Rant about medicare

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I am incredibly thankful I have private health insurance through my job, but i have to pay $500 a month for the premium, thats for my family of four.

I am glad that I can go to my doctor and request a test if I think I need it, have surgery when I want and not have to wait till the last minute (like a hysterectomy or hernia repair).

But then again, I'm not entirely opposed to a universal health system. I mean it seems so unfair that people can't have affordable healthcare. Then again some that cry they can't afford to pay $150 to go to a doctor spend hundreds of dollars on cigarettes and alcohol and designer bags.... so you wonder where do their priorities lie?
curlypearl and curlyprincess1 like this.
I'm very fortunate, I guess, living in California and having Kaiser. Before I reached Medicare age I had Kaiser from my work, so I just stayed on it with an Advantage plan. Yes, I'm limited to their doctors, but they have a ton of them - here in Los Angeles Kaiser probably has as many docs as a entire city like Spokane or Indianapolis - and I've never been denied any treatment that I needed.

Occasionally when I really wanted a second opinion outside of Kaiser I just paid for it and then shared the ideas with my regular doctor, who is totally open to outside suggestions; he reads the journals, unlike some docs I know about. I suppose if I really needed some arcane, obscure treatment that they don't provide I'd be SOL, but neither I nor anybody in my family has run into that.

My sister-in-law just got a knee replacement from Kaiser without objections. They sent a physical therapist to her home twice a week until she was well enough to go in for therapy. Sometimes, of course, you have to be proactive and put up a bit of a fight, but they always seem to come through.
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
Originally Posted by yossarian
And to add to this, the UK National Health Service is the largest employer in Europe, what it covers is excellent. Paid for via taxes so those that whinge but can 'secretly' afford to pay their way do so (unless they are defrauding the taxman).

UK citizens who are financially comfortable still have the option of spending the money we save on the occasional bit of private tests or private treatment or even an insurance policy if we so choose. It doesn't have to be either/ or.
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Last edited by Firefox7275; 08-12-2013 at 05:38 PM.
I'm not on medicare but both of my parents were / have been on medicare for awhile now (dad deceased and mom is 85). They've never had a problem seeing who they wanted to see, etc. In fact, especially when my dad was living, he was always been sent to specialist, etc. Of course, geriatric medicine is a whole other racket as far as I'm concerned but that's another discussion for another day.
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Most of the doctors I know simply won't take Medicare. Fortunately, I am working now so I have health insurance through my employer, but when I wasn't able to find work and used Medicare it was totally useless because no doctors in NYC take it! I can't really blame them - one told me he gets $7.00 for a doctor's visit for which he charges $150.
Originally Posted by curlypearl
That guy is lying to you. There is NO doctor's service under Medicare for which the doctor would only be paid $7. There are bunches where your COPAY might only be $7 though. You can look your Medicare payments up on line for every visit if you create an account on their website. There are probably also some tests and things for which your COPAY might be $7 - but your copay is not all the doctor gets paid.

One thing a lot of places have been doing to get more money out of the pockets of Medicare patients - many of whom are getting less than $800 a month, and how they live on that I cannot begin to imagine - is to have their doctor's offices classified as "outpatient hospital facilities". Now they get to charge you hospital fees as part of your bill, and these hospital fees must come out of pocket until you hit your hospital out of pocket expenses, which is something in the neighborhood of $1200. So basically unless you are unfortunate enough to need surgery early in the year, you will never hit that out of pocket. For one 20 minute doctor visit, I was charged a co-pay of $28 - and then an additional copay for "hospital fees" of another $50. On top of this the doctor was paid in the neighborhood of $120 by Medicare. So they're not going to the poorhouse any time soon.

BTW, that wasn't even to see a real doctor - that was for me to see a resident, eg a medical student. (Residents are not allowed to practice without supervision and they are not fully licensed MDs - ergo, they are still medical students. ADVANCED medical students, but still students). When I asked why the fee was so high to see a medical student - this was actually more than I was charged to see my GP - I was told that I was being billed for the time his SUPERVISOR spent on the case. So basically I was being forced to pay the expense for HIS education. Go figure. They'll get you any way they can.

Needless to say, with copays of over $60 to $90 per visit, I just don't go to the doctor at all - so I'm pretty much in the same situation I was in before I was declared disabled and became eligible for Medicare. I can't really afford to go to the doctor. Except at least now if I need more surgery that will be paid for - well except the first $1200, but that beats nothing.

To bad surgery wasn't paid for back when I needed it, and if I'd had it when I first needed it, maybe I wouldn't have become disabled so soon. But that's a different can of worms. Anyway.

Go to the Medicare site to find a doctor in your area who takes Medicare. I would give you the link, but apparently I'm not allowed to "until you've posted a few times."

So you'll have to google "find a medicare doctor" and then select the link that says "Find doctors, hospitals, & facilities | Medicare dot gov". It was second in the list when I did the search just now.

Then call their office and make sure that information is up to date. Try to get out of them whether there are additional charges, eg those sneaky hospital fees. The clinic I was going to - associated with a local university-based hospital, and, incidentally, they do their level best to make new patients accept treatment from residents (eg medical students) - never told me about these additional charges despite my repeatedly asking about what fees I would be charged above and beyond what Medicare would pay them. You might need to specifically ask if the office is classified as a "hospital outpatient clinic". If it is then you may be subject to significant additional out of pocket expenses, which the local clinic here, at least, STILL wouldn't tell me how much they would be in advance even after I found out about them. How you're supposed to budget for a doctor's visit, I have no idea.

Unfortunately this is not illegal. It SHOULD be, but it is not.
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Soj, thanks so much for all that useful information. I wonder why the dr. said that! I'm not seeing him anymore anyway, but none of the drs. that I do see say they don't accept medicare now. Fortunately, I'm still working so I have insurance.

When I stop working, for the drs. that don't accept Medicare (that seems to be increasing in NYC) I will have a supplemental plan. I think I am expected to pay their regular fee then submit to medicare and after I get whatever Medicare sends me, I submit to the supplemental. I'm not sure how it all works.

I really am sure that many drs. in NYC are refusing Medicare. I feel like I paid into it for years and won't get anything out of it. I'm in Manhattan by the way.

I'm very sorry that your situation is so rotten. It's so unfair!

Thanks again for chiming in!
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Last edited by curlypearl; 01-19-2014 at 07:42 AM.
Everyone, thanks for responding. I don't want to seem like a grump but it just is so discouraging. I don't blame my drs. at all for not participating and at the same time why was I forced to pay into a system that is basically useless to me and so many others?

Could someone explain how the Canadian system works and why hasn't the US copied it?
Originally Posted by curlypearl
The US is a world leader in medical innovation. We apply for more patents, conduct more research, publish more journal articles and comparatively speaking, invest less of our GNP in medical technology.

The UK is our closest "competitor" in this area, and by many measures, we exceed their output four-fold.

Sure, most of us want affordable care for all. But at what price? We'd still be able to innovate w/ a single payer system. But how well? No one knows. Are we willing to stall the race to find a cure for cancer, AIDS, diabetes, etc., to find out?

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