Where Have The Doctors Gone?
Medical Care, 2014
by – Sheri de Grom

I knew it would happen; I just wasn’t sure when. My internist and I were discussing some of my continuing health concerns and he admitted he would have chosen a different approach to my care if Medicare wasn’t in the picture.

Unfortunately, I was forced into Medicare when I turned sixty-five—just like the tens of thousands and perhaps millions of other American citizens who don’t want Medicare coverage. You may read my blogs, ‘Medicare, I Hate You,’ and ‘The Death Squad.’

One of my medical specialists recently retired so I asked my internist if he could suggest a doctor to replace him. Of course the unspoken questions always include: will they be practicing medicine longer than I’ll need them; do they listen to patients’ concerns and address them; and, finally—the determining question—does the doctor accept Medicare?

My internist provided me with the names of two young physicians he admired and he knew they were taking a few Medicare patients while building their private practices. I called each one today, one week after my internist had provided their names, and they are no longer accepting patients wherein they must bill Medicare first and then any secondary insurance. If I were not forced into Medicare, an additional cost for me, my individual insurance that I personally pay for and our Tricare would pay 100% of the cost billed. The federal government has taken away my freedom of choice!

I don’t blame doctors for not accepting Medicare and other government-funded insurance systems. Not only do the rules seem to change daily, but the reimbursement rates also decline yearly. Physicians can make more money as a certified Prius auto inspector than as a doctor treating a geriatric population with Medicare or those with Medicaid or Tricare. Additionally, the auto inspectors have a higher standard of living as they don’t have college and medical school loans to repay.

My internist said every physician who can is declining new patients if the patient’s primary insurance is Medicare. The same holds true for Medicaid and Tricare populations.

I wish I were allowed to opt out of Medicare the same as most physicians. I wouldn’t think twice about opting out. It doesn’t matter to me that I paid into Medicare my entire career (both twenty-year careers). I still don’t want it. As long as the Tea Party and Obama care leave me alone, I’ll be able to take care of myself and my husband as long as we live, thank you very much.

The one piece of legislation in favor of patients currently enrolled in Medicare is that if they are already a patient of the doctor, the doctor must continue treating them after they turn sixty-five and are Medicare-eligible or meet guidelines established by legislation that makes the individual Medicare eligible. Unfortunately, this isn’t true for the military and their families dependent upon Tricare.

I grew up with the moral code of being responsible for myself and those I love. I planned carefully my entire career and, yes, my husband and I have better insurance than probably 90% of the U.S. population. At the same time, the sacrifices we made to receive eligibility for this coverage were often heartbreaking, life-threatening and felt as if every limb was being pulled apart.

It’s not only that Medicare and other government-controlled programs aren’t paying doctors a living wage, there’s another insidious underbelly haunting doctors who treat the elderly. (Please note, I don’t consider myself elderly in any sense of the word but for insurance and health care law, I’m elderly).

We have an emerging trend of elder abuse adding liability risk to doctors. It’s a different



form of elder abuse than we are used to hearing about. It has nothing to do with what comes to my mind when I think or read about elder abuse. I’ve always thought of inadequate living conditions, lack of nourishment or proper diets, not to mention, physical, emotional, or financial abuse.

This new form of abuse involves a doctor and/or his staff not following up with a patient’s continuum of care. Today we have an alarming trend of attorneys finding ways to circumvent tort reform statutes and elder abuse is not included in medical liability reform.

Cases I’ve reviewed are simple enough. Some of the greatest legal risks for physicians involve the failure to contact patients after they’ve missed an appointment. Additionally, medical record documentation rates high on the list involving cases where medical care was given, but wasn’t written down and therefore didn’t count. (In the medical arena, if something isn’t written down, it didn’t happen.)

Another example of legal actions taken include: general practitioners or internists referring patients to specialists for advanced diagnostic testing for something the general practitioner or internist suspects is occurring. Then, for any multitude of reasons, the patient never visits the specialist and subsequently dies of the very ailment the referring doctor suspected.

The above scenario is all too common and, as baby boomers age, more and more will enter the elder-care medical system and not have an advocate at their side. And this missing individual is much more than an advocate. They are the ones who keep track of appointments and ensure the patient arrives as scheduled. The advocate also makes arrangements for proper medication to be picked up and often times administered. Many of us have taken care of our parents, even from long distances, to ensure they have quality of life obtained through proper medical care. I manage all aspects of my husband’s medical care.

An example of a doctor not following continuum of care occurred immediately after my husband had an appointment with his internist Jan. 7, 2014. The internist said he would call the following day with further instructions based on the results of the overnight completion of blood tests. Although I’ve called the internist’s office three times since Jan 7, the internist has not called as promised. I’ll continue calling until I get the results I need but in the meantime, I’ll also visit the hospital where my husband’s blood work was analyzed. I’ll take with me a copy of Tom’s medical power of attorney and request copies of all laboratory reports and the results for each test my husband has had within the last six months. We are entitled to the information and I’ll blog later on the documents necessary to have in place to make the medical system work for you. You should never be held hostage.

Statisticians often remind us baby boomers that we’re not expected to live as long as our parents. I see this as reality. More of us enter the elder-care population each day and the time will come when we’ll need someone who truly cares about our quality of life and much of that quality is dependent on appropriate health care.

Due to the rising number of elder-care legal actions, physicians either can no longer get medical liability insurance to cover the growing population or they simply aren’t willing to take the many risks in treating elderly patient.

Physicians who once followed their patients upon admission to a nursing home or other care facility now elect to turn their medical care over to the facilities’ staff physician. This is a difficult adjustment for the patient and the family. This shift in medical care can be traced to the rising cost of physicians’ growing-hikes for liability insurance premiums. It’s a simple fact; doctors have to reconsider treating the elderly.

One last cautionary note: hospitalized Medicare patients are often moved into a step-down unit of a hospital



for observation, rehabilitation or intense physical therapy. It appears to the patient and the patient’s family that Medicare is covering this care the same as the previously hospitalized days, but unfortunately, the patient is now being treated in what Medicare classifies as an outpatient environment. Medicare’s payment drops drastically in this scenario leaving the patient and the family uninformed until they receive their first statement.

What are your thoughts? Being a caregiver requires a lot of time and energy (both mental and physical). Who protects your medical interests? Does anyone know what you want?

Thank you for reading with me as we enter this world of who’s going to pay for what in 2014.

I’ll be back next week with, ‘Sharks At My Grave.’ Thank you in advance.

About Sheri de Grom

Retired Fed/JAG, 5 yrs. on Capitol Hill. Former book buyer for B and N. Concerned citizen of military drawdown. Currently involved in mental healthcare reform, health care strategist and actively pursuing legislative change wherein dual retirees are exempt from enrolling in Medicare at their own discretion without losing tertiary healthcare benefits. Monitor and comment on Federal Register proposed legislation involving Mental Health, Veterans Affairs, Health and Human Services, Medicare and rural libraries. Licensed OSHA Inspector to include Super Fund sites. Full time caregive to Vietnam era veteran. Conceptualized, investigated possible alternatives, authored, lobbied for, and successfully implemented Title X, Section 1095 (known as the Third Party Collection Program of Federal Insurance).
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  1. pnissila says:

    I am so glad to have found this blog as a link from another one! Great information and great writing. I have signed up as a follower. In two years I will reach 65. I have already been taking notes, here, on the issues you raise. I am a teacher and receive good insurance at the moment; however, who knows what kind of mess the “affordable care” health business will be in in two more years.

