Somebody Out There Has A Good Health Care Plan

Why do our representatives continue to talk about a heath care reform bill that nobody agrees on. It’s not just Democrat against Republican anymore, it’s everybody against everybody. Remember the “gang of six”, that consisted of Democrats and Republicans, who were putting together their own bill behind closed doors? Well, they managed to come up with an even worse version than the full house. 

Many, including me, think that we are rushing this a little too much. The argument against that is; this debate has been going on for years, so that’s not rushing it. Well, talking about  something and putting it on paper to become a law, are too very different things. Yes, it’s true that health care reform has been talked about for years. It’s also true that something needs to be done. However, we need to have a bill that will help those that need it, cut costs, leave those who are happy alone and get it to pay for itself.

Here we are with 15 million people out of work, businesses closing by the score and somebody is talking about a national sales tax to help pay for health care. Stop with the taxes already. I heard the other day that we can help pay for it but getting rid of the 65 million dollars in Medicaid fraud that has been going on for years. My first thought was; if we know there is 65 million dollars in fraud, why aren’t we already doing something about it. To top it off, that was the amount of the abuse in only five states.

Maybe, what the government needs to do is offer a reward to the individual or company that can come up with a workable plan.  They are already doing it to get more energy efficient cars. We already know that the smartest people in the country are not in the government, so let’s offer some incentive for them to come out of hiding.

I feel for the people who don’t have health care, but let’s separate them from those who “choose” not to have it and then find an efficient way to help the rest. If you want to make sure we have real health care reform, tell our elected Representatives that they have to be on whatever plan is finally voted on.

Make Health Insurance Choices Understandable

My Mom (84 years old) came to stay with us for an extended vacation back in August. When she arrived she was having difficulty getting around because of bad knees. She had a total knee replacement on the right side and never properly recovered. Part of the reason is that she lived in a row home in Philadelphia. She had to climb 10 steps just to get up to the house, thirteen to go use the bathroom or go to bed and another thirteen to go and wash clothes or get something out of the freezer. Sometimes she had to crawl up and down the steps.

When she arrived here, we made an appointment to see our family doctor. When we called for the appointment we asked if they accepted her health insurance and were told “yes”. When we arrived for the appointment she was told that, with her insurance and Medicare, she didn’t even have to pay the co-pay. A month later they called to say that they didn’t accept her insurance and she would be responsible for the bill herself. It seems that they accept insurance from the same company, but were not in her network.

When I called her insurance company to seek authorization to see a doctor here, they checked and said there were no doctors in their network within 50 miles of us. There were also no orthopedic surgeons here in their network. Basically, she can travel the 50 or more miles when the need arises or she can return to Philadelphia. I’m still hoping for a special dispensation and should hear something tomorrow. I was also told she might want to look into changing her policy to something better suited to her status and age group.

As to the first doctor bill, I’m working on the basis that they made a mistake, not once but twice, and they should eat the cost of the visit.

The Medicare she has is Part “A” and covers the hospital only not doctors visits. I checked on getting her Part “B”, but they said she had turned it down in 1992 and would now have to pay a 10% penalty for each year since 1993. That means it would cost her over $300 a month just to get Medicare Part “B” now. Did I mention she is on a fixed income? The reason she turned it down in 1992 was because she was still working for the Federal Government and already had a good insurance plan. After that she simply never thought about it again until now. The insurance plan she does have is the same one she had when she worked for the IRS.

When she turned down Medicare Part “B” in 1992, no one told her the benefits or disadvantages. When she retired, the Office of Personnel Management, did not talk to her about her insurance or the option of changing it. She was simply supposed to know these things. Let’s get serious, an answering machine confuses Mom. She is not the questioning, detailed type.  I’ve been trying to find some options for her but frankly, the benefits are not easy to understand. I wish there was someplace I could go to compare different policies from different companies, side by side.

We’ll eventually figure it out, but the insurance companies should make policies easier to understand and our government should start listening to what the people are saying. While I agree we need reform, we need to get there by lowering costs, controlling lawsuits and getting a handle on the cost of prescription drugs. If we can do that, then the premiums will come down and more people will be able to afford their own policies. Beyond that, let the government expand Medicare/Medicaid to all of those who would still not be able to buy a policy of their own, but don’t mess with those of us who are happy with what we have.

Getting Back to Normal, Whatever That is!

Mom arrived safe and sound and we had a very busy weekend. Mom brought a bunch of stuff with her that will take some time to sort out. With my impending surgery, I didn’t feel much like getting out so we sat around the house the entire weekend. Naturally, we got to catch up on all the family trials and tribulations as well as the good stuff. On Monday the 17th my sister, Jean and brother-in-law, Paul returned to Philadelphia, leaving us with the twins, Ashley and Brooke, for a couple of weeks. It was quite an experience having two eight year old girls around.

On Wednesday morning, I went in for the hip replacement. I don’t remember anything until I arrived in my room. The pain wasn’t as bad as I expected and before long they were getting me out of bed and walking down the hall. I was hoping to go home on Saturday but the doctor decided on Sunday instead.

It was a wild week for my wife. One day, Mom had a reaction to her medication and felt weak and sick to the stomach. She vomited most of the day. My grandson, Rylan was particularly fussy and the twins were full of energy. At one point my wife was feeding Rylan, Mom began vomiting and Ashley ran into the house yelling that Brooke feel off her bike and was gushing blood. Delia, handed the baby to me, slid a bucket to Mom and went out to investigate, all without missing a beat. She took it all in stride and within twenty minutes everyone was settled down. As it turned out Brooke had scratched both hands but the “gushing” blood was a slight exaggeration.

On Monday my Physical Therapist, Lee,  arrived to begin the torture. I was also assigned a nurse, Staci, to check on the incision and my general health. On Friday Jean and Paul came back to pick up the twins and go on their “real” vacation in Maryland.

Both Lee and Staci said I am doing great. I used a walker for a week and then went to a cane. Two weeks after the surgery the doctor said I could  shower on my own and removed all the staples. Next Wednesday I can drive and the following Monday I can return to work.

So that brings us up to date. I feel good and the old pain from the bad hip is gone. I still have some discomfort from the surgery, but all in all I’m getting around good. Mom is doing great and her own health is improving since she doesn’t have all those steps to deal with.

In the next several days I’ll get back on track and get back to posting all the other stuff I’ve been waiting to rant about. It’s great to be able to sit at the computer again. Thanks for waiting for me.