Medicare D Fuck-ups/Single-Payer Health Care Plan Needed!
There is only one way to say this: bushco and his gang totally fucked up what remained of a health care system (Medicaid) by the adoption of the Medicare D. (Medicare D is supposed to pay for rx’s for those qualify.) However, Medicare D is bullshit, as I will demonstrate in this diary. (I linking to dkos and Booman Tribune as a source for information.) For starters, people are not getting their rx’s, and
most of these insurance companies aren’t notifying the people that they’re servicing…Medicare fucked up and put 22,000 of them on Medicare D. So guess what our only thing to do is? Yup, they gotta call Medicare to cancel, or else their coverage is relagated to secondary, which won’t cover their drugs.
One problem tho. Medicare’s lines? You can’t get through.
And, some people with disabilities are being denied the rx’s that they need to live, as there is a ridiculously long wait for getting out the necessary information. In Wisconsin
CMS (Center for Medicare Services) took a look at the Medicaid system. Since Seniorcare is using the same system, but with different codes, they immediately assumed that the recipients were ALMOST ALL under Medicaid, signing them up for Medicare D.
And for those with low incomes
under Medicaid and Medicare, you supposedly are automatically qualified for “extra help”…CMS fucked up again.
Yup, a lot of people who qualify for extra help were put in as regular enrollees. Which means they’re in for a lovely little $250.00 deductable. Plus they’re NOT going to be paying their 1-3 dollar Copays. They’re looking at fifty plus bucks a script. Just so people know, these are the people who are on FIXED income.
continued
Supposedly, there was extensive training to employees and other volunteers to assist senior citizens and others w/enrolling in and understandinf the Medicare D plans.
The one thing that really pisses me off is the funding that the Medicare Matters group received to train the volunteers re: the part D and the purchasing of the computers that you have described. (We know that computers aren’t cheap.) Figure in the costs of the development/upgrading of computer network(s). Now, add in the administrative costs, the actual training costs, other expenses, the costs for the development of each insurance plan, the training of the “agents” and multiply that figure by 50 (for each state).
I cannot even begin to guess at the dollar amount involved in all of that. And bushco and his gang say that a single-payer health care system is unrealistic/unaffordable! That is fucking bullshit!!
There’s still more:
Medicare Line Fuck-up
You can’t get through. They’re understaffed, and undertrained. You’re looking at a 30-60 minute wait, MINIMUM…half the time they send you somewhere else, when they are the only ones who have the information. (Undertrained, again.)
The What plan am I in?…list, from Medicare. A few problems with it…updated once a MONTH. Not good…Two codes on it refer to multiple plans, so people need to call multiple numbers in order to find out their plan…pharmacists have gotten bad info that Medicaid doesn’t cover drugs at ALL anymore. That’s wrong, and people are wrongly believing that they need to sign up for Medicare D. That’s WRONG. Medicaid Drug coverage DOES NOT CHANGE. This Republicrap plan ONLY affects people under MEDICARE. If you’re under Medicaid only, count your blessings and tell your pharmacists to stick that Medicare D plan where the sun don’t shine.
So there’s an insider’s view. Most of the major problems can be placed squarely on the CMS.
ANOTHER update on the wonderful world of Medicare D.
national chain drugstores are now denying eligible people their drugs…three national chains have demanded Medicare part D cards for prescriptions from MEDICAID recipients.
And I did not receive MY card until a few days ago! It is my understanding (per my pharmacist) that there are many others who did not receive their cards at all! I am in MI. Also, the pharmacy that I use has been told that there is a computer problem re: billing for rx’s. Fprtunately, the pharmacy is charging the amount of the co-pays only for now and hoping this will be straightened out in the future. I know I lucked out on that one!
<pb>Now back to Wisconsin
pharmacists have been told that the Wisconsin Forward Card no longer is active. They aren’t even checking, just refusing them outright….wondering if this is going on in OTHER states too? Sounds to me like yet another national fuckup…these mistakes are far too widespread and profitable for my comfort. Especially considering that these people are faced with the problem of either paying RETAIL price for the drugs or going without…Dual-Eligibles, who are supposed to be getting low co-pays, due to the tab being picked up by the state, well, they aren’t in the system right. Yup, guess who gets the lovely deductables and high co-pays.
