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missmaggierock

This is a huge problem about Medicare

16 years ago

I am upset right now and I know I may not use the

right terms for some people, but here I go anyway.....

Yesterday March 1st the amount of money doctors are

reimbursed for Medicare patients was lowered...

My very dear friend has a brain tumor. He is trying to

get an appointment with a well known clinic in Memphis.

They will not see him because he has Medicare...also

a very good suppliment.

Did you know this was going to happen???

Comments (37)

  • 16 years ago

    Don't even get me started on Medicare. I know more and more attorneys turning away potential clients if they are on Medicare because they are impossible to deal with and we can't settle claims without their cooperation. It's beyond ridiculous.

  • 16 years ago

    What do you mean by "going to happen"? This has been going on forever. Doctors won't take patients whose insurance (any kind) doesn't pay out big bucks.

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  • 16 years ago

    I agree that things are bad with Medicare. But the problems now are minor compared to what they will be when the Prez rams through his health care reform package. Really, really scary for us old folks.

  • 16 years ago

    Please don't listen to the scare-mongers, Wanda. They only have the insurance companies interests at heart. Yeah, I know this is a hot topic, but couldn't let this pass.

  • 16 years ago

    Yes, my doctor has already said that if this cut went through, their practice may not accept any new Medicare patients.
    Existing patients, however, will not be dropped.

    I hear many doctors will do this.

  • 16 years ago

    I had read about this also, but never thought about being
    involved....we have an established doctor. It's that
    next step when you need someone special and they turn
    you down.

    I have called Washington DC and talked to someone local
    from our Senators office. They are hoping to restore the
    funding. It's a cut of 21 percent. That quite a bit.

  • 16 years ago

    I don't understand, in this case, if he has a "very
    good" supplemental insurance, why he isn't accepted.

    Why would the Dr. care who paid the bills, as long
    as someone was?

  • 16 years ago

    Because Medicare supplemental insurance usually covers the 20% co-pay of the MEDICARE payment.

    So, if Medicare allowed $2,000 for a service last year, and it now pays only $1600, Medicare will pay $1280(80% of the 1600) and the supplemental will pay the other $320.
    The doctor now gets $1600...a $400 cut.

  • 16 years ago

    The doctor now gets $1600...a $400 cut. Could the patient pay the difference himself?

  • 16 years ago

    Donna...I've been thinking along those lines myself, if my doctor decides to drop Medicare patients.
    But, I think Medicare has that it is illegal to do this...might be possible with an existing relationship, but not with a new doctor.

    I hope you all realize that this cut is for doctors only...the thieving hospitals are not getting cut.

  • 16 years ago

    My husband has MS and depression. He takes several psychiatric type drugs, including sleeping pills, anti depressants, amphetamins(legal ones). for those, he needs a Psychiatrist. Last year his Psychiatrist told him he will no longer accept Medicare or private insurance. That means DH now pays $150 himself for a 30 minute session. His only choices were to stop those medications or try to find a new MD who is willing to accept new Medicare patients.

  • 16 years ago

    Ok - you are talking about strictly Medicare. I
    thought he also had a good supplemental group/employer paid
    policy. Thanks for the explanation.

  • 16 years ago

    Because Medicare is a federal program, most Dr's cannot refuse a patient, may have a long wait though! But I think many of the charges are too high. You see a Dr for 2-3 minutes it get a bill of over 100.00? Most of the time it is the nurses that do all the work, and the Dr will come in, ask your pain from 1-10 (federal requirment now), look at the notes and may prescribe meds or not and go away.

  • 16 years ago

    I hear this is happening more and more, because the docs don't want to deal with even insurance anymore and many can find enough patients who will pay cash for visits. Do you have a Kaiser option? We've been with them for 25 years and have been treated very well.

  • 16 years ago

    Sorry Kaiser almost killed my DH, and did contribute to the death of a very close friend. Would I go back--no way in you know what. They really screwed up my blood presure meds. And when we did move they refused to transfer any information. Thank goodness we had some of the records ourselves.

  • 16 years ago

    Sjern...there "is" a very real problem here...I've heard the doctors talking myself. My doctor may just retire early...then I won't be an "established" patient with a good doctor...there are other things, but the country just can't afford what is happening...

