My Mom was denied health care today (Medicare patient)

[the trade]

My 65 year old Mom was denied health care today from a doctor who refuses to treat Medicare patients. When she offered to pay cash, he said he could not treat her because Medicare considers that fraud.

Imagine that...she offered to pay cash for treatment, therefore relieving the taxpayer of the burden, and she was denied because Medicare considers that fraud. This is government exerting control over our lives, plain and simple.

Her only choice is to get off of Medicare and pay cash for everything, or only see doctors who will treat Medicare patients.

This is the first real government intrusion into the health of my family and it hurts. Just wait and see what happens if the Democrats get their way with the public insurance option.

Rationing. Plain and simple.

I am very, very sad today, for my Mom and for my country. :frown:

[bitterclinger84]

:( That is sad. I'll be praying that your mom finds a good doctor who accepts Medicare!

[jimmyc123]

Really? Because my dad's on Medicare and he just saw a doctor today with no problem. Looks like we have conflicting anecdotes.

[the trade]

Really? Because my dad's on Medicaid and he just saw a doctor today with no problem. Looks like we have conflicting anecdotes.

Nope. Its simply that some doctors refuse to see Medicare patients because of all the bureaucratic headaches involved with treating them. This doctor happens to be particularly good, so when I offered to chip in and help her pay cash I could not believe my ears when he said "No, Medicare considers that fraud."

Its just amazing how upside-down everything is right now. It seems hopeless. :frown:

[zantax]

Really? Because my dad's on Medicaid and he just saw a doctor today with no problem. Looks like we have conflicting anecdotes.


Let's see what the liberal bible has to say shall we?

from http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html

Doctors Are Opting Out of Medicare





kedin (http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html#)
Digg (http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html#)
Facebook (http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html#)
Mixx (http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html#)
MySpace (http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html#)
Yahoo! Buzz (http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html#)
Permalink (http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html#)




(http://www.nytimes.com/adx/bin/adx_click.html?type=goto&opzn&page=www.nytimes.com/yr/mo/day/business/retirementspecial&pos=Frame4A&sn2=cf471019/950bf25c&sn1=9dd22b31/d2cdb3ca&camp=foxsearch2009_emailtools_1011075c_nyt5&ad=500DOS_120x60_c&goto=http://www.foxsearchlight.com/500daysofsummer)



By JULIE CONNELLY
Published: April 1, 2009

Two trends are converging: there is a shortage of internists nationally — the American College of Physicians, the organization for internists, estimates that by 2025 there will be 35,000 to 45,000 fewer than the population needs — and internists are increasingly unwilling to accept new Medicare patients.
In a June 2008 report, the Medicare Payment Advisory Commission, an independent federal panel that advises Congress on Medicare, said that 29 percent of the Medicare beneficiaries it surveyed who were looking for a primary care doctor had a problem finding one to treat them, up from 24 percent the year before. And a 2008 survey by the Texas Medical Association found that while 58 percent of the state’s doctors took new Medicare patients, only 38 percent of primary care doctors did.




1, 2009 [/QUOTE]

[Guitar]

Just another reason why the only way to solve the health care crisis is to eliminate Part D of Medicare, eliminate Medicaid and give Medicare to all US citizens. That would level the playing field for all. To pay for this eliminate Capital Gains and Inheritance taxes, eliminate the IRS and establish a national sales tax. Also charge Medicare premiums for all US citizens that make more than 250,000 a year on a sliding scale with higher incomes paying more for Medicare. This would solve the healthcare crisis and return our nation to the great country it was.

[bioya1]

Nope. Its simply that some doctors refuse to see Medicare patients because of all the bureaucratic headaches involved with treating them. This doctor happens to be particularly good, so when I offered to chip in and help her pay cash I could not believe my ears when he said "No, Medicare considers that fraud."

...

How did you verify that he was telling the truth?

[msny]

My 65 year old Mom was denied health care today from a doctor who refuses to treat Medicare patients. When she offered to pay cash, he said he could not treat her because Medicare considers that fraud.

Imagine that...she offered to pay cash for treatment, therefore relieving the taxpayer of the burden, and she was denied because Medicare considers that fraud. This is government exerting control over our lives, plain and simple.

Her only choice is to get off of Medicare and pay cash for everything, or only see doctors who will treat Medicare patients.

This is the first real government intrusion into the health of my family and it hurts. Just wait and see what happens if the Democrats get their way with the public insurance option.

Rationing. Plain and simple.

I am very, very sad today, for my Mom and for my country. :frown:


I sympathise BUT...

Tell your mom to get another doctor then. My mom was on
medicare for many years, and never had a problem finding
one.

The doctor denied her service NOT for any plan or company
right? (I would think thats not even legal, dunno)

I'm in a PPO medical plan and I can only see certain doctors
within my plan anyways.

So what?

[the trade]

How did you verify that he was telling the truth?

I called my father who is a retired physician (they are divorced) and he said that he ran into the same problem with Medicare when he was practicing, and he retired 4 years ago.

[zantax]

How did you verify that he was telling the truth?

US law?

from http://www.cchconline.org/17medicarefacts.php

Medicare patients cannot pay cash for care. A 1997 law (the Balanced Budget Act, section 4507) forbids private contracts between patients and doctors. With few exceptions, Medicare recipients cannot pay cash for a Medicare-covered service that Medicare denies.

[ddye]

My 65 year old Mom was denied health care today from a doctor who refuses to treat Medicare patients. When she offered to pay cash, he said he could not treat her because Medicare considers that fraud.

Imagine that...she offered to pay cash for treatment, therefore relieving the taxpayer of the burden, and she was denied because Medicare considers that fraud. This is government exerting control over our lives, plain and simple.

Her only choice is to get off of Medicare and pay cash for everything, or only see doctors who will treat Medicare patients.

This is the first real government intrusion into the health of my family and it hurts. Just wait and see what happens if the Democrats get their way with the public insurance option.

Rationing. Plain and simple.

I am very, very sad today, for my Mom and for my country. :frown:
My fiance runs a large medical practice and talks to me a lot about medicare coverage, and you have to be withholding part of the story. There's nothing at all preventing any patient from paying for services with cash.

Doug

[bioya1]

US law?

from http://www.cchconline.org/17medicarefacts.php

The cold irony of that being contained in a balanced budget bill aside, I cannot imagine what that Congress was thinking with that provision. Can you?

In any event, the operative part of the quote from that blatantly anti-Medicare site you found is:


With few exceptions, Medicare recipients cannot pay cash for a Medicare-covered service that Medicare denies


seems to limit this to rather few actual sistuations, doesn't it?

[the trade]

I sympathise BUT...

Tell your mom to get another doctor then. My mom was on
medicare for many years, and never had a problem finding
one.

The doctor denied her service NOT for any plan or company
right? (I would think thats not even legal, dunno)

I'm in a PPO medical plan and I can only see certain doctors
within my plan anyways.

So what?

Because the doctor she wants to see is the only one that knows what he is doing in a very specific field and in her home town. The only alternative, it seems, is to explore the idea of finding a doctor in the nearest major city which is over 300 miles away from where she lives.

The doc denied her service because of Medicare, not because of her supplemental insurance. It is a bug in the system that is demonstrative of what happens when you manage things with big government bureaucracy.

When you can't even pay cash to see the doctor of your choice, you know something is screwed up.

[msny]

My fiance runs a large medical practice and talks to me a lot about medicare coverage, and you have to be withholding part of the story. There's nothing at all preventing any patient from paying for services with cash.

Doug

That might be true IF his mother was NOT on medicare.
No one is REQUIRED to be on Medicare, unlike the new
socialists Obama nannycare plan where we will have be, or be fined.

[zantax]

The cold irony of that being contained in a balanced budget bill aside, I cannot imagine what that Congress was thinking with that provision. Can you?


Sure I can, they were thinking that if they allowed people to pay the real cost of medical services it wouldn't be very long before no doctor accepted medicare.

[the trade]

My fiance runs a large medical practice and talks to me a lot about medicare coverage, and you have to be withholding part of the story. There's nothing at all preventing any patient from paying for services with cash.

Doug

I am not withholding anything and I verified it with my Dad who ran a private practice for 35 years. I would appreciate it if you would ask her about this and get back to me. I would be interested in her comments.

[msny]

Because the doctor she wants to see is the only one that knows what he is doing in a very specific field and in her home town. The only alternative, it seems, is to explore the idea of finding a doctor in the nearest major city which is over 300 miles away from where she lives.

The doc denied her service because of Medicare, not because of her supplemental insurance. It is a bug in the system that is demonstrative of what happens when you manage things with big government bureaucracy.

When you can't even pay cash to see the doctor of your choice, you know something is screwed up.

So that makes you in favor of Obamas plan then?

Or are you just telling us the problem?

[zantax]

That might be true IF his mother was NOT on medicare.
No one is REQUIRED to be on Medicare, unlike the new
socialists Obama nannycare plan where we will have be, or be fined.

Wrong again, if you refuse medicare you don't get you SS payments.

from http://www.cchconline.org/17medicarefacts.php

Medicare is essentially compulsory. People who refuse to join Medicare Part A are not allowed to receive their earned Social Security benefits.

If medicare weren't mandatory it would have been replaced by private insurance long ago.

[ddye]

Because the doctor she wants to see is the only one that knows what he is doing in a very specific field and in her home town. The only alternative, it seems, is to explore the idea of finding a doctor in the nearest major city which is over 300 miles away from where she lives.
Funny, whenever conservatives support the right of pharmacies to refuse to sell birth control, their argument is that a person can always go to another pharmacy. Seems to me that argument is also relevant here.

The doc denied her service because of Medicare, not because of her supplemental insurance. It is a bug in the system that is demonstrative of what happens when you manage things with big government bureaucracy.

When you can't even pay cash to see the doctor of your choice, you know something is screwed up.
Again, there is something missing here that we are not being told.

Doug

[zantax]

Funny, whenever conservatives support the right of pharmacies to refuse to sell birth control, their argument is that a person can always go to another pharmacy. Seems to me that argument is also relevant here.


Again, there is something missing here that we are not being told.

Doug


I cited the relevant statute, maybe you missed it? Here you go.
the Balanced Budget Act, section 4507)

[the trade]

Again, there is something missing here that we are not being told.
Doug

There really isn't. Why is that so hard to believe?

[zantax]

And how it came about


from http://www.law.uh.edu/healthlaw/perspectives/Medicare/981123Sorry.html

During 1997, Senator Jon Kyl (R-AZ) sponsored legislation explicitly allowing Medicare patients to contract with doctors at rates above the Medicare program’s mandated fees and won overwhelming Senate approval. The Clinton Administration threatened to veto the entire balanced budget deal if the Kyl language was included. The Administration professed to fear the creation of a "two-tiered" health care system, one for the rich and one for the poor, but it is alleged that the Administration saw that giving patients a right to choose threatened the piecemeal effort to revive the "Clinton-care" plan defeated during the President’s first term. In order to preserve their budget deal, however, Republicans agreed to compromise language in Section 4507, which requires that any doctors who treat a Medicare patient privately must file an affidavit swearing they will see no Medicare patients for two years.

Aren't democrats wonderful?

[rjhambone]

Really? Because my dad's on Medicaid and he just saw a doctor today with no problem. Looks like we have conflicting anecdotes.

My daughter broke her leg a couple weeks ago. We went to the ER and were referred to an Orthopedic specialist that was on call. We called to get her a cast put on the next day, and we were told he does not accept Tricare. My wife had to scramble at the last minute just to find someone who accepts military active-duty "insurance" to take care of my kid. I can imagine it's similar for other government-run plans.

[Wake-Up]

There may be some missing information here.

Healthcare providers can elect to participate with MCR or not. It is a professional and business decision.

If you do not participate you can accept cash for payment and it is not fraud. The problem may be that this physician participates with MCR but does not like the reimbursement for the services related to her care. If he his participating he can not invoice as a cash customer.

MCR pays 80% of THEIR usual and customary charges and the 20% is the patients which can be billed to a supplemental or secondary policy.

The kicker is MCR usual and customary. A doc may bill $1000 for a service but if he participates with MCR, MCR's allowable for that service may be $100. MCR then pays 80% of the $100 or $80. The patient is responsible for the $20 only and the provider can not try to collect the $1000 - $80 or $920. All they can get is the $80 + $20.

Just about every insurance does this as well and the rates are agreed to when the provider signs a participation agreement with the provider. There are differences for In or Out of Network but thats beyond this discussion.

It works this way for doctors, hospitals, DME, pharmacy, nursing service etc.

If you do not participate with MCR you can bill a patient for cash and that amount is between the patient an the doctor.

There is more to the OP story than relayed. Probably a misunderstanding, poorly communicated information or just missing information from the OP.

[bioya1]

Sure I can, they were thinking that if they allowed people to pay the real cost of medical services it wouldn't be very long before no doctor accepted medicare.

Put another way, it can be hard to prevent doctors and other health care service providers from unnecessarily lining their pockets.

If you haven'tstopped and thought about mechanisms whereby costs are driven upward, you might find this (admittedly long) article interesting:

http://www.newyorker.com/reporting/2...a_fact_gawande (http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande)

BTW, before you read a few lines and jump to tort reform, be advised that Texas has just about the most "doctor friendly" tort rules in the nation.

[the trade]

There is more to the OP story than relayed. Probably a misunderstanding, poorly communicated information or just missing information from the OP.

Thanks Wake-Up! I will research this and see if it applies to my Mom's situation.

[bioya1]

And how it came about


from http://www.law.uh.edu/healthlaw/perspectives/Medicare/981123Sorry.html



Aren't democrats wonderful?

Again, isn;'t that limited to those few instances where Medicare has denied the care in question?

[zantax]

Put another way, it can be hard to prevent doctors and other health care service providers from unnecessarily lining their pockets.

If you haven'tstopped and thought about mechanisms whereby costs are driven upward, you might find this (admittedly long) article interesting:

http://www.newyorker.com/reporting/2...a_fact_gawande (http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande)

BTW, before you read a few lines and jump to tort reform, be advised that Texas has just about the most "doctor friendly" tort rules in the nation.

