Tag Archives: Medicare

Medicare Redicare

For the last three years, I’ve had the same Medicare company and so this year I assumed my healthcare appointments, coverage, providers, etc. would probably remain pretty much the same as in previous years. However, I’m finding changes and they’ve kind of surprised me. A couple of days ago, I received a letter from my company stating they are “making it easier to take charge of my health.” Are they saying it’s going to be easier for ME to take charge of my health, or that they are making it easier on THEM to take charge? Hmmm.

I decided to continue reading to see if the answer lay further on. Ah, ha! The very next sentence stated my company was working with another company to bring a mobile clinic to my neighborhood in order to give me preventative health screenings close to home. And these screenings would be custom geared to my specific health needs and could be completed in one appointment. Then to top it all off, these screenings would be provided to me at no extra charge. Gosh, I feel as though I’ve won the lottery! All I needed to do was call a certain phone number and I could get scheduled. Wow, huh?

I couldn’t decide what to do with the letter, so, like Scarlett O’Hara I left it sitting on the counter in my kitchen and went on with my day. Then the next day, I received a phone call from a cute sounding young man from my company (we’ll call him “Brad” since he may have called you, too) who asked if I’d gotten a letter from them recently about this screening company. I told him I had and he said he was calling to get me signed up and scheduled for an appointment. How efficient! “Brad” explained that when the results came back from the different tests conducted, they would be sent to my primary doctor and she would discuss the results with me in a subsequent visit.  I told him I thought that would work out well since I was already scheduled to see her for a checkup in early August.

I secretly was thinking it seemed strange to me to have this company schedule screenings this late in the year since each Medicare year begins in January. I may have already had these screenings because I see my primary doctor for a checkup about three times a year, as it is, and each time she covers a screening or two—but what do I know.

I asked “Brad” where the location was of this screening place and he told me it was a mobile unit near my local Winn Dixie grocery store. Then he asked me if I was able to climb a few steps. I told him I was old, but not too old to get into a trailer. I guess it must have been the way I said it, because “Brad” burst out laughing, which caused me to get tickled, too. I was becoming fond of “Brad.” He told me I had a good sense of humor and suddenly I thought of him calling seniors all day who were likely seriously obsessed with their own health issues and probably not much fun to talk with. Poor kid. I asked him if his job was tedious and he said, not at all. He was helping people get the care they needed. Okay, his reply may have been scripted, but he answered so quickly, I felt he was being sincere. Now I was ready to adopt “Brad!”

So I can honestly say I spoke with someone today who seemed to sincerely care. How often do we feel that way these days? I hope all you other seniors out there get a call from “Brad.”

 

Coco Ihle is the author of SHE HAD TO KNOW, an atmospheric traditional mystery set mainly in Scotland.

Join her here each 11th of the month.

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Filed under life, musings, writing

ELECTION YEAR – One Person’s Struggle with Heart and Mind

They say a person should follow their heart.  As a natural born idealist, my heart tugs at my mind. My heart has good intentions.  It knows what it wants.  My mind warns me that, at least in some cases, the heart has a tendency to ignore reality.

I have been an idealist for a very long time.  My favorite song is John Lennon’s Imagine.  I can imagine; and, more, I want to imagine.  However, I see caution signs all around me.  The biggest sign is the one that says humans are not even close to the idealism of a world imagined by John’s poignant lyrics.

I grew up in a family that was not only run by a militarist dictator but one who was also a criminal.  He ruled over his realm with an iron fist and demanded everyone acquiesce to his commands.  The partner in his parenting relationship was a weak individual who would rather hide her eyes than stand up for what was right.  She had her mind and idealisms yet it was easier to do as she was told and allow her dictator spouse to rule with impunity, regardless of the outcome.  Having been the one subject in his realm who experienced all his authoritarianism, including his secretive propensity for criminal behavior, I retreated into my mind.  That is where I began to listen and lean to the left of politics.

When I left home and moved to Washington, D.C. in 1970, it was an easy choice for me to embrace the anti-war movement, feminism and every single anti-establishment sentiment that rippled through the environment of that movement.  Later and as a liberal arts college student in the midst of an institution that taught idealism, I flirted with socialism.  At one point I even joined a young socialist group.  It was there, at the meetings, that my idealism got its first taste of reality.

The group’s ideology was one that tugged at my heart; but, the political structure of that ideology forced me, for the first time, to question the reality of that ideology.  The structure dictated that I behave according to the group thinking.  I was back where I began under the roof of a dictator who wished to own both my soul and body.  So, one evening, as we all sat around a huge table, I spoke my mind.  I questioned the political structure of the group and asked why I should allow them to tell me how to live, but more, how to think.  I never returned to that group, but went my way knowing that I needed to gather more information before I committed to any one humanly orchestrated ideology.

Election year, 2016, finds me back at the crossroads of ideology vs. reality.  There is no doubt that my heart and mind still exist on the side called liberalism.  I am an ardent liberal.  However, my 68 years of real world experience cautions me to weigh all the information before I commit to who I will cast my vote for now and in November.  There’s one more element involved.  One of the two opposing candidates is a woman.  I have never given up my feminist affinities.  I know that part of me is solid because it is always weighing all the information.  My father ensured that part of me would stand vigilant at all times.  Nevertheless, there is still the matter of my heart.

It would be so easy for me to feel the bern.  John Lennon’s Imagine and Simon and Garfunkel’s Looking for “America” pulls me to that side of the spectrum.  I want to imagine.  I want to believe.  I want to follow my heart.  Alas, my mind and its wealth of learned knowledge won’t allow me to slip silently into the slumber of the song the siren sings.  I know too much.

