Streams

Open Phones: Medicare

Thursday, April 07, 2011

If you are over 65 and on Medicare call us and tell us what works and what doesn't with your Medicare coverage. 

Comments [38]

Harry Schroder

What is the phone # for the Brian Leher call in?

I want to say that two prescriptions that I must take will go up in 1012 from $3 per prescription to 42$. 1400%. I can't afford that increase. This is unconscionable. Any comments?

Harry Schroder

Dec. 15 2011 11:39 AM
Paul from NYC

I went from private insurance to Medicaid to Medicare in the space of 3.5 years. I'm pretty happy with Medicare. It's lightyears above Medicaid in quality of service; I no longer feel like a complete leper when I tell them who my insurer is (there is still stigma since I'm under 65 they know I must be disabled).

I think physicians acceptance of Medicare is more limited by attitudes than economic realities. All the doctors tell me the same thing--with Medicare they know what they're getting paid and there's little hassle, but the wait for the money can be long. The big problem is many doctors don't want to treat people whose cognitive functioning is impaired--and many elderly and disabled fit that category--because it takes up too much of their time.

As for driving down costs? As long as illness is an easily exploited commodity that makes some people an awful lot of money I don't see it happening.

Apr. 07 2011 02:22 PM
chris O'Neil from NYC

i have a medicare advantage plan, which is good for me and terrible to providers, I recently had radiation, instead of major surgery. The hospital bill was less than $5,000 for the entire treatment, under top doctors at one of the work's premiere hospitals. Although it saved the insurer over $200,000., the private company
discounted almost all - they paid less than $200.
Please stop assuming that Medicare must be cut - - all medical costs are high and rising. The underlying tenet is that the country cannot increase taxes - even those that fund social security and medicare beyond a salary limit of $110,000. An increase in this ceiling - maybe tied to the cost of living - might solve the whole thing.

Apr. 07 2011 01:31 PM
Sharon from Maine

I went on Medicare in January of this year. I purchased the very best BC/BS companion plan and perscription plan. I've seen a huge savings on my perscriptions and on my treatments. I have had a serious medical condition since I was 14 and have had to pay an absolute fortune for very little coverage to insurance comapnies. I would be very upset if they made changes to medicare.

Apr. 07 2011 01:10 PM
Ryan from Eau Claire, WI

As a physician, I think several realities need to be made abundantly apparent to the public. 1) insurance companies are not there for your benefit. They are there to increase profits to their shareholders. So with that as a backdrop any stystem that would put more people in that system, who are reliant only upon that system for healthcare is unacceptable. 2) the most costly diseases to treat in america are diabetes, heart disease, and renal failure. All 3 are in most cases, entirely preventable diseases. We want to reduce the cost of healthcare change the food that people eat and the lifestyles they live so that we have to support fewer of these people in the Medicare system.

Apr. 07 2011 12:51 PM
Terry from Manhattan

I am 66 and have been on Medicare for 18 months. The premiums I pay for Medicate Advantage PPO II through GHI are absolutely nothing compared to what I paid that same company for individual/small company insurance for exactly the same coverage BEFORE I was 65. What's wrong with this picture. I now pay Part B plus $52 per month -- and it includes drugs. I have been told that if you are healthy, Advantage Plans are the best way to go. When I get older and more frail like my mother, then I have been told that supplemental insurance and Part D are what one has. Unfortunately, even though supplemental insurance coverage is pre-proscribed by law, insurance have found a way to bilk the more frail elderly out of millions in premiums for no reason at all except their executive salaries and profits. Not fair. If AARP's United Healthcare is 50% less than GHI, why? GHI actually said they know they are more expensive and they don't expect anyone to buy their supplemental, even they have the most providers in NYC signed up with them. Amazing.

I recommend for both Social Security and Medicare that we increase the qualification age to over 70 for those who are 50 something now. We know that in the 30's only half or so of the population lives beyond 65; now we live beyond 80, and thank God. So let's raise the "retirement" ago accordingly -- and raise the Medicare age the same way, maybe slightly lower so people can get Medical Care they can afford while they stay alive longer. It will be less expensive to give medicare insurance than catastrophic, end-of-life care.

As for Medicaid, keep it in clinics, absolutely out of the expensive Emergency Rooms. If one isn't on their death bed, they should be turned away from ER's and sent to a public clinic, which is mountains cheaper for regular care. But if the qualified poor do not get health care, they will be more expensive to serve when they get very sick and end up in hospitals, when their illness could have been nipped in the bud. Thank you for this opportunity to talk about this most important subject. God bless NPR and WNYC.

