Yesterday I blogged about my business’s fifth birthday … and this week, it turns out, marks six months before I turn 65!
And that means I go on Medicare.
I’ve learned enough in these five years to know at least two things:
- You’re a patsy if you think the American medical system will necessarily take care of you. It might, but if it does, it may be in the process of making itself a boodle of money.
- Yes, there are many exceptions – individuals and organizations who care and who work hard. But I’ll repeat: you’re a patsy if you sit back and assume the system will take good care of you.
- When it comes to money in American healthcare, don’t expect anything to be explained clearly.
- 18 months ago I blogged about a famous policy paper, Hospital Pricing in America: Chaos Behind A Veil of Secrecy by Princeton economist Uwe Reinhardt. That paper was published 8 years ago, and hardly anything has changed. (The title of the article is real and not an exaggeration.)
- In 2013 I lived the chaos and the veil myself, in my own shopping for everything from CT scans to shingles vaccines to skin cancer treatments. I saw at close range that Reinhardt was not exaggerating, and I blogged it in a series called “cost-cutting edition.”
There are signs of hope, such as ClearHealthCosts, but although I work for change, I’m not waiting for the posse to save me.:-) I’m gonna be pro-active, engaged, empowered, responsible! I want to get educated, because I’ll be on Medicare for the rest of my life. And I want to approach the education from the patient’s perspective … not what the system wants to tell me, but what people like me have found necessary.
So, you who’ve been through it: what do I need to be aware of? What choices will I need to make?
I do know these things about Medicare:
- Medicare comes in a crazy Alice-in-Wonderland list of benefit “parts,” a plan that was most certainly not created by us out here and is not subject to free-market simplifications. (See this summary of the Parts: A, B, C, D, F, G, and K … no E, H, I, J.) And I know it has a “doughnut hole.”
- It is a cesspool of money, run by the people who get the money. Did you know that in 2003 Congress passed (and the President signed) a law that prohibits Medicare from negotiating better prescription prices? A cesspool run by the money people. (And every attempt to fix that law has been blocked – in Congress.)
- Medicare is also a cesspool of policies that block you and me from knowing which doctors are better, for our own benefit. Are you familiar with “never events” – the list of things that should never, ever happen in medicine? The list includes things like amputating the wrong leg, operating on the wrong patient, being electrocuted by cardioversion (“get the paddles”), giving you the wrong baby, etc.
- I mean, really, these should never happen, right? You’d want to avoid places who do a lot of these, right??
- Well, just this month Medicare announced that it will no longer publish the facts on which hospitals do never events! That certainly wasn’t decided by someone with my interests at heart. So I want – and you should want – to be as responsible for yourself as you can.
But I also know this: people love their Medicare. In 2012 I heard a speech by the great author and columnist T. R. Reid, who toured the world living in different countries’ health systems and wrote The Healing of America. In his talk he said (paraphrase):
Medicare in America looks like socialized medicine – it’s government-run universal coverage. But we also know it can’t be. Why? Because Americans hate socialized medicine, but they love their Medicare. So it must not be.
Yes, I know people love their Medicare – even if they act crazy in their thinking. So I’m not approaching this without hope – I’m just approaching it with my eyes open. :-)
I assume people will try to sell me various plans. Which do I need? How do I decide what I need?
p.s. If you want a great description of which countries do what in universal coverage and socialized medicine, read this discussion on the PBS Frontline site, Does Universal Coverage Mean Socialized Medicine?, between T.R. Reid (above), and Uwe Reinhardt (above), and others.