Rant about medicare

Like Tree32Likes

I haven't heard anyone around here mention that their doctors don't accept patients on medicare (not saying it doesn't happen, I just don't know of any). My parents have never had an issue with their doctors, but they did have problems with the local hospital and had to use a hospital 30 miles away for awhile. It was ridiculous.
The entire health care system needs overhauled top to bottom.
Originally Posted by jeepcurlygurl
I have lupus and fibro and have 2 drs who dont accept medicare and 1 doesnt accepts HMO's. he's also whay's known as a concierge dr. I pay a fee to use him as my dr and he bills my insurance.
Somethings needs to be done thats for sure. I pay about 20k a year in copays deductibles etc.

I talk to a lot of sick people who have non-textbook problems. They have a lot of problems even with the canadian, australian, and uk systems. No system is ideal. It seems those with acute health issues have a more positive experience than those with chronic issues.
Healthcare should not be amount large profit margins for the admin (cant think of the word havent slept in 2 days) while family drs are barely getting by. It's a mess
rbb and curlypearl like this.
I haven't heard anyone around here mention that their doctors don't accept patients on medicare (not saying it doesn't happen, I just don't know of any). My parents have never had an issue with their doctors, but they did have problems with the local hospital and had to use a hospital 30 miles away for awhile. It was ridiculous.
The entire health care system needs overhauled top to bottom.
Originally Posted by jeepcurlygurl
I have lupus and fibro and have 2 drs who dont accept medicare and 1 doesnt accepts HMO's. he's also what's known as a concierge dr. I pay a fee to use him as my dr and he bills my insurance.
Somethings needs to be done thats for sure. I pay about 20k a year in copays deductibles etc.
Originally Posted by crimsonshedemon
Is that like a retainer for an attorney? Interesting arrangement. But an expense you should not have to pay just because you or a loved one has a serious disease. So that supports curlypearl's original point (which I didn't mean to guano - quite sorry) about doctors refusing to accept Medicare.

You bring up several excellent points. First of all, the insurance premiums are only part of the equation, since there's a minimum you have to hit before insurance kicks in, and even then there's still co-payments for everything from doctor's visits and exams to prescriptions.

I talk to a lot of sick people who have non-textbook problems. They have a lot of problems even with the canadian, australian, and uk systems. No system is ideal. It seems those with acute health issues have a more positive experience than those with chronic issues.
Healthcare should not be amount large profit margins for the admin (cant think of the word havent slept in 2 days) while family drs are barely getting by. It's a mess
But at least you don't have to postpone medical care because you can't afford a) the cost of care and b) to miss work, since you don't have legally mandated sick leave. As a result, many people don't see a doctor until they're seriously sick, at which point the cost of treatment is much higher than it would have been early on, and many other people have been exposed to illness.

BTW, administrative costs are far higher for private insurers compared to Medicare (12% versus 2%). In addition, people on Medicare and Veterans Administration health care, both of which are government-run, are much more satisfied with their quality of care than people on private insurance,

i would just like to add that my marginal tax rate would probably cause all of you to go:



but i've had 3 surgeries in the past 20 years, including one with serious complications, and walked into and out of the hospital without a penny changing hands, no credit cards, no bills.

my sister and i got money BACK from the Quebec health system after my father died - his cancer care cost us nothing. the same with mom's spinal surgery last fall.
Originally Posted by rouquinne

Yes, taxes are considerably higher in countries with universal health care. On average, the French pay 47% in income and payroll taxes (!). But that covers college education, job training, child and elder care etc. in addition to health care. So if you start adding that stuff up, I'd bet most Americans are paying more than their Canadian, European and Australian counterparts.

And they don't have the stress of wading through paperwork and bills when you're dealing with the emotional trauma of a serious illness.

How do you get money back? Is that for survivor benefits?
curlypearl likes this.
we got money back from the very luxurious hospice where dad spent his last few months because he paid a room and board fee out of his pension. for each month, the amount was deducted on the 1st. Papa died on May 9th and we were refunded the rest of the month.