Apr. 07 2011 11:56 AM
Casey

I am under 50 and I became eligible for Medicare in 2003 because of a disability. I also have Medicaid. I stayed with original Medicare until the end of 2010 but I finally switched to an HMO for dual eligibles (having both Medicare/Medicaid) because I got tired of the Part D plans playing premium games and telling me I would be switched every year.

I can relate to one caller who said it can be more of a hassle, but so far it reminds me of when I had to go through a primary care doctor for referrals in the past and hoping that you can continue to see specific practitioners since they have to be in "network." So far, I have no complaints because all of my providers participate in the network; I would probably go back to original Medicare if they decided to stop participating in the plan, though.

Apr. 07 2011 11:40 AM
Frank from NJ

I owe my life to Medicare, in particular to the Kidney Dialysis Act of 1972, which provides Medicare to anybody who is diagnosed with End-Stage Renal Disease at whatever age. Private insurance never did and never will cover dialysis and transplantation, so I would have been dead in my early 50's, had I had to pay the $1K+ per month for the treatment, much less the $100K+ that removing both my kidneys and transplanting one in after 4 years of dialysis cost. I am now on "regular" Medicare and wouldn't switch out for the best private coverage in the world.

Apr. 07 2011 11:36 AM
Natalie from Brooklyn

I am over 65 and covered by Medicare and my employer's retiree plan. I have a question about the Medicare Advantage plans which seem to take from the big Medicare pot (into which we all pay) and buy private plans with this money. This would apparently mean that people like me are paying for others. private coverage with our dedicated Medicare contributions. This means our Medicare dollars are not being spent fairly or efficiently.

Apr. 07 2011 11:35 AM
Bill from New Rochelle

els,

Ryan's vouchers are actually Soylent Green?
http://gilagreen.files.wordpress.com/2010/06/soylent_green.gif

Apr. 07 2011 11:33 AM
jawbone2 from Parsippany

So...under Ryan's plan our leaders will be killing their own people! And our leaders are actually already doing that now and have been doing it by not having universal affordable health CARE. How many die each year from lack of insurance for health CARE?

No self respecting nation supporting Responsibiity to Protect can tolerate such dangerous behavior.

Time for R2P -- Responsibility to Protect! And A UN Security Council resolution to implement it!

Surely, if we're on board with R2P (Responsibility to Protect), even our leaders will see the need to sign on to a Security Council Resolution requiring, oh, no-kill zones (ie, the entire US) which will allow flights into this country without restriction of doctors and health care professionals from...Cuba is closest, right? From other enlightened nations as well. And Canada can sell us necessary prescription drugs at far lower cost than our leaders make their citizens pay. Other benevolent nations which face up to their responsibility to protect their own peopl will have free range in this nation to create demonstration projects of how health care is done well, for actual CARE, not just rampant profit.

Once they have stabilized the population in terms of health care needs, then certainly some international organization(s) will remain to ensure our leaders don't return to their evil and life threatenting ways.

Since Pres. Obama went for a profit protection plan for big insurers and some favored big health industry players instead of extending Medicare to All, we need outside help and control over our leaders.

Maybe the other leaders will tell him it's time for him to go....

R2P, babeeeee!!!

It may be the only way we get universal CARE in this country.

.

Apr. 07 2011 11:32 AM
Bill from New Rochelle

Merle,
Medicare is a subsidy, paid for by the taxpayers.
Your insurance is a profit making corporation, maximizing profit.

They are not comparable, except under the GOP / Ryan plan; which would put Medicare in the same boat as your "private insurance."

So, under that proposal, buy another 20% of private insurance to pay for their profit, and then watch your medicade shrink and your insurance increase until you die.

Go out and have some drinks, and dance while you still can.

Apr. 07 2011 11:29 AM
Karen from Queens

I am over 65, on Medicare and have worked in health care (social worker @ major NYC hospital) for 40 years. The doctors we know are continuing to drop out of Medicare like flies because of the low reimbursement rates. This is more and more of a nitemare for my husband and me because as a result, we now have to switch doctors often. As we can see from our M/C statements, the reimbursement rates do seem inequitable indeed. If we can't have a single payer or public option plan, I think the one thing that could help the physicians to stay in M/C would be tort reform (thus lowering their exorbitant malpractice insurance). Also, some form of means testing seems in order. Why should patients making $500,000 a year pay as little as someone making $50,000 for the same Medicare benefits?