You mean allowing the government a monopoly in health care will allow them to dictate lower cost medical care? Gee, what a surprise, who woulda thunk it...

[bioya1]

You mean allowing the government a monopoly in health care will allow them to dictate lower cost medical care? Gee, what a surprise, who woulda thunk it...

Should I conclude that you approve of the taxpayer gouging highlighted in that article?

If so, you could have quite a career in procurement for the Pentagon.

[ddye]

I am not withholding anything and I verified it with my Dad who ran a private practice for 35 years. I would appreciate it if you would ask her about this and get back to me. I would be interested in her comments.
I will show her this thread when she gets home from work and either post, or PM you.

OK?

Doug

[msny]

Wrong again, if you refuse medicare you don't get you SS payments.

from http://www.cchconline.org/17medicarefacts.php



If medicare weren't mandatory it would have been replaced by private insurance long ago.


Then keeping to the conservative mantra, dont sign up for SS...

[bioya1]

You mean allowing the government a monopoly in health care will allow them to dictate lower cost medical care? Gee, what a surprise, who woulda thunk it...

BTW, I presume that you are aware that private insurers also set limits on reimbursements. Unlike Medicare, they get to negotiate over drug prices too.

[zantax]

Should I conclude that you approve of the taxpayer gouging highlighted in that article?

If so, you could have quite a career in procurement for the Pentagon.

No, I didn't bother to read it, I grant your premise, that handing the government a monopoly in health care coverage will allow them to force doctors to take below market rates for their services. Resulting in a doctor shortage and a boom in law school applications.

[zantax]

BTW, I presume that you are aware that private insurers also set limits on reimbursements. Unlike Medicare, they get to negotiate over drug prices too.

Do they penalize doctors for taking private payments for things they don't cover too? Didn't think so.

[bioya1]

No, I didn't bother to read it, I grant your premise, that handing the government a monopoly in health care coverage will allow them to force doctors to take below market rates for their services. Resulting in a doctor shortage and a boom in law school applications.

I am used to your closed mind by now.

[animalnut]

I read something a few weeks ago that said more and more docs are opting not to participate in Medicare.

[Rankandfile]

The OP is correct in what happened to his mom. It happened to a dear aunt of mine, who actually went back to work after age 65 to keep her private medical insurance so she could stay with her same doctor who did not accept Medicare.

[bioya1]

Do they penalize doctors for taking private payments for things they don't cover too? Didn't think so.

Exactly how would you know? You don't seem willing to actually research anything.

[zantax]

I am used to your closed mind by now.

Nope, I have changed my mind on many things over the years, I used to be a pro-choice democrat for instance.

[animalnut]

I am used to your closed mind by now.

You are so open minded and non-partisan!

[Jousts]

Funny, whenever conservatives support the right of pharmacies to refuse to sell birth control, their argument is that a person can always go to another pharmacy. Seems to me that argument is also relevant here.


Again, there is something missing here that we are not being told.

Doug

Birth control is an elective need where time to "find another distributer" will not create further complications; unless the user can not practice constraint.

It is not a solid analogy.

[Rankandfile]

We have a severe doctor shortage where I live. My family physician quit practicing general medicine due to all of the govt. rules. Up here, most people are either on Medicare, Medicaid or Medi-Cal, and the doctor said the paperwork was killing him. The wait to see an ortho is 3 months. It's still better than in Canada, but with Obamacare, I don't see any health care people coming into this area anytime soon. I had to go 250 miles to see a dermatologist as there is not one in the entire tri-county area.

[zantax]

So for those of you out there that think you'll somehow avoid ending up in a government plan, or that you won't also be restricted to receiving only the care the government deems necessary, if health care reform passes, take careful note of what I have documented about medi-care in this thread, it's your future.

[Iggy]

Let's see what the liberal bible has to say shall we?

from http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html






1, 2009

[/QUOTE]
Looks like his anecdote is in conflict with most.

[bioya1]

Then keeping to the conservative mantra, dont sign up for SS...

Talking the talk is always so much easier than actually walking the walk.

[animalnut]

Nope, I have changed my mind on many things over the years, I used to be a pro-choice democrat for instance.

DITTO. That's when I used to vote without understanding the issues, and for the candidate I liked the most. Duh. I also used to use the standard "I don't think anyone has a right to tell a woman what do do if she's pregnant...." I am now pro-choice only in that I figure people can CHOOSE to prevent a pregnancy. I believe LIFE begins at conception.

[Iggy]

Talking the talk is always so much easier than actually walking the walk.

I'll opt out of SS when they give me back the money they've stolen out of my paychecks all these years.

[zantax]

Talking the talk is always so much easier than actually walking the walk.


Say what? You can opt out of SS? News to me.

[bioya1]

So for those of yo out there that think you'll somehow avoid ending up in a government plan, or that you won't also be restricted to receiving only the care the government deems necessary, if health care reform passes, take careful note of what I have documented about medi-care in this thread, it's your future.

For those of you curious about his philosphical bent towards the elderly, I offer:

http://forums.hannity.com/showpost.php?p=57843441&postcount=57

Quote:

Originally Posted by bioya1 http://forums.hannity.com/firestorm/buttons/viewpost.gif (http://forums.hannity.com/showthread.php?p=57843381#post57843381)
Medicare's imbalance is 3-4 times bigger than Social Security's.

Here are the only choices available with respect to solving those imbalances: (a) increase taxes and fees; (b) reduce coverage (e.g. what many are whining and sniffling about); or (c) reduce reimbursement rates to health care providers even further (which will lead to (b) over time anyway).

Doing nothing (or following GWBush's lead by making the problem much, much worse) is not a responsible option any more.

What do we do?
http://forums.hannity.com/firestorm/misc/progress.gif



Throw the people that can't pull an oar out of the boat.

[bioya1]

Say what? You can opt out of SS? News to me.

Who forces you to accept the payments?

[ddye]

Birth control is an elective need where time to "find another distributer" will not create further complications; unless the user can not practice constraint.

It is not a solid analogy.
It is relevant. And since the OP wasn't specific, you are assuming much that is not spelled out.

And the argument that losing an available service might force people to travel long distances is certainly relevant. It doesn't matter what the lost service is.

Doug

[zantax]

DITTO. That's when I used to vote without understanding the issues, and for the candidate I liked the most. Duh. I also used to use the standard "I don't think anyone has a right to tell a woman what do do if she's pregnant...." I am now pro-choice only in that I figure people can CHOOSE to prevent a pregnancy. I believe LIFE begins at conception.


I fell for the communist style peer consensus brainwashing in my high school "health class". You know the one, where the facilitator, oops I mean "teacher", steers the group to a pre-determined outcome and then shames any hold-outs by appealing to group consensus. I was none to happy when I finally learned what was done to me.

[bioya1]

I'll opt out of SS when they give me back the money they've stolen out of my paychecks all these years.

Like I said, talk is cheap.

[Iggy]

For those of you curious about his philosphical bent towards the elderly, I offer:

http://forums.hannity.com/showpost.php?p=57843441&postcount=57

So what will it be, exactly, when Obamacare bureaucrats tell an elderly person they're too old to be treated because it wouldn't be economically feasible?

[zantax]

Who forces you to accept the payments?

Lol, I see, I can opt out of receiving payment but not paying into, if you want to call that opting out I have some good farm land in manhattan you might be interested in.

[Iggy]

Like I said, talk is cheap.

Its my money. They stole it. I want it back. Whats so hard for you to grasp there?

Anyway, at the rate these *******s in Washington are going SS will be long gone by the time I'm eligible to get back my stolen money.

[bioya1]

So what will it be, exactly, when Obamacare bureaucrats tell an elderly person they're too old to be treated because it wouldn't be economically feasible?

Iggy,

I posed that same question to you in another thread. I even answered another question you posed after I asked that question and politely asked you at tthat time to answer mine.

http://forums.hannity.com/showpost.php?p=57844321&postcount=66

Why don't you extend me the courtesy of answering my question before I am expected to answer yet another one of yours?

[zantax]

Its my money. They stole it. I want it back. Whats so hard for you to grasp there?

Anyway, at the rate these *******s in Washington are going SS will be long gone by the time I'm eligible to get back my stolen money.

You're dreaming, you'll never be eligible, it will be means tested long before you retire.

[fava]

Really? Because my dad's on Medicaid and he just saw a doctor today with no problem. Looks like we have conflicting anecdotes.

Looks like the other anecdote is covered by fact.

http://www.entrepreneur.com/tradejournals/article/171812259.html

[Iggy]

Iggy,

I posed that same question to you in another thread. I even answered another question you posed after I asked that question and politely asked you at tthat time to answer mine.

http://forums.hannity.com/showpost.php?p=57844321&postcount=66

Why don't you extend me the courtesy of answering my question before I am expected to answer yet another one of yours?
Sorry, I was offline for a while. I have to work to pay for everyone else's health care, energy bills, food, clothing, cars, mortgages, retirement, prescription drugs, research, abortions, illegal aliens, aid to foreign countries, GM, Chrysler, AIG, banks, power-hungry Washington extortionists, junkets to exotic locales, etc. I have too many people depending on me for me to be on here 24/7.

Anyhow, I answered it even though I thought the answer was obvious.

[the trade]

Looks like the other anecdote is covered by fact.

http://www.entrepreneur.com/tradejournals/article/171812259.html

Great article. Thanks Fava.

[ksr2009]

Here is my experience with goverment run medical services:
I experienced government run health care when my husband was in the Air Force, and they almost let my daughter die before I could get authorization to take her out of the system and find a private doctor who saved her life. I can still remember the Chief of Pediatrics yelling at me in the waiting room, that obviously I wasn't happy with their services. Nope, not when you keep running tests that keep getting worse and worse and you won't due anything. I took her to a private Urologist who performed emergency surgery. I can't believe the pain my 2 year old went through because the Military services were deplorable. I also had my baby in the Navy Hospital, and you could not pay me to ever go back to a Military facility. My father died in a VA hospital after reading his x-rays wet, and told him he just needed more exercise. He died a few months later of lung / brain cancer. I was in the room when someone came in and without saying anything to me, turned off his life support. I was 16. No warning from anyone. I still live with the memory of him taking his last breathe.
My step-father is military retired, and his medical benefits are decreased every year. I don't want this for myself, my children or my grandchildren. I want less govenment, not more. The VA will not even test our returning soldiers for PTSD because they can't afford to treat it.
And the 8% tax on the small business owner is not the way to increase jobs. I thought Obama was for less tax. Stop this insanity now.

[Wake-Up]

Thanks Wake-Up! I will research this and see if it applies to my Mom's situation.

Potential suggestion. You can always ask the physician or his office staff if he can recommend another doc in the same specialty that does participate with MCR. This has probably come with him before and he should be able to refer you to a doc he trusts as well that can help.

[johnrocks]

How did you verify that he was telling the truth?

As a Medicare agent I can promise you that many Doctors are refusing new Medicare patients and that it IS against the law for a Medicare beneficiary to give cash to a Medicare provider,she would have to go to either a non Medicare provider or opt out of Part B of Medicare.

[bioya1]

So what will it be, exactly, when Obamacare bureaucrats tell an elderly person they're too old to be treated because it wouldn't be economically feasible?

Intelligent cost-benefit analysis needs to be employed in any expenditure.

Should the government pay for a bed ridden 90-year old with terminal cancer to have a hip replacement operation? No, it doesn't make any sense as to any meaningful extension of or enhancement to that person's quality of life.

[ddye]

Here is my experience with goverment run medical services:
I experienced government run health care when my husband was in the Air Force, and they almost let my daughter die before I could get authorization to take her out of the system and find a private doctor who saved her life. I can still remember the Chief of Pediatrics yelling at me in the waiting room, that obviously I wasn't happy with their services. Nope, not when you keep running tests that keep getting worse and worse and you won't due anything. I took her to a private Urologist who performed emergency surgery. I can't believe the pain my 2 year old went through because the Military services were deplorable. I also had my baby in the Navy Hospital, and you could not pay me to ever go back to a Military facility. My father died in a VA hospital after reading his x-rays wet, and told him he just needed more exercise. He died a few months later of lung / brain cancer. I was in the room when someone came in and without saying anything to me, turned off his life support. I was 16. No warning from anyone. I still live with the memory of him taking his last breathe.
My step-father is military retired, and his medical benefits are decreased every year. I don't want this for myself, my children or my grandchildren. I want less govenment, not more. The VA will not even test our returning soldiers for PTSD because they can't afford to treat it.
And the 8% tax on the small business owner is not the way to increase jobs. I thought Obama was for less tax. Stop this insanity now.
And how many stories are there about health insurance companies denying coverage that causes people to die, or finding ways to get out of claims made by people who paid premiums for 20 years?

Stop acting like greedy insurance companies are one tiny bit better. They are not.

Doug

[bioya1]

Sorry, I was offline for a while. I have to work to pay for everyone else's health care, energy bills, food, clothing, cars, mortgages, retirement, prescription drugs, research, abortions, illegal aliens, aid to foreign countries, GM, Chrysler, AIG, banks, power-hungry Washington extortionists, junkets to exotic locales, etc. I have too many people depending on me for me to be on here 24/7.

Anyhow, I answered it even though I thought the answer was obvious.

I appreciate the courtesy.

I don't honestly know how we can continue to ignore a $24 trillion imbalance though.

[Iggy]

Intelligent cost-benefit analysis needs to be employed in any expenditure.

Should the government pay for a bed ridden 90-year old with terminal cancer to have a hip replacement operation? No, it doesn't make any sense as to any meaningful extension of or enhancement to that person's quality of life.

90 years old... what's the cut off? 70? 65? Will the government adjust the eligible age like they do for social security?

Seriously, you don't want Washingotn to have this kind of power. Seriously.

[bioya1]

And how many stories are there about health insurance companies denying coverage that causes people to die, or finding ways to get out of claims made by people who paid premiums for 20 years?

Stop acting like greedy insurance companies are one tiny bit better. They are not.

Doug

Actually, they are probably worse. It's funny how profit motives and bonuses drive people to make morally heinous decisions.

[johnrocks]

And how many stories are there about health insurance companies denying coverage that causes people to die, or finding ways to get out of claims made by people who paid premiums for 20 years?