And they don't have the stress of wading through paperwork and bills when you're dealing with the emotional trauma of a serious illness.
exactly this....
curlypearl likes this.
My blog:

http://labellatestarossa.blogspot.ca/

Little Mother of all the Roaches, President-for-Life of the MAC Harlots!
I can't reccomend this documentary enough. You can get it on iTunes.

Escape Fire: The Fight to Rescue American Healthcare
curlyprincess1 likes this.
I used to work for a joint replacement surgeon. 80% of his practice was MC pts. He's doing very well despite how little they pay (and I think it's decreased 2% recently) because the volume is huge. He's a specialist that does over 1K surgeries a year. So far he's ok. But the family doctor is what I fear is going to be no more some day. Med students are not going to go in general practice. If not a surgeon then a specialist.
I used to work for a joint replacement surgeon. 80% of his practice was MC pts. He's doing very well despite how little they pay (and I think it's decreased 2% recently) because the volume is huge. He's a specialist that does over 1K surgeries a year. So far he's ok. But the family doctor is what I fear is going to be no more some day. Med students are not going to go in general practice. If not a surgeon then a specialist.
Originally Posted by Mooshville
I don't understand this. Of all doctors, the family doctor is who you see most often. How do you go to a specialist most times if not first seen by your family doctor? Unless you self diagnose or seen from an emergency room situation. Most medical issues I have, my GP was instrumental in catching, then referring me to a specialist.

texture - medium/fine, porosity - low/normal, elasticity - normal
co-wash - NaturelleGrow Coconut Water or Marshmallow Root, Slippery Elm Bark & Blue Malva Cleansing Conditioners
LI - KCKT mixed w/ SM C & H Curl & Style Milk
DC - NG Mango & Coconut H2O or Chamomile/Brdck Root
Gel - SM souffle (winter), KCCC (summer) or CR Naturals Aloe Whipped Butter Gel (year round)
Sealers - Virgin Coconut Oil, Avocado butter, Aloe butter
Ayurvedic treatments - Jamila Henna, Sukesh, Aloe Vera Powder, Hibiscus Powder
.




I used to work for a joint replacement surgeon. 80% of his practice was MC pts. He's doing very well despite how little they pay (and I think it's decreased 2% recently) because the volume is huge. He's a specialist that does over 1K surgeries a year. So far he's ok. But the family doctor is what I fear is going to be no more some day. Med students are not going to go in general practice. If not a surgeon then a specialist.
Originally Posted by Mooshville
I don't understand this. Of all doctors, the family doctor is who you see most often. How do you go to a specialist most times if not first seen by your family doctor? Unless you self diagnose or seen from an emergency room situation. Most medical issues I have, my GP was instrumental in catching, then referring me to a specialist.
Originally Posted by juanab
You don't need a referral if you have Medicare. You can go to any doc you want as long as they take Medicare part B.
I used to work for a joint replacement surgeon. 80% of his practice was MC pts. He's doing very well despite how little they pay (and I think it's decreased 2% recently) because the volume is huge. He's a specialist that does over 1K surgeries a year. So far he's ok. But the family doctor is what I fear is going to be no more some day. Med students are not going to go in general practice. If not a surgeon then a specialist.
Originally Posted by Mooshville
I don't understand this. Of all doctors, the family doctor is who you see most often. How do you go to a specialist most times if not first seen by your family doctor? Unless you self diagnose or seen from an emergency room situation. Most medical issues I have, my GP was instrumental in catching, then referring me to a specialist.
Originally Posted by juanab
You don't need a referral if you have Medicare. You can go to any doc you want as long as they take Medicare part B.
Originally Posted by Mooshville
But whether you need a referral or not, wouldn't one go to a GP for an unspecified pain or illness before they go to a specialist?

