ARRRGGGGGHHHHHHH!!! HMO's SUCK!!!

[WhatMoney]

They said he needed to be admitted to the hospital but THERE WAS NOTHING THEY COULD DO FOR HIM THERE BECAUSE HE DID NOT HAVE A MEDICARE DOCTOR ASSIGNED TO HIM.
The reason he did not have a Medicare doctor assigned to him was because NO DOCTOR IN HIS TOWN WOULD TAKE ON A MEDICARE PATIENT because it takes too long for them to get paid.

I've never heard of a town or hospital that would not have at least one doctor that would accept Medicare. What part of outer Podunk did your brother-in-law live?

A "Medicare doctor" is simply any primary care physician who accepts Medicare insurance. These are usually Family Care, Internal Medicine, or GP doctors, and in most areas about 70% of all PCP's have and accept new Medicare patients - basically anyone who is 65 or older. Also hospitals have staff doctors and residents who accept Medicare and temporarily will take Medicare insurance patients for admission who do not have a PCP. So your story is unusual to say the least.

There must have been only 2 doctors in town, and the one taking medicare left, leaving the entire senior population with no doctors? Possible in some very remote rural areas of the country I suppose this could happen, since doctors can make more money working in larger cities, so avoid poor rural areas.

But that still would not explain why the hospital would not admit an emergency patient using a hospital staff physician to sign the admission papers, and bill Medicare. There is something you have left out of this story.

The claim that Medicare "takes too long to pay" is just BS. Medicare in fact pays up faster than most private insurance companies, and seldom challenges the doctor's decisions, unlike the private (HMO) companies. Medicare is one of the more efficient medical insurance programs in the country, and horrors, it's even run by the government. I expect you and most here are not over 65, and so have little direct knowledge of this government program.

I've been dealing with Medicare for the last 10 years, for both my parents, myself, and several others. It's an insurance system that works fine for most, despite the Bush administration's attempt to privatize (read screw it up and make it more expensive) standard Medicare.

[Bandit]

I've never heard of a town or hospital that would not have at least one doctor that would accept Medicare.

They do not want to take medicare & I am not sure why unless it is because medicare does not pay or they cannot screw medicare like they do with other insurance. I know someone here who has medicare & is still looking for someone who will take him so he can get some of his teeth fixed. I think people do have a hard time trying to find that one doctor who will take them in.

[AMISLANDER]

I hope I die before I get old......I have PPO, no major issues yet...but the medical care does not look promising in my opinion...My xhusband is a physician and his words of advice," if it's not broken, don't fix it...hospitals and doctor's offices are full of disease & germs, stay away as much as possible."

[Bandit]

Is this acceptable for one of the richest and most powerful countries in the world?

I am starting to wonder about that though because going back a couple of decades ago after Russia had it's heyday of being the most powerful in the world, when communism & poverty took hold, where the lines went on for blocks in feezing cold weather trying to get some food and medicine. They were too busy trying to force communism/atheism on everyone instead of caring for the people.

I know the U.S. is not nearly as bad as that but it could happen very easy. yet when I see the headlines & current political debates...we have way bigger problems than we did a decade ago.

The United States is the only wealthy, industrialized nation that does not have a universal health care system.[1] The government directly covers a little over one-quarter of the population[16] through health care programs for the elderly, disabled, military service families and veterans, children, and some of the poor.

http://en.wikipedia.org/wiki/Universal_health_care

Later it reads that Mass. & San Fran. have started their own universal health care last year...

I wonder how that is going?

[Bandit]

I hope I die before I get old......I have PPO, no major issues yet...but the medical care does not look promising in my opinion...My xhusband is a physician and his words of advice," if it's not broken, don't fix it...hospitals and doctor's offices are full of disease & germs, stay away as much as possible."

I kind of hope I die as well before I get too old or have to suffer all the time.

I hear that the disease, bacteria & germs inside of doctors offices & hosptials are a different strain and much more powerful than your typical infections that people get.
I still don't fully understand that yet.

I am starting to wonder if I did not pick up something from that extra clean hospital surgery (maybe & maybe not) because I have been constantly ill with things that I find hard to describe.

[PaKettle]

I've never heard of a town or hospital that would not have at least one doctor that would accept Medicare. What part of outer Podunk did your brother-in-law live?

Not that rural at all. It's a midwestern town of about 30-40k people. There are at least 10 doctors in town, but none will accept NEW Medicare patients. My brother in law did not realize that they would not accept him into the hospital without the approval of a Medicare "sponsor" doctor, I'm sure, or he'd have found one in the closest city.