    I also live in Oregon, like another commenter, and I, too, couldn’t believe the gross mishandling of the roll-out of our state’s insurance plan. Where are “they” finding these IT incompetents? A couple of bright, tech-savy high school kids could have done a better job getting this up and running….and at fractions of the cost, both at the federal level and our state level.

    My suspicion, however, at least as regards the BIGGEST current problem, seemingly, with the national “affordable care” act, read: the system roll-out, is that like other suspect legislation rammed through via questionable political machinations we’ve been “Hegelian’d.”

    As in the old Hegelian dialectic process whereby the sharp edges of two opposing viewpoints are “softened” by a carefully orchestrated “coming to consensus” process thus creating new-thought about the issue (some call it a “dumbing-down process,” others call it a “bait and switch” tactic), the real issue, as in THIS IS BAD LEGISLATION, is lost in the shuffle as the desperately sick and the worried well (along with the “press” and perhaps a blackmailed supreme c.j. or two?) shift their focus on getting the IT systems fixed instead of the LAW fixed.

    After a suitable time of collective, mounting trauma when the population JUST WANTS IT DONE, the prez or a surrogate holds a press conference (with few if any questions allowed from the “press,” go figure) to reassure us that the crashy system WILL be fixed! The culprits will be given a sound verbal thrubbing! Eventually! (Film and extensive commentary at 11, 12, 1, 2, 3…) And (the closer we get to the mid-term election cycle?), by golly, you and you and you, too, can get EXTENSIONS!!

    And by now the labyrinth of political maneuvering has taken many people so far from the original question, as in, HOW CAN WE GET THIS BAD LAW CHANGED OR DELETED? and topic-fatigue has taken such a heavy toll, people take what they can get: the Hegelian “solution.” Or folks just feel powerless.

    At the moment, anyway.

    Well, not everyone. 😉

    So, once again, thank you for your hard work and your diligence. We all need this heads-up and this information.

    My experience as a care-giver to my mother (who passed last August) and her MOUNTAINS of insurance forms for her care in her assisted living facility had already alerted me to snags and drags on the system and on patience. I can see the wisdom of planning ahead for my own adventures in Medicare coming up, and the necessity of keeping good records.

    Blessings to you and your husband. My prayers go out to you both.

    • Phyllis – It’s going to be such a pleasure having you as a follower. Your well thought-out comment coupled with being passionate about the issues causing our country harm does me good. I fully believe the Supreme Court knew what they were doing and since none of them have held a real job for a single day in their life, why should they care what happens to anyone else. We’ll never see another honest election (not that we’ve had one since the first Bush was elected) with the courts latest ruling.
      I hope you have a great week coming up.

  2. Ian McGregor says:

    Hello Sheri,
    Thanks for sharing informative post! I am too on Medicare, I think you’re correct. I’ve got this year’s Medicare book and I’ll check it out.

    • Ian – We are losing benefits rapidly. A new body of administrative law has popped up that keeps one of my providers of care from being paid. The citation is Section 603(c) of the American Taxpayer Relief Act of 2012 (ATRA). The portion of this administrative law having to do with Medicare has absolutely nothing to do with Medicare yet as so often happens, it rode it all the way to law as an add on and ‘we’ don’t have enough advocates protecting us on the hill to keep these things from happening. The entire law is outrageous and I’ll be blogging about it in a couple of weeks.
      The issue for me is that I don’t care if Medicare pays or not. My healthcare provider is willing to accept what BC/BS pays as payment in full. What’s really interesting is that before I was forced into Medicare, this healthcare provider was paid at 100%. Sheri

  3. Your comprehensive post has drawn many, many comments, all valid. At the moment, I have an HMO and an excellent doctor who, bless her, decided to confine her practice to those of us over 65. However, I certainly can connect with the statement that some doctors decline to treat or follow up older patients’ needs. Seven years ago, I had a cancerous kidney removed. However, some of the cells escaped. I was told there was a 50/50 chance that, within two years, I would develop lung, brain, or bone cancer. My oncologist scheduled regular catscans for two years. The next time I wrote to him that it was time to schedule another scan, there was no answer from his office, After his office ignored my next three requests, I stopped asking. I’m sure my age(in the 80’s) has had a lot to do with not scheduling any more scans. I felt as if I had been cast aside on the rubbish heap, but it no longer bothers me. After all, if something did show up, what could they do? Since I have only one kidney, I am not a candidate for chemotherapy, and radiation might very well harm the remaining kidney. My daughter has Medicare and Tricare. She does have to pay for some treatments, but, at least so far, they have covered the major ones, although Tricare is reluctant at times and will not pay entirely for some treatments, or not at all for others. When it was her only insurance, they paid for a lot more. My experiences and those of my friends cause me to conclude that the medical profession knows a lot about a little and little about a lot.

    • Dear English Professor – I’m happy the HMO provider has the professional ethics to stand by her patients. We don’t see that often in today’s healthcare arena. The law reads that if a doctor is seeing you before you turn 65, then they must continue to treat you after you turn 65.
      I well understand where your daughter is coming from. As a retired federal employee I elected to keep my health insurance as I moved into retirement and it’s one of the best decisions I’ve ever made. My husband is also retired military and we have access to Tricare for Life but in my opinion, they are a joke.
      Due to my husband’s illness, I knew he would be dead before Tricare would approve medical care for him. Therefore, my BC/BS has been worth every penny of the $700 I pay them every month.
      Before I was forced into Medicare in order to keep Tricare, we had 100% coverage on everything. Now, I’m having to fight Medicare at every turn. Tricare never paid anything except for our deductibles so they were getting off easy and now they pay nothing due to my continuing coverage with BC/BS.
      In the next couple of weeks I’ll be posting other issues that Medicare has managed to slip into Administrative Law without the public having real knowledge of what was going on. We can forget about AARP looking out for our interest. This particular piece of legislation flew right by them and they deemed it a great deal for their subscribers!

  4. Ms. de grom,
    I enjoyed your article and certainly appreciate your very conversational style of great writing. I expected to put on my helmet and start fighting along side of you with vigor and commitment but guess what? It is not at all like that here in Tampa. My guess is and this is after a long life of doctors and specialists and your scenarios are just foreign to me and my experience. I’d bet you a nickel that almost 100% of doctors in my area take Medicare. Very few refuse Medicare and I personally know of none. My Medicare has worked fairly well since I became fully disabled about 10 years ago. I am not sure if your problems are from your geographic region and area.
    Well I can tell you I did like your blog very well and would love to hear more from you at anytime… Thank you, claudy

    • Claudy – Thank you for taking the time out of your day to respond to my post regarding Medicare and Where Have the Doctors Gone. A good friend of mine has relatives living in the Tampa area and they don’t have problems with finding doctors there either. I’m convinced it has to do with supply and demand. If you’d like to take a look at the map of Florida, many areas are undeserved by Medicare but most of the large cities seem to have many specialties seeking patients. Some editorials I’ve read about Florida and Medicare is that as doctors are closer to retirement and along with that retirement comes the choice to move to Florida but they want to practice medicine a few more years. They will then become licensed under a larger clinic and automatically be covered for any liability.
      For those of us that have grown up with freedom of choice are not happy with having that freedom taken away. I’ve had premier health care my entire life. Of course I’ve made career choices and other life style choices based on keeping premier coverage. Trust me, Medicare is not providing first rate care to any patient. It can no longer provide the care it once did because ‘gatekeepers’ are now over seeing the Medicare program and doctors are no longer allowed to treat patients the way they would like.

