The Medicare Mess May Affect Your Stroke Recovery

The Medicare mess affects everyone recovering from any and all diseases or conditions. On our highway to health, we are continually faced with roadblocks that prevent us from obtaining quality physical and emotional healing. We face further stress by trying to make correct insurance choices while desperately dodging high medication costs at the same time trying to stay with physicians that are familiar with our care. Medications, vitally necessary for preventative care and stability, may be too expensive to obtain unless covered under a monthly changing Medicare formulary that even Einstein would have had difficulty understanding.

For example, stroke costs our nation about 54.9 billion annually. Thankfully, due to technology and science, more people are surviving stroke than ever before. But the fact remains that the unhealthy Baby Boom generation is collapsing now, and the healthy Baby Boomers will collapse before help with the Medicare mess will be available. Stroke is just one of various conditions and diseases our nation must address.

What goes on behind the scenes at your doctor's office and pharmacy is just as important as the care you receive from your physician.  Before you visit your doctor for your annual physical here's some facts you should know. Medicare allows only one physical per lifetime. So if you've had a stroke, your physician will be looking at decreasing risk factors such as high blood pressure, high cholesterol, and other cardiovascular complications. Your physician will be providing preventative care. However, Medicare does not pay for preventative care either. This is one example of why physicians are saying that they are losing money when caring for Medicare patients.

This cycle of denying payment for preventative treatment turns into a Catch-22 as physicians are forced to attach a different diagnosis for the office visit. The more expensive tests that are ordered the more Medicare goes into debt trying to pay for them and the cycle continues. Recently, I visited my physician for an annual physical. On that day I learned that Medicare was my only provider and that Medicare will not reimburse the physician for his services. Therefore, the doctor was forced to create another diagnosis and send me to the lab. Also, I was referred to physical therapy and a specialist. In addition, I was referred to an ophthalmologist who performed more extensive tests. In conclusion, that "physical" would have cost about $300.00, however because of the tests and referrals the cost gradually grew to well over $3,000.00 or ten times the expense to Medicare.

The players in this health care crisis are as follows: the physicians supported by the American Medical Association (AMA), the insurance companies including those handling Medicare, the pharmaceutical companies, and finally the patients. Which group does NOT have powerful lobbyist representation in Washington?