I am 68 years old.  I am a recipient of Medicare.  Before making the decision of how I wanted to have my Medicare administered, I joined an organization and sold Medicare to people who were first time recipients and those who were existing recipients, but had never been exposed to the different insurance choices within the system called Medicare.  I demanded of myself to know my choices.

Medicare in its purest form is not all it’s cracked up to be.  Medicare in its purest form means a recipient is subject to pay 20% of all medical costs.  At first blush, that doesn’t sound all that foreboding.  However, when one weighs the medical institution that currently exists in the U.S., for a typical human recipient, financially, Medicare is a prohibitive system.

Imagine the typical full-blown hospital bill for one hospital stay.  Such a bill includes copious fees for, e.g., doctors, tests, and procedures.  They also include facility usage fees which include those $100 Kleenex boxes.  Fact:  given the evolved and complicated medical institution, based on one hospital stay, a person on straight Medicare could easily go bankrupt.  It would take much more than eight years to rein in that system, and it wouldn’t go quietly.  The party on the right, lobbyists, the drug companies, doctors, et. al would fight tooth and toenail for the status quo.

I recall the McDonald’s guy, Morgan Spurlock, currently with CNN, did an investigation on the cost of getting a colonoscopy in the U.S.   During his one-hour report, he broke down the history of our medical institution which is the elephant in the room.  It’s big, complicated to the point of incoherence, and has one goal in mind.  Profit.  Through hours of research, Morgan could never lock down a cost for the procedure.  What he did discover was that in the U.S, without insurance, this procedure would be too costly.  Instead, he opted to go to Thailand for a vacation/procedure holiday which cost him less than what the procedure less the vacation would have cost him in the U.S.  In other words; the medical institution has had years to become what it has become.  One man named Sanders is not going to have the time to rein in that system in four or even eight years.  Bernie Sander’s call for 100% Medicare for everyone is a pipe dream.  The siren is singing a myth.

Medicare for everyone?  I sure as hell don’t want to be put on pure Medicare.  Having had dual knee replacement surgery, I would have already experienced bankruptcy at the hands of the medical institution.  With a Medicare Advantage plan, I had to know all my plan co-pays to monitor the bills mailed to my home by the sub-contracted medical industry called Medical Billing.  If I didn’t know my plan co-pays, I would have wound up paying, at least, five times what my co-pays were.  In reality, the medical system is corrupt.  It complicates its corruption with layers of red tape, hidden information and multiple layers of sub-contractors.  The medical institution is determined to keep the system too difficult to understand.  Had I not known my plan, I would never have made the phone calls I did to verify that the numerous bills that found their way into my mailbox were bogus.  I may have unwittingly paid them.

Okay, you say, there are institutions in place that keep the cost of Medicare down.  Yes, there are, but, guess what?  They are all run by another institution called the insurance industry.  Medicare Advantage insurance companies are the institutions that, just as all medical insurance companies do now, negotiate with the medical profession to keep medical costs in check.  Because I knew my co-pays,  my procedure was well within my budget.  However, reality tells me that most people will not know their co-pays and will fall victim to the crooked medical institution that sneaks bills into the mail that are not owed.  I know this because I sold Medicare Advantage to Medicare recipients, existing recipients.  Most recipients have no clue what their co-pays are.  Thus, they fall victim to medical billers who slip in bills that tell the recipient he/she owes the difference between retail and the negotiated fees for a procedure.  Did I just lose you?  The point, the Medicare system is so complicated that to think of making it available to the masses is pie in the sky.  It will take more than two terms of bern to create a system that could become that ideal system.  Mr. Sanders would have to become a permanent president to make that happen and, the other party would have to cease to exist.  It just isn’t realistic.  It’s the song Imagine in spades.

Yes, there’s another alternative for keeping down cost called Medicare Supplements or Medigap.  Having sold it as well, unless a person was chronically ill, I typically steered people away from it.  For a healthy person like myself, it’s a waste of money.  Where Medicare Advantage is a pay-as-you-use insurance plan, a Medicare Supplement plan is like car insurance.  You pay a high premium every single month whether you use it or not.  Plus, with every birthday, the cost creeps up until the premium becomes prohibitive.

One more thing to consider.  A single payer Medicare type system for everyone means for everyone.  That includes the one-tenth of 1% of the population who are billionaires.  The Donald Trumps of the world would also become beneficiaries of a Medicare system called Bern.

Then there’s the promise of free college tuition for everyone.  Think about that institution and its red tape and hidden fees, etc.  Eight years of one presidency isn’t going to be able to make a single dent in that system.  Plus, even if the presidency became a forever one, 100% free tuition for everyone means the children of the one-tenth of 1% billionaires would also become beneficiaries.  That doesn’t even sound like pie in the sky to me.  It sounds like pie in the face of the 99.9% of non-billionaires.

Well, here I am back at the beginning of my quandary.  Should I follow my natural born idealistic heart and allow myself to feel the bern or do I listen to my pragmatic years of experience in the real world?

I don’t know about you, but I chose to face reality.  The U.S. is not ready for a Bernie Sanders.  There’s a lot of prep work to do before the U.S. can begin to work toward his dream.  There are institutions that must be reined in, some that must be created and some that must be eliminated.  There’re lots to do.  The U.S. is not ready for Mr. Sander’s revolution.  It is pie in the sky and a disaster waiting to happen.

I know who I’m casting my vote for in a few months and in November.  I’m voting for the woman who is still fighting to break through that damned ceiling, the one who has the real experience and fortitude to take on all the big boys, domestic and foreign, the one who will build on all the good that has come about over the last eight years.  I’m voting for the battle worn lady named Hillary Clinton.  She will get us closer to the bern than the Bernie will.

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Filed under Maribeth Shanley, writing