      • Ms. de grom,
        I am sure you are correct but my personal experience feels like I had no problem finding a doctor. In fact right now I have the best care a very good doctor and she takes my Medicare. But indeed you make a valid point and the fact is the USA pays way more an gets way less than any other industrialized nation. Remember President Obama was going to take on the insurance companies and offer a “Public Option”? Well that sure would have brought down the cost of insurance but what happened is the President went upstairs just after being elected with the insurance companies and came out with lipstick all over his face and instead of taking them on he gave them a big fat kiss! He never took them on and it seems he must have been put in the White House by the people he supposedly was going to take on! Well wasn’t that a smooth hat trick? The actual truth is we no longer have a democracy and our political system is shot. Every poll shows the majority of Americans believe or government is bought and paid for by the highest bidder and for that reason I think we will see revolution in our lifetime and I think the Occupy Movement was just a hint of what is to come! It will be spontaneous and total with all the people and not just the poor or colored like in the past. Our media is a joke and seem to think out of media is out of mind but I think not. Nonetheless, I do sense your honesty in making healthcare better for all involved. That is why you have my respect and adoration. Thank you again, claudy

        • Dear Claudy, I’ve been trying to get a response back to you and well, what can I say? Perhaps my time management isn’t what it once was. I like to think I can still multitask as long as I have someone to share the tasks with. I would never have thought of doing such a thing even 10 years ago.
          Your comments are right on target. Some of the upcoming posts I’m working on have to do with private and corporate interest buying votes. We haven’t had a real election since the recount Prez. Bush demanded.
          I couldn’t agree with you more about Prez. Obama. He promised much while busy taking selfies’ of himself (and last I checked he’s not even in the right generation where it’s considered part of the cultural pattern).
          I’m not finished writing about the shambles of our health care by any means. Tens of millions of dollars are being made from Medicare Part D and it’s not the patient making the money. And of course there’s the continuation of The Justice Department. They honestly are working hard to put as many Medicare and Medicaid crooks in the federal pen.
          I’m also going to be talking about the downsizing of the military and who’s going to take care of the enemy when they come ‘ashore.’ That’s our shores and we won’t have anyone to defend them.
          I couldn’t agree with you more about a pending revolution. My father predicted it would happen at least 20 years before his death in 2007. We American’s are a proud people and we can only be shoved around for so long. When the revolution does come, I don’t think we’ll know who our enemies actually are. I don’t think it will be by race or economics. I don’t want to think we’ll become caged rats and turn on each other but what else is their to predict. I hope to see more of your comments in the future. Thanks so much for reading with me and engaging in thoughtful conversation. Sheri

          • Ms. de grom,
            No matter the age or the issue it seems that everybody and I mean everybody senses a revolution on the horizon. You are correct that the American people will take only so much and then it is over and we take action! It is coming and I am sure I will see you in the streets along with everybody else with the future on our minds and hope for a better tomorrow…. claudy

  5. chris13jkt says:

    Wow I’ve just known that Medicare in the US is quite terrible 😦

    • Chris – Any government run healthcare system is socialized medicine at its best. Freedom of choice is not available. Those of us that have always had the best of the best (because we’ve elected to make other sacrifices in our world of work, etc) know the quality of health care available and Medicare isn’t it. When Medicare was initially drafted into law it was good. It took care of a large population of 65+ workers that fell in the group that were born between 1890 and on through WWII. However as more and more employment offered health insurance became available as a part of their benefit package, Medicare was no longer essential. We’ve now reached the point where administrators are telling physicians how to treat their patients and that’s not okay by me. Thank you for stopping by to read with me.

  6. Lignum Draco says:

    I don’t know much about healthcare in the US, but what you describe is an absolute mess, for all concerned.

  7. Excellent post, Sheri.
    I am only 53, but because I am disabled I too am on Medicare. I switched Doctor’s this week and the first available appointment he had was March, 6.

    • Bill – Don’t you love it when you think you’ve settled in for a good long relationship with a physician only to learn they are moving on to a more lucrative career such as a hospital CEO, a hospitalist, or even a Prius inspector. Then of course, there’s the issue that our former doctor could often step in and answer concerns over the telephone and just maybe we’d get lucky and not have to go to the office. We’re back at square 1 with that new doctor and how much are they really going to learn about us when our initial appointment is 20 minutes.
      I’m happy you stopped by to read and comment. Thank you.

  8. dear Sheri,
    After reading your article..my depression has just become worse…I did not think it was possible.I am totally confused with this insurance business and have already cut out medications because I cannot afford them. However, on the bright side, I have lost 30 pounds since my retirement from teaching I wish I understood the Affordable Care Act better…and I suppose many people wish the same. I think greed has certainly driven the ideals of what I grew up with into the ground. Hope –all we have to lean into the future with!

    • Jane – I apologize for making your depression worse. Some days I wonder if the CEOs of the health management organizations (otherwise known as gatekeepers) understand what they are doing to the American public or do they even care. In days gone by, when a doctor knew a patient was having a difficult time buying their medication, they always had a desk of samples and the doc could usually give the patient enough to get by until the next office visit. We no longer see that happening since the crack-down on doctor’s receiving fees for speaking at conventions held at luxury resorts, etc. I frankly don’t care if a doctor has a free luxury vacation at the expense of a pharmaceutical company if said doc is able to provide me medical care at an affordable price. Medicare is definitely not for the faint of heart.

  9. Our local news recently reported on a woman who kept receiving the cards for some other people. She knew they needed them and tried to get them to the appropriate people. All of their medical information was on the list attached to the cards, yet even when notified time and again they would just send them back to her – the wrong person.

    This was so unsettling she called the news station and asked for their help in locating the people expecting and waiting on their Medicare and Medicaid cards. They got involved and contacted the local agency, with assurance it would be corrected.

    Guess what? They sent more cards to this same woman for all of these people with no connection to her. She had never heard of them. The address had a number attached to the end of the street as if for an apartment, though none existed on her rather tawny street. She had never seen any of the doctors on any of the cards – (the mistake didn’t happen there).

    My guess is a computer glitch, but once in the system, they refused to accept it as a mistake. And that was just in issuing the cards.

    I said all of that to get to this point. There are so many problems with this new system, this computerized medical tracking, we can’t even begin to fathom what all of the ramifications will wind up being.

    What if she had been dishonest? Who is receiving all of our medical records? Why pay into this system for our entire working lives if we are just treated like ‘downed animals’ when we need it?

    Yikes! We can do better than this and if we can’t, we should all be given a refund with compounded interest and penalties attached! (This is how I feel about social security too. It shouldn’t even be on the table for discussion in cuts.)

    Thanks for letting me rant. You’ve stirred a hornet’s nest here.

    • Renee – Your right on every element here and you have every right to rant. This goes on over and over. I’ve been working on a blog regarding the safety of our medical information and you’ve hit upon a perfect example of what is so wrong with everything that’s happening to every citizen without our voices being considered. I’d like to use your comment (giving you credit of course) but you’ve provided excellent real life example of how our system is working against us and how very wrong it is.

  10. gpicone says:

    Unfortunately, if you were not covered by Medicare or were able to opt out, your own coverage would be worthless because your insurance company would then opt out of you. All you have to do to get your favorite or chosen doctor to treat you is to pay them what they want. Tell them that whatever Medicare doesn’t pay, you’ll promise to make up out of your own pocket. That’s how rich folks do it. We blame public servants who want more money for the work they provide and we now refuse them the right to strike or even collectively bargain but if a physician refuses to treat a patient solely on the basis of the money they will or will not get paid, everyone seems fine with that. I have yet to see a doctor move into my neighborhood because he could no longer make a living wage or even because he was busted down to my “living” wage, so I have no sympathy for them. Healthcare is expensive because no one in our society can control the costs of healthcare which are rising at a meteoric rate that is leaving the cost of living in its dust. Yes, having Medicare puts us at a disadvantage but only because we have gotten older which is the greatest disadvantage of all in a society that values material gain and wealth over wisdom, kindness and love.

