Vice President Joe Biden spent a lot of time last night saying that under Affordable Care Act, Medicare will not be affected. Here in Maryland, Govenor O'Malley is very proud of the fact he is first in the nation to enact health care exchanges in his state. President Obama made many promises in 2008 that our healthcare would not be affected either cost-wise or care-wise.
Let me tell you a story - just one example, I'm sure - of how one senior citizen's Medicare has been affected already....even though the AHA has not yet been fully implemented. I have a friend who is over 70 and is a very active member of the community. She had two knee replacement surgeries because of bone-on-bone pain that made it very hard to continue doing all that she is capable of.
In her words: "I just got another letter from Medicare. This one says that they have refused to pay Anne Arundel Medical Center for the hospitalization when I had my knee surgery. It showed that the hospital had appealed it and that they were turned down by a professional “review” board (whose job is probably to do just this.) What don’t they understand about a bone-on-bone joint problem? I had no other options.
They say that the hospital is responsible (not the beneficiary) because they did not notify me that I might have to pay it. I see a scheme here to force hospitals to give all patients notification that if Medicare turns down the payment, they will be held responsible. How many people are not going to be willing or able to pay for expensive surgery? They will opt not to have surgery. This will really cut down on Medicare costs – which they need to do since Obama removed $600 + billion from Medicare. And the patients will suffer pain, etc. and have conditions that deteriorate. What will that cost in the long run? Why is this not being made known???
I found out yesterday that Medicare had paid for the second knee but they have been playing this game with the first knee.
I do want you to tell people about my other Medicare letter. I got a letter a month or 2 ago and so did all of the other Medicare patients at the physical therapy office I am going to. My therapist thinks it went out all over the country. They put a dollar amount on the therapy I can receive in 2012 which is based on money, not on whether I am getting well. I realize I am costing them a pretty good amount this year, but I did have 2 knees done and I need to recover. I don’t see how you can limit therapy when someone has not gotten their range of motion back."
As you can see, what the president and vice president are telling us and what is really hapening are two different things.
As the old adage goes, "Fool me once, shame on you. Fool me twice, shame on me." Do not be fooled by the president's rhetoric again.
Who else has stories to share?
Let me spell it out for you: the savings in Medicare under the Affordable Care Act *haven't gone into effect yet*. So these anecdotes have nothing to do with it and only serve to confuse people.
He too had severe degenerative knee arthritis, bone-on-bone. As was TOLD to us by his doctor, Medicare and private insurances have very specific guidelines when it comes to replacement. The goal is to avoid or minimize invasive treatment. This is for any age and any type of elective surgery. First, he had to have 90 days of "documented" conservative treatment as in non-invasive therapy. (Anti-inflammatory medicines, physical therapy, etc). When these didn't relieve his pain, arthroscopy was done: his doctor went in and looked around and cleaned up the knee joint. This is standard procedure and treatment for most if not all knee replacements. The he had a series of shots in his knee. After the above was attempted first, then he had his total knee replacement with months of rehab. NO PROBLEM with MEDICARE payment. Perhaps her doctor didn't follow the guideines that have been in place long before any aspects of the ACA have taken place. ? an aggressive surgeon? Seems plausible, since the 2nd knee was paid for.
The $700 million in cuts to Medicare has been mischaracterized. Over the next 10 years, payments to providers will increase. Payments to providers will not increase as rapidly as was previously planned before ACA kicks in. These same exact cuts are also included in the Ryan budget, which was sponsored by Ryan, and approved by the U.S. House. For an interesting read, see this link for a blog post written nearly 3 years ago by a pro-life Catholic. The writer opposes the ACA, but his point is that there is big difference between what Republicans say about Medicare and what they do about Medicare. The author backs up his points with facts and voting records. If you want to apply the "fool me once..." rule, I think you should take a look at who has really been fooling you about Medicare. http://the-american-catholic.com/2009/12/06/fact-checking-republican-medicare-scare-tactics/ Which party do you think will help preserve Medicare? The party that made Medicare a reality in 1965, or the party that said that it's not needed and it will never work? The party that wants everyone to have health insurance, or the party that believes the fallacy that private insurers want to insure the elderly? I know who I trust.
The first occurred when I had abdominal surgery last fall. I'd lost a great deal of weight in the past and had redundant skin, which would have made a proper incision difficult, so the surgeon recommended a medically necessary tummy tuck as part of the surgery. Denied the first couple of times because it was "cosmetic." Actually, it was a different code. I pushed aggressively, as did my doctor, and thankfully, so -- when they opened me up, they found more cancer they wouldn't have been able to see had they put the incision in a different place! The second occurred during chemo. I needed an expensive drug because my white blood cells plummeted to a dangerous level and I had a serious infection. Denied, but eventually paid for. I'm still fighting the third battle. They pre-approved my radiation, but denied the claims when they received them.