  • 16 years ago

    Medicare ... insurance ...

    ... sounds like there's room for a good bit of buck passing, here.

    Or, rather, unwillingness to pass the bucks as "required" (whatever that last word means!).

    ole joyful

  • 16 years ago

    Because Medicare is a federal program, most Dr's cannot refuse a patient,

    Not true. There is no Federal law that says a doctor has to accept any Medicare patients.

  • 16 years ago

    I am not on Medicare. My DH is, since August. We
    did make sure we are established with a doctor that accepts
    Medicare. My neighbor is on medicare. He has had great
    treatment and no problem with any doctor accepting him until yesterday...March 1 when the funding changed.
    I bet a lot of people are going to have trouble as this
    change takes place.
    I dont know what their choice is going to be. I can't
    begin to think what "brain surgery" would cost.
    People have paid into medicare for years, you then pay
    a premium for medicare and also pay for a suppliment.

  • 16 years ago

    I hope this health care system is fixed soon, it's very sad.

  • 16 years ago

    Monica is right- a physician may decide not to take any new Medicare patients just as he can decide not to accept certain insurance plans. Our Oncologist has already told us that he's waiting to see what the new legislation brings before deciding whether to retire or not. He's 62 and planned on working full time until 65 then he hoped to reduce his hours and on call schedule. But he told us that he doesn't like what's happened in his practice and that he is spending more time working but not spending more time with his patients due to the time consuming paperwork, the ever changing and complicated insurance regulations and yes, the reduction in reimbursements. There's a good chance he'll hang up his stethoscope within the year although he is considering going back to his first love - teaching.

  • 16 years ago

    This is only the beginning of hospitals and drs. not accepting medicare.
    http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aHoYSI84VdL0

  • 16 years ago

    I hope this health care system is fixed soon, it's very sad.

    Well, the congress just made it worse.
    And there more bad news coming.

  • 16 years ago

    Our medical delivery system has evolved into a rather unique monstrosity. On one hand it's capable of offering highly sophisticated treatments for conditions that were hopeless only a short time ago. Yet at the same time we have millions of people without any medical insurance or available medical care.

    I have no faith that the government will sort this mess out quickly. Look at the less than adequate job it's done running the VA hospitals. Even the Post Office is losing money. Congress seems to be more concerned about securing their own political positions than acting in the best interest of the people who elected them.

    And I have to agree - it's going to get much worse.

  • 16 years ago

    "Thieving hospitals" also get reimbursed at levels that don't cover their costs which include providing care to the indigent including the emergency care they're required to provide to anyone who walks in the door whether they can pay or not.

    Hopefully this is a wake up call that more government intervention into health care is not a good thing. Medicare reimbursement (and the administrative burden it requires) has been driving physicians out of family practice and internal medicine for years. I keep wondering, based on that federal government program, why anyone in their right mind would want MORE government involvement in health care. I can only think it's because people are unaware of these negative impacts of government run programs.

  • 16 years ago

    For some reason, it seems that our Canadian health care system runs a lot better than Medicare does. I don't know why that would be. All systems have problems, but I'm glad we have the system that we have.

    I do think a big problem with the Post Office is that there is so much lost revenue due to people using the internet instead of the mail system for a lot of things. People complain about the small amount of money it costs to send a letter clear across the country. But some of those complainers will spend $3.50 or more on a latte, or $50-$100 on a c/p plan.

    Sorry, I'm very tired and my mind is wandering.

  • 16 years ago

    We have both medicare and Tri care 4 life.Still i'm glad my chemo is behind me one less worry.
    Kathi

  • 16 years ago

    Yes there are issues with any medical system including Canada's. My Dad's cardiologist, nephrologist and oncologist all have practices just north of Philadelphia. I've spent many hours taking my Dad to his specialists during the last 2 years he lived with us and I met quite a few Canadians who had come here for treatment. There were many reasons- the wait time for a pacemaker was too long, the treatment wasn't available, the patient was deemed too old to qualify for the surgery (not too unhealthy for the surgery, but beyond the age perimeters). One of the reasons Natasha Richardson died of her head injuries is that Quebec didn't have a Medivac helicopter which is something we see fairly regularly here. Yes she didn't wear a helmet and refused initial treatment - but after collapsing and a medical emergency was apparent the only option was a 2 1/2 hour ride to the trauma center.