Stop acting like greedy insurance companies are one tiny bit better. They are not.

Doug

You can at least sue an insurance company,you can't sue the govt. Our system needs overhaul but it needs less third party payors,not more,imho,at least for the petty crap,get catastrophic and ditch comprehensive..save a bundle.:dance:

[Jousts]

It is relevant. And since the OP wasn't specific, you are assuming much that is not spelled out.

And the argument that losing an available service might force people to travel long distances is certainly relevant. It doesn't matter what the lost service is.

Doug

I assumed it was an elderly woman based on the inforrmation offered....such as "my mom" and "medicare"...something tells me it was not "elective" medical care...perhaos preventive, but for the eldrly, preventive is not deemed as elective

I disagree on your second point. If an amusement park closes in my town and I will need to travel 200 miles to get to the closest one, I would not even bat an eye.

If I had to travel 200 miles to get to a doctor, It may prove to be life threatening.

[ksr2009]

If you want to see how bad it can get, go to an area where there is a high population of seniors and see how hard it is to find a doctor that will even see a medicare patient.
HMO that don't give you choice of doctors? Come down with a life threatening illness and can't find a really good specialist who is covered in your plan. Then you will wish you had freedom of choice. Or when you think your doctor is not listening to you and you can't get a referral.

[bioya1]

90 years old... what's the cut off? 70? 65? Will the government adjust the eligible age like they do for social security?

Seriously, you don't want Washingotn to have this kind of power. Seriously.

I did not use an age standard there. There is no reason why a 90-year old in good health wouldn't get one. Similarly, there is no reason why a 60-year old with terminal cancer should expect one.

I don't think you are coming fully to grips with what the economic hole we face here is. It is $24 trillion and I believe the number is understated! If we don't do something, we will go broke.

[truthiness]

Okay folks, so what is your solution for Medicare ??? There are a number of state-subsidized health care plans through out the country that doctors do not want to deal with but they essentially are either forced to deal with them because it is stipulated by their group practice or they cannot turn down the payment that is offered.

I hear a lot of Republicans complaining about government run healthcare, yet they offer very little in the area of solutions for the poor, out of work, or retired ?

Unemployment is on the rise, therefore many people will not be able to afford healthcare in any form, but Republicans just want to complain about how government
run heathcare plans will fail ?

Will someone on this board, please, please, please provide me with an articulate solution to Medicare and not just complain about the bureaucracy that is crippling it ?!

We have many a crisis in this country, and I believe Obama cares deeply about all of them ( I would never say the same about the former President ). Some of you believe Obama is a socialist, a Marxist, satan, whatever...but come on folks, this guy is a Consitutional scholar !? I am not saying that makes him right about everything, but I believe he cares deeply about this country....why else would he have taken so much time to learn about what makes it tick ???

[johnrocks]

US law?

from http://www.cchconline.org/17medicarefacts.php

I didn't notice this until after I posted,thanks. This may interest some...

During 1997, Senator Jon Kyl (R-AZ) sponsored legislation explicitly allowing Medicare patients to contract with doctors at rates above the Medicare program’s mandated fees and won overwhelming Senate approval. The Clinton Administration threatened to veto the entire balanced budget deal if the Kyl language was included. The Administration professed to fear the creation of a "two-tiered" health care system, one for the rich and one for the poor, but it is alleged that the Administration saw that giving patients a right to choose threatened the piecemeal effort to revive the "Clinton-care" plan defeated during the President’s first term. In order to preserve their budget deal, however, Republicans agreed to compromise language in Section 4507, which requires that any doctors who treat a Medicare patient privately must file an affidavit swearing they will see no Medicare patients for two years.

On December 30, 1997, the United Seniors Association (Association) filed suit against the Clinton Administration to enjoin the enforcement of Section 4507 of the Balanced Budget Act. As interpreted by the Health Care Financing Administration (HCFA), Section 4507 would prevent seniors from privately contracting with their doctors for otherwise covered medical services deemed "not reasonable and necessary" by HCFA. The term "private contracting" refers to a situation in which a beneficiary pays for Medicare-covered healthcare services or items with his or her own resources instead of the physician submitting a claim for payment to the Medicare program.

On March 6, 1998, the trial court heard oral arguments on the Plaintiff’s Motion for Preliminary Injunction and took the matter under advisement. The trial court ruled against the Association on April 14, 1998. The Association appealed the trial court’s decision. The appeal is currently pending before the United States Court of Appeal – D.C. Circuit. (Court of Appeals Docket No. 98-5142). SeePublic Access to Court Electronic Records (PACER) for the D.C. Circuit for docket sheet information; dial 1-800-676-6856 for subscription information.Whatever the D.C. Circuit Court of Appeals may rule, this issue will continue to be challenged, through legislation and/or politically through the sheer number of elderly to whom this issue is so important.
http://www.law.uh.edu/healthlaw/perspectives/Medicare/981123Sorry.html
This was 10 years ago so they undoubtedly lost the appeal too.

[Jousts]

Actually, they are probably worse. It's funny how profit motives and bonuses drive people to make morally heinous decisions.

So I assume we should also start to question those evil greedy funeral directors as well?

Afterall, to bury someone with a proper funeral can cost over 10K.

Where does it stop?

We are America. We are unique. Capitalism is our basis. Most areas of business can be deemed as necessary for life...so should all businesses be not for profit?

[zantax]

I did not use an age standard there. There is no reason why a 90-year old in good health wouldn't get one. Similarly, there is no reason why a 60-year old with terminal cancer should expect one.

I don't think you are coming fully to grips with what the economic hole we face here is. It is $24 trillion and I believe the number is understated! If we don't do something, we will go broke.


The only way we'll go broke is allowing the government to take it over. Employers can't print money, in short, they are already taking steps to reduce the cost of coverage and will not and can not pay much more and doctors and hospitals can not charge more then people are willing to pay.

[Iggy]

I did not use an age standard there. There is no reason why a 90-year old in good health wouldn't get one. Similarly, there is no reason why a 60-year old with terminal cancer should expect one.

I don't think you are coming fully to grips with what the economic hole we face here is. It is $24 trillion and I believe the number is understated! If we don't do something, we will go broke.

And the government spending us deeper into a hole is going to stop that how?



Note: I'm leaving again. Got stuff to do.

[ksr2009]

I agree that private insurance companies don't do the right thing either. I actually have a lawsuit against one for my Long Term Disability. They refused to look at 9 doctors opinions, and multiple test results when they denied my claim. It has been 3 years and this has nearly bankrupt me.

[Wake-Up]

So what will it be, exactly, when Obamacare bureaucrats tell an elderly person they're too old to be treated because it wouldn't be economically feasible?

That is correct and the bottom line is if it's the govt or a totally free market, insurance/govt free healthcare system, some people will not be able to afford some procedures.

The difference is if you, as a private patient, can not afford the treatment, you can then shrug your shoulders and accept your fate versus some actuarial table telling you the payor or govt can not pay for the procedure.

It would be your choice versus some entity but the end result could be the same. When people are willing to accept that reality we can have serious discussions about doing away with govt oversight and insurance limits.

People dont like paying into MCR, I don't either, but understand either way there will be no free ride and some people may die because the care is rationed in some fashion or they can't afford the service. You can't have it both ways.

Some argue that if the system were totally free market driven prices for services would drop to affordable levels. There is no proof that would happen and affordable by whose standards of income?

People need to be responsible for their own care and insurance should be for catastrophic relief. Preventative care should be budgeted for and paid as you go, fee for service but will any plan, private or govt, cover all medical contingencies or emergencies for every procedure, drug, service available today and tomorrow? Not likely so someone has to make the tough decisions. Docs, some administrator or the patient and family. Thats reality.

[ksr2009]

And the government spending us deeper into a hole is going to stop that how?



Note: I'm leaving again. Got stuff to do.
And who is going to make these decisions as to who gets treatment and who doesn't? Pretty scary stuff.

[countmein]

Did you all know that the doctors in Illinois are being given bad checks by the state of Illinois for payment for medicare/medicaid patients? Yep that's right. They are months behind in payment and now they are telling healthcare providers not to cash the government checks that we sent you. Why? Because they will bounce. In this case, I do not blame a doctor for not wanting to see patients on Medicare/Medicaid. They need to stand up to the state, and the best way to do that is to rile up the citizens against the state government.
In the state of Illinois, let's put the blame where the blame is due, on the government, not the healthcare providers.

[bioya1]

Okay folks, so what is your solution for Medicare ??? There are a number of state-subsidized health care plans through out the country that doctors do not want to deal with but they essentially are either forced to deal with them because it is stipulated by their group practice or they cannot turn down the payment that is offered.

I hear a lot of Republicans complaining about government run healthcare, yet they offer very little in the area of solutions for the poor, out of work, or retired ?

Unemployment is on the rise, therefore many people will not be able to afford healthcare in any form, but Republicans just want to complain about how government
run heathcare plans will fail ?

Will someone on this board, please, please, please provide me with an articulate solution to Medicare and not just complain about the bureaucracy that is crippling it ?!

We have many a crisis in this country, and I believe Obama cares deeply about all of them ( I would never say the same about the former President ). Some of you believe Obama is a socialist, a Marxist, satan, whatever...but come on folks, this guy is a Consitutional scholar !? I am not saying that makes him right about everything, but I believe he cares deeply about this country....why else would he have taken so much time to learn about what makes it tick ???

I have to run (business calls) so I need to be short here.

Medicare impacts but is also impacted by health care costs in the rest of society. Those costs are too high and are continuing to spiral out of control.

No one on either side of the aisle seems to want to come to grips with the biggest cause of those uncontrollable costs and that is third party payer programs of all types.

My opinion (shared by at least one other poster on this board) is based heavily on these ideas:

http://www.hoover.org/publications/digest/3459466.html

While I like it, I don't think it is politically viable in this country. Th eUS public fears the free market more than anything.

Obama's plan is just a mish-mash of a bunch of compromises. My fallback would be some adaptation of the Netherlands' model.

[bioya1]

Did you all know that the doctors in Illinois are being given bad checks by the state of Illinois for payment for medicare/medicaid patients? Yep that's right.

...

The state of Illinois does not pay Medicare claims.

You are correct as to Medicaid.

Our public finance here is a disaster.

The clowns are actually borrowing another $3.5 billion to make the minimum payments to an already underfunded pension plan.

[zantax]

The state of Illinois does not pay Medicare claims.

You are correct as to Medicaid.

Our public finance here is a disaster.

The clowns are actually borrowing another $3.5 billion to make the minimum payments to an already underfunded pension plan.


When you look at government revenue drops, state and federal, it's glaringly obvious the only real choice is shrinking government, we're broke, now is absolutely not the time to be expanding instead of decreasing government.

[bioya1]

...

Capitalism is our basis.

...

That's what we like to say but the truth is quite different.

[PheonixOps]

My 65 year old Mom was denied health care today from a doctor who refuses to treat Medicare patients. When she offered to pay cash, he said he could not treat her because Medicare considers that fraud.

Imagine that...she offered to pay cash for treatment, therefore relieving the taxpayer of the burden, and she was denied because Medicare considers that fraud. This is government exerting control over our lives, plain and simple.

Her only choice is to get off of Medicare and pay cash for everything, or only see doctors who will treat Medicare patients.

This is the first real government intrusion into the health of my family and it hurts. Just wait and see what happens if the Democrats get their way with the public insurance option.

Rationing. Plain and simple.

I am very, very sad today, for my Mom and for my country. :frown:

She can always get off of Medicare and go for the private insurance option. Like an HMO or something. Try Anthem or something like that. Good luck.

[ArmyMAJretired]

Not to throw a wet rag on this but my company provides insurrance through Kaiser.

I have a list of doctors that are
Tier I: Lower HMO rates
Tier II: Higher PPO rates
Tier III: pay out the wazoo high deductible and 60% coinsurance

Every system has limits.

I understand some doctor's don't thake military insurance TRICARE because they pay so little and take long to pay like Medicare.

[DMK]

My boyfriend is a physician. He CANNOT accept cash from a Medicare patient. Nor can the patient offer to pay the difference between what Medicare covers and what he charges. When he signed a contract stating he would take Medicare patients he was bound to that agreement. Doing otherwise IS considered fraud.

As far as fewer doctors accepting Medicare, who can blame them when their reimbursements are nit picked to death, the paperwork is a nightmare and they haven't seen an increase in their reimbursements in TEN years.

What Medicare sets the rates for reimbursement at, the private insurers then follow suit. All of it has caused payment and reimbursement nightmares for doctors.

[bioya1]

When you look at government revenue drops, state and federal, it's glaringly obvious the only real choice is shrinking government, we're broke, now is absolutely not the time to be expanding instead of decreasing government.

My last post for now:

I tend to agree with your sentiment but spending a little now can save a lot more over the long run.

We can and should afford the short-run costs to fix health care. If that means cutting something else, so be it. Continuing to postpone fixing a system that has clearly failed makes no sense when costs continue to soar all out of control.

In the 1980s, Reagan proposed taxing health care benefits not once but twice. If we had mustered the political courage to have done that then, the crisis we face in health care costs would be much smaller today.

[Penrod]

My 65 year old Mom was denied health care today from a doctor who refuses to treat Medicare patients. When she offered to pay cash, he said he could not treat her because Medicare considers that fraud.

Imagine that...she offered to pay cash for treatment, therefore relieving the taxpayer of the burden, and she was denied because Medicare considers that fraud. This is government exerting control over our lives, plain and simple.

Her only choice is to get off of Medicare and pay cash for everything, or only see doctors who will treat Medicare patients.

This is the first real government intrusion into the health of my family and it hurts. Just wait and see what happens if the Democrats get their way with the public insurance option.

Rationing. Plain and simple.

I am very, very sad today, for my Mom and for my country. :frown:

Is this serious?

How about find a Dr that does?

But your right if the Dems get their way all these Drs will be busy. Very very busy. Any chance of a choice will be gone. Rush says buy property in the Caribbean islands. They will become the healthcare center of the US. Just like they are with off shore banks.

[PheonixOps]

US law?

from http://www.cchconline.org/17medicarefacts.php

Now why might the be??? What's the "rest of the story"? :think:
How does one qualify for Medicare?