    • G.P. – I have to say you didn’t do all of your research on this one. My regular insurance will take me back at the same rate I pay them at the present time (almost $900 a month) for premier coverage. That’s because I’ve never let them go and have no intention of ever letting them go. I believe that may be the smartest thing I’ve ever done in my lifetime so far. I wish I could say it were for the legislation which I had a hand in writing that made federal insurance plans pay for mental health at the same rate as they did for any other health care, but that’s not the smartest thing I ever did. The smartest thing I ever did was to hold on to what I had given up so much of my life for – my federal insurance plan. The parity insurance was really important but because the late Senator Kennedy was at the helm, the law would have passed anyway.
      I’m not sure what public servants you are talking about but as the Director of Operations of my own division in DC, my baseline employees were all union. I won’t say the union was always the easiest to deal with, but I learned the rules and followed them diligently. I hired and fired fairly and promoted from within wherever possible. However, with that being said, some union shops are just plain crooked and the American public needs to see some warm fuzzes from union leaders from time to time.
      You talk about doctors cutting their rates or accepting what Medicare will pay and I’ll pay the difference. That’s just it. We have 100% coverage if Medicare would just get out of the way. But, Medicare has to be billed first, always. If they deny, the other two insurance companies cannot pay. If Medicare would change a simple 2 letter code on how they adjudicate our claims, our other insurance would kick in and pay the amount billed.
      We have 2 physicians that haven’t received a penny from anyone since 2011, That’s right, since 2011. They simply tell us they like us and don’t want to turn us over to anyone that doesn’t know our medical history. I’d say we have doctor’s with heart, grit and love with perhaps a tad bit of wisdom thrown in for good measure.
      I hope you have a good doc or two on your side when you are looking Medicare in the face and realize you are not getting the best care possible.

  11. Patty B says:

    I am sharing your article in the hopes people read this. It breaks my heart knowing how hard Tom worked to provide for us and little by little I see it being stripped away from us. Granted he provided enough for me to live comfortably and pay off the house but if this keeps us I will loose everything we worked for. I keep hearing everyone should be treated equally, we should all be able to get free health care, etc…. but all I see is the working middle class, retirees and military families getting the shaft while everyone else reaps what we sow. As I look into the future I see me never retiring and working till the day I die or dependent on my children.

    • Patricia – You are right. Trricare takes on every hit that Medicare takes and sometimes more. Our retirement benefits are eroding before our eyes. The cost of living goes up every month while our hard earned promised benefits slide away. And the sticky part, unless we enroll in Medicare, we aren’t eligible for Tricare For LiFe.

      • Patty B says:

        My boss’s wife is finding the horrors of that right now. I have a way to go but sadly by time I get to that age I may have no choice but a Federally run program like ACA. I’m sure Social Security won’t be around by time I reach 65.

        • Patty – I believe both Medicare and Social Security will be around at least 30 years longer than expected if ‘government’ would allow those of us that don’t want to take part a chance to get out of the system. I earned the right to our BC/BS – and I pay 2/3 of the premium now that I am retired. The amount is a little over $900/mo. Then add in vision insurance and that’s another $30/month (we don’t need the vision insurance as Tom and I are both diabetic and my BC/BS covers as many medical visits as our eyes requires. (We pay the monthly premium because it provides a substantial amount towards a pair of new frames each year and a nice part of the lenses. It’s a darn good thing for me as I’ve had tons of vision problems since an auto accident in DC in 1995. On top of the amount I pay for our BC/BS we also pay another $100/mo rider to my federal rider for dental insurance. It’s a difficult policy but I’m grateful to have it. And, then, there’s the $140 or so the government takes out of our check each month for Medicare part B WHICH WE DON’T WANT AND HAVE NO SAY OVER. And, I might add, governs shoddy medical care. I can assure you, there’s nothing good going on in health care at the present time that will help any of the population – that is unless you want to talk about the poverty level and those that used to receive Medicaid. Now instead of Medicaid, thousands of those individuals now receive supplemental income from the very government we pay additional taxes to so they may have commercial insurance.

          • Patty B says:

            Tom and I were upset over that too. He had good coverage between Tricare and being retired from the state and the cost was cheaper to keep the state insurance. You would think it should be optional if you already have insurance. Now that I only have Tricare I am pleased with it. The only thing I do not have is eye care but with diabetes I am assuming Tri Care covers that part of it with my cost only going towards eye glasses. I just had close to a $10,000 bill from my biopsy and my out of pocket has only been around $500, so I can’t complain. Anyway the government has really screwed up medical care – which is what I have always said they would do. I know more about economics than these guys do and that doesn’t say much for them. I did get the info you sent, thanks I will pass it along.

            • Patty – Because the electronic medical record keeping is so bad (information going to wrong patient files, etc.) I question the biopsy you had to pay the deductible on. If the biopsy was as a result of your previous cancer, it could very well be argued as a wellness procedure and that $500 would be yours. Would your doctor have performed the procedure if you hadn’t already fought cancer before? Tricare has changed contractors so often, we cannot take anything for granted from them and I do mean nothing. They pay almost zero for Tom and I since I have the BC/BS but I’ve helped enough other people unscramble their Tricare claims to know that more often than not, they’ll bill the military member instead of checking to see if the claim was coded correctly.

              • Patty B says:

                interesting, I will give them a call next week and find out. I would think they would have done the biopsy anyway because it was an abnormal reading from the mammogram but it is worth checking into and if I can get my money back then it would be worth it. Thanks for letting me know.

  12. Gallivanta says:

    We have very limited medical insurance options in New Zealand. Most of us rely on a type of socialised medical system financed by our taxes to the Government. It works well enough. However choices and treatments can be limited and I can’t rely on a continuum of care. There are problems with this model of care but, to date, it has served me adequately. I would be stressed beyond belief trying to cope with all the medical insurance issues that people have to deal with in the US. You may be interested in this Wiki article http://en.wikipedia.org/wiki/Caregiver_syndrome . I was looking for clarification on something I read long ago which gave research details about the stress factors that cause a family caregiver to have a reduced lifespan compared to a non-caregiving cohort. The lifespan was reduced by 10 years. The Wiki article says 7 years but no citation is available.

    • Gallivanta, Thank you for stopping by for a chat. Not being able to count on continuum of care would drive me crazy. Sometimes I have to poke and prod for doctors to know I’m demanding an answer but sooner or later they seem to get the message. They do know I’m not going away. Many of my friends refuse to be assertive and I suggest they may be signing their own death certificate or for those they care about.
      Years ago I read that a caregiver lost 7 years from their normal lifespan and since then the number has been upped to 11 years. Thank you for sending the link from Wikipedia. I am a firm believer that the more sources I have on any given subject, the better the answer. I’ve been reading a great deal about maintaining my own balance and remembering to keep a balance in my life. Sometimes it’s hard and I believe having so many friends to communicate with on-line is a true blessing from God.