    While the US is critiqued (often fairly) for too many tests like MRI's and Cat Scans as of a year ago Pittsburgh, PA had more units than all of Canada. My neighbor brough his mother over from the Netherlands because she needed heart valve surgery and she couldn't get it at home due to her age.

    Every aspect of medicine care is over due for reform. Please don't think I'm trying to be unduly harsh on the Canadian system, I'm just pointing out that one isn't necessarily better at across the board medical care. There's a lot we could learn from the government run systems and it's going to be a hair pulling experience watching our Congress try to find the remedy (and pay for it).

  • 16 years ago

    On the other hand, I had my eye surgery in Niagara Falls, Ontario. The clinic is packed with Americans who come to that clinic for surgery, and they come from all over. They rent a hotel room for a couple of days and then they go home when they are recovered. When I was there, there were more Americans than Canadians there, and I remember incredulously speaking to the clinic staff about it.

    Our population is so much smaller than yours, so we would have fewer tests conducted and less equipment. But I also think that with your system, there may be people having some of those tests unnecessarily, which is a risk in a profit driven industry. I mean, that's my impression with the little bit of knowledge I have about your system, I could be wrong and won't mind being corrected if I am.

    That being said, McMann, I'm just making conversation. I'm not offended by your position. Because it can be difficult to interpret "tone" with the written word, I don't want to be misunderstood.

  • 16 years ago

    Oh Susan- you are correct about the difficulty in conveying tone in the written word. That's way I prefaced my earlier comment by stating that our system has evolved into a unique monstrosity and that we could learn a great deal from a government run system. I tried to be clear that I wasn't trying to unfairly criticize any one system. Now - I'm off for my annual mammogram and then I'll celebrate by meeting an old girlfriend for lunch at one of Philly's best restaurants- Le Bec Fin. And of course it's raining.

  • 16 years ago

    I see nothing wrong with a government medical care program for BASIC lifesaving needs. In other words if you have an abscessed tooth (which could kill you) they will pull it. If you desire an expensive root canal with a gold crown and cosmetic ceramic white cover, then pay for it out of your own pocket. If you have cancer, a mastectomy and chemotherapy will save your life, but the reconstruction which is considered cosmetic can be paid for out of pocket. No one should die because they don't have money for a lifesaving treatment. Luxury care would be nice to offer but the money is just not there to offer it to everybody. People should pay for Viagra and Ambien out of their own wallet and not expect the government to cover EVERYTHING they desire medically. Antibiotics - Yes. Valium - No.

  • 16 years ago

    Tort reform would also bring down costs... A LOT.

  • 16 years ago

    Marie, I'm sorry you had problems with Kaiser, but believe me, problems exist in all clinics. Again, we have received nothing but excellent care from K.; I'm in No. Cailif.

    This IS a very political topic right now, and it seems that most of the posters are of one mind along that spectrum. I am not on that side; I find it disgusting that our medical care is for-profit and believe the rest of the modern world has it right. We are alone in our emphasis of profit for shareholders above humane care for all.

  • 16 years ago

    Tort reform would also bring down costs... A LOT.

    Oh?
    I will give you that this concept is thrown out there .. a lot. A common misconception, and, and, and, well..... it "sounds good". But really, it is not a big fish to fry.
    What the Congressional Budget Office says could be saved by "tort reform"..... 0.5%. Where I come from 1/2 of 1% is not ..... "A LOT"

    One-third of the states already have caps on noneconomic damages, and about two-thirds have imposed other measures being proposed at the federal level. Because of this, Congressional Budget Office said, "a significant fraction of the potential cost savings has already been realized."

  • 16 years ago

    My problem is gov't is inefficient,they can't handle our money and they obviously have problems running mostevery department.

  • 16 years ago

    Just popping in to say that this is a great discussion. It's very respectful and it's interesting to me to hear all the different opinions.

  • 16 years ago

    This is just to say about the REAL facts...
    a huge Neuro group in Memphis
    will not see new medicare patients at this time, since
    March 1 because medicare reimbursement was reduced.

    My neighbor is trying to find a doctor to do his surgery.
    Maybe he will be lucky....how scary this can get.