[Penrod]

Yeah I turn 62 next year. Looks like Ill soon have to sign up whether I want to or not.

[the trade]

Is this serious?

How about find a Dr that does?




Copied and pasted from post #13:

Because the doctor she wants to see is the only one that knows what he is doing in a very specific field and in her home town. The only alternative, it seems, is to explore the idea of finding a doctor in the nearest major city which is over 300 miles away from where she lives.

The doc denied her service because of Medicare, not because of her supplemental insurance. It is a bug in the system that is demonstrative of what happens when you manage things with big government bureaucracy.

When you can't even pay cash to see the doctor of your choice, you know something is screwed up.

[zantax]

Now why might the be??? What's the "rest of the story"? :think:
How does one qualify for Medicare?

I don't have time for guessing games, if you have a point make, make it, I have an awful lot of liberals to embarrass today.

[Penrod]

Copied and pasted from post #13:

Because the doctor she wants to see is the only one that knows what he is doing in a very specific field and in her home town. The only alternative, it seems, is to explore the idea of finding a doctor in the nearest major city which is over 300 miles away from where she lives.

The doc denied her service because of Medicare, not because of her supplemental insurance. It is a bug in the system that is demonstrative of what happens when you manage things with big government bureaucracy.

When you can't even pay cash to see the doctor of your choice, you know something is screwed up.

Ok but there are other Drs. Thanks as thats what I figured. Again this will get much worse if we all are on the government program. Just look at VA healthcare.

[PheonixOps]

My daughter broke her leg a couple weeks ago. We went to the ER and were referred to an Orthopedic specialist that was on call. We called to get her a cast put on the next day, and we were told he does not accept Tricare. My wife had to scramble at the last minute just to find someone who accepts military active-duty "insurance" to take care of my kid. I can imagine it's similar for other government-run plans.

There are probably some doctors that don't accept Anthem.............. "It's the fwee marwket!".

[JudasGoat]

Really? Because my dad's on Medicare and he just saw a doctor today with no problem. Looks like we have conflicting anecdotes.

I have 1 flat tire but 3 full ones on my car. I guess I don't have a problem and I'll just drive it anyway...

[the trade]

Ok but there are other Drs. Thanks as thats what I figured. Again this will get much worse if we all are on the government program. Just look at VA healthcare.

The other doctors in her home town suck.

I normally don't spend this much time on this board, but what happened today really freaked me out. Its a safe bet that the people defending the government on this thread have not had something like this happen to someone that they love.

Nevertheless, I am glad I posted this because I have learned a great deal about Medicare. Thanks everyone for your posts.

[simssk]

Just another reason why the only way to solve the health care crisis is to eliminate Part D of Medicare, eliminate Medicaid and give Medicare to all US citizens. That would level the playing field for all. To pay for this eliminate Capital Gains and Inheritance taxes, eliminate the IRS and establish a national sales tax. Also charge Medicare premiums for all US citizens that make more than 250,000 a year on a sliding scale with higher incomes paying more for Medicare. This would solve the healthcare crisis and return our nation to the great country it was.

Are you serious? It sounds like you are. So anyone that makes over 250,000 bucks a year should pay for medicare which will be our healthcare - for anyone who makes less than $250,000? Really?

Now that's leveling the playing field all right. How about our representatives and our president? Should they be made to be covered by the new medicare as well or are they allowed to be exempt. After all, they are our leaders and should be glorified as such.

Just checking your intent here.

[PheonixOps]

Did you all know that the doctors in Illinois are being given bad checks by the state of Illinois for payment for medicare/medicaid patients? Yep that's right. They are months behind in payment and now they are telling healthcare providers not to cash the government checks that we sent you. Why? Because they will bounce. In this case, I do not blame a doctor for not wanting to see patients on Medicare/Medicaid. They need to stand up to the state, and the best way to do that is to rile up the citizens against the state government.
In the state of Illinois, let's put the blame where the blame is due, on the government, not the healthcare providers.

Wow, what happened to that mantra I always hear on the radio stating that: "Doctors will still treat people if they can't afford it, it's their Hippocratic Oath." I guess that flies out of the window of one is on Medicare? :))

[Penny in WV]

Sounds like this health care thing is stressing you guys out...perphaps a "stress conference" at an AZ resort at the tune of $700,000 would cheer you all up. What you ask...that's exactly what the SSA did, all on tax payer money.



PS...sorry to hear about your mom...I wish her the best of luck and don't doubt your story.

[the trade]

PS...sorry to hear about your mom...I wish her the best of luck and don't doubt your story.

Thank you Penny.

[PheonixOps]

I don't have time for guessing games, if you have a point make, make it, I have an awful lot of liberals to embarrass today.

Here's a simple thing. She can either find a doctor that can help her, or she can stop receiving Social Security and sign on to a private plan. Since the HMO's and private insurance is supposed to be the way to go, it should be a piece of cake............

[Penrod]

Here's a simple thing. She can either find a doctor that can help her, or she can stop receiving Social Security and sign on to a private plan. Since the HMO's and private insurance is supposed to be the way to go, it should be a piece of cake............
Didnt she already pay for SS and medicare over the years with her FICA and other taxes? Now she should take a hike?

[the trade]

Didnt she already pay for SS and medicare over the years with her FICA and other taxes? Now she should take a hike?

Exactly.

[zantax]

Here's a simple thing. She can either find a doctor that can help her, or she can stop receiving Social Security and sign on to a private plan. Since the HMO's and private insurance is supposed to be the way to go, it should be a piece of cake............


Will she be getting the money she paid into the system over the course of her lifetime, plus interest, back?

[johnrocks]

Here's a simple thing. She can either find a doctor that can help her, or she can stop receiving Social Security and sign on to a private plan. Since the HMO's and private insurance is supposed to be the way to go, it should be a piece of cake............

She has no options in the private sector if she's 65 or older Pheonix unless she has a group plan,railroad retirement or government plan to fall back on,that's about it for the elderly since Medicare came on board.

[wildcat87]

Wow, what happened to that mantra I always hear on the radio stating that: "Doctors will still treat people if they can't afford it, it's their Hippocratic Oath." I guess that flies out of the window of one is on Medicare? :))

while I don't think it's funny, I was wondering when someone was going to make this point. Where are the "People can always get medical care" folks on this one?

As for rural care- there is almost NO WAY to attract doctors to those areas without government student loan forgiveness. And you can bet in- at least in the rural area where I grew up- that most of the folks are going to be on Medicaid, Medicare or some sort of government healthcare for vets or DOT retirees. In fact, try getting local health care in many rural areas of the country at any place other than the county clinic.

[Penrod]

She has no options in the private sector if she's 65 or older Pheonix unless she has a group plan,railroad retirement or government plan to fall back on,that's about it for the elderly since Medicare came on board.
Are you trying to claim medicare and medicaid have put a stranglehold on healthcare for seniors? And have put private companies out of business in this field?

[zantax]

She has no options in the private sector if she's 65 or older Pheonix unless she has a group plan,railroad retirement or government plan to fall back on,that's about it for the elderly since Medicare came on board.


Are you saying a government health plan somehow drove the private insurers out of the market? How can that be?

[PheonixOps]

The other doctors in her home town suck.

I normally don't spend this much time on this board, but what happened today really freaked me out. Its a safe bet that the people defending the government on this thread have not had something like this happen to someone that they love.

Nevertheless, I am glad I posted this because I have learned a great deal about Medicare. Thanks everyone for your posts.

So she CAN actually be treated, just not by the exact doctors she wants? Those doctors that "suck", do they have a lot of malpractice suits against them or are do they have disciplinary action against them?

[wildcat87]

She has no options in the private sector if she's 65 or older Pheonix unless she has a group plan,railroad retirement or government plan to fall back on,that's about it for the elderly since Medicare came on board.

John, do you really think there is a private market solution for people 65+?

[johnrocks]

Are you trying to claim medicare and medicaid have put a stranglehold on healthcare for seniors? And have put private companies out of business in this field?

Yep,she can get a supplement or she can get Medicare Part "C" which is a Medicare Advantage plan but that's bout it.

[bloods vs crips]

US law?

from http://www.cchconline.org/17medicarefacts.php

that only addresses situations when Medicare opts out, not when the doctor doesn't accept Medicare.

[wildcat87]

Are you saying a government health plan somehow drove the private insurers out of the market? How can that be?

do you really think health insurance providers want to insure those 65+? Especially one with a condition that requires such special care?

[johnrocks]

John, do you really think there is a private market solution for people 65+?

Not now but there was before Medicare came along. My Mom says she recalls her Dad raising hell because he was put on Medicare,he liked his Senior Health plan that he had.

[johnrocks]

that only addresses situations when Medicare opts out, not when the doctor doesn't accept Medicare.

correct. A Doctor can opt out and many are doing just that.

[Penrod]

Yep,she can get a supplement or she can get Medicare Part "C" which is a Medicare Advantage plan but that's bout it.
I was just using that to show what will happen to us all if this crap goes through. Thanks.

[the trade]

So she CAN actually be treated, just not by the exact doctors she wants? Those doctors that "suck", do they have a lot of malpractice suits against them or are do they have disciplinary action against them?

She has been to 3 other doctors in the course of 2 years. None of them have been able to help her. They have prescribed inappropriate medication (unethically, in my opinion, but we have decided not to pursue it legally). However, a newer doctor has emerged with a very good reputation and a new style of treatment and comes heavily recommended within the medical community.

Why is any of this relevant, anyway? She simply wants to be able to go to this new doctor, pay in cash, but can't because of government bureaucracy. Does that seem right to you?

[PheonixOps]

Didnt she already pay for SS and medicare over the years with her FICA and other taxes? Now she should take a hike?

NOT AT ALL. Is it mandatory that if she receives SS checks, that she has to participate in Medicare? Is there any other option?

[wildcat87]

She has been to 3 other doctors in the course of 2 years. None of them have been able to help her. They have prescribed inappropriate medication (unethically, in my opinion, but we have decided not to pursue it legally). However, a newer doctor has emerged with a very good reputation and a new style of treatment and comes heavily recommended within the medical community.

Why is any of this relevant, anyway? She simply wants to be able to go to this new doctor, pay in cash, but can't because of government bureaucracy. Does that seem right to you?

is it an experimental treatment?

[Penrod]

NOT AT ALL. Is it mandatory that if she receives SS checks, that she has to participate in Medicare? Is there any other option?
Exactly the point.

[johnrocks]

NOT AT ALL. Is it mandatory that if she receives SS checks, that she has to participate in Medicare? Is there any other option?

Not really,your automatically enrolled in Part A(Hospital) but Part B (outpatient/Doctor visits) is optional.

[johnrocks]

I was just using that to show what will happen to us all if this crap goes through. Thanks.

lol,I thought so.yw

[wildcat87]

Not now but there was before Medicare came along. My Mom says she recalls her Dad raising hell because he was put on Medicare,he liked his Senior Health plan that he had.

But do you see anyone in the healthcare industry lobbying to take on the care of seniors? I would think the technological progress that has been made in treatment of seniors, and the attendant rise in costs combined with longer life spans, would be the absolute LAST thing any for profit company would want.

[the trade]

is it an experimental treatment?

No. The guy is a true specialist in the area of treatment that she requires, and the others have been "dabbling" in it although their specializations are similarly linked.

[PheonixOps]

Will she be getting the money she paid into the system over the course of her lifetime, plus interest, back?

Please enlighten me. Can she temporarily stop receiving social security, sign on to a private health plan and get treated by the doctor she wants?

What about people who were CEO's or "well off" can they receive SS after a certain age and keep their own private insurance??? Or are they forced into receiving Medicare? Who receives Medicaid? What's the difference between the two?

[wildcat87]

Not really,your automatically enrolled in Part A(Hospital) but Part B (outpatient/Doctor visits) is optional.

so, you can, in fact, opt out and see the doctor you want?

[wildcat87]

No. The guy is a true specialist in the area of treatment that she requires, and the others have been "dabbling" in it although their specializations are similarly linked.

Roger that. I have to say though, this sounds like my own family's dealings with private insurers.

[johnrocks]

so, you can, in fact, opt out and see the doctor you want?

Yes,IF you opt out. Undoubtedly she hasn't .

http://www.hhs.gov/faq/medicaremedicaid/1668.html
Answer:

Medicare Part B helps cover medical services like doctors’ services, outpatient care, and other medical services that Part A doesn’t cover. Part B is optional.

[PheonixOps]

She has no options in the private sector if she's 65 or older Pheonix unless she has a group plan,railroad retirement or government plan to fall back on,that's about it for the elderly since Medicare came on board.

Thanks John, does she have the ability to sign up for a private group plan, if she wanted to?

[zantax]

But do you see anyone in the healthcare industry lobbying to take on the care of seniors? I would think the technological progress that has been made in treatment of seniors, and the attendant rise in costs combined with longer life spans, would be the absolute LAST thing any for profit company would want.


Not a problem, as long as they are allowed to charge what it costs, plus a profit. Why would they care what seniors cost if they can charge that plus a profit? That's like saying no one would want to manufacture yachts, because they cost so much. If you need an example, look at the private supplemental programs offered to seniors. I am also pretty sure there are private senior health insurance plans on the market, they just can't compete effectively with government subsidized medicare and so aren't widely used.

[stodr]

Then keeping to the conservative mantra, dont sign up for SS...

? What conservative has said don't sign up for SS? Hell they paid into it why would they want to give up that money

[zantax]

Thanks John, does she have the ability to sign up for a private group plan, if she wanted to?

Yes, but she would technically still be covered by part a, unless she opted out in which case she couldn't collect her SS benefits and so still wouldn't be allowed to see a doctor participating in medicare and have her private plan pay for something medicare denied, that's my understanding of it anyway.

[wildcat87]

Not a problem, as long as they are allowed to charge what it costs, plus a profit. Why would they care what seniors cost if they can charge that plus a profit? That's like saying no one would want to manufacture yachts, because they cost so much. If you need an example, look at the private supplemental programs offered to seniors. I am also pretty sure there are private senior health insurance plans on the market, they just can't compete effectively with government subsidized medicare and so aren't widely used.