A "Medicare doctor" is simply any primary care physician who accepts Medicare insurance. These are usually Family Care, Internal Medicine, or GP doctors, and in most areas about 70% of all PCP's have and accept new Medicare patients - basically anyone who is 65 or older. Also hospitals have staff doctors and residents who accept Medicare and temporarily will take Medicare insurance patients for admission who do not have a PCP. So your story is unusual to say the least.

There must have been only 2 doctors in town, and the one taking medicare left, leaving the entire senior population with no doctors? Possible in some very remote rural areas of the country I suppose this could happen, since doctors can make more money working in larger cities, so avoid poor rural areas.

But that still would not explain why the hospital would not admit an emergency patient using a hospital staff physician to sign the admission papers, and bill Medicare. There is something you have left out of this story.

I cannot say for sure, as I do not live where my brother in law lived and I am only getting the story from my sister and mom. But it seems logical that since my brother in law had a serious illness they would not have allowed him to go without a "family doctor" unless they had to, and I assure you they would not have been paying for one "out of pocket" as they did, unless they had to because they could not find one to accept him as a Medicare patient. That part I am sure of, as they were dirt poor.

The claim that Medicare "takes too long to pay" is just BS. Medicare in fact pays up faster than most private insurance companies, and seldom challenges the doctor's decisions, unlike the private (HMO) companies.

Again, I only know what I was told and my mother and sister have no reason to lie to me about this. The doctors in town have been quoted as saying this is why they won't take new Medicare patients. For whatever reason it is, there should be some kind of law to account for people who NEED a Medicare doctor in a case like this, when the person's doctor has left town and there is no one in town willing to take a new Medicare patient. For WHATEVER reason. Don't doctors take a "Hippocratic Oath" that puts care of the patient above something as low on the scale as money? "To keep the good of the patient as the highest priority" is the exact phrase, I believe. Yet people are turned down at hospitals and sent to other far-away hospitals for lack of money? Okay, send them to another hospital but only AFTER you've treated their emergency condition!

Medicare is one of the more efficient medical insurance programs in the country, and horrors, it's even run by the government. I expect you and most here are not over 65, and so have little direct knowledge of this government program.

I've been dealing with Medicare for the last 10 years, for both my parents, myself, and several others. It's an insurance system that works fine for most, despite the Bush administration's attempt to privatize (read screw it up and make it more expensive) standard Medicare.

I agree that the government CAN run a good medical system if they put their energy and [our] money into it. However, it seems from this story and from others I have heard that there are people who do fall through the gaps and this is something that needs attention.

I started out talking about HMO's and then I got side-tracked onto Medicare due to a comment someone made that reminded me of my brother-in-law's situation.

But both my story and my brother-in-law's death point to the same problem: a lack of good health care in this country.

Again, people say to me, "Would you live in some 3rd world country and deal with their health care?" The answer is "Yes! Absolutely!" There are definitely many 3rd World (Okay, "Developing or "2nd Word" countries is more what I mean) countries that have much better health care than we do! Especially if you can afford to go to "private" doctors and hospitals which are still about 1/5 the price of what we pay here.

[bmcmull]

What you do not what is socialized health care. I do not need anybody managing my health care for me. What we need is for the laws to be re written getting the lobyist out of washington that work on these medical bills. It is the insurance companies and the drug companies that need to be brought under control. I thought my money management was bad check out the federal budget. Give me more of my money and allow me to negotiate my own medical cost. If one DR is too much use someone else. And when I do get the bill then let the insurance company pay thier part after I negotiate where I go and who I see.

[bmcmull]

also understand the termonology new patients, maybe they are over booked as it is. I had to wait almost 6 months to get the pediatrition I wanted for my daughters. Not because they wouldnt take the ins. but because they where not accepting new patients.

[robivi3]

Bandit, you said it. The problem was compounded by Insurance companies. My grandmother once said that she got an appendix removed for around $50 bucks. It was alot of money but you could work deals. More bucks has raised prices, just putting it simply. The same with student loans, the loans opened a whole new way to run up the cost. And I do understand about getting hooked into the State Run systems. It is all catch 22, if one of my family is sick I would go through anything to save them, that is reality.