  13. It’s sad when we can’t get a decent professional… even some of the professionals listed as a “doctor” are really nurses. Best wishes to you. 🙂

    • Thanks so much for checking here and leaving your comment. I’m cautious and inquire to ensure we will not be seen by a PA or a nurse practitioner. It’s not that they know less than a doctor but if I’ve done my research on the physician, I demand the physician. However, on a positive point, it was a PA that advised us on a neurosurgeon for my husband’s spine surgery and he turned out to be the best in a multi-state area. He was absolutely brilliant and my husband has had no fall-out from that particular surgery.

  14. robertsonwrites says:

    Sheri, there is not even enough to say about this issue! I am sorry that you are struggling with finding a doctor.

  15. pilbra says:

    The same thing is happening here I experienced it today for the first time and was a bit angry

  16. This is a thought-provoking post. I suppose it is not sufficient for us to clarify where each one of us stand with regard to public health care support structures all over the world. We need to more deeply understand what is it that makes higher health care demands on the system as its ability to pay for the services diminishes? Clearly this is not a sustainable trend so how could we bring in ‘outside the box’ thinking here?


    • Shakti – I was immediately drawn to your question, “Clearly this is not a sustainable trend so how could we bring in ‘outside the box’ thinking here?” I took a little visit over to your blog and recognized immediately that you are a global thinker (the best kind of thinker as far as I’m concerned when seeking resolution to a chronic problem) and this one has been around forever.
      We have a trend going on in the US that’s plagued us forever and unless the attorney general’s office or the Inspector General’s office dig into the dirt of US contractors, the issue of paying too much for medical care will continue to haunt us. The ruthless contractors have made fortunes off the endless oversights’ of government. Contracting officials rarely (as in never) go back to the contractor and determine if the contract is being followed correctly!
      The United States Congress will not force a reevaluation of contractors due to the very contractors being the ones that paid the most towards the election of said congressional election.

  17. Thanks for the heads up, Sheri. My introduction to Medicare is just around the corner.

    • Hello, John: It’s nice to see you here. My suggestion – make sure you have the docs you want to continue to see lined up before you reach that wonderful Medicare age. That one thing is the best you can do for yourself. I suggest to everyone that they should have already established a base line relationship with: cardiologist, gastro, endocrinologist, urologist, psychiatrist and of course your regular provider of care. Juggling Medicare is not for the faint of heart.

      • I was fortunate (blessed) to learn, December a year ago, that I was eligible for VA Health Care because I am a Vietnam vet (wasn’t eliminated because of the household-income test). Since I entered the VA system last Feb., I have been wonderfully cared for by the VA docs and specialists. I think the only difference is that Medicare will have to pay the VA. We have a VA clinic here in Athens and a VA hospital an hour away, so it’s all very convenient.

        • John: You are indeed lucky that your VA has taken you under their wing (sort of to speak). Tom falls under the Vietnam era also plus 20 year veteran. Medicare does not reimburse VA for medical care. One government entity cannot be forced to pay another government entity or reimburse them in any way when the rules governing the expense are mandated by legislation.
          One thing we learned too late is that each time you go to the VA is that you are entitled to travel reimbursement. They don’t reimbursement for earlier trips you made but if you aren’t already submitting miles, you might want to consider starting.

  18. ksbeth says:

    this is really upsetting, sheri. thank you for shedding a bit of light on an issue that i don’t know much about. it is so wrong in so many ways.

  19. Name anything the government has improved.

    • David – It’s sad to say but I can’t think of a darn thing. I received a call from a Viet Nam veteran today asking me what he should do. He had gone to the VA seeking care and because he’s just turned 65, they told him to seek care in the civilian community. If he didn’t want to do that, it would be 18 months before they could schedule him an appointment. He still has enemy fire in his leg and lower back. I don’t know about you, but I don’t really think that came from crossing the street in Conway!

  20. jbw0123 says:

    I so hear you. I’m married to a physician (anesthesiologist, also trained as an internist and double boarded). Faced with the crazy 12 balls in the air life of a general practitioner, my husband opted for a specialty instead. I think it was partly also because operating all those machines makes him feel like an airplane pilot. Anyway, back to your point about internists: a huge percentage of internists say they regret going into medicine. Deservedly so. They do the hardest jobs, get paid the least, often finish medical school more than $150,000 in debt. We live in a country where the rational thing, as opposed to the right thing, is to go into a high-paying specialty, where you control your schedule and do the least work. Bass-ackwards.

    Our state (Oregon) got off to a good start this year, putting together a system of care teams for better communication, followup and preventive care, but then the (private) contractor hired to do the website blew it. We will have to wait and see.

    Someone above wrote about commonsense Canadian care, which is a ray of hope. We are just as human as Canadians and thus hypothetically as capable of setting up a system that works better. It doesn’t matter to me what kind of system, government, private, whatever — but it has to be based on a common agreement that medicine is first and foremost to help prevent illness, and to help people when they get sick, not first and foremost a way to get your pot ‘o gold.

    I am sickened and saddened to hear about your difficulties finding good care. May the new year bring you a good physician, who listens, and puts you first.

    • Julie – You sing my song and have the inside track on the other side of our medical care. I looked at a Medicare Statement of adjudicated claims that came in yesterday. All on one listing was billing for an internist visit (he’s listed as the best in a 7 state area and I have no idea how I got so lucky). The others were for my neurologist, endocrinologist, eye surgeon, and gastro.) Yes, I recognize that’s a lot of specialist but those guys keep me ticking and feeling more or less alive most of the time. Each of the specialist received a minimum of $100 more than my internist and he’s the one that steered me to each of them when he suspected a particular issue that could turn into a life-threatening concern.
      Each of the specialist rank at the very top in their chosen specialties and it was the very reason I asked him for a name to replace the doctor that retired on me.
      I’m against socialized medicine in every sense of the word. I do not want someone else telling me when I can or cannot have something and who will or will not perform the service. Perhaps that has to do with my years of investigating white collar crime within the medical arena and medical malpractice.
      When Medicare first came along, the government didn’t have a say when it came to how or what treatment a patient received. They did not tell doctors how to care for their patients.
      Bean counters with Medicare sent me home from the hospital early in Oct. 2012 with less than 1/2 of my blood, a hospital acquired infection, a right arm and hand that I couldn’t move and the list goes on. As a result of that early dismissal, Medicare has paid $47,000+ in additional care that I would never have had to go through had they listened to the surgeon.
      My now secondary insurance, BC/BS – although I pay for full coverage, said that if law allowed them, they would have automatically approved an additional 12 days and would never have allowed me home with less than 1/2 my blood and MRSA being actively treated. The chief claims adjuster told me, when I was discharged from the hospital, I was too ill to be transported to skilled nursing care. I didn’t want to go there but what they did do was send me home to a husband that was too ill to take care of me.
      It was my internist that was left with a broken women that’s slowly being but back together.
      A fun thing that happened just before I went under with the anesthesia was the ring tone for the anesthesiologist went off and it was the theme to The Black Ranger. It still brings a smile to my face today. I consider it the primary terrific experience that came out of that 6 hours on the table. Please, toast your husband on my behalf.

  21. treyzguy says:

    I think I learned more than I wanted too….
    But be careful what you blog.
    The Ministry of Truth will charge you with Thought Crime…..

  22. Oh, dear. Sheri, your posts usually leave me fired up, but I’m afraid that this one has left me in a puddle of despair (or did I leak a little?). My mother was just forced into retirement (i.e. laid off at the age of 66…and BEFORE Christmas) and is signing up for Medicare for the first time. She’s also moving across the state this year so that she can be closer to me.