John?

[wildcat87]

Originally Posted by wildcat87
so, you can, in fact, opt out and see the doctor you want?

Yes,IF you opt out. Undoubtedly she hasn't .

http://www.hhs.gov/faq/medicaremedicaid/1668.html
Answer:

Medicare Part B helps cover medical services like doctors’ services, outpatient care, and other medical services that Part A doesn’t cover. Part B is optional.

That's what I thought. Thanks John.

[johnrocks]

Thanks John, does she have the ability to sign up for a private group plan, if she wanted to?

If you are employed and a group is offered,there are regulations covering what can and can't occur,they can only opt out of group into Medicare at certain times and things like that,too "deep" to get into on a forum,lol. Here is the section covering group at Medicare.
http://www.medicare.gov/Choices/Employer.asp

[PheonixOps]

while I don't think it's funny, I was wondering when someone was going to make this point. Where are the "People can always get medical care" folks on this one?

As for rural care- there is almost NO WAY to attract doctors to those areas without government student loan forgiveness. And you can bet in- at least in the rural area where I grew up- that most of the folks are going to be on Medicaid, Medicare or some sort of government healthcare for vets or DOT retirees. In fact, try getting local health care in many rural areas of the country at any place other than the county clinic.

I don't think that someone not able to receive medical care is funny either. I just think it's funny to see a couple of premises proven to be basically full of ****...........

[johnrocks]

That's what I thought. Thanks John.

Your very welcome. I know you and Phoenix well enough here as posters to know you guys want the best and fairest and I commend you for that. I have an 88 year old Mom on Medicare.

[zantax]

John?

No, zantax, which I believe was fairly obvious, next time if you only want one specific person to answer a question try saying nobody else is allowed to try and answer, sorry I wasted my time trying to answer your question, I won't make the same mistake twice.

[bitterclinger84]

US law?

from http://www.cchconline.org/17medicarefacts.php

I can't even begin to wrap my mind around that... Can someone explain the rationale behind not allowing people to pay cash for something that Medicare covers if their Dr won't accept Medicare?

[PheonixOps]

Yep,she can get a supplement or she can get Medicare Part "C" which is a Medicare Advantage plan but that's bout it.

Thank you.

[wildcat87]

No, zantax, which I believe was fairly obvious, next time if you only want one specific person to answer a question try saying nobody else is allowed to try and answer, sorry I wasted my time trying to answer your question, I won't make the same mistake twice.

You posted a response to me and I was deferring to a person who works in this everyday.

Please let me know when you find any evidence of the healthcare industry lobbying to cover seniors privately.

[Garfield]

My 65 year old Mom was denied health care today from a doctor who refuses to treat Medicare patients. When she offered to pay cash, he said he could not treat her because Medicare considers that fraud.

Imagine that...she offered to pay cash for treatment, therefore relieving the taxpayer of the burden, and she was denied because Medicare considers that fraud. This is government exerting control over our lives, plain and simple.

Her only choice is to get off of Medicare and pay cash for everything, or only see doctors who will treat Medicare patients.

This is the first real government intrusion into the health of my family and it hurts. Just wait and see what happens if the Democrats get their way with the public insurance option.

Rationing. Plain and simple.

I am very, very sad today, for my Mom and for my country. :frown:

This is very common, there are some doctors that will not take Medicare patients, I have run into this many time as I am on Medicare, have not used Medicare since I am also a VA patient and I use the VA system, not Medicare.

During the Clinton years, I forget all the details on this. But there was some law passed where a patient can not pay in cash for services, must use some kind of health insurance and just make the co-payment.

So this is all to common, especially now.

[Penrod]

This is very common, there are some doctors that will not take Medicare patients, I have run into this many time as I am on Medicare, have not used Medicare since I am also a VA patient and I use the VA system, not Medicare.

During the Clinton years, I forget all the details on this. But there was some law passed where a patient can not pay in cash for services, must use some kind of health insurance and just make the co-payment.

So this is all to common, especially now.
And do you think everyone would be happy to have VA healthcare?

[bloods vs crips]

And do you think everyone would be happy to have VA healthcare?

hell no, it's a nightmare, unless you live in a small area and have access to a local facility. Otherwise, pain in the ass!

[countmein]

Wow, what happened to that mantra I always hear on the radio stating that: "Doctors will still treat people if they can't afford it, it's their Hippocratic Oath." I guess that flies out of the window of one is on Medicare? :))

I didn't say that any of the docs that I know are REFUSING to treat Medicaid patients, I said that they don't want to. They have employees in their office to pay, rent, untilities, loans for med school, ect. How are they suppose to care for patients when they are not being paid for their services? They already except much less $$ per visit for medicaid patients, and now they are receiving bad checks, months after treatment, and being told to hold them until the state has the money. If they do deposit them anyway, they bounce.
I also stated that the only way the docs are going to get heard by the government is to get their patients on medicaid riled up and calling their reps/senators. The only way that will happen is if the patients start to feel the pain too. The reps/senators in this state don't seem to give a **** about the docs in Illlinois. Only so many votes there. But if the stupid games they are playing in Springfield start impacting the thousand upon thousand of medicaid patients and they start to feel the pain, they start calling and threatening to vote against them, then maybe something will finally get done.

[Guitar]

Are you serious? It sounds like you are. So anyone that makes over 250,000 bucks a year should pay for medicare which will be our healthcare - for anyone who makes less than $250,000? Really?

Now that's leveling the playing field all right. How about our representatives and our president? Should they be made to be covered by the new medicare as well or are they allowed to be exempt. After all, they are our leaders and should be glorified as such.

Just checking your intent here.

No other primary coverage would exist, so yes the POTUS and all members of Congress would have the same coverage as everyone else. The difference would be in the type of Medicare supplement that you choose. In the end the rich would be paying more for healthcare but still would be paying less in taxes than they did before since the Capital Gains tax, Income taxes and Inheritance taxes would be eliminated. It won't work unless you implement all of the changes. Insurance companies could sell more Medicare supplements, Disability income, Life insurance and LTC insurance. This would make a more financially secure America. By eliminating part D of Medicare and covering prescriptions under Part B of Medicare billions would be saved in the administration of Medicare. Also by subsidizing medical education and educating more Doctors costs would go down, as would the cost of Doctors. I don't think anyone else has come up with a solution that would work- what's yours?

[McCoyFan]

This is very common, there are some doctors that will not take Medicare patients, I have run into this many time as I am on Medicare, have not used Medicare since I am also a VA patient and I use the VA system, not Medicare.

During the Clinton years, I forget all the details on this. But there was some law passed where a patient can not pay in cash for services, must use some kind of health insurance and just make the co-payment.

So this is all to common, especially now.


lots of fraud and waste in the system also

[msny]

So for those of you out there that think you'll somehow avoid ending up in a government plan, or that you won't also be restricted to receiving only the care the government deems necessary, if health care reform passes, take careful note of what I have documented about medi-care in this thread, it's your future.

I guess even illegal aliens will be REQUIRED to sign up either way.....:mad:

[msny]

Talking the talk is always so much easier than actually walking the walk.


Isnt that the truth!

So why is Obama straying on his promises from bailouts
to stimulus to nannycare?

Eh?.....:boohoo:

[zantax]

You posted a response to me and I was deferring to a person who works in this everyday.

Please let me know when you find any evidence of the healthcare industry lobbying to cover seniors privately.


And if you didn't want to pay attention to my answer the polite thing to do would be to ignore it, not jump on me for trying to help you out.

And I already pointed out to you that there are private health care plans, as well as supplementals, offered for seniors.

[Garfield]

And do you think everyone would be happy to have VA healthcare?

I am not sure how to respond to that.

I am doing OK with the VA system in San Antonio. I do have to be pro-active in my care, which means I am always asking and sometimes demanding answers, but everything seems OK, so far

[EmergentAurora]

If you read all the posts in this thread and put them together, you can figure out why he could not accept her cash for treatment

He (the doctor) is in the PROCESS of opting out. It says that while in the process they (the provider) cannot accept cash from any NEW medicare patients for the period of 2 years. So he cannot accept her cash for treatment because he has not completed his opt out period required as someone who formerly accepted Medicare payments. My guess is that at the end of those 2 years he would no longer be an approved Medicare provider and at that point could accept cash. Unfortunately, she has gone to see this doctor at the wrong time.

I am not commenting on right, wrong on in between...I just posted becaues I believe I unwound the confusion.

[PheonixOps]

Exactly the point.

There should be options. I think Johnrocks mentioned Part B & Part C as options.

[PheonixOps]

so, you can, in fact, opt out and see the doctor you want?

As far as I know.....yeyyuuup........

[PheonixOps]

Yes, but she would technically still be covered by part a, unless she opted out in which case she couldn't collect her SS benefits and so still wouldn't be allowed to see a doctor participating in medicare and have her private plan pay for something medicare denied, that's my understanding of it anyway.

I don't know Zantax, John mentioned a Part B and Part C alternative.

[PheonixOps]

If you are employed and a group is offered,there are regulations covering what can and can't occur,they can only opt out of group into Medicare at certain times and things like that,too "deep" to get into on a forum,lol. Here is the section covering group at Medicare.
http://www.medicare.gov/Choices/Employer.asp

Thanks John. There's always loopholes and ways to take advantage (legally) of certain situations and regulations in my opinion. I'm willing to bet that people and companies have already found ways or potential ways to benefit and/or not be adversely affected by that "cap and trade" crap..................
Just like the Economic Recovery Act, intelligent people who have the drive and intitiative will find ways to profit and benefit from that as well.............

[PheonixOps]

Your very welcome. I know you and Phoenix well enough here as posters to know you guys want the best and fairest and I commend you for that. I have an 88 year old Mom on Medicare.

Thanks John, right back at ya bro. I just like to go beyond the ******** presented, I don't care what side it's from.................. I hate when people present only one side of a story in order to promote their political agenda. It happens quite often from all sides..................
My Mom is 74 and on Medicare, and so far (Thank God) no problems.
I wasn't being insensitive to the OP's "situation", but I sincerely felt and feel that a lot of it was to promote a certain agenda.......... Maybe I am wrong, if I am, I will gladly apologize.....

[Ninjacorpse]

You can at least sue an insurance company,you can't sue the govt. Our system needs overhaul but it needs less third party payors,not more,imho,at least for the petty crap,get catastrophic and ditch comprehensive..save a bundle.:dance:

You would think more people would be concerned about that.

[GoodQuestion]

Any thoughts on why this has remained law for over 20 years, through 2 terms of a republican president, congress in control of republicans, etc.?

[wildcat87]

You would think more people would be concerned about that.

actually you can. and win.
http://thehill.com/the-executive/after-lawsuit-medicare-to-ease-drug-benefit-enrollment-for-poor-2008-06-19.html

[johnrocks]

actually you can. and win.
http://thehill.com/the-executive/after-lawsuit-medicare-to-ease-drug-benefit-enrollment-for-poor-2008-06-19.html

I stand corrected,under limited circumstances you can per the Federal Tort Claims Act of 1946 it provides a limited waiver of sovereign immunity.
http://www.finchmccranie.com/refresher.htm

[blackcatrun]

I called my father who is a retired physician (they are divorced) and he said that he ran into the same problem with Medicare when he was practicing, and he retired 4 years ago.

Could be that the doctor wasnt accepting the coverage because they often take months if not years to get a payment.

[janer]

Talked to a doc who said that Medicare has slow reimbursement and is talking about cutting what they do reimburse 20% in the next year. Imagine having a customer or client tell you they are going to expect the same level of goods/services from you but they will be paying you 20% less for them in the future. Medicaid pays so little that it is often costs more to go through the reimbursement paperwork than you recoup. Of course, Medicare and Medicaid, and really all patients who use a third party plan don't really care - they're getting it "free" - or with a modest co-pay.
Doctors who do take Medicaid (and perhaps Medicare, too) cannot accept any financial reimbursement at all. They can refuse to participate in certain low-reimbursement programs, and not only the government ones. Any professional person who is going to accept as little as 20 cents on the dollar shouldn't be practicing medicine, he should see a doctor.

[wayoverthehill]

That might be true IF his mother was NOT on medicare.
No one is REQUIRED to be on Medicare, unlike the new
socialists Obama nannycare plan where we will have be, or be fined.Nobody is required to be on Medicare Part B which is the plan that pays doctor fees and costs $96.50 a month. However, everyone who turns 65 is automatically registered for Medicare Part A which is free.

I've been on Medicare nearly 4 years and have never had a problem finding a doctor to accept Medicare assignment. However, when I receive my benefits statement, there is quite a difference between the amount billed and the amount paid by Medicare. My supplement picks up the rest and I pay over $200 a month for that. But it wouldn't surprise me if more and more doctors opt out of treating Medicare patients since some of the money to pay for the "new" universal health care plan will be raised by cutting Medicare reimbursements to doctors and hospitals.

So we are screwed any way you look at it.

[wayoverthehill]

Wrong again, if you refuse medicare you don't get you SS payments.

from http://www.cchconline.org/17medicarefacts.php



If medicare weren't mandatory it would have been replaced by private insurance long ago.Why would anyone refuse to join a program that doesn't cost them anything? They don't have to use it if they have private insurance. Just don't show the doctor's office your Medicare card.

[PheonixOps]

And do you think everyone would be happy to have VA healthcare?

What's better VA health care or NO health care at all, with NOTHING to fall back on?????

[Penrod]

What's better VA health care or NO health care at all, with NOTHING to fall back on?????
Im asking the man who is on it. Do you think its better than private insurance? Im a vet and can go there but have never been. Ive heard horror stories and my experiences in the Marines didnt give me much faith in their healthcare system.

[PheonixOps]

I didn't say that any of the docs that I know are REFUSING to treat Medicaid patients, I said that they don't want to. They have employees in their office to pay, rent, untilities, loans for med school, ect. How are they suppose to care for patients when they are not being paid for their services? They already except much less $$ per visit for medicaid patients, and now they are receiving bad checks, months after treatment, and being told to hold them until the state has the money. If they do deposit them anyway, they bounce.
I also stated that the only way the docs are going to get heard by the government is to get their patients on medicaid riled up and calling their reps/senators. The only way that will happen is if the patients start to feel the pain too. The reps/senators in this state don't seem to give a **** about the docs in Illlinois. Only so many votes there. But if the stupid games they are playing in Springfield start impacting the thousand upon thousand of medicaid patients and they start to feel the pain, they start calling and threatening to vote against them, then maybe something will finally get done.