Ideals are one thing but when someone is sick in the family and you gripe, it's a free pass and i wouldn't blame anyone for what they do to save someone. I remember when my son converted to Judaism (age 15 after reading the Christain Book "The Case for Christ"), some in our Church tried to "reach out", some shunned him because obviously his appearance changed. My wife sort of flipped as did I. Most told us to burn his books and tell him to leave when he is of age. Yeah, right bro, until it's your kid. They treated him like he had a frikking addiction. Not one other problem with this kid, he had been the backbone of the Church and frankly the pastor once said "we just miss him because he was so supportive to the youth ministry". And he was, he is a loving person. But he is also extremely intellectual and wrestles with any thought somewhat deeply for lack of a better way of saying it (he speaks seven languages fluently, no joke). The Pastor, much to his credit never once suggested burning books or throwing him out, he isn't like that. My point is to raise him so that ten years down the road his wife doesn't come and say "he can't pay the rent". That is why ven though he goes to a Rabbinnical College we support him, pay his airfare, love him, talk to him and send the frigging $$$$$ every week. His soul is between him and God, not us and God. My wife now sees my point, he has a plan and that is fine. I won't have to support him.

My point is that it is easy for me to preach what I preach, I have it pretty good. I know that. Those people who wanted to "throw him out" were all younger than me (the old folks with kids grown advised against it) and had little children. It's easy to preach what you won't tolerate when your kids are small, you will tolerate much out of love for your child. The same goes for medical care. When folks gripe here about the Social Medical care debate I have my view, but I also understand that some folks may be dealing with bearaucracy private or Government while having illlness. They also have apoint, we are not living in 1890. Socially the world is different and our view of social responsibility changes in each generation.

[WhatMoney]

The doctors in town have been quoted as saying this is why they won't take new Medicare patients. For whatever reason it is, there should be some kind of law to account for people who NEED a Medicare doctor in a case like this, when the person's doctor has left town and there is no one in town willing to take a new Medicare patient. For WHATEVER reason. Don't doctors take a "Hippocratic Oath" that puts care of the patient above something as low on the scale as money? "To keep the good of the patient as the highest priority" is the exact phrase, I believe. Yet people are turned down at hospitals and sent to other far-away hospitals for lack of money? Okay, send them to another hospital but only AFTER you've treated their emergency condition!

Well, there still must be something you haven't been told by your relatives, since hospitals just don't refuse to treat someone who has Medicare insurance or any health insurance. A hospital may refuse admission if you have NO insurance, and cannot supply a credit card for direct payment, or have no co-signers, etc, Especially if it's a for-profit hospital. They do like to have some assurance they will get paid for their services - as hospitals have to write off enough of their bills as it is.

I do not believe there was no doctors in that town that would not accept either regular Medicare or a private Medicare Advantage plan. A town of 40K should have at least 40 doctors - and with a hospital in town there should be several hundred including specialists. What is more likely is your brother-in-law had a private Medicare plan called PFFS (Private Pay For Service). These are run by private insurance companies and allow you to choose any doctor that will accept you, just like in standard Medicare.

But most doctors will NOT accept Medicare PFFS plans because of the extra paperwork, or their unfamilarity with these plans. The PFFS plans pay the same as Medicare, except the payment comes from the insurance company instead of the government. Blame this state of affairs on Bush and Co, who supported these PFFS plans, but made doctor participation voluntary. But no doctors in a town of 40K that would accept standard Medicare is not believable. What are all the baby boomers about to turn 65 going to do in that town?

As far as a popular specialist not accepting new patients or having long wait times - well that is a problem everywhere. If you insist on having the most popular doctor in town there is going to be a backlog of patients. There are probably young less established specialists who would welcome new patients. Some specialties are in short supply - dermatology and geriatic specialists for example.

Blame the cost of medical education, the medical schools, the AMA and the government for not helping more doctors in high demand specialities. And new PCP specialties are not a popular choice for many medical students either, because they cannot charge as much as the specialists. Of course it's all about money with most doctors. If they wanted to spend 10 years in advanced education to the PhD level and only earn an average income, they could have been engineers or mathemeticians or teachers.

[robivi3]

What-good point, practical also. Another problem is that our current system of managed care has also raised the cost. Your care is so split that for certain ailments you get carted from one office to another. Time consuming and costly. Getting a simple physical with my doctor is a pain in the a**.

[Bandit]

What-good point, practical also. Another problem is that our current system of managed care has also raised the cost. Your care is so split that for certain ailments you get carted from one office to another. Time consuming and costly. Getting a simple physical with my doctor is a pain in the a**.

Excellent point. When I was growing up the doctor was the doctor. From delivery to retirement the same Doc did it all. The family doctor did just about everything & he knew what to do. Today you have to go to twenty different doctors & they still can't figure out what the problem is. Everything has become too antiseptic and too refined to the point no one knows anything except one thing. ROFL!

so you go through a maze looking for clues on how to get out of the maze, (I forget what that game is called)...