    I was excited for her prospects because we live in a city much larger than hers; one that offers significantly better access to medical care, including a medical school and a top-notch cancer center. Of course, I’m in Florida, so it’s difficult for any doctor who wants to earn a dime to refuse Medicare patients, but, more so in places like Sarasota, Palm Beach, or Naples. Our city has a slightly younger population than the likes of Naples, where it’s said that the dust in the streets isn’t dust, but ashes. I certainly hope that my poor mother doesn’t encounter the types of problems that you have – particularly, it seems, with specialists. She suffers from a number of disease states, each of which requires at least one specialist.

    So while I loved your well-written, informative and interesting post, as always, I hope to report back to you in the future with positive news about my mother’s experience with Medicare. It would break my heart if she has to settle for substandard care or can’t see the doctors she needs for treatment. I have prepared her to accept that she may have to take more generic prescriptions; the fact that she’ll have to change half of her meds is beyond frustrating to us both. I wonder if there is a legal basis for a lawsuit against Medicare based on age discrimination? Why are people being discriminated against by being forced to change medications and doctors based on their age? This is the time in their life when they need the best medical care, not the worst. Medicare should be a reward for surviving long enough to qualify for it.

    Is it possible that this is a regional thing in your area? It seems like every town or city has a personal battle going on with at least one insurance provider, at any given time. In Sarasota, it was Blue Cross Blue Shield, who wouldn’t pay some of Sarasota Memorial Hospital’s charges, so all the doctors affiliated with the hospital stopped accepting BCBS for a few years. Lawsuit and everything.

    • Yes, yes indeed I so hope you have a positive experience to report regarding your Mother. My latest statistics from last night: 87% of all general practitioners across the entire US no longer accept Medicare, Medicaid or Tricare. An additional 42% of all practitioners will not accept Obama care. I’ve explained these numbers a bit more in my response to Florence’s comment below. Let’s hope Florida helped keep the numbers down some and your mom will have smooth sailing.
      An issue you raised that really gets me going is the forced retirement of your Mother. As long as someone still functions at an acceptable level (according to their written performance plan) and they want to continue to work, then there’s not an issue. On the other hand, if the individual simply is afraid of staying home alone all day and their work is their social interaction, then by all means, retirement is the direction to go.
      The real monkey about Medicare is that if you want to draw your Social Security, you must also accept Medicare. Here’s where I was hit by my very own stupid stick.
      My federal retirement is off-set by social security and I paid into both my entire career. It always aggravated me that I had to pay the maximum into social security as I knew I would never collect it (at least that’s what I was told).
      When an individual turns 65 they are enrolled in Medicare Part A automatically. The government does it for you. (How’s that for freedom of choice)?
      Before age 65, Tom and I had 100% coverage and premier care. I kept my Federal BC/BS although I had to pay more for it and doctors and other providers loved to see us coming. However, neither one of us wanted to seek medical care, it just happened that way. They also have no cap on care and I saw that as a plus.
      Tom is retired military and is entitled to Tricare for Life. I believe any man or woman who gave the prime of their life to the fight for the freedom of this country and did so during war time is more than deserving for whatever they can get out of Tricare (and trust me, it’s very little). If we hadn’t had BC/BS we would both be dead by now.
      The fact that you live in a city with a medical school will give you access to doctors and ancillary care that otherwise might not have been available in other circumstances. Often that’s where you’ll find your premier care.
      Generic prescriptions are always a problem and if your mother is forced into a mail-order situation, it will only be worse. I have a planned post coming up (haven’t finished my research). Medicare is being robbed blind over and over by the middle-man involved in pharmaceuticals. Generics are often never tested for FDA approval. They are automatically accepted and stamped approved. They are only tested in 3rd world countries and there’s no way the bodies of those individuals could be in the shape our bodies are when they actually receive the medication (placebo or actual drug). Maybe their bodies are better all along. Anyway, that’s not a reliable test and they are not questioned. The medication simply goes on the market. Plus they receive a nice payment for the drug test.
      If your mother has to select a prescription plan and has no other choice, if at all possible, find an independent community pharmacy (Stay away from the big box stores at all cost whenever possible). Make an appointment to have a sit down with him and ask if there’s anyway he can help you around the generic and mail order situation. Depending on the number and cost of prescriptions, your Mom will hit the hole where she has to start paying for her meds until the end of the year.
      I don’t believe problems are regional. We may see different patterns emerge in different areas and they all add up to socialized medicine.
      Thanks for stopping in. Have you noticed, you are now listed as a blog I follow!

      • No, I hadn’t noticed that. Thank you, Sheri!

        I had no idea that so many doctors had dropped Medicare. Wow. Crazy numbers. Perhaps it is better in Florida for seniors.

        Thanks for letting me know about automatic enrollment in Medicare. I didn’t know that either.

        Yes, generics concern me, too. I wrote an article about them years ago for a Florida magazine, shortly after I’d stopped working for one of the biggest pharmaceutical companies in the world. At the time I wrote the article, the active ingredient(s) in any generic could be up to 11% more than the patented medication or up to 11% less. That’s a range of 22%. I’m not comfortable with having 10% of my medicine missing.

        My mother and I both suffer from hypothyroidism. As you know, it’s so important for those with thyroid problems to avoid generic thyroid medication because the smallest variation in dosage can dramatically affect a person’s health. Same goes for many other medications, including those to treat cardiac disease, high blood pressure, mental illness, prostate enlargement, etc. My mother’s thyroid has been such a challenge to control that I will pay out-of-pocket each month for her Synthroid if I have to.

        We may have to disagree when it comes to socialized medicine; I understand your frustration with the application of the system, but I still think it has potential to help a lot more people than it harms, specifically, people who wouldn’t have had sufficient access to healthcare any other way.

        I believe the part of the current problem is that we’re trying to convert from a free market medical system to a more socialized model. The UK launched socialized medicine immediately after the war, before insurance companies and corporations became so involved in our medical care. It was easier to convert a country with no consistent medical care, nor method by which to pay for said medical care, recovering from a catastrophic war, to socialized medicine because it had few opponents by comparison.

        I’ve heard good and bad things about the UK’s medical system. For example, The Telegraph recently reported a study that claims that NHS hospital patients were 45% more likely to die than similar patients in US hospitals. That figure is terrifying. However, many of my British friends don’t seem to have any complaints. What I do know is that what we have isn’t working, so we have to be open to trying and improving other models since we can’t seem to manage the growing cost of healthcare any other way. Interestingly, as of 2013, the people of the United Kingdom live longer than people in the U.S., so there’s that. The French, who also have socialized medicine, live almost 2.5 years longer than we do, ranking 13th in the world for longevity vs. the US at number 35.