But you do seem to advocate that the doctors give the patients a hard time, so things can change. What about the doctor and situation that the OP bought up? He seemingly refused to treat his mother, do you think that is right so he can make a point?

[PheonixOps]

Any thoughts on why this has remained law for over 20 years, through 2 terms of a republican president, congress in control of republicans, etc.?

Hey! That doeswn't couwn't! It's the "evil" Liberals!

[PheonixOps]

Why would anyone refuse to join a program that doesn't cost them anything? They don't have to use it if they have private insurance. Just don't show the doctor's office your Medicare card.

See! I knew that there was a loophole!!!!!!!

[PheonixOps]

Im asking the man who is on it. Do you think its better than private insurance? Im a vet and can go there but have never been.

Same here, I always found an alternative.........BUT I'd rather have that than NOTHING.

[wildcat87]

Just FYI

just went to esurance and tried to price out a health insurance plan for a 65 year-old in Georgia.

Not one plan. Zero. Nada.

It said applicants must be 64 or under.

[Crystal]

Many good doctors are opting out of medicare.

We tried to refuse medicare for hubby (he is old enough) and they said we can do that but then MY HEALTH INSURANCE AND HIS MILITARY HEALTH CARE COULD BOTH REFUSE TO COVER HIM.

You are FORCED into medicare even if you are 100% covered by other insurance and do not want it.

[wildcat87]

Many good doctors are opting out of medicare.

We tried to refuse medicare for hubby (he is old enough) and they said we can do that but then MY HEALTH INSURANCE AND HIS MILITARY HEALTH CARE COULD BOTH REFUSE TO COVER HIM.

You are FORCED into medicare even if you are 100% covered by other insurance and do not want it.

meaning they would refuse coverage based on his age? if that's the case how is he "100% covered?"

[johnrocks]

Just FYI

just went to esurance and tried to price out a health insurance plan for a 65 year-old in Georgia.

Not one plan. Zero. Nada.

It said applicants must be 64 or under.

Yep,underage only goes to 64 1/2,after that it's Medicare time.

[GoodQuestion]

The RNC should adopt the elimination of medicare as part of their party platform for 2010 and beyond.... :dance:

[wildcat87]

Yep,underage only goes to 64 1/2,after that it's Medicare time.

Thank you again. You're pretty handy... :)

[wildcat87]

The RNC should adopt the elimination of medicare as part of their party platform for 2010 and beyond.... :dance:

and then who covers seniors? you think there is private market money to be had insuring the poorest segment of the population with the worst health?

[McCoyFan]

Yep,underage only goes to 64 1/2,after that it's Medicare time.

...a never ending client base

[wayoverthehill]

So what will it be, exactly, when Obamacare bureaucrats tell an elderly person they're too old to be treated because it wouldn't be economically feasible?I'll let you know. I expect to have my Remicade treatments cut off whenever Obamacare goes into effect.

[johnrocks]

...a never ending client base

:lol: how you think I can spend so much time here posting?:lol: Seriously though, I'm going to be doing more final expense and less Medicare in a few weeks and I'll be scarce here Monday - Wednesday.:boohoo:

[PheonixOps]

Just FYI

just went to esurance and tried to price out a health insurance plan for a 65 year-old in Georgia.

Not one plan. Zero. Nada.

It said applicants must be 64 or under.

Wow, so if the private insurance that people seem to be touting is so good,what do people over 64 do? Do they just go to the doctor of their choice and say, "I don't have any insurance and I can't pay you the full amount." , and they will simply get treated, like many of the republican talking heads say?

I just want to get this straight...........my vision of the "universal health care plan", is something that should be:
A) Voluntary and NOT mandatory like car insurance.
B) CONTRIBUTORY like a very large group plan. My wife works for a medium sized city here in Virginia, let's say 10,000 employees. The health insurance coverage is great and the premiums are a joke................they are nothing.
C) I will be against it if people earning over ANY amount of money are taxed for it, so other people can be covered.
D) This plan should be able to pay for itself with the premiums received.
E) HMO's should be able to bid for the contracts
F) It should be multi-tiered. Have a "catastrophic" option that "bare boned", that has a minimal premium, a better one that has a larger premium, and another one that has all of the bells and whistles that has a larger premium as well.

If it's not any of this, I will be against it as well. The exact details haven't been hashed out yet, I'm willing to sit back and see what evolves, instead of being a "doom and gloom" reactionary that jumps to conclusions and promotes some silly ********, all to promote a political agenda.

[PheonixOps]

Many good doctors are opting out of medicare.

We tried to refuse medicare for hubby (he is old enough) and they said we can do that but then MY HEALTH INSURANCE AND HIS MILITARY HEALTH CARE COULD BOTH REFUSE TO COVER HIM.

You are FORCED into medicare even if you are 100% covered by other insurance and do not want it.

Sorry, but i don' believe that, especially when there are Medicare options, A, B, and C...........

[wayoverthehill]

Intelligent cost-benefit analysis needs to be employed in any expenditure.

Should the government pay for a bed ridden 90-year old with terminal cancer to have a hip replacement operation? No, it doesn't make any sense as to any meaningful extension of or enhancement to that person's quality of life.
Let's see how you feel when YOU are "that person".

In the meantime, let's be sure to spend money on all the illegals so they can have their anchor babies here.

[wildcat87]

Wow, so if the private insurance that people seem to be touting is so good,what do people over 64 do? Do they just go to the doctor of their choice and say, "I don't have any insurance and I can't pay you the full amount." , and they will simply get treated, like many of the republican talking heads say?

I just want to get this straight...........my vision of the "universal health care plan", is something that should be:
A) Voluntary and NOT mandatory like car insurance.
B) CONTRIBUTORY like a very large group plan. My wife works for a medium sized city here in Virginia, let's say 10,000 employees. The health insurance coverage is great and the premiums are a joke................they are nothing.
C) I will be against it if people earning over ANY amount of money are taxed for it, so other people can be covered.
D) This plan should be able to pay for itself with the premiums received.
E) HMO's should be able to bid for the contracts
F) It should be multi-tiered. Have a "catastrophic" option that "bare boned", that has a minimal premium, a better one that has a larger premium, and another one that has all of the bells and whistles that has a larger premium as well.

If it's not any of this, I will be against it as well. The exact details haven't been hashed out yet, I'm willing to sit back and see what evolves, instead of being a "doom and gloom" reactionary that jumps to conclusions and promotes some silly ********, all to promote a political agenda.

yep. most seniors have tons of extra money each month to pay cash for medicine and doctors visits. those that don't spent their lives doing God knows what and need to just suck it up or borrow money from their kids.

[wayoverthehill]

I did not use an age standard there. There is no reason why a 90-year old in good health wouldn't get one. Similarly, there is no reason why a 60-year old with terminal cancer should expect one.

I don't think you are coming fully to grips with what the economic hole we face here is. It is $24 trillion and I believe the number is understated! If we don't do something, we will go broke.Talk to Obama. He's the one who is spending money like it was in a bottomless pit.

[The Debater]

Then keeping to the conservative mantra, dont sign up for SS...


Great idea! Where's the form so I can get them to stop confiscating 7.65% of my salary?

[PheonixOps]

yep. most seniors have tons of extra money each month to pay cash for medicine and doctors visits. those that don't spent their lives doing God knows what and need to just suck it up or borrow money from their kids.

LOL, I never said that. ;) A few talk show hosts seem to think that it's no problem for people to go and get health, etc. with no insurance policy and it would be no problem.................








:))

[wayoverthehill]

Okay folks, so what is your solution for Medicare ??? There are a number of state-subsidized health care plans through out the country that doctors do not want to deal with but they essentially are either forced to deal with them because it is stipulated by their group practice or they cannot turn down the payment that is offered.

I hear a lot of Republicans complaining about government run healthcare, yet they offer very little in the area of solutions for the poor, out of work, or retired ?

Unemployment is on the rise, therefore many people will not be able to afford healthcare in any form, but Republicans just want to complain about how government
run heathcare plans will fail ?

Will someone on this board, please, please, please provide me with an articulate solution to Medicare and not just complain about the bureaucracy that is crippling it ?!

We have many a crisis in this country, and I believe Obama cares deeply about all of them ( I would never say the same about the former President ). Some of you believe Obama is a socialist, a Marxist, satan, whatever...but come on folks, this guy is a Consitutional scholar !? I am not saying that makes him right about everything, but I believe he cares deeply about this country....why else would he have taken so much time to learn about what makes it tick ???How do you figure Obama has taken "so much time to learn about what makes it tick"? The fool doesn't even know how many states there are. And the only thing he "cares deeply about" is securing his grasp on the lives and fortunes of the citizens. Total power is his goal. Don't be naive.

[johnrocks]

Sorry, but i don' believe that, especially when there are Medicare options, A, B, and C...........

Physicians are opting out, I heard that only like 20% of Doctors in Texas are accepting new Medicare patients,of course that was heresay from a R Congressman on C Span but the Association of American Physicians and Surgeons, Inc. is touting this hard.
http://www.aapsonline.org/medicare/m-optout.php
and even the New York Times has an article on it...
http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html

Doctors Are Opting Out of Medicare



Article Tools Sponsored By
By JULIE CONNELLY
Published: April 1, 2009

EARLY this year, Barbara Plumb, a freelance editor and writer in New York who is on Medicare, received a disturbing letter. Her gynecologist informed her that she was opting out of Medicare. When Ms. Plumb asked her primary-care doctor to recommend another gynecologist who took Medicare, the doctor responded that she didn’t know any — and that if Ms. Plumb found one she liked, could she call and tell her the name?

[johnrocks]

We're even have a shortage here due to Medicare of PCP's.
Some doctors are concerned a slow exodus of private primary care physicians in the Monroe area could lead to a health care crisis.

In the past four years, more than a dozen physicians have left their private practices. Some of them have taken jobs in hospitals and others left the area.

That has left patients with fewer choices.

Dr. Nashat Khanfar, a pediatrician who has practiced in Monroe for nine years calls, the loss a crisis in the making.

Primary care physicians make up general family practices, pediatrics, obstetrics and internal medicine. With fewer options, people turn to emergency rooms.

“The emergency room has now become a place for primary care,” said Khanfar. “The result is limited access to health care.”

The U.S. Department of Health and Human Services has designated Ouachita Parish a health professional shortage area. Among other criteria, the designation takes into account birth rate, poverty and number of qualified physicians.

Aimee Kane, director of corporate communications and physician relations at St. Francis Medical Center, called Monroe’s medical community competitive with cities of similar and even larger sizes. The difficulty, Kane said, comes with serving the surrounding area.

“We serve a large rural area,” Kane said. “Our region is over 570,000 in population.”

Dr. Kerry Anders, both a chief of staff at a hospital and a private physician, said he’s concerned about the future.

“I’m concerned about the next generation,” Anders said. “The community will need replacements, and that concerns me.”

Economic woes also contribute to the problem because people lose insurance and must depend on Medicaid. That results in diminishing returns for private physicians, said Bubba Rhymes, director of physician practice management at St. Francis.

“You have overhead costs for private practices increasing,” Rhymes said. “You have inflation. But reimbursements from Medicare and Medicaid aren’t keeping pace. Oftentimes, they’re paying less and less.”

http://www.cenlamedia.com/alb/index.php/site/article/monroe-losing-primary-care-doctors/

[The Debater]

So she CAN actually be treated, just not by the exact doctors she wants? Those doctors that "suck", do they have a lot of malpractice suits against them or are do they have disciplinary action against them?


No care rationing here....move along, nothing to see......

[wildcat87]

LOL, I never said that. ;) A few talk show hosts seem to think that it's no problem for people to go and get health, etc. with no insurance policy and it would be no problem.................








:))

there needs to be a "tongue in cheek" emoticon

[Penrod]

Same here, I always found an alternative.........BUT I'd rather have that than NOTHING.
Why is it always all or nothing?

Should everyone get the worlds best surgeon or not have the operation?

[PheonixOps]

How do you figure Obama has taken "so much time to learn about what makes it tick"? The fool doesn't even know how many states there are. And the only thing he "cares deeply about" is securing his grasp on the lives and fortunes of the citizens. Total power is his goal. Don't be naive.

Where did you get that silliness from? Talk radio? Like Micheal Savage? In my opinion, President Obama wants to do the best for the people that he can do. Otherwise he won't be re-elected and the next President can reverse much of the programs that he set for, thus the BEAUTY of our country and system.........
The other stuff seems like a bunch of reactionary , paranoid delusions. What is "total power" in your opinion? How do you think that he can get "total power" when the 2010 elections are coming up? Without Congress,his hands are tied. Do you really think that all of the sudden he will issue "martial law" and suspend "Habeus Corpus"?

[wildcat87]

Lets dive in depth and find out why this is. Is this because all people over 65 have no money or because the government web of regulations and wild torts against doctors for the dumbest things have forced this?

you think just maybe insurance companies don't think they can make money insuring seniors?

[wayoverthehill]

Yeah I turn 62 next year. Looks like Ill soon have to sign up whether I want to or not.You don't become eligible for Medicare until you turn 65. Even if you start collecting SS at 62. They will send you all the information you need about 6 months before you turn 65.

[wildcat87]

We're even have a shortage here due to Medicare of PCP's.
Some doctors are concerned a slow exodus of private primary care physicians in the Monroe area could lead to a health care crisis.

In the past four years, more than a dozen physicians have left their private practices. Some of them have taken jobs in hospitals and others left the area.

That has left patients with fewer choices.

Dr. Nashat Khanfar, a pediatrician who has practiced in Monroe for nine years calls, the loss a crisis in the making.

Primary care physicians make up general family practices, pediatrics, obstetrics and internal medicine. With fewer options, people turn to emergency rooms.

“The emergency room has now become a place for primary care,” said Khanfar. “The result is limited access to health care.”