Did they not all learn the same basics? Granted, no Dr. knows everything but this being carted all over town...the toe doctor, the toe nail doctor, the lung doctor, the pimple doctor (I only do pimples), the hand bone Dr., the face bone Dr....
One dentist only does fillings, go to this dentist for cleanings, go to another dentist for bridge work, see a different dentist for root canal, see a different dentist for extraction-oh yah, they all have special names that have (ENT) in it, but didn't they all learn how to do the same basic things?

I only do big toes in this office, you will have to go across town and pay/see the pinky toe Dr. I am stretching here, but Aint it the truth?

You have an extra office visit for each little thing & get charged that way. It was not always like that.

[Bandit]

What you do not what is socialized health care. I do not need anybody managing my health care for me. What we need is for the laws to be re written getting the lobyist out of washington that work on these medical bills.

ROFL! BUt don't you know if you wear your seat belt that is a health issue? If you wear it you will be safer. But that is not always true.

Now they want us all to turn our auto lights on during the day because we will be safer and make that a law.

I would have to agree with you though, some of these health related laws are not helping people, they are only helping people get fined for forgetting to turn their lights on & wear a seat belt.
Anyone who studied the seatbelt law knows how that all happened with our politicians- starting in N.C. There was big money to be made.

Now you can't smoke anywhere in public or you get fined. That is sweeping the nation.

What Next?...hmmmm.... you wont be able to drink hot coffee at your desk at work or in the car because is is not safe for other peoples health so they don't get a skin burn.

[Minnymouth]

I have found in our rural area here in KY, lots of the established doctors will NOT take new patients... and 75% of the new doctors doing internship with the older ones are foreignors.

And a lot of the doctors here are refusing to take medicare patients because of all the paperwork they have to go thru. They want that "cash up front" with no hassle.

Its almost impossible to see a specialist without being recommended by a family doctor.

Me myself, I know I need to see a specialist, but my doctor doesn't want to "loose the business", SO they keep treating me. I say something about a referral to a specialist..... they say, "Oh no, we can handle this"...... WELL, THEY AREN'T!! I've changed doctors before because they want to "play with my allergies", instead of helping me.

Allergies and asthma are two the most "money making" medical problems. It's, let's try this, then no, let's try something else. Pretty soon you have lots of meds you paid for but can't use!! And the problem still exist. And the sicker you are the better they like it...... instant money to them!! "A bring her back next week thing!"

And now I'm at the age where they want to "test" you to death looking for anything....... I draw the line on the tests. If it's not broke, don't fix it.... and surely don't stir it up!

Sometimes I feel like the medical profession is just a joke when it comes to treating their patients.

I stay away from doctors as much as I can... I have to be pretty sick to even go see one. In fact, when a doctor sees me, its because I'm almost hospital bait by then.

I hope I never have to put "my life" in the hands of a doctor.... because to most of them all we are are $$$$$$$ in the pocket to them....

My opinion....

[JollyGG]

Okay there has been lots of bashing of doctors and the medical profession in this thread. I agree our current medical system is broken. There are lots of options out there to fix it. No option is going to be perfect. I favor the "medicare for all" approach, but you know what they say about opinions and a**holes. However, I clearly see that every option has it's advantages and disadvantages.

But overall I don't think any doctor, nurse or medical professional goes into practice to make money and screw the public. Medical school and just plain being a doctor takes alot of hard work, time, continuing education, comitment. Doctor's do not go play gulf every afternoon dispite popular opinion. They work very hard and often sacrifice alot of family time to care for their patients. Are they looking to be well compensated for doing so? We heck yeah. I would be too. Are they conserned with covering their own butts so they don't get sued? Oh yeah.

But most medical professionals care. They send people to specialists and for additional tests. One because they can. Doesn't eveyon want to play with the newest toys and technology. It it a good reason? No, but it is one reason. Another reason you now get sent for more tests and referals is because everyone wants to cover their butts. If they don't be extra cautious and do everything possible to diagnose and treat you they worry that they can be sued and so they cover their butts by ordering every test imaginable and by refering people to specialists. And the last reason is simply that medicine has changed. In the last 50 years there have been unimaginable scientific advances. We now have better antiboidics, better pain meds, better treatment options and bettter diagnostic options then ever before. However, with all those improvements there has been a cost. Our care is better but it does lack the personal touch. Basically, because anymore one doctor can't know it all. There is too much to know. Just to keep up with new advances a doctor would have to read over 100 journal articles every day. They do the best they can.