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And, the author of the Wisconsin diaries got fired. The rationale for the firing was
somebody had been posting classified information…Medicaid got crap from Medicare, (The almighty Client). If it hadn’t been for them raising a stink about the post, they never would have noticed…Officially, it’s for “personal use of the internet” which of course means “they gave me internet access”. I guarantee that there is not one person employed there who doesn’t have that lovely little Damocles sword over their head…)
I agree completely with the following
Medicare D is still a rat shit, bullcrap, overall cluster effin, disaster of a Republican program. Not that the Mainstream media gives a shit. (Been calling around all day to see if the local papers are interested in the story, but they’re a little busy…)
Another diary links to an article that was in the NYT. The specific issue discussed is diabetes and its impact on those who are low income or uninsured.
that low income worker who is managing to somehow come up with the co-pays for all that medicine, and is grateful to eat a little less to do it, is getting bit in the butt again by his HMO, who will deny him preventive or early stage care, betting that he will either get by without it, change jobs, or perish, before his condition requires them to fork over big bucks.
Some harsh descriptions of reality are also included in the above diary that is linked to. A few excerpts from the posts follow:
The structures of daily life promote poor diet, lack of exercise, and medical misinformation. The healthcare structures quite vividly promote getting sicker than is necessary, for bald profit to all but the patient.
and
my experiences with Medicare D and bronchial pneumonia have convinced me more so than ever that a single-payer health care system is desperately needed…the current health care system is insane and the insurers are the only ones that benefit. If something is not done quickly, there are going to be many people who are sick and dying…there are some doctors who share the view that this country needs a single-payer health care system.
and
I’ve been an RN for 40 years. In that time, I’ve watched patient centered care be completely replaced by profit centered care. The outcome, for all but those rich enough to have top of the line insurance, is nothing short of societally sanctioned genocide, in my opinion. The chronically ill and/or disabled, the poor elderly, kids, the mentally ill, all the uninsured, all are being invited to sicken and die off.
and
The insurance companies don’t want to PAY for the more expensive, specialized drugs or treatments — they want cheap, generic medication and one-size-fits-all low-cost solutions…the pharmaceutical industry in particular wants profits, and that means expensive, specialized medications…not cheap, generic or lowcost anything.
Now, back to Medicare D:
…the changes in Medicaid/Medicare D that now covers rx’s…a person has to know almost as much as a doctor/pharmacist/medical biller to determine what plan is the right one for him/her. God knows how I did it. And God help anyone who is still trying to decipher it, as the Medicare D was made to be so complex, it is virtually impossible for the average person to understand. If a person has any questions, he/she is told to go online…how many…have the ability to surf the net, have access to a home computer, let alone know how to use a computer? Yeah, a person can go to the library to go online. What about people are computer-phobic?
and
another supposedly helpful tip by that asshole little Scotty’s big brother McClellan…was to tell seniors if they have questions to make an appointment with their doctor and that doctor will go over what is the best plan for them…yeah some doctor(who knows less and cares less I’m sure about all those plans)is going to spend several hours each with all his patients…if we get 8 minutes for a real gdamn medical problem we are lucky…my visits are usually 5 minutes…I have to usually wait anywhere from 1 to 2 and half hours for that fucken 5 minutes.
This is a very heavily edited conversation w/my doctor:
“This is crazy. How are you supposed to get their rx’s?…Why the hell get rid of Medicaid? Only the insurance companies will benefit by this…Do you know what we need in this country?” (My answer, “A single-payer national health care system.”) “The problem is who will run it–you need someone w/no axe to grind to do it. You can’t trust the government.”
Yes, the last statement is harsh. But, the fact of the matter is that, during every debate re: the federal budget, social services are always the first to be cut. In my mind, this creates more division in this country, by singling out classes of people to be treated differently, due to inequities in government funding. Just look at the divisions between those who have health insurance, those who are dependent on Medicare/Medicaid, and, let’s throw in another group: veterans. How many times have the repubs said/implied that health services for those who are now in Iraq will remain intact? And, what population’s medical needs will be sacrificed, even more so than they have been already to pay for any treatments that those who do return from Iraq will be in need of?
