of medical insurance that allows us the flexibility to see the best doctor available.   The Obama Administration would call that a Cadillac plan.  For us it has been a necessity.   For run of the mill medical problems any doctor will do, but there are times when you need an expert, the expert.

In mid October, I traveled to the Mayo Clinic in Phoenix to undergo a rare and difficult operation.  This was my first experience as a Medicare recipient.   It was an eye opener and a humbling experience.

When I first contacted the department in the specialty needed at the Mayo, I was told it wasn’t taking any new Medicare patients.  I was crushed.  My doctor at home couldn’t find anyone in the area who could put me back together again and suggested that I contact this famed  medical institution.

Mayo Clinic prides itself in treating the hard cases.  However, people, who are fortunate enough to live in an area where the Mayo Clinic is available, often use Mayo physicians exclusively.   Clearly, times are changing.

After making my case, an appointment was made with the expert I so desperately needed and surgery was scheduled.  While going through the pre-op testing, my husband turned on the local news to discover that the West Valley Mayo Clinic, which serves many retirees in the Phoenix area, would no longer be a Medicare provider for physician services.  Senior citizens were dismayed.

The letter that went out to these Medicare recipients also stated they would not be able to transfer to another Mayo facility.  “The challenge we have had for some time with Medicare reimbursements is not unique to Mayo,” said Michael Yardley, chairman of public affairs of Mayo Clinic in Arizona.   Indeed it is not.  That is why more and more hospitals and physicians are declining Medicare.

Medicare simply does not support the cost of doing business at a facility that provides quality care.   Those that take Medicare patients have to make up the difference with patients who can afford to pay their own way or have quality health insurance.   When a facility becomes dominated by Medicare patients, that facility has to decide if it wants to stay in business or not.  It’s gotten so bad that the Medicare Payment Advisory Commission reported that nearly 30 percent of the 2.6 million Medicare beneficiaries seeking a new primary care physician between September 2007 and October 2008 had trouble finding one.

When I became eligible for Medicare, I picked up a supplemental to cover the charges Medicare didn’t pay.  I expected my providers would be paid in full.  Not so.  Hospitals are limited to what Medicare approves and doctors are not allowed to bill more than 15 percent over what Medicare approves.   Medicare approved charges are thin, way too thin.

Mayo Clinic is non profit.  That means the cost of my surgery was less expensive than it would have been elsewhere.  Nevertheless, the hospital was forced by Medicare to write off two-thirds of the expense incurred.  That is an outrage!

We pay into Medicare all of our working lives and, when it is time to receive this insurance, our providers are shortchanged.

One primary care doctor reported he gets roughly $15 for every Medicare office visit.  When you consider the cost of the office, paying the staff and the malpractice insurance,  doctors are barely getting by or going in the hole with each Medicare patient they see.

Despite this fact, Medicare is going broke.  To make matters worse, the so-called  health care reform bill in Congress calls for $500 billion dollars in cuts to the program and the Democrats want to lower the age of eligibility to 55, putting even more strain on the system.

Politicians pushing for government-run health care tout Medicare as a success and they won’t be happy until everyone is under a government program.

Many actually believe that when the government takes over health care we will all receive more for less.  The truth is we will receive less and it will cost more than we can possibly imagine.  Many, who at this time would be saved, will pay with their lives.

You, who expect to get something for nothing, check the Medicare reimbursement rate in your state and do the math, if you dare.

8 thoughts on “Medicare Revelations

  1. Last year I tried to find a doctor in the Reno area. None of my choices would accept Medicare. They have broken their contracts with the government for precisely the reasons Jane states. The specialists will not be taking medicare if this bill goes through which means cardiologists, oncologists and the like. Seniors will lose their health care while congress has its own plan that won’t affect any of them. Reid has changed the wording on his pubic option and senators who vote without reading will support the bill which, in fact, still offers a public option. They aren’t listening to their constituency as I’m sure they’ve been promised victory in spite of the public ramblings of anger. I don’t know what it will take short of voting them out of office and going back in to amend the bills passed or soon to be passed. Remember when the House and the Senate bills go to conference ANYTHING can come out at that time. If you think what they have now is bad … just wait!


  2. Republicans should have made this the most important talking point of their fight against Democratic health care reform.
    The main reason that the cost of private insurance has increased so much is that the hidden Medicare subsidy has increased.
    Second, Medicare is popular BECAUSE it is broke. The government has promised more health care to seniors than it can afford based on the taxes it levied. Unlike private insurance CEOs, Congress hasn’t bothered to ensure Medicare was sustainable. They did their accounting on a cash flow rather than accrual basis creating a demographic time bomb that is about to go off (in Social Security as well).
    The solution to health care is to take health care decisions from the government and give them to the governed. It will become more competitive and prices will drop. You can’t manage health care costs when no one really knows what health care really costs.


  3. o.k. so I agree – and I do whole heartedly! But what can we do at this stage of the game, and the game is almost over?

    Dr. Lange


  4. I know that many of you feel helpless, but when they feel the heat, they see the light. Remember what happened when Congress was ready to pass — and Bush 43 ready to sign the amnesty bill which was called “Immigration Reform.” Normal, everyday people shut down their phone lines and it was stopped, dead in its tracks.

    It’s too late for letters, but call the local office of each senator — that way they know you are a real constituent — everyday until this is over, even if you think your senators are lost causes. Also, call their offices in Washington, D.C. just for good measure. If enough of us do that, it will end. If not, all you have to lose is a few minutes of your time.


  5. Welcome back Jane!

    Sorry to learn of your health problems and the trials of being a Medi-Care patient.

    Lawyers will eventually put quality physicians out of work. Who wants a 2nd rate doctor?

    Who the lawyers miss will be “done-in” by the politicians (more lawyers). That is the futureof healthcare in this country.


  6. Jane,

    Several years before I worked with you in radio, my dad had lost his sight in one of his eyes, all due to Medicare and the political screwballs that came with it. I hope things go well with you and your husband. This Medicare screwball that’s being thrown at us is a disaster in the making…I kind of wish that some of these politicians would get stuck with this in their families, so that they could see and feel the pain they’re inflicting on the rest of us.


  7. Yes, Jane, i noticed you were away. Welcome back! I hope your health is being and will be restored, and we continue to benefit from your writings. God bless you!


  8. Hi Jane,
    I was wondering why we had not read anything written by you. We pray all is better and you are in good health. Yes, this business with Medicare is scary. My cousin had the same experience at the Mayo in Jacksonville. After a months of chemo and then back for her yearly check she too found out they would not be acceping Medicare. We are going to be facing more of the kind of delimmas I fear with the healthcare bill if it goes through. When will the American people wake up? Mr O deserves nothing but COAL!!!! Take care.Merry Christmas!


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