texture - medium/fine, porosity - low/normal, elasticity - normal
co-wash - NaturelleGrow Coconut Water or Marshmallow Root, Slippery Elm Bark & Blue Malva Cleansing Conditioners
LI - KCKT mixed w/ SM C & H Curl & Style Milk
DC - NG Mango & Coconut H2O or Chamomile/Brdck Root
Gel - SM souffle (winter), KCCC (summer) or CR Naturals Aloe Whipped Butter Gel (year round)
Sealers - Virgin Coconut Oil, Avocado butter, Aloe butter
Ayurvedic treatments - Jamila Henna, Sukesh, Aloe Vera Powder, Hibiscus Powder
.





I don't understand this. Of all doctors, the family doctor is who you see most often. How do you go to a specialist most times if not first seen by your family doctor? Unless you self diagnose or seen from an emergency room situation. Most medical issues I have, my GP was instrumental in catching, then referring me to a specialist.
Originally Posted by juanab
You don't need a referral if you have Medicare. You can go to any doc you want as long as they take Medicare part B.
Originally Posted by Mooshville
But whether you need a referral or not, wouldn't one go to a GP for an unspecified pain or illness before they go to a specialist?
Originally Posted by juanab
Yeah, if you don't have a clue what's going on. I've had clearing of the throat problems for years. Rather than wasting my copay/deductible money on my pcp I went straight to an ENT specialist with my PPO plan. There is no money in gp and it's getting worse for them. I'm not saying it will be no more, the the options you have of choosing a GP if you have Medicare are going down.
You don't need a referral if you have Medicare. You can go to any doc you want as long as they take Medicare part B.
Originally Posted by Mooshville
But whether you need a referral or not, wouldn't one go to a GP for an unspecified pain or illness before they go to a specialist?
Originally Posted by juanab
Yeah, if you don't have a clue what's going on. I've had clearing of the throat problems for years. Rather than wasting my copay/deductible money on my pcp I went straight to an ENT specialist with my PPO plan. There is no money in gp and it's getting worse for them. I'm not saying it will be no more, the the options you have of choosing a GP if you have Medicare are going down.
Originally Posted by Mooshville
I can go to anyone I choose on my insurance plan at any time, but I would rather go to my GP (11 years now) before I go to a doctor I don't know. But I get your point. I certainly hope that doesn't happen though. I truly believe the good GPs are worth their weight in gold and help keep costs down actually.

texture - medium/fine, porosity - low/normal, elasticity - normal
co-wash - NaturelleGrow Coconut Water or Marshmallow Root, Slippery Elm Bark & Blue Malva Cleansing Conditioners
LI - KCKT mixed w/ SM C & H Curl & Style Milk
DC - NG Mango & Coconut H2O or Chamomile/Brdck Root
Gel - SM souffle (winter), KCCC (summer) or CR Naturals Aloe Whipped Butter Gel (year round)
Sealers - Virgin Coconut Oil, Avocado butter, Aloe butter
Ayurvedic treatments - Jamila Henna, Sukesh, Aloe Vera Powder, Hibiscus Powder
.




It seems to me from the UK that the word socialism is filthy dirty but the word communism is heavily and erroneously overused in the US. Those who want to prevent reform simply roll out the scary words and blackmail politicians and voters with them. There's nothing communist about the National Health Service, it's not even really seen here as socialist tho I suppose technically it is - most of the public seem to be pro a 'free at the point of access' healthcare system regardless of their voting preference.

AFAIK our Labour (used to be socialist but now only barely left of centre) and Liberal-Democrats parties (= your Democrats) want to keep the NHS much as is, tho I suspect the Conservatives (=your Republicans) would privatise it given half a chance.

The NHS is actually the largest employer in Europe, the mind boggles as to what is spent on US healthcare, given that we in the UK spend much less that you in the US per head. Personally I feel it's a crying shame we can't all learn from one another, take the best of each other's systems. Although I know the US has huge problems with the results of poor lifestyle choices, there are also whole swathes that are totally on board with healthy eating, regular exercise and supplements, we don't seem to have that 'personal responsibility' to the same extent.
curlypearl and yossarian like this.
2a-2c, medium texture, porous/ colour treated. Three years CG. Past bra strap length heading for waist.