        • I didn’t know about being automatically enrolled in Medicare for hospital care when you turn 65 until I received a card in the mail announcing I was enrolled. I went to the local social security office and advised them I didn’t want Medicare and was told, “It doesn’t matter, you have it anyway.” You can imagine how well that went over with me! After all, I already had 100% coverage. Why did I need Medicare to pull me into a lower level of medical care.
          You are so right to be concerned about generic medications. Millions of Americans every year take them and millions of Americans die as a result. Thankfully, we have a wonderful relationship with our community pharmacist and he knows we do not accept generics and he’s able to work miracles. We don’t take generics on issues that matter the most.
          A primary example for me is Maxalt – XL. After my two serious traumatic brain injuries while working for the government in DC, Maxalt was one of the few drugs that would help my migraines. Just this past year they went generic. I refused to accept them and my pharmacist intervened and I still receive the brand name.
          Tom had all kinds of thyroid problems (perhaps caused by synthetic thyroid medications). We came very close to losing him before the internist had a huge discussion with our insurance company and generics are no longer allowed.
          I’ve discovered the best way for us to protect our health is in forming that personal relationship with our community pharmacist and unless legislation is passed to stop some of the brutally underhanded decisions being made to put them out of business, we will no longer have a community pharmacist on our side to protect us.
          Regarding our disagreement for socialized medicine. I believe for those of us that have already established our own health care protection, leave us alone.
          For that vast number of the poor you refer to, I agree they need availability of medical care. What we have since the implication of the Obama care is Medicaid falling away from the state’s responsibility. The individuals enroll in one of the available Obama care programs and because they meet poverty guidelines, the government aids or pays their premiums in its entirety. Actually this is better than the Medicaid that was in place before Obama care. I’m in favor of this program only because it takes the burden off the states and shifts it to the federal government.
          You state, “. . . I still think it has the potential to help a lot more people than it harms, specifically, people who wouldn’t have had sufficient access to healthcare any other way.”
          I’ll give you that the system may help the poor but in the process it will destroy the ‘used to be middle class and those of us that planned from the beginning of the best way to care for our own needs and didn’t ask for handouts from anyone.’
          I haven’t heard enough positive facts about socialized medicine in the countries that I’ve lived and worked in to truly believe every medical provider or patient receiving care is satisfied about their method of receiving care.
          You are correct, what we currently have is not working. I’m not convinced it’s bad medicine that’s killing us earlier than many other countries. I believe our life-style has more to do with the decline of our life span. We sit with our computer’s 12-14 hours per day, grab food that’s not healthy and eat it on the run, stay plugged in far too long to far too many devises, don’t reach out to friends nearly often enough, don’t take the time to hug our children and pets or even exercise. The list goes on and on.
          I’m also convinced stress kills more of us than any other single factor. I have nothing to back up that claim. It’s simply an observation.

          • But don’t you think the people in the UK and France, for example, are just as plugged-in, stressed out, etc. as we are? After all, the British eat four times a day and consume quite a bit of caffeine. And the sun hasn’t shined there since 1957. Likewise, the French dip their brie in melted butter with one hand, while smoking with the other. I haven’t been to France, but I have been to London, and the pace there was as frenetic as any major U.S. city I’ve visited.

            That said, I think the British people’s fondness of ensuring that a fresh pint is never further than a block or two away probably encourages both walking, socialization and relaxation – all of which are proven to increase longevity. Now if I could just figure out how to get around the unhealthy consequences of drinking many said pints, each and every day. LOL

            If I have to disagree with someone on the potential of socialized medicine, I can’t imagine anyone else I’d rather do it with. At least you’re not screaming that Obamacare is the devil; I can’t say that for everyone I know – and you make well-reasoned arguments, to boot. Keep talking…you may just change my mind one day. 🙂 But I’m not showing my mom that Medicare post. I’m afraid I’d scare her to death. 😉 However, I will keep reading. xo MSP

  23. I thought this is what movies are made from but not that this information is so staggeringly brutal. Mind-boggling. In Canada, so far, my mother received therapy after being rear-ended (lots of it), plus massage and acupuncture. Later, when she didn’t feel right she arrived at the Emergency Dept. at the hospital, several times in the middle of the night. They couldn’t find what the problem was. Finally, when she’d had too much pain, she refused to leave the hospital until an in-depth investigation was made. They found cancer. She continued to get good care.
    What a different story from Medicare etc. Sorry, it’s so hard for patients on the other side of our border.

    • Tess: No one likes to talk about Medicare and its many problems. Most individuals have never had premier insurance (such as Tom and I have been fortunate to experience) and don’t recognize they are being short-shifted. Our country is moving more and more toward socialized medicine every day and those of us that are accustomed to freedom of choice are pointing out the inadequate care being presented. Myself and many others do not want socialized medicine in any form. We had the best of the best medical care with 100% coverage to include pharmacy and all the ancillary provisions.
      Frankly, because I worked white-collar crime for so long, I’m sick and tired of the whole mess. This is just as painful, if not more so, than when I was shot in the back (and that was not a pleasant experience)! When my freedom of choice is compromised, I’m ready to fight back.

      • What a ridiculous state of affairs. I cannot imagine that. Every day I live in fear our now autocratic leaders will force a new healthcare system which doesn’t work as well as the one we currently have.

        • Tess: You write so well and know what you want for a healthcare system. You certainly don’t want what we have (at least I don’t think you do). It’s never too late to become an advocate for what you and your doctors, etc. want.

          • We can only hope our wonderful leader doesn’t take things into his own hands as he has been doing and making an announcement once it’s a done deal. He’s crafty and unrepentant. For instance, our veterans are treated like the worlds unwashed and unwanted. They’ve had so many benefits taken away from them. See what I mean?

  24. Sheri, you have my ear and you can bite it off if you wish. Yes, I agree with what you say about government programs. Let the government run anything and they will likely mess up. It’s the way of our world.

    However, I don’t think medicare or medicaid for the poor make doctors run screaming. The programs themselves are not at the bottom of what’s wrong. What’s wrong with our medical is what has always been wrong about social services. Too many abuses, not enough common sense. Welfare was being abused so instead of fixing it, they destroyed it, so that now truly poor folks get shit and the little ones being pushed out by the dozen still end up collecting. Not to mention that disability and SSI have become what we called in social services … the “new” welfare.

    IF AND I DO MEAN IF … doctors, hospitals and private health care facilities did not BILK the system with fraudulent billing, excess billing, blatant miss handling and misuse of government funds … the system might have had a fighting chance to work.

    Now on top of all of that people are being forced into more NOT LESS medical programs and the root of the problem has never been addressed. BILLIONS each year are lost each year from crooked doctors and hospitals. Why in the hospital should one Bayer cost TEN DOLLARS … why the minute you walk in the door of 95% of all medical facilities are you at risk for staff infections, misdiagnosis and a host of other incompetence??

    What we do with social programs and government funded medical programs is equal to throwing the baby out with the bath water. We can’t seem to do anything else in this country but start wars that no one ever wins. BTW … if our medical and military were working why am I being bombarded daily and nightly with the Wounded Warriors Program ??? Why on earth can’t we take care of our own with the billions allocated? Because those who get those billions mis-handle them.

    And that’s my opinion 🙂

    • Florence – I so appreciate you bringing forth issues that must be addressed in today’s commentary.
      It’s a given, country-wide, 87% of all general practitioners no longer accept Medicare, Medicaid or Tricare. As of research presented last night, 42% of medical care providers are not accepting any of the so called ‘shelf-package’ programs Obama care forced people into wherein the same individuals had insurance before Obama care became law. Can you imagine taking your child in for an appointment with their regular pediatrician due to chronic ear infection or some other situation that needs attention and as a prudent use of health care dollars, you elect not to take your child to the ER during the night. You reach the reception desk with your crying child, the one in pain along with perhaps two other children because you don’t have the funds or anyone else to watch your other children. You’ve been up all night with your sick child and you’ve run out of ideas to help your child.
      At the reception desk you are told they have been unable to verify your new insurance plan and therefore will have to pay cash for the appointment. The doctor will bill your new ‘Obama care platform insurance’ for reimbursement and if the payment arrives, they will write a check for your share.
      The mother has $15.00 and still must buy gas and groceries.
      From different circumstances I know these sick in the gut hopeless feelings. How can I help my baby when I don’t know how to help myself. The same is true when I hold Tom in my arms and he’s going into a psychotic break and some resident tells me all they can do is shoot him full of drugs.
      I’ve been that young mother and I’m also the wife of Tom. During my career with the government I did everything I could for our country to include: working 80 hour plus weeks to ensure the very villains you refer to were removed from our society and sent to federal prison. No one really cared about prosecuting them in the 1980s and 90’s but now they do. The swindlers are currently being prosecuted, convicted and sent to federal prison. I cheer each time a report arrives of how many are being put away each week.
      Thankfully, I can still secure the health care I need for Tom but it’s at no thanks to Medicare. We both have chronic medical problems and some days I simply don’t feel like fighting.
      You speak of the Wounded Warrior Project. Actually that’s one of the few premier programs workings and that’s because it’s veteran driven. We should hear about every Veteran program until the end of time due to only 1% of the eligible population base offered to serve and they, our veterans, are the ones along with their families, that have paid the highest price of all.
      Thank you for your always thought provoking comments.

