Medicare, I Hate You
One Woman’s Opinion
By – Sheri de Grom
I don’t want Medicare, not Part A or Part B. My husband doesn’t want Medicare either. However, federal law requires we enroll in and pay for Part B. Part A is automatically granted to everyone when they turn 65. If you aren’t familiar with Medicare, Part A is the portion which pays toward hospital charges while Part B pays a portion of out-patient visits, medical tests and other ancillary needs.
Here’s where our government sticks it to the men and women of the armed forces who gave the best years of their lives by serving their country with a minimum twenty-year career. If these retired armed forces veterans don’t enroll and pay for Medicare Part B, they lose their TriCare benefits.
I thought our TriCare benefits were paid for by my husband crawling through the jungle in Vietnam as I wondered if the man I loved would come home alive or in a box. If he did return alive, would he be the same man I had married? I also thought our benefits were paid for when my husband spent week upon week training troops in the ice and snow of northern Germany and during subsequent war games in various countries. The military told him they hadn’t issued him a family, and they said so often.
Some say we should have to pay for Medicare like everybody else. My position? I’ll pay for it if I have to—but I don’t want the so-called benefits. My husband and I are the same as everyone else who’s worked their entire lives; we’ve paid into Medicare with every paycheck. I still don’t want Medicare. Give my benefits to someone else.
Many of you who follow my blog know I’m retired from the federal government. I made many of my career choices based upon having access to health insurance benefits I could afford and that would cover both my husband and me.
Each congressional member, both House and Senate, have access to the same health insurance I paid for during the years I worked and that I continue to pay three-quarters of the premium as a retiree. The exception is that congressional members receive the same healthcare coverage without paying any premiums. That’s a benefit I would love.
I understand most federal retirees drop their insurance coverage once they retire. Most can no longer afford to pay the premiums.
Technically, my husband and I should have full healthcare coverage with Medicare and TriCare. Should is the operative word.
The lower reimbursements provided to hospitals, physicians, and other caregivers by Medicare will eventually cause these same providers to stop taking Medicare-covered individuals. They will be forced to lower their standard of care due to the rising costs of maintaining their practice or they’ll be forced to consolidate into health management organizations wherein the patient has no say over the care they receive or when.
All of my providers of care and I are cheated when the government forces me to enroll in Medicare. I choose to pay for full coverage Blue Cross/Blue Shield (the gold standard of health insurance). Last year before I was eligible for Medicare, my providers were paid appropriately for my care.
Because of the required enrollment in Medicare, it becomes the first or primary payer of all medical care I receive. Medicare pays at a substantially reduced rate compared to what Blue Cross/Blue Shield pays and my care providers are cheated by the government for services rendered.
Because Medicare is the first or primary payer, BC/BS becomes the secondary payer, and they only pay the co-payment. Suddenly, everything becomes clear. TriCare never pays for anything and TriCare is an earned benefit of my husband’s, a Vietnam-era vet. (Yes, I’ve mentioned he’s a Vietnam-era vet twice.) These vets received no respect, ever. Now, the government elects to stomp on them again. They didn’t have a choice about Vietnam and they don’t have a choice about Medicare.
My number one reason for hating Medicare and all it represents is that with me, the federal government has taken away my freedom of choice.
My second reason for not wanting Medicare is that their convoluted rules nearly killed me. Computers cannot care for people. Only trained healthcare professionals can determine what is best for a patient.
I had what is normally a routine surgery in October, 2012, for which the normal hospital stay is three days. Unfortunately, my surgery turned into an experience that was anything but normal. The procedure which should have lasted ninety minutes took six hours.
On a Saturday, the third morning after my surgery, my surgeon entered my room for the fourth time that day. I like and respect my doctor but I wasn’t used to his dropping by my room so frequently, plus there was a major home university football game that day. It was a given that he had box seats.
Something wasn’t right but I wasn’t sure what.
I’d frequently discussed with my doctors the wrongs the United States Congress had brought on Medicare and the individuals it’s supposed to protect. My surgeon and I had engaged in some of the same discussions.
As it happened, on that Saturday morning, the Medicare computer only read my admitting diagnosis from the hospital electronic data file. There was no over-ride mechanism in place for Medicare and no phone number to call. Medicare said I had to go home.
If Blue Cross/Blue Shield (BS/BS) were still my primary payer, they would have granted an additional twelve days, and possibly more. Unfortunately, Blue Cross/Blue Shield could no longer over-ride a Medicare decision wherein computers talk to computers. BC/BS has licensed medical staff wherein hospital medical staff can explain the need for additional days.
- The Medicare computer didn’t care I’d lost almost half of my total blood volume during surgery and my body didn’t want to make more.
- The Medicare computer didn’t care that my blood pressure hovered at 70 for forty-eight hours after surgery. (I’m normally at 102 with no deviation.)
- The Medicare computer didn’t care that I’m diabetic and my blood sugar crashed to 52 during surgery (normal range is 90-110), and it was over thirty-six hours before it was up to 75. My blood sugar read 80 when I was released to home with no dietary instructions. (Thankfully, I knew what to do).
- It was another week before we knew I had also acquired a hospital-grade infection—but I’m sure the Medicare computer wouldn’t have cared about that either. Medicare did have to pay for the numerous doctor appointments that resulted because of the numerous co-morbidities. It took seven weeks and six rounds of different antibiotics before the infection was crushed.
If my husband hadn’t been at my side 24/7, I’m not sure how I would have survived those first awful weeks I was home. I questioned myself over and over, why wasn’t I getting better? Feeling bad didn’t begin to explain how I felt. Others had told me they’d had the same surgery and were up and about in two to three weeks.
I understand Medicare is all important to a large population of the United States, but not to me. I planned differently. That doesn’t make me special. I gave up a lot in order to have health coverage and now the United States Government, the very entity I worked for, takes away my freedom of choice.
I watched the television program ‘Need To Know’ on PBS. (pbs.org/needtoknow) They are doing an informative series on Medicare and other healthcare concerns in the United States. The first installment is about hospitals being penalized for Medicare patients returning for readmission within thirty days of discharge. The percentage is high. One in five Medicare patients returns to the hospital within thirty days of their admission. I was a prime candidate for return, but it was Medicare that forced me home in the first place.
I wish I had an answer for the healthcare crisis that confronts each of us, but I don’t. For me, the only acceptable choice is one I’m allowed to make myself. The United States Government and the Medicare computer don’t have a clue.
Physicians and disease would not have been the cause of my death during those dark days of October, November, and even early December when I was asking why. I’ve now had three specialists tell me Medicare would have been the direct cause of my death, but then I already knew that. I wasn’t healthy enough to be discharged to a skilled nursing facility where Medicare would have had to pay so Medicare discharged me directly to home.
What do you think? Does healthcare and your choice or lack thereof scare you?