The U.S. Department of Health and Human Services has designated Ouachita Parish a health professional shortage area. Among other criteria, the designation takes into account birth rate, poverty and number of qualified physicians.

Aimee Kane, director of corporate communications and physician relations at St. Francis Medical Center, called Monroe’s medical community competitive with cities of similar and even larger sizes. The difficulty, Kane said, comes with serving the surrounding area.

“We serve a large rural area,” Kane said. “Our region is over 570,000 in population.”

Dr. Kerry Anders, both a chief of staff at a hospital and a private physician, said he’s concerned about the future.

“I’m concerned about the next generation,” Anders said. “The community will need replacements, and that concerns me.”

Economic woes also contribute to the problem because people lose insurance and must depend on Medicaid. That results in diminishing returns for private physicians, said Bubba Rhymes, director of physician practice management at St. Francis.

“You have overhead costs for private practices increasing,” Rhymes said. “You have inflation. But reimbursements from Medicare and Medicaid aren’t keeping pace. Oftentimes, they’re paying less and less.”

http://www.cenlamedia.com/alb/index.php/site/article/monroe-losing-primary-care-doctors/

so Medicaid/care should pay more?

[wildcat87]

Where did you get that silliness from? Talk radio? Like Micheal Savage? In my opinion, President Obama wants to do the best for the people that he can do. Otherwise he won't be re-elected and the next President can reverse much of the programs that he set for, thus the BEAUTY of our country and system.........
The other stuff seems like a bunch of reactionary , paranoid delusions. What is "total power" in your opinion? How do you think that he can get "total power" when the 2010 elections are coming up? Without Congress,his hands are tied. Do you really think that all of the sudden he will issue "martial law" and suspend "Habeus Corpus"?

Obama will have mind control over each and every doctor.

[Penrod]

you think just maybe insurance companies don't think they can make money insuring seniors?
Maybe its because eveyone already has taken our money for the last 40 or more years already? In fact we still have most of the money. This is the governments way to kill us off faster and save on SS and medicare and collect more in the death tax.

Get rid off the old and the young unwanted.

[johnrocks]

You don't become eligible for Medicare until you turn 65. Even if you start collecting SS at 62. They will send you all the information you need about 6 months before you turn 65.

yep,Guaranteed issue during that time too so if you are going on Medicare and have any bad health illnesses,go ahead and get your supplement during that time. I've sold people with liver cancer ,insulin dependent and other things during that time.:angel:

[wildcat87]

No care rationing here....move along, nothing to see......

there are other doctors that will see her. And it is, in this instance, the doctor himself rationing care- as a private businessman that is his right- and her.

[wildcat87]

Maybe its because eveyone already has taken our money for the last 40 or more years already? In fact we still have most of the money. This is the governments way to kill us off faster and save on SS and medicare and collect more in the death tax.

Get rid off the old and the young unwanted.

yeah, that's probably it. You're right, there's lots of money to be made insuring seniors.

[johnrocks]

so Medicaid/care should pay more?

What choice do they have Wildcat, I mean Doctors are like the rest of us,they want the most that they can get and if they can place a 40 year old with better paying group insurance or even 50 of those types since they won't be going as often,they will choose that I would think.

[wildcat87]

What choice do they have Wildcat, I mean Doctors are like the rest of us,they want the most that they can get and if they can place a 40 year old with better paying group insurance or even 50 of those types since they won't be going as often,they will choose that I would think.

I hear you. But I also hear complaints that the system is already basically bankrupt. If that's the case....

[johnrocks]

you think just maybe insurance companies don't think they can make money insuring seniors?

To be honest,I think insurance companies love Medicare.

[wayoverthehill]

Please enlighten me. Can she temporarily stop receiving social security, sign on to a private health plan and get treated by the doctor she wants?

What about people who were CEO's or "well off" can they receive SS after a certain age and keep their own private insurance??? Or are they forced into receiving Medicare? Who receives Medicaid? What's the difference between the two?
Medicaid is for people with low incomes. Once you turn 65 it doesn't matter if you are poor or rich, you are automatically signed up for Part A which is FREE. So if you don't want to use Medicare and you have another plan, what's to prevent you from using it? I've never heard of this BS of not getting your SS checks if you don't sign up. You are AUTOMATICALLY signed up. You do have to sign up for Part B and that costs $96.50 a month and comes right out of your SS check.

It ain't rocket science, folks.

[wildcat87]

To be honest,I think insurance companies love Medicare.

why wouldn't they?!!!?

[wildcat87]

Medicaid is for people with low incomes. Once you turn 65 it doesn't matter if you are poor or rich, you are automatically signed up for Part A which is FREE. So if you don't want to use Medicare and you have another plan, what's to prevent you from using it? I've never heard of this BS of not getting your SS checks if you don't sign up. You are AUTOMATICALLY signed up. You do have to sign up for Part B and that costs $96.50 a month and comes right out of your SS check.

It ain't rocket science, folks.

Thank you for clearing that up.

[PheonixOps]

Physicians are opting out, I heard that only like 20% of Doctors in Texas are accepting new Medicare patients,of course that was heresay from a R Congressman on C Span but the Association of American Physicians and Surgeons, Inc. is touting this hard.
http://www.aapsonline.org/medicare/m-optout.php
and even the New York Times has an article on it...
http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html

Doctors Are Opting Out of Medicare



Article Tools Sponsored By
By JULIE CONNELLY
Published: April 1, 2009

EARLY this year, Barbara Plumb, a freelance editor and writer in New York who is on Medicare, received a disturbing letter. Her gynecologist informed her that she was opting out of Medicare. When Ms. Plumb asked her primary-care doctor to recommend another gynecologist who took Medicare, the doctor responded that she didn’t know any — and that if Ms. Plumb found one she liked, could she call and tell her the name?

Wow, not good news........... Medicare does need to pay more, I think that, that seems to be a part of the problem....... They should raise the premiums and NOT raise the taxes on the rest of us. I think that the raise in premiums should be as small as possible initially and see if that works out, if not raise it incrementally until they can "make it worth the doctors while". Within reason, there should always be a "quantity discount".

[johnrocks]

Medicaid is for people with low incomes. Once you turn 65 it doesn't matter if you are poor or rich, you are automatically signed up for Part A which is FREE. So if you don't want to use Medicare and you have another plan, what's to prevent you from using it? I've never heard of this BS of not getting your SS checks if you don't sign up. You are AUTOMATICALLY signed up. You do have to sign up for Part B and that costs $96.50 a month and comes right out of your SS check.

It ain't rocket science, folks.

Well,you can get Medicare/Medicade which that is what the poor does,their Medicade pays what Medicare doesn't and their drugs are cheap.

[nanajan]

Really? Because my dad's on Medicare and he just saw a doctor today with no problem. Looks like we have conflicting anecdotes.

Did he say that all doctors refused medicare patients? I am on medicare too and I can still see my doctor. but increasingly doctors are refusing because of the costs, restrictions, and burdensome paperwork.

After BO great health care reform is enacted it will get worse for us senior citizens. He has said himself that if the cost outweighs the benefit, elderly Americans can take an aspirin and go to bed to die.
http://patriotupdate.com/home/story/156/Did_Obama_Say_We_Should_Kill_The_Old_Folks_To_Save _Money_Last_Night

[The Debater]

But you do seem to advocate that the doctors give the patients a hard time, so things can change. What about the doctor and situation that the OP bought up? He seemingly refused to treat his mother, do you think that is right so he can make a point?


So how do you feel knowing that her informed decision about the best care available to her was overruled by gov't regulation?

Last time I checked, this country was not founded on the principle that government knows best.

[johnrocks]

Wow, not good news........... Medicare does need to pay more, I think that, that seems to be a part of the problem....... They should raise the premiums and NOT raise the taxes on the rest of us. I think that the raise in premiums should be as small as possible initially and see if that works out, if not raise it incrementally until they can "make it worth the doctors while". Within reason, there should always be a "quantity discount".

But here's the scary part,the "baby boomers" are beginning to reach Medicare age and they are not being replaced in the workforce which means trillions in future,unfunded liabilities . Now benefits can be reduced to kick the can down the road a few more years,taxes can be raised to do the same thing but if your under 30 or so,your probably going to see real problems here if it's not dealt with and politicians are cowards,they won't do politically unpopular things that are required.

[PheonixOps]

there needs to be a "tongue in cheek" emoticon

LOL, NO doubt!

[wildcat87]

So how do you feel knowing that her informed decision about the best care available to her was overruled by gov't regulation?

Last time I checked, this country was not founded on the principle that government knows best.

No. It was overruled by her doctor and HER. She can go to another doctor or she can opt out of Plan B and pay cash.

[PheonixOps]

Why is it always all or nothing?

Should everyone get the worlds best surgeon or not have the operation?

I never stated anything about "all or nothing". I simply stated that I would rather utilize the VA plan than have nothing to utilize. If we can find a happy medium, I would be quite happy..........

[wildcat87]

But here's the scary part,the "baby boomers" are beginning to reach Medicare age and they are not being replaced in the workforce which means trillions in future,unfunded liabilities . Now benefits can be reduced to kick the can down the road a few more years,taxes can be raised to do the same thing but if your under 30 or so,your probably going to see real problems here if it's not dealt with and politicians are cowards,they won't do politically unpopular things that are required.

Unpopular things like healthcare reform? :)

[The Debater]

Wow, so if the private insurance that people seem to be touting is so good,what do people over 64 do? Do they just go to the doctor of their choice and say, "I don't have any insurance and I can't pay you the full amount." , and they will simply get treated, like many of the republican talking heads say?

I just want to get this straight...........my vision of the "universal health care plan", is something that should be:
A) Voluntary and NOT mandatory like car insurance.
B) CONTRIBUTORY like a very large group plan. My wife works for a medium sized city here in Virginia, let's say 10,000 employees. The health insurance coverage is great and the premiums are a joke................they are nothing.
C) I will be against it if people earning over ANY amount of money are taxed for it, so other people can be covered.
D) This plan should be able to pay for itself with the premiums received.
E) HMO's should be able to bid for the contracts
F) It should be multi-tiered. Have a "catastrophic" option that "bare boned", that has a minimal premium, a better one that has a larger premium, and another one that has all of the bells and whistles that has a larger premium as well.

If it's not any of this, I will be against it as well. The exact details haven't been hashed out yet, I'm willing to sit back and see what evolves, instead of being a "doom and gloom" reactionary that jumps to conclusions and promotes some silly ********, all to promote a political agenda.


I'd go for that plan. The problem is I know our politicians and universal health care will look nothing like that.

[PheonixOps]

Obama will have mind control over each and every doctor.

:)) That's the way some idiots, dullards, and their handlers/manipulators make it sound like, that's for sure!

[Crystal]

meaning they would refuse coverage based on his age? if that's the case how is he "100% covered?"

No meaning the insurance companies had good lobbyists when medicare was introduced or added to that allows them to deny coverage if a person is eligible for medicare.

WE had 100% coverage already and still have it because I have to carry health insurance for me and hubby was covered under that. We tried for 2 years to have mine be self only but filing with medicare is a nightmare and the good doctors DO NOT take medicare patients or already have their "quota". After 2years of being at the "back of the line" we picked up hubby on family plan on my insurance. Now he getsw good care again.

If medicare is an example of what we will all get with obama care.....NO THANKS.

[wayoverthehill]

Where did you get that silliness from? Talk radio? Like Micheal Savage? In my opinion, President Obama wants to do the best for the people that he can do. Otherwise he won't be re-elected and the next President can reverse much of the programs that he set for, thus the BEAUTY of our country and system.........
The other stuff seems like a bunch of reactionary , paranoid delusions. What is "total power" in your opinion? How do you think that he can get "total power" when the 2010 elections are coming up? Without Congress,his hands are tied. Do you really think that all of the sudden he will issue "martial law" and suspend "Habeus Corpus"?
It's not silly at all. Everything he is doing is in order to advance that agenda.

BTW, stop with the talk radio schtick, OK? I've never listened to Michael Savage in my life and wouldn't know who he was if I ran over him. You are certainly entitled to your opinion that Obama wants to do the best for people that he can and I am thusly entitled to MY opinion that you are dangerously naive, at best.

As for him being re-elected, God save us. I do have hopes that the 2010 midterms will decrease the Dem majority so that Obamas hands will be somewhat tied. Otherwise, I just don't know. No I don't think he will declare martial law, etc. but it's obvious that he still has half the country starry-eyed. Hopefully they will wake up before it's too late.

[PheonixOps]

Maybe its because eveyone already has taken our money for the last 40 or more years already? In fact we still have most of the money. This is the governments way to kill us off faster and save on SS and medicare and collect more in the death tax.

Get rid off the old and the young unwanted.

So Penrod, what is your proposed solution to this problem?

[johnrocks]

Unpopular things like healthcare reform? :)

lol,I'm afraid this is only going to compound the situation however,it's pretty doggone popular with millions.:lol:

[The Debater]

there are other doctors that will see her. And it is, in this instance, the doctor himself rationing care- as a private businessman that is his right- and her.


So in other words, patients have no right to determine what treatment is best for them, or to pursue what they believe is in their best interests?

Whether you like it or not, it is gov't interference in health care that led to the OP's situation.

Apparently the spirit of Henry Ford is alive and well in Washington - you can choose any doctor you want, as long as it's OUR doctor.

[PVN]

My fiance runs a large medical practice and talks to me a lot about medicare coverage, and you have to be withholding part of the story. There's nothing at all preventing any patient from paying for services with cash.

Doug

Untrue, unless Medicare refuses to pay for the services. Then you are free to pay cash.

[nanajan]

I'll opt out of SS when they give me back the money they've stolen out of my paychecks all these years.


ditto! It isn't like it is a volunteer or welfare program.

[wayoverthehill]

Wow, not good news........... Medicare does need to pay more, I think that, that seems to be a part of the problem....... They should raise the premiums and NOT raise the taxes on the rest of us. I think that the raise in premiums should be as small as possible initially and see if that works out, if not raise it incrementally until they can "make it worth the doctors while". Within reason, there should always be a "quantity discount".Well, the word is that there will be no SS COLA in 2010, 2011, or 2012, so there will be no increase in Medicare premiums either.