CO-wash: Inecto coconut/ Elvive Volume Collagen
Treatments: Komaza Care Matani, coconut/ sweet almond oils, Hairveda Sitrinillah
Leave in: Fructis Sleek & Shine (old), Gliss Ultimate Volume, various Elvive
Styler: Umberto Giannini jelly, Boots Essentials gel
Flour sack towel, pixie diffuse or air dry.
Experimenting with: benign neglect
Reviving this thread, because I was wondering about something. I had nothing but good experiences with Medicare when I was taking care of my father. Now my father-in-law is starting to have mysterious health problems and is seeing a lot of doctors. He has Medicare Advantage through the company he retired from. This is Medicare through a private insurance company (United Healthcare) instead of the regular government Medicare. It has some good things -- it includes prescription insurance and also vision care. But the really big problem is that he is only supposed to go to doctors that are in the plan (like an HMO or PPO). We are having trouble finding specialists that accept this plan. And a lot of doctor's office staff don't seem to understand how it works -- they typically submit the claims to regular Medicare first, and then it gets rejected.

Anyone else had experience with this? Any tips for how to better work the system?

Last edited by SuZen; 07-23-2013 at 05:05 AM. Reason: Typo
But the really big problem is that he is only supposed to go to doctors that are in the plan (like an SMO or PPO). We are having trouble finding specialists that accept this plan. And a lot of doctor's office staff don't seem to understand how it works -- they typically submit the claims to regular Medicare first, and then it gets rejected.

Anyone else had experience with this? Any tips for how to better work the system?
Originally Posted by SuZen
I just have traditional Medicare; the Advantage plans in my area were too restrictive and expensive. But I read a LOT about them before I made my decision. They are HMOs, basically, and you have to be very careful about going through proper channels, getting preapprovals for everything and, as you experienced, going only to doctors/hospitals that accept the plan. (My doctors didn't accept the Advantage plans in my area, which is another reason I didn't go with one.)

You should be able to check online at the Medicare.gov website to find a local doctor that will accept that specific insurance -- have you tried that? Also, be very careful about his prescriptions -- it's easy to be prescribed something that's not on the formulary and end up paying full price (and/or ending up in the donut hole).

As for billing, he should make sure to specify the Advantage plan he's using when he checks in for a doctor's appointment. Medicare billing can be tricky; I've had to go back and talk to the billing department a few times myself when the wrong code was used for my cholesterol tests and Medicare was rejecting it.

Good luck!
curlypearl likes this.
~ Wendi in IL
3a - fine, colored hair w/normal porosity (loves protein!)
CG since March 2010
Co-Wash: V05, Suave or Cure Care
Low Poo: Desert Essence
Condish: GVP Balm, CJ Beauticurls Strengthening
Leave-In:
Cure Care, KCKT
Styler: SS FHG, Re-Coil, LALSG, BRHG

Thanks a lot, Wendi. The problem is that his company switched from regular Medicare to Advantage about 3 years ago, so some of his doctors that he's been seeing all along no longer accept his insurance. He's getting forgetful and a bit confused, and if he goes to appointments alone, he doesn't remember to tell them about having Advantage instead of regular Medicare. We especially have trouble with labs, who always submit to regular Medicare even though they have the correct insurance information from his doctors.