      • Damn, I love this dialogue. I can’t tell anyone else what to feel or how to “write” but you need to put these into a book for everyone who isn’t lucky enough to read your blog to see. That is a book waiting to be written 🙂

        • Florence, Thank you for your kind words. And, yes, you know how hard it is to gather this information and have it printed in a book format, even an e-book format. Even if the book is available, it’s been my experience that many individuals still entering into the Medicare and other government programs refuse to read the literature before they sign up for the policies that don’t work and what the ramifications will be.
          One of the main reasons I love sharing commentary with you is that we can do it in such a way that we allow each other to do so and still remain friends and allow the other to have their own opinion. We are not veneers of one another. Who wants a friend that’s nothing more than a carbon copy of their own beliefs.
          In working on my WIP, I set a scene that actually took place during an investigation of Medicaid fraud. I may turn that into a blog someday as I’ve cut the scene due to word count and the story doesn’t lose anything when it’s cut out.
          Keep those challenging questions coming. I’m invited to take part in a round table forum of legislators at the federal level along with top officials at NIH, NAMI, the Dept of Ag as they control the food stamp program and the list goes on.
          Please don’t ever stop your way of digging into what you see as unjust. I want to hear everything you have to say. I’ll be able to take these issues to the table each and every month. You are well informed and I honor your thoughts because you don’t hold back.
          Is it possible to send me an e-mail. When my hard drive sank, there went all of my e-mail addresses. The address that seems to be the most stable for me at the current time is sdegrom@conwaycorp.net. Thanks a bunch.

  25. I always learn so much when reading your posts, Sheri, and I know this information will help me as I navigate the miasma of Medicare laws when the time comes.
    Thank you.

    • Patricia: I hate to say this, but now is the time to start looking at your options for medical care once your husband retires. I’m assuming your health insurance is through your husband’s employment. If that’s the case, is their a clause where the insurance will be available for the two of you after he retires (although you would more than likely have to pay more for it than you currently do now). That is the best it will ever get. If the employer based insurance does not continue, you will be tossed into the Medicare ring with millions of others wherein Medicare is primary (just like everyone else – and you’ll be forced to sign up for it if you wish to collect social security). Hopefully your husband’s insurance will continue to be an option and they would be your safety net for deductibles and the primary pay for all prescriptions you might take. Prescriptions might not mean much to you now, but if Tom and I had to pay out of pocket for our prescriptions out of pocket, last year alone we would have paid a little over $65,000. The way it was, we paid a little over $4,000. For me, that more than justifies what I have to continue to pay for my Federal Blue Cross/Blue Shield.
      I know this seems so unnecessary when you are young and healthy, but there are so many issues to think about. If you plan to retire in the location where you currently live, now is the time to start the discussion with your husband. None of us like to think about this stuff but it’s more necessary than ever. Some day it won’t be our future, it will be our present day life and then it’s too late to think about any of it. I don’t want you to be in that place.

  26. words4jp says:

    I agree with gpcox. This is scary. I seen and heard if all of these incidents and examples you have stated. It sickens me. I have awhile till I get to the big M, and I am not looking forward to it. Insurance sickens me – the healthcare system sickens me.

    • I cannot advise on what might be the best plan of action be for you, but as I mentioned in my response to G.P., now is the time to line up physicians that will hopefully follow you into a healthy retirement. Attempt to make at least one and better yet, two of your physicians your (almost friends). You’ll encounter some doctors who are more willing to chat and answer questions than others. Our paradigm of medical care is changing rapidly and we as consumers must stay in the drivers seat if we want adequate care. We can’t wait and just let ‘it’ happen to us. We all must stand up collectively and fight for what is rightfully ours.

  27. gpcox says:

    This is scary information, especially since I go on Medicare next year. [off topic – almost emailed you yesterday, how are you and Tom doing?]

    • Hi, GP – Go ahead and e-mail away. With my hard drive being down since 22 Dec, I now go from the most recent incoming message and attempt to work my way down through the remaining 45,000+ or so.
      A word of warning about Medicare – ensure all of your physicians are young (specialist your specialist) and that they want to stick around your area for a good long time. If you don’t have specialist in the major arenas such as heart, gastro, endo, etc., my suggestion is that you make appointments for base line evaluations. That way, you will have become a patient of that physician and when the appointment screener ask if the doctor has seen you before, you may truthfully answer yes. The reason I experienced the situation I did was because my specialist retired years before the expected age (with his own medical issues). Often we cannot do enough to protect ourselves and those we love.

  28. It’s a sad state the medial care for our elderly & disabled. My husband Vinny has been receiving Social Security Disability now since 2004 after an injury at work that he sustained. He was put on pain pills & sent back to work. At the time, Charlotte Sanitation ran 1-man garbage trucks. Vinny would drive, stop, get out & dump all the cans, get back in, repeat. After two months of working on pain pills, he got out & lifted a can and felt something pop. Refusing to give him an MRI, they put him through four weeks of therapy & more pain pills and sent him back to work. After working for six months, he woke up at 3:30 a.m. to get ready for work & couldn’t get out of bed. He had no feeling on his entire left side of his body. The disc that had ruptured had cut through the nerve damaging it permanently. Three back surgeries, years of therapy, thousands of meds later & what we’re left with is the shadow of a life we once knew. Everything downsized but the pain & bills. Now we struggle to meet his medical bills that average around $700.00 a month doctors & meds. All because we can’t find a pain management doctor in the area who will accept Medicare. You & Tom have been such a pillar to the others who you’ve opened up to & shared your heart & life with on your blog. Through your posts, I can see that true love can endure anything. I read your posts & find strength in them, Sheri. & for that our friend, I’m truly grateful. We will be praying for you & him that God watches over both of you & grants you peace beyond all understanding & relief!! 😀

    • How I wish I’d known you then. Now is wonderful but the city of Charlotte is responsible for so many wrongs here and it now affects every day of your life.
      The city broke many federal workplace laws. It’s against the law to have an employee working while taking pain pills in a position such as Vinny’s. Had he slipped a gear, failed to stop at a stop sign or any number of other things due to his inability to think fast enough, the city would have huge liability issues. Additionally, because I investigated so many situations where improper care and a host of other issues were in place, you had a darn good case against the city for lifetime disability instead of going with SS and ending up with limited income and practically no medical care. Federal laws are in place for cases such as this and unfortunately few individuals know about them and fewer attorneys will tell you about them because they are long and drug-out.
      In a previous reply to another comment I left you, I asked about the possibility of hooking up with a medical school. If that were a possibility they normally cover all medical expenses including those not related to the disease they are studying as well as pay for mileage and hotels, etc.
      Prayers are coming your way. How we wish you both relief from the pain and the horrors of the insurance system and medical providers that are not working for you. Sheri

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