Apr. 07 2011 11:11 AM
Merle from NYC

I've just been on Medicare for one year. I'm very satisfied with it, but am amazed by two things: 1) how much higher the premium is for my private supplemental coverage ($250/month for 20% of the costs incurred under Medicare vs. $110/month premium for Medicare, which pays 80% of the costs. There's something wrong with that formula 2) the very high cost for drugs under Medicare Part D, because there is no ability to bargain over prices. It's a travesty to say that the individual benefit is $2800. It's not. You could just pay $1000 out-of-pocket, but the very high retail cost of the medication is "charged" to you, and goes into the concept of the $2800 benefit, so you could fall into the donut hole very quickly if you happen to be unlucky enough to be prescribed newer, more expensive drugs.It's a giveaway money-maker for the drug companies.

I think there are runaway medical costs because there are no curbs on doctors prescribing a lot of unnecessary tests that they may or may not profit from; perhaps standards could be developed for that. We need patient and family education about end of life care, where the bulk of money is spent, for very little patient benefit.

Apr. 07 2011 10:58 AM
amalgam from Manhattan by day, NJ by night

@ Brian from Brooklyn -

I agree and have been stating the same thing for a while:

The problem with healthcare costs in the US is its delivery and especially its fee-for-service payment system. Without that being addressed in a comprehensive way, just taking on Medicare/Medicaid does little to contain costs.

The ACA was at least a beginning of wholesale cost containment - although it still keeps the problematic (at best) insurance companies as the intermediary - and with certain programs and research designed to reduce costs.

Better to work on controlling costs through changes to the ACA than to do it piecemeal like the Ryan plan does. (Plus the Ryan plan takes the wrong approach ENTIRELY by using the ideological, impractical, method of Medicare privatization!)

Apr. 07 2011 10:51 AM
Joan C. Thomas

I AGREE WITH KAY THE INTERNIST WHO CITES OVER-USE OF NON-GENERIC PRESCRIPTIONS FOR DRUGS AND HIGH-TECH TESTING.
RECENTLY, A FRIEND TOOK A FALL OUTSIDE HER HOSPITAL. THEY ADMINISTERED A CAT SCAN . . . IN REALITY, SHE HAD A SCRAPE ON HER CHEEK AND A BLACK EYE.
YEARS AGO, THE DOC WOULD EXAMINE YOU AND SEND YOU HOME ADVISING YOU TO CALL HIM IF YOU HAD ANY SYMPTOMS.
I HAVE BEEN ON MEDICARE FOR EIGHT YEARS AND FIND IT EFFICIENT. IT IS COMFORTING TO HAVE ACCESS TO IT AFTER YEARS OF HAGGLING WITH CORPORATE HEALTH PLANS.

Apr. 07 2011 10:50 AM
Pat from West Milford NJ

My father received excellent medical care under medicare. However, much of the care was redundant. Best example was when he was admitted to a local hospital in Southern NJ on a Saturday. They did not have the preventative care equipment to perform a test. They sent him to a regional hospital on Monday, in an ambulance, when he arrived at the regional hospital, they began to ask him his basic medical history. Aside from the fact that he had vascular dementia - why did the receiving hospital need to start with a clean slate on him? He had a long and complicated medical history - Why were those records not readily available? Subsequent tests were redundant and costly. So inefficient. This is the problem.

Apr. 07 2011 10:50 AM
Sandy

Peple making over a cetain amount already have to pay more for medicare.

Apr. 07 2011 10:47 AM

I am 66 and started receiving Medicare last year. I have strait Medicare and a supplemental plan. I am very satisfied with my healthcare. I have only had one doctor who does not accept medicare. My GYN does not accept medicare and so I switched to a GYN who only accepts Medicare. Very interesting but both doctors have very different opinions about accepting Medicare. My current doctor feels it is less paperwork, and less complicated. My former doctor feels that the reimbursement rate is too low for her.

Sandy in Brooklyn

Apr. 07 2011 10:47 AM
JohnL from Brooklyn

Ryan's plan does absolutely nothing to actually address the costs of healthcare -- only what the Gov. will pay for it. What happens to those who can't make up the difference?

As far as means testing -- means testing is a strategy for turning the middle class against Medicare (or any social program). When the middle class gets "means tested" OUT of the program it sets up fertile ground for the "why should I 'give' my hard earned money to those lazy poor people?" !!

Apr. 07 2011 10:45 AM
Marian from Manhattan

I turned 65 in January and am very happy to be on Medicare. I moved to NYC three years ago and the hardest part of finding new doctors was finding ones who would take my insurance. My husband was already on Medicare and had no such trouble. We pay a surcharge because we are income is over a certain amount. I think it could be tiered even more. Those who make over $250,000 could pay an extra surcharge and those over $500,000 even more.