I didn't know we could get a list of approved doctors from medicare.gov, I will definitely check that out.
i would try to find out if he can switch to the gov medicare. remember my mom telling me about the problems my aunt had with private medicare and how they were trying to help her switch. i think they were able, but not sure.

i do know united healthcare is terrible to work with. i am a provider and i have seen how they have gobbled up most of the insurance companies, then greatly reducing the payable amounts to providers, requiring ridiculous paperwork. unfortunately, they also gobbled up my personal insurance, oxford, but i am in a tricky situation and cannot find premiums low enough to switch to. one of my drs had told me that united healthcare was making it very difficult for him to order tests for patients.
from my perspective, it seems like blue cross/blue shield (NOT to be confused with the empire plan in ny which is actually united healthcare) is the best, with aetna right behind it.

so if your uncle can switch to medicare thru gov, that is the best. otherwise, i don't even know if blue cross/blue shield offers that, but if they do, that's a good second best.

maybe do a google search to try to find help searching this stuff out. there must be people who are knowledgeable about this.

good luck and let us know what happens.
[FONT="Arial Narrow"]
3a, some 2c & 3b, medium texture, porosity normal, low elasticity
washing/cowashing, conditioning, protein tx: curl junkie products
leave in:cj conditioners and treatments as leave in
styling: cj pattern pusha, cj honey butta leave in, cj cccc, cj ciab, lalsg. cj aloe fix gel is my high dews/summer HG!!
sealants - spiral solutions emollience butter, jane carter nourish & shine
Yes, I am terrified at what the ramifications OC will have on this nation next year.
Yes, Im terrified at what the ramifications OC will have on this nation next year.
Originally Posted by curlyprincess1
Such as 45,000 of our fellow Americans NOT dying because they didn't have health care?

The fearmongering surrounding health care reform is reprehensible, but sadly bnot unprecedented. The right-wing tried the same tactics prior to the passage of Medicare, yet almost 50 years later that government program (along with Veterans Administration health care) outperforms EVERY private insurer.

The US is the only industrialized country without universal health care coverage, yet we spend far more per person, are much sicker and have a shorter life expectancy. The free market has failed in every respect - as Firefox7275 rightly noted, it's time for Americans to learn from our European, Canadian, Japanese and Australian counterparts.

US: $8233 per year per person
Canada $4445
Germany $4338
UK $3433
Japan $3035
France $3974
Firefox7275 likes this.
When the power of love overcomes the love of power, the world will know peace. - Jimi
2c/3a, BSL, medium, low porosity
Low-poo: Bobeam and CV poo bars; Acure Argan Oil & Stem Cell
Conditioner: Acure Argan Oil & Stem Cell; Desert Essence Shea
Stylers: Sweet Curls Elixir Curl Cream; SM CES
PT: BASK Whiskey Soak

Last edited by yossarian; 08-09-2013 at 05:37 PM.
Absolutely yossarian.
I voted for Obama and I'm for universal health care but I have no faith in Obamacare. When I voice this concern many of my friends leap down my throat but I just don't think it is a good solution. I don't have any suggestions - I'm gloomy about the entire situation.

When I was on medicare no doctor would take it. We are just in a medical mess in this country.

Someone said Italy has a good system. Any Italians on board who can comment?

By the way, when I worked for an organization that used United Health Care they were absolutely horrible. They would say they lost my claims, or deny them or make up every excuse imaginable. I work for a different co. now with CIGNA. They are better.
2/c and some 3A. Modified CG.
Protein sensitive
Highly porous. Color over grey.
Best 1st day method: Super Soaker
Conditioners: Curl Junkie Beauticurls Strengthening Conditioner,
Deep condish: Curl Junkie Curl Rehab
Stylers: Experimenting with cones & sulfates while the dews are high.
Sometimes try roller sets - classic glamor but I prefer my curls.
Every day is a gift

Last edited by curlypearl; 08-10-2013 at 09:33 PM.
Come to the retirement state, all the docs here take Medicare, but in order to make enough money they have so many patients and are so busy you are just a number in their offices. And they order as many tests as they can bill for so they can make as much as they can... oh yeah, I live in Florida.
curlypearl likes this.

Trending Topics


Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are On



All times are GMT -6. The time now is 01:28 PM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright 2011 NaturallyCurly.com