Thursday, August 23, 2012

President Obama Strengthened Medicare

About 6 yrs ago, my husband was diagnosed with sleep Apnea and needed a CPAP machine to help him breathe through the night. The people in charge of providing him with the equipment charged Medicare over $1,600 and us almost $200 a month. This is a rental for 13 months, after this period of time, the patient owns it.

Do the math: 200X13 = $2,600 + $1,600 = $4,200

The mask did not fit right and the machine was as loud as a revving engine.  Needless to say that no matter how hard he tried to sleep with a mask that resembled those worn by a fighter jet pilot, he just could not manage to do so.

The mask was not designed to move with the patient, and unless he slept on his back the entire night without moving, the stupid thing would slide and the hose would get tangled around his neck and shoulders.

After a few days of not sleeping (neither him, nor me), he complained about it and requested a mask that would allow him to sleep.

We were in for a fight.

The medical supplier's attitude was: "Get used to it and sleep on your back. It costs us money to give you a different mask."

After explaining to deaf ears that it is impossible for him to sleep on his back due to a failed Laminectomy (or stay in a position for very long), and that the metal rods and screws permanently embedded in his spine make this impossible, he ended returning the machine in less than a month.

Medicare was charged for at least two months of use and we were charged for one. Money down the drain for everyone involved except the supplier.


CPAP Machine - Sleep Apnea
The day before yesterday, his primary care physician (PCP) went over his chart and asked about his use of the CPAP because of the other issues he is having, namely he thought, related to sleep and fatigue.

Dr. S., noted that recent studies show a correlation between people with sleep Apnea and the development of different forms of cancer. It was enough to make us pay attention, but there was more to it than that.

"The brain," as Dr. S. explained,  "spends the night fighting for oxygen and unable to relax, even if you think you are sleeping, you really aren't." - "This," he continued, "Also creates other health issues that are harmful to your heart and other internal organs."

Dr. S. requested that we contact the sleep study facility and have them send the results and numbers to his office and he would get back to us in a few weeks.

We did as requested and the Sleep Study clinic faxed the documentation immediately. Late that afternoon we got an urgent call from a supplier of medical equipment to come in right away. Dr. S., had set up the appointment for the next afternoon. There was no quibbling over it, it was expected that we show up. Period.

Sleep Apnea
I know Dr. S., and if he got on the ball this quickly, it means that the numbers and results were alarming enough for him to move everything at the speed of light.

My husband got a CPAP machine today. It is A) quiet - as in you don't hear anything. Perfect for the spouse that does not need one.

B) they fitted him with the right mask and told him he had six months to try all the others if that one was not suitable. *WOW*

C) We signed the bill.

Here is the kicker: There was no COPAY to the patient and they charged Medicare half the price of what the previous company had charged years ago for an inferior machine and a Darth Vader mask that only fits right in the movies.

This is first hand knowledge on how President Obama has cut wasteful spending from Medicare by reversing the evils of the past presidency.

Mitt Romney Lies
Mitt Romney is lying about the funds cut off from Medicare. Romney is not stating the context of the so-called "Medicare cuts" because facts and context are detrimental to his goals. What has been slashed from Medicare is wasteful spending.

Medicare is providing better coverage to the elderly and disabled than it has in the past. The donut hole is smaller now and will be permanently closed in 2020. The damned donut hole costs thousands of dollars every year per patient and seniors and disabled patients have seen significant savings thus far.

Medications cost less too and we can feel that in our checking account, which just like my husband, will be breathing a little better moving forward.


For those who don't know... MEDICARE ADVANTAGE is a PRIVATE insurance company and it cuts into the benefits that Medicare pays and double and triple charges for medical services Medicare can pay by itself at a fraction of the cost. YOU DON'T NEED TO SIGN UP FOR IT. It is a rip off. Furthermore, essential services a patient might need are NOT covered. You can thank President George W. Bush for this wasteful privatization attempt of Medicare known as Medicare Advantage.

I know we are not the only people out there who have seen a reduction in medical costs in the form of copayments and medications and that means a lot to people struggling to survive/live on a tight fixed income.


Health care cost rise
Many of us are in our 40's and 50's and are too young to have Medicare, but after having experienced both systems, I can't wait until I do.

We spent years paying for all health related expenses out of our savings due to the "pre-existing" condition. Thanks to President Obama, the insurance companies can no longer deny anyone from a pre-existing condition and this is something that everyone needs to know.

When someone lives with chronic pain, their ability to fight for their rights is severely diminished.  Since my husband got coverage through Medicare, I have not had to fight for his medical care with a $10 hr. employee hell-bent in saving the private insurance money and them getting a bonus through denying care (I had a neighbor who did this for a living. One of the most miserably unhappy people I have ever met.)

We all pay into the system through years of contributions. The coverage is far superior to private insurance and worth a mention, but can't stress loudly enough how much better than the coverage is not having to fight for the right medication or treatment options. Having no stress in this area is priceless when you are juggling a thousand other things and keeping your life as normal as possible when dealing with disabling conditions.

Case in point: When the surgeon who wanted to operate on my husband turned out to be a quack, we sought a second opinion out of state and had the surgery done safely with real professionals at Stanford Medical. Try doing that with a private insurance company.

We did not have to jump through hoops. We only had to figure out the price of a hotel, time frame, and cost of gas.

Everyone in this country should have that peace of mind. It is a human right that no one should be denied.

Nationalized Health Care works in every industrialized country and has shown to work here just as well in the form of Medicare for the elderly and disabled of any age. The military and government officials have socialized medical coverage. Only the Middle Class is excluded from having the same rights while they are the ones paying for it all.

The Mitt Romney's of this world want to privatize Medicare and Social Security because there are billions of dollars screaming to go to offshore accounts. They don't want us to know what it feels like to have Medicare, because in the words of Mitch McConnell: "We can't give this to the people, they would like it."

Damn right we would!


U.S. Dept. Of Health and Human Services: What is Sleep Apnea?
The Washington Post: The Medicare Advantage Scam by Ezra Kline

Image Credit: By Habib M'henni + User:DMY [GFDL ( or CC-BY-SA-3.0-2.5-2.0-1.0 (], via Wikimedia Commons
Mitt/Pinocchio credit to PlanetPoV

1 comment:

Richard said...

Medicare system is complicated but it works and is far less frustrating than private insurance--especially when you need it.

Privatization is not only not the answer but will make all things worse as there will be a fee structure associated with it--and likely increase overall costs before benefits (if any) are derived.

Many long term national issues need to be addressed in the health care system--we'll see these developing into the near future. You don't address then here, nor should you have done so.