But what the heck, all of us old farts are rich, right?

That's why I'm still working. :rolleyes:

[wayoverthehill]

Well,you can get Medicare/Medicade which that is what the poor does,their Medicade pays what Medicare doesn't and their drugs are cheap.I was under the impression that one could not get on Medicare unless they were 65, or if under 65, disabled.

Isn't Medicaid the same plan as Medicare except it is guided by income rather than age?

[JoJo626]

A physician CAN refuse to see any group of patients he/she desires. In my area there are physicians who only see patients between ages of 18 and 64, physicians who only see private insurance and NO self-pay patients at all, physicians who will accept Medicaid only up to age 17, etc.

When I've interview at a Medicaid accepting pediactric office, it was unreal the number of patients they herded through a day because of the crappy reimbursement rates. One doctor just can't give competent care to over 200 kids a day. When I worked at a cancer center, our Medicare/Medicaid patients couldn't have their chemo on an outpatient basis. They had to be admitted to the hospital for treatments because Medicare/Medicaid reimbursement didn't even cover the (wholesale) cost of the drugs much less the administration supplies, nursing costs, and hours used in the chair. A business can't be expected to operate at a loss, which is why many providers are not participating providers with Medicare.

My current office accepts Medicare and Medicaid. The paperwork is a nightmare for us. My previous office did not accept either, and it was busy office, but we were able to devote much more time treating and educating our patients instead of worrying about filling out paperwork to keep some pencil-necked gov't employee happy.

[The Debater]

No. It was overruled by her doctor and HER. She can go to another doctor or she can opt out of Plan B and pay cash.


She should be able to go to the doctor of her choice, plain and simple. IF the doctor was not accepting medicare patients, he should not be barred from accepting them as cash paying patients. Maybe the doctor didn't understand the law, and I don't know enough to say with any certainty that he was correct (from my reading in this thread it looks like the doctor may have been mistaken) - but if the government wasn't muddling the picture this woman could have gotten the care that she felt was best for her.

Was Medicare designed to viciously deny services to patients? Of course not, but it's the law of unintended consequences - this situation arose because of the government's meddling. That's why I'm scared to death of the health care bill Obama and the Dems are pushing. Given their track record this year, it's likely to be full of holes and result in unintended regs that screw the patient.

[johnrocks]

I was under the impression that one could not get on Medicare unless they were 65, or if under 65, disabled.

Isn't Medicaid the same plan as Medicare except it is guided by income rather than age?

It's rather a simple let a little more complicated than I want to commit to typing:lol: If you fall in certain income ranges you can get Medicare and Medicade. I know I've met em and can't sell them a supplement.:lol:

[PheonixOps]

Medicaid is for people with low incomes. Once you turn 65 it doesn't matter if you are poor or rich, you are automatically signed up for Part A which is FREE. So if you don't want to use Medicare and you have another plan, what's to prevent you from using it? I've never heard of this BS of not getting your SS checks if you don't sign up. You are AUTOMATICALLY signed up. You do have to sign up for Part B and that costs $96.50 a month and comes right out of your SS check.

It ain't rocket science, folks.

So we actually agree.............

[PheonixOps]

So how do you feel knowing that her informed decision about the best care available to her was overruled by gov't regulation?

Last time I checked, this country was not founded on the principle that government knows best.

I don't feel anything because I think that the scenario may be bogus in order to promote a certain political agenda. If it's true, he/she is not the only doctor in the world, the person in question HAS options..................

I NEVER said that "government knows best"................

[toreyj01]

First off, the question I would like to ask is what exactly does this provider offer that other physicians cannot? If I am not being too personal, what exactly does your mother need to be consulted about?

Secondly, Medicaid and Medicare are historically difficult to work with, but none the less provide fairly decent care for our nations senior citizens at a very reasonable rate. While the remuneration is poor, I actually favor that because I think that private insurance should have some sort of advantage over government plans.

You may not get every specialist, nor have every procedure you desire if on government health care, nor should you. If private insurance has any chance to survive in a universal coverage system, it clearly must provide some advantages that the government plan does not.

I am sorry if your Mother is suffering because the physician she went to see has so little dedication to his craft and so little disregard for his vows that he lets inconvenience dictate who suffers and who does not. I personally would never turn away a patient in need, no matter their ability. This seems like a problem with the practitioner and not the policy, IMHO.

[ksr2009]

Medicare part B only pay 80% of usual and customary charges. That is why senior (65+) need supplements if they can afford them. Good luck. Try and buy one especially if you have pre-exisiting conditions.
With National Health Care:
1 - the government will decide how much they will pay doctors. Less money = less service
2 - the government will decided what tests you are eligible for. Need a TSH test for thyroid. Once again, they will probably not pay 100% of labs and diagnostic testing will be severely limited.
3 - Need RX? You will only get generic, which is not always the same as the brand. May be in the same family of drugs, but may not work as well, and has different side effects.
4 - Need RX? The government will tell you how much you are allowed. Insurance compaines already do this. This will cause more paperwork for the doctors, writing letters as to why you need to dosage they prescribe. And more frustration for the individual.
5 - Need to see a specialist? Have cancer? You will be on a waiting list for the doctor the govt tells you to see. Doesn't matter if he is good, Board Certified, etc.
6 - Need to see a specialist? More paperwork for the doctor to justify why.
None of this is important if you plan are being healthy during your senior years.
7 - Need nursing home care? If the govt provides it, you will be given an available bed, may be on the other side of the state, where you have no friends, relatives or support.
8 - Need nursing home care? Make sure you are going to get better because once you are declared terminal, they won't let you stay. Only if you are going to get better.

I sold Medicare Supplements and Long Term Care policies back in the late 80's, only lasted a year. Couldn't ethically take seniors money for coverage that probably wouldn't be there when they needed it. It took me that long to see what was really going on. Many seniors think that once they have LTC, and end up in a nurising home for an extended period of time, they are fine. They don't understand they still have to pay the monthly premiums.
If the government gets involved more than they are now, seniors won't have to worry about living long. If you don't believe what I'm saying, find a medicare supplement policy or LTC care policy and look at what it DOESN'T cover, not what it does cover the cost and the finanacial rating of the carrier.
The health care system here is not perfect, but it's not as bad as National Health Care.

[PheonixOps]

But here's the scary part,the "baby boomers" are beginning to reach Medicare age and they are not being replaced in the workforce which means trillions in future,unfunded liabilities . Now benefits can be reduced to kick the can down the road a few more years,taxes can be raised to do the same thing but if your under 30 or so,your probably going to see real problems here if it's not dealt with and politicians are cowards,they won't do politically unpopular things that are required.

I agree, that's why I said hat they should raise those premiums for Medicare/Medicaid. Even if it's 10 to 15 dollars more a month, it may help.

[wildcat87]

So in other words, patients have no right to determine what treatment is best for them, or to pursue what they believe is in their best interests?

Whether you like it or not, it is gov't interference in health care that led to the OP's situation.

Apparently the spirit of Henry Ford is alive and well in Washington - you can choose any doctor you want, as long as it's OUR doctor.

She CAN determine what treatment is right for her. She just has to drop out of Part B and pay cash for it.

[PheonixOps]

I'd go for that plan. The problem is I know our politicians and universal health care will look nothing like that.

I don't know if they would or wouldn't, but I sure hope that they would. If not, I would join the ranks of the people against it. I still think that it's too earlry to tell.
What I don't like is the "used car man quick sell" that seems to be happening. In my opinion, at the earliest, this should happen after the August recess.............not before.

[Penrod]

So Penrod, what is your proposed solution to this problem?
Dont make people get insurance that dont want it for starts.

Have the medical boards in the states do a cost estimate for procedures and set price caps

Have free clinics for those who really cant afford it instead of them using emergency rooms

Stop frivolous law suits against Drs and care givers

Thats a start off the top of my head.

[wildcat87]

She should be able to go to the doctor of her choice, plain and simple. IF the doctor was not accepting medicare patients, he should not be barred from accepting them as cash paying patients. Maybe the doctor didn't understand the law, and I don't know enough to say with any certainty that he was correct (from my reading in this thread it looks like the doctor may have been mistaken) - but if the government wasn't muddling the picture this woman could have gotten the care that she felt was best for her.

Was Medicare designed to viciously deny services to patients? Of course not, but it's the law of unintended consequences - this situation arose because of the government's meddling. That's why I'm scared to death of the health care bill Obama and the Dems are pushing. Given their track record this year, it's likely to be full of holes and result in unintended regs that screw the patient.


Here's what you're missing. The only way the OP's mother is going to be able to see this doctor is to pay cash. There are no individual private insurance plans that take people 65+. If she wants to see him she just needs to drop out of part B.

[ksr2009]

First off, the question I would like to ask is what exactly does this provider offer that other physicians cannot? If I am not being too personal, what exactly does your mother need to be consulted about?

Secondly, Medicaid and Medicare are historically difficult to work with, but none the less provide fairly decent care for our nations senior citizens at a very reasonable rate. While the remuneration is poor, I actually favor that because I think that private insurance should have some sort of advantage over government plans.

You may not get every specialist, nor have every procedure you desire if on government health care, nor should you. If private insurance has any chance to survive in a universal coverage system, it clearly must provide some advantages that the government plan does not.

I am sorry if your Mother is suffering because the physician she went to see has so little dedication to his craft and so little disregard for his vows that he lets inconvenience dictate who suffers and who does not. I personally would never turn away a patient in need, no matter their ability. This seems like a problem with the practitioner and not the policy, IMHO.
It doesn't matter what the mother's condiiton is. Some doctors are good at some things, other are not. I've been blessed to find an excellent PCP, and have referred many people to her who are not getting adequate care from their own PCP's. If she needs care, she should be able to see a physician that she believes is up to date of her individual issue and has confidence in.

[PheonixOps]

It's not silly at all. Everything he is doing is in order to advance that agenda.

BTW, stop with the talk radio schtick, OK? I've never listened to Michael Savage in my life and wouldn't know who he was if I ran over him. You are certainly entitled to your opinion that Obama wants to do the best for people that he can and I am thusly entitled to MY opinion that you are dangerously naive, at best.

As for him being re-elected, God save us. I do have hopes that the 2010 midterms will decrease the Dem majority so that Obamas hands will be somewhat tied. Otherwise, I just don't know. No I don't think he will declare martial law, etc. but it's obvious that he still has half the country starry-eyed. Hopefully they will wake up before it's too late.

One thing we can agree upon, I'd like to see Congress more balanced. I don't like a majority of ANY party in Congress..............

[wildcat87]

Medicare part B only pay 80% of usual and customary charges. That is why senior (65+) need supplements if they can afford them. Good luck. Try and buy one especially if you have pre-exisiting conditions.
With National Health Care:
1 - the government will decide how much they will pay doctors. Less money = less service
2 - the government will decided what tests you are eligible for. Need a TSH test for thyroid. Once again, they will probably not pay 100% of labs and diagnostic testing will be severely limited.
3 - Need RX? You will only get generic, which is not always the same as the brand. May be in the same family of drugs, but may not work as well, and has different side effects.
4 - Need RX? The government will tell you how much you are allowed. Insurance compaines already do this. This will cause more paperwork for the doctors, writing letters as to why you need to dosage they prescribe. And more frustration for the individual.
5 - Need to see a specialist? Have cancer? You will be on a waiting list for the doctor the govt tells you to see. Doesn't matter if he is good, Board Certified, etc.
6 - Need to see a specialist? More paperwork for the doctor to justify why.
None of this is important if you plan are being healthy during your senior years.
7 - Need nursing home care? If the govt provides it, you will be given an available bed, may be on the other side of the state, where you have no friends, relatives or support.
8 - Need nursing home care? Make sure you are going to get better because once you are declared terminal, they won't let you stay. Only if you are going to get better.

I sold Medicare Supplements and Long Term Care policies back in the late 80's, only lasted a year. Couldn't ethically take seniors money for coverage that probably wouldn't be there when they needed it. It took me that long to see what was really going on. Many seniors think that once they have LTC, and end up in a nurising home for an extended period of time, they are fine. They don't understand they still have to pay the monthly premiums.
If the government gets involved more than they are now, seniors won't have to worry about living long. If you don't believe what I'm saying, find a medicare supplement policy or LTC care policy and look at what it DOESN'T cover, not what it does cover the cost and the finanacial rating of the carrier.
The health care system here is not perfect, but it's not as bad as National Health Care.

Do you think there is private market solution for senior healthcare coverage? Do you think there is anyway for a company to make money insuring the poorest and highest risk population? I don't.

[PheonixOps]

Well, the word is that there will be no SS COLA in 2010, 2011, or 2012, so there will be no increase in Medicare premiums either.

But what the heck, all of us old farts are rich, right?

That's why I'm still working. :rolleyes:

LOL, I think that you may be reading me the wrong way................
I think that our elders should have the opportunity to be afforded the best health care possible. What is your proposed solution for this problem?

[ksr2009]

Do you think there is private market solution for senior healthcare coverage? Do you think there is anyway for a company to make money insuring the poorest and highest risk population? I don't.
That's a very good question. It all comes down to money. I'm lucky, in that if I retire prior to 65, my employer will continue my medical coverage until I'm 65.

I have to agree with one of the other comments, that the government if moving too fast on this issue. There is no perfect solution. The older we get, the more medical issues we have. The one thing I do know is that I want to be able to choose my health care provider. And we as a nation can not afford to support everyone that comes into this country. We need some checks and balances. We need some reason and common sense. We need to be accountable.

[toreyj01]

It doesn't matter what the mother's condiiton is. Some doctors are good at some things, other are not. I've been blessed to find an excellent PCP, and have referred many people to her who are not getting adequate care from their own PCP's. If she needs care, she should be able to see a physician that she believes is up to date of her individual issue and has confidence in.Personally speaking, I am in Interventional Cardiology and work with chaps that are celebrities locally and chaps that are relatively unknown. By and large the skill set that either possesses has little to do with their notoriety.

There are brilliant physicians who have little need nor use for self promotion. That doesn't make the quality of their care any less or more capable than the self promoter.