Medicare — Spending Billions to Save Thousands

Government wasteful spending is totally out of control but it is the invisible waste that may be killing us.  This blog is just the tip of a huge wasteful spending iceberg that no one talks about because it is supported and promoted by powerful special interest groups that spend billions lobbying elected officials to waste more of our money.  Here I focus just on Medicare, but the problem is far deeper than that.  http://www.cnbc.com/id/38385072/10_Ways_to_Reduce_Wasteful_Gov_t_Spending

Medicare is a great benefit to millions of people.  I am a senior citizen who has directly benefited from Medicare and am very grateful that the program exists.  If not for Medicare I would not have been able to afford my heart transplant at age 68, never mind the expense of anti-rejection drugs.  So that’s my disclaimer.  I am not an opponent of Medicare.

What I question is the many contradictions in Medicare coverage.  I don’t think Medicare has considered for one moment the adage, “An ounce of prevention is worth a pound of cure.”  For example, if you suffer from end-stage kidney disease Medicare will pay for dialysis until a kidney is available for transplant and they will pay for the transplant.  Survival rates for transplanted organs are very high, provided patients take their anti-rejection medicine which runs about $1,000 a month.  But, and here’s the rub, Medicare will only pay for anti-rejection drugs for 36 months, then you are on your own.  If you can’t afford the drugs and go into rejection, Medicare will pay for your care and for continuing dialysis treatment at the rate of over $70,000 a year until a new organ is available and then they will pay for a second transplant (about $100-150,000) but the 36 month clock starts ticking again and…if you can’t afford the drugs after the three year period, you can again go into rejection and Medicare will put you back on dialysis and sometimes even pay for a third transplant.  All of this unnecessary cost would be avoided if they would only consider preventive medicine and pay for the anti-rejection drugs for the life of the transplant recipient.  Currently Medicare pays out almost $9 Billion (yes, a B) a year in dialysis costs.   This report is a bit dated but it tells the story quite well http://www.nytimes.com/2009/09/14/health/policy/14kidney.html

But, as the commercial says, “Wait…there is more.”  Medicare will not pay for Dentures or dental work.  Ill fitting dentures can cause painful and dangerous mouth sores that keep people from eating, cause infections and even malnutrition.  But why bother with prevention.  The geniuses who make the Medicare rules would rather pay to treat the problems brought on by bad dentures than provide new teeth, avoid the associated medical problems and save the government millions of dollars.

Medicare will not pay for new eyeglasses.  But if you fall down and break a hip because you didn’t see the sleeping dog on the floor in front of you, Medicare will pay for treatment or even a hip replacement and the follow-up rehab.  But no new glasses, so you could fall again and go through the whole process ad infinitum.  Medicare will continue to pay for your injuries, though http://ucanhealth.com/topics/?T=medicare_durable_medical_equipment

Medicare Part B helps pay for purchase of following durable medical equipment if certain requirements are met. You are responsible for paying directly, or through supplemental insurance, at least 20 percent of the Medicare approved amount.

• power wheelchairs
• some positioning devices
• walkers, rollators
• scooters
• seat-lift mechanisms for lift-chairs
• artificial limbs
• orthotics, splints

Medicare will not pay for hearing aids.  But, if you can’t hear the fire truck rounding the corner as you cross the street and are hit by it, they will pay for whatever care you need (if you survive the accident) until you are on your feet again. But hearing aids….absolutely not.  Medicare would rather spend thousands if not millions on treating all the problems caused by poor hearing but they don’t even think about prevention. 

I could go on and on listing the contradictions in Medicare coverage but why should I have to?  Don’t our elected officials know how ridiculous all this is?  Why are they so reluctant to change it?  When the health reform bill passed this year the house version included a provision to eliminate the 36 month restriction on paying for anti-rejection drugs but the senate version and the final bill did not.  How in the hell do elected officials justify spending billions to save thousands?

I don’t know about you but I think it’s time politicians and bureaucrats started treating our money like it was their own and quit this stupid, wasteful spending.  And as I indicated earlier, this is only the tip of the iceberg.  Can you imagine what the Pentagon, and other agencies waste.  We could probably pay for all the social programs we need, put everyone back to work and send the stock market soaring again if the people in charge would think about what they are doing and quit making stupid decisions which are undoubtedly influenced by powerful lobbying concerns like the dialysis industry.  “Nuff said for now.  

If you are not an organ donor, please become one.  If you are a donor please do what you can to encourage others to do the same.  You can register online by going to http://www.donatelife.net/index.php   

Also, please join Organ Transplantation Initiative (OTI) http://www.facebook.com/#!/group.php?gid=152655364765710 a group dedicated to providing help and information to donors, donor families, transplant patients and families, caregivers and all other interested parties.  Your participation is important if we are to influence decision makers to support efforts to increase organ donation and support organ regeneration, replacement and research efforts.