Tuesday, March 17, 2009

No Wonder Medicare is Broke


I wouldn't have believed this if I hadn't seen it with my very own eyes. A doctor I practice with send a Medicare patient (that means over age 65 with their health care covered by you and me paying taxes!!!) to a medical supply store to get a carpal tunnel splint. Even though we carry these splints in the office, we don't supply them to Medicare patients because Medicare will never reimburse us the $22 fee for the splint. So we have to send the patient to an ortho supplier, which is a hassle for the patient but what choice do we have?

This splint doesn't require fitting. It comes in small, medium and large and just "velcros" together. The patient got a copy of the bill to Medicare....drumroll...$900.00. Yes, $900.00 for a simple wrist splint.

Medicare will not pay the entire amount but the supplier knows they will get a HUGE portion of that charge. What if they only get 1/2? Folks, you can't make this stuff up. The waste and crazy payment systems are killing us. They bill it BECAUSE THEY CAN!

No wonder our health care system is broken.

14 comments:

Catherine D said...

Wow....you can buy those in Canada at any drug store for a few dollars. My goodness!

HealthNutWannabeDad said...

Thank goodness for government health care, eh?

Paul

Eat Well. Live Well.
ER BurnTheFat.com
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Healthnut said...

This happens all the time. There are ALOT of dishonest doctors who OVER BILL the insurance or Medicare just to get compensated for MORE. When I was younger, my doctor would code my visits as something else just to get MORE money. Of course, I would complain to the insurance company.

There are doctors out there who target the poor seniors because of their vulnerabilities. I know a senior who did not have high bp (something like 120/85) but still got a prescription for bp meds.

Crooks like that SHOULD NOT be practicing medicine. They are the ones who are DESTROYING the health care system. Unfortunately, they get away with things like this because the public doesn't complain or know any better. Believe it or not, it is these irresponsible, unethical crooks who are making the health care so much MORE EXPENSIVE.

BTW, the following article on Medicare should raise your bp. Medicare "insanely" stopped making payments on drugs that an organ transplant patient needed. Is Medicare asking the patient to die sooner?


http://www.nytimes.com/2009/03/13/health/13kidney.html?partner=rss&emc=rss

"Three years later, Medicare stopped paying for the expensive immunosuppressive drugs that Ms. Oliver needed to minimize the risk that her body would reject the organ. Because her kidney was functioning successfully at that point, she was no longer considered to be suffering from end-stage disease and so no longer qualified for the special coverage."

KM said...

Healthnut: I agree about some doctors over billing to get higher compensated. Recently I saw a specialist that did a quick five minute exam maximum 15 minute office visit (including getting undressed and dressed) and billed ins. for a forty minute consult. I'm on a PPO Insurance with a high deductiable so I have to pay. That doctor billed $185 but her agreeded contracted price for me to pay was $141. Also this doctor told me there was only one choice of treatment with difficult side effects (when there were others) or having to have surgery (she is a surgeon in that speciality). She also did not take time to discuss the side effects just gave me a two page hand out as she was walking out the door. Needless to say I won't see that physician again.

I saw my internist who is an excellent role model of an ethical doctor for the same problem who did two exams and spent more time billed $30 less, prescribed a different treatment, and cares about her patients.

In the past for a different problem I have seen a general surgeon who put me on a two week medication to see if the problem would go away before doing an in office unplesant minor surgery. I really admired this doctor for not putting money first before the patient, and the problem cleared up with medication. So years later when I needed a different surgery I came back to her and was never pressured but given the options but left with the choice being up to me.

Even though there are unethical doctors out there that add to more stress (having to fight for accurate charges and correct treatment) and make you feel worse by creating additional problems,and having to seek other opinions, I have also been fortunate to experiance some ethical, excellent doctors.

orag said...

read this: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

Adam Davis said...

Fantastic example of why we do not need government run healthcare. Thank you.

Anonymous said...

http://www.newyorker.com/reporting/2009/06/01/090
Is why healthcare SHOULD NOT BE a BUSINESS!
Universal healthcare NOW.

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It is a pity that they have to go after they have suffered a lot to get the splint in another place. I don't think that they want to go to another with the pain.

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