You hear a lot of talk from politicians and bureaucrats about how to curtail the cost of Medicare. They’re all good at crying about it, but they rarely come up with good solid solutions to the problem.
Usually, the first thing they want to do is make it more difficult for people to get the medical care they need. My friend Sheri de Grom posted a blog last week that will make your hair stand up about the way Medicare has treated her in her quest to get much-needed treatment. Click here to see her post.
The next thing on their agenda always seems to be making it more and more difficult for doctors to make a living. I don’t know about brain surgeons, but I know my internist struggles to generate enough income to pay his malpractice insurance, his office help—including the extra personnel it takes to cross all the t’s and dot all the i’s to satisfy Medicare—and leave enough for a comfortable living for himself and his family.
While internists and general practitioners and many other doctors struggle to remain in practice with all the straight-jackets placed upon them by Medicare, owners of home health agencies and hospices laugh all the way to the bank. I don’t remember the exact figure, but the last hospice that took care of my mother billed Medicare $125 to $150 per visit for an aide to come out and help bathe and dress her.
Stop and think about this for a moment. Let’s see if we can find any fairness in the current system.
Any medical or osteopathic doctor you see had to spend four years in college plus four years in medical school—running up debts of several hundred thousand dollars in the process—and then three or more years of internship and residency before he or she can hang out a shingle. In return, if he or she accepts Medicare patients, the government cuts fee payments back to $50 or $60 per patient visit.
By contrast, the hospice aide has to take a course to become a Certified Nurse Assistant. He or she may or may not have a high school diploma. And the company employing that person charges tow to two-and-a-half times the doctor’s reimbursement. At the same time, these companies pay the aides a little above minimum wage.
I have no axe to grind with the aides. Most of them are wonderful people who are dedicated to their patients. They earn every penny they get paid. What I question is allowing these companies to charge Medicare $125 to $150 for services they pay their employees $9 to $12 an hour to perform.
To make this situation even more ridiculous, Mother could get along fine without hospice if Medicare would allow her to be served by a home health agency. She has resident caregivers in the house where she lives who can bathe and dress her. All she really needs is access to a nurse. Maybe one who would stop to check on her once every week or two—but mainly one who would be available when she injures herself, which happens frequently with a 97 year-old person.
Paying for a home health nurse to stop by now and then would cost maybe a fourth what the hospice coverage costs—and maybe even less—but Medicare, in its great wisdom, will not allow her to have home health because she has caregivers in her assisted living facility.
We save money by providing a more expensive alternative and forbidding a less expensive one. How does this make sense?
The politicians and bureaucrats who have come up with this system are the ones who will be running all of our healthcare once Obamacare kicks in. That doesn’t give me a lot of confidence in our future.
What experiences have you or your loved ones had with government-sponsored healthcare? How do you feel about turning your own future health over to the people who have so thoroughly screwed up the Medicare system?
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