Saving Medicare and Social Security for all generations, means what it says, from those receiving benefits today to those working and contributing for coverage tomorrow. The government began Medicare forty six years ago and since then each and every American worker contributes to the system.
Unlike other areas, Medicare continues to grow through the working public, but recently the government borrowed from your money, it was like borrowing Peter to pay Paul. Then, they continue to use Medicare as a private fund when its’ purpose is for those who contributed into the program for their health care when they retired. We must keep Medicare strong, unlike past generations when factory workers, unions etc., guaranteed a good retirement plan; it is now up to the employee, in most cases, to plan their own retirement.
Recently I was asked to participate on a conference call with 15,000 other people when AARP contacted me. Although I am not retired I have spoken out on health care at the National level and for AARP with the late Senator Edward Kennedy for “Save Our Security,” in Boston.
Forty-six years ago our government approved Medicare, and now it is at risk. Social Security and Medicare need to be protected for the population who contributed their hard-earned money for a brighter future. Unfortunately, increases have been next to nothing, for both the elderly and the disabled on Medicare. Each year living grows a little higher, but the cost of Medicare increases, and the treatments decrease. While the cost of living goes up, people receiving Social Security and on Medicare should be living equal lives.
The young and old alike come across difficult health situations, and they deserve the same treatment as those with private insurance. We do not need to doubt something that has worked, but doubt the reasons then help secure it for years to come. Remember the saying, “You don’t toss the pan out until there is no handle on it.” The republicans were the first to attempt to change the way Medicare is run, followed by their dipping into the people’s funds and then they say how poorly Medicare is doing, and things have to change. Imagine that, citizens contribute to a government run system for their security only to learn the government dipped into their funds. This is not the main reason for fear regarding Medicare.
President Clinton was committed to reform Medicare, giving more to the elderly to secure Medicare for future generations, placing money into the Medicare fund. It was in 2001, after Clinton was out of office, when Medicare withdrew many services for many reasons, (remember – the dipping began) most Americans had no knowledge of these services being removed from approved treatments.
One of the important issues at the time was Medicare withdrawing coverage for arthroscopic knee surgery for osteoarthritis; an article in the New England Journal of Medicine suggested the popular procedure did nothing to improve the symptoms and physical therapy and anti-inflammatory drugs did the same thing. Pardon me, are they looking at the population as a whole or as one patient and their individual needs? For instance, take the drug Plavix, given to those after heart problems to keep their blood thin, and NCIDS (anti-inflammatory drugs) known to thin the blood. The elderly are the highest users of anti-inflammatory drugs and adding to the list only causes concern for additional life threatening problems. The New England Journal of Medicine went on to say that those who did have surgery felt the same relief as those who underwent surgery experiencing the placebo effect. The 2002 government study showed a similar outcome for those with or without surgery. Tell this to the person of any age who can barely walk due to their knee. Yet, this study prompted Medicare to drop coverage for the surgery as a treatment for osteoarthritis. Perhaps this is why doctors continue to tell patients with knee problems to have surgery while they are young, could coverage have something to do with it? No one wants surgery unless they really need it.
For many year’s I have been involved with health care from the people’s viewpoint, speaking out around the country. Then one day I too had a problem with my own knee and went to see a group of orthopedic doctors. This is where the story begins, how to save your Security and keep Medicare strong.
As I participated on a conference call with 15,000 others, and AARP, and officials from the office of Medicare, they asked for questions from the listeners – to my surprise my question would be one of eight throughout the lengthy call.
I explained my trip to the orthopedic doctor, accompanied by my husband, and a request no matter what doctor I see, for a complete medical report to be mailed; I sign the request form. (If you do not do this, start making it a habit.) The printed history of the appointment arrived in the mail and it was wrong, everything about it, wrong. Charges were made to Medicare for things I never received. Here are only a few; returning for a follow up to have another shot in the left knee and indicating I had a shot in the right knee. I never had a shot in the right knee as they explained, and I never returned for a follow up for a shot I the left knee – but I do recall the quote, “once it is in one knee it usually goes to the other.” I refused all shots. They mentioned my exam was extensive, and I nearly died reading the statement. The doctor never left the doorway as he leaned against the door frame, gazing up and down the hall, hardly listening to the questions I had for him. He said his few words, wrote up a record and sent it off for payment. The doctor never touched me, nor did he watch me walk, hop, or move the knee in a prone position as stated. There stood a doctor who talked from the doorway, who wrote up the findings without even stepping inside the examination room; I became suspicious. You would wonder how many times this doctor did the same thing to the hundreds of others who would have Medicare Insurance, as first or secondary coverage?
When a copy of the history was received there was nothing, no codes, nothing but a written history of what he did and his diagnoses. I returned a call to the office explaining nothing on the history is correct, giving them the benefit of the doubt; perhaps they mailed the wrong chart. Following my call the doctor returns the call, his voice not pleasant, as if I was taking up his time, as if he were still standing in the door way. He continued to deny anything I said, and he basically called me a liar until I mentioned my husband accompanies me on all visits. Once I mentioned I was not alone I held the phone in complete silence. I mentioned the fact I never received one needle for treatment, let alone two. I explained he never looked at my knee, or did he do all the things mentioned in the report. He never entered the room.
What do we have but a doctor writing false reports to Medicare and other Insurance Companies with fake histories, and medical treatment never given to a patient. We have a doctor who charged the system, then scooted out to treat the next patient. The red flag began flying high as I pictured a doctor roaming from room to room picking out those he would abuse, by abusing the system.
I remember his words, “You must have surgery on the right knee but most of the time it affects the other knee too.” Remember, he never entered the room. Before he left the doorway, he said my back needed surgery but his friend handles that – I think my mouth fell open. He was about to invade another part of my body without any final solution such as physical therapy, swimming, medication; It would be my primary care who solved my knee problem. Remember that problem he said I had with my back, well I never had pain in my back.
Although I called the doctors office to correct any error, he simply did not agree he did wrong, and he kept saying he did everything on the chart. I was angry, and anger is something I seldom feel, most things work out, but this would not slip through my fingers. I wondered how many patients he treated in this way.
His demeanor on the phone was identical to the stance in the doorway. He did stop talking when he realized my husband was in the room. Then he lightened his tone and told me he would look into the situation, and all this time I thought he did. I mentioned those codes and I needed them for my records, but nothing was mailed.
I called the government office of Medicare and told them the charges were false, and not to pay for certain treatments. Once again I needed the codes, but remember when you call government offices and other businesses they warn you that you are being recorded. They had all the information they needed regarding charges and treatments. This would give way to the doctor and the location. (Some people are afraid to report a doctor who is doing wrong, simply because they fear other doctors will not take them on as a patient.)
A few months after the incident I was asked to take part in a conference call with AARP about Medicare. I prepared a question concerning codes, to reveal the problem. The question, one of eight, became part of the discussion to warn Medicare recipients to watch out – and always check their medical history. It showed others not to trust everyone. It pleased me to use my words to inform others so their received better treatment.
At the end of the conference call we had one more task, to choose from five reasons why Medicare is in the shape its’ in. We were told to push a certain key on the phone. A few minutes later the tally was in, 80% of those on the conference call believed they experienced abuse by the Medical Profession. 80% out of 15,000 people knew about a medical person who was charging Medicare for treatment never received.
A couple of months later a news report came across the networks that approximately 185,000 doctors were over charging Medicare to the amount of at least 585 million dollars this year alone.
I also learned a few weeks after the announcement while swimming at the YMCA, the doctor I had confronted over charges to Medicare was no longer in the area – and a woman stated, “He had been with the group for such a long time.”
Does it pay to save Medicare? You bet it does, and most of all no one legally has the right to be charged for services not received.
We must save the system for many reasons. The first step would be to tell Medicare about any mishandling of your personal records. No one is punished for telling the truth, and the way health care is today all they need is your name, social security number, and a recording of the conversation to get down to the matter at hand.
I advise never sit back and let others run your health care and take charge of your own health. Always ask for a complete record while at the doctors. These simple measures can help protect the system and your future care.