Apr. 07 2011 10:44 AM
Edward from NJ

@Chris from Manhattan, the problem is that health care in the US isn't merely rising relative to GDP. Relative to GDP, America pays far more for health care than any other country for similar or worse health outcomes.

http://economix.blogs.nytimes.com/2009/07/08/us-health-spending-breaks-from-the-pack/

Apr. 07 2011 10:44 AM
els

Nothing equates to a "death panel" more than vouchers for the elderly population.

Apr. 07 2011 10:41 AM
kelly from somerset nj

I am a geriatric care manager and a volunteer with SHIP (Statewide Health Insurance Assistance Program - a Federally Mandated program to help beneficiaries resolve Medicare issues).
The prescription drug benefit is far too complicated to administer and allows individual plans to negotiate prices for drugs rather than the federal government negotiated directly and thereby getting the lowest possible price.

Apr. 07 2011 10:39 AM
Robert from NYC

Strange as it sounds with regard to that guy who said the private companies pay so little to the Drs, I had two surgeries whereby what the private company I had thru my job some years ago paid so little that I was embarrassed to go back to the surgeon for a f/u exam! I had to bite my tongue to stop myself from offering to pay him more money. Of course, I didn't and he never brought it up but, even I, Mr Socialist, know when a Dr is getting screwed!!!

Apr. 07 2011 10:39 AM
Chris from Manhattan

Why the assumption that cutting healthcare costs is the top priority? Why shouldn't healthcare costs rise, in absolute terms and relative to GDP? So what if we end up spending more on health and less on something else? What's more important than your health?

Apr. 07 2011 10:36 AM
Kay ( from Manhattan

Your telephone lines are busy so I am responding by email. I am in internist and geriatrician practicing in New York. I am distressed by our current health care system, and by the Ryan Revisions, which puts the burden on our elderly to pay unrestrictedly rising costs. I would like each practitioner to take the responsibility of lowering costs by eliminating unnecessary medications, using less expensive medications rather than newly-released duplicate drugs, and my eliminating expensive imaging and other testing. The medical community can reduce health costs so that the elderly and others are able to afford healthcare

Apr. 07 2011 10:35 AM
Bill from New Rochelle

I keep hearing about how much fraud there is in Medicaid / Medicare.

* Why don't we make this Fed-Med fraud a major Federal offense, with major federal prison time; and the FBI investigating it, rather than overworked & inexperienced local and state DA's.

* Ryan's plan is simply dumping it on states that are already on the ropes, and adding an immediate cut of 20% (profit;) with no hope of paying for real insurance for the elderly.

Apr. 07 2011 10:35 AM
Tony from UWS

Please read A LIFE WORTH LIVING by Dr. Robter Martensen. It explains much about end of life care and how extending life of terminal patients is a big business that costs medicare a fortune.

Apr. 07 2011 10:34 AM
Edward from NJ

Why do medical costs rise so disproportionately to inflation? Have doctors been getting raises for the past few years?

Apr. 07 2011 10:33 AM
Brian from Brooklyn

The problem with increasing costs making Medicare costs increase more and more is NOT a problem inherent to the medicare itself, it is a problem inherent to the medical and pharmaceutical industry. You CANNOT control the costs of medicare without controlling the cost of medicine generally.

The Ryan plan does NOT control costs, it shifts those costs onto the States (for medicaid), the poor (medicaid), or onto the elderly (for medicare). Thus, it is a terrible plan.

Apr. 07 2011 10:31 AM
Robert from NYC

I just went on Medicare this year when I reached age 65 in January and frankly I'm satisfied with it but not with the supplemental my employer offers. But as for Medicare the problem is nothing or very little more than the fraudulent abuse that happens. The overhead is far less than private companies and as it is said that's because most of that money to private companies is to prevent and avoid the fraud that Medicare is hit with. But I'd rather my money go to Medicare to fight the fraud than that it go to the CEOs of mega private healthcare companies. In the long run it would cheaper. And I agree with that caller's position on Part D. That was a disaster that, BTW AARP pushed for.

Apr. 07 2011 10:31 AM
RCT

I took care of my late mother in her old age, including after a major stroke. Medicare was great. Her bills were paid. We had virtually no paperwork to complete. She received excellent care, a top NY hospital. The solution is to raise the premiums for those who can pay - say, 3 percent instead of 1.5. The Republicans don't care if we all die. We need too to study costs - as was supposed to be done re the health care bill but got taken out.

Apr. 07 2011 10:30 AM
Katie from Huntington, NY

I'm old enough to remember news reports back in the 60s-70s of the elderly (they weren't called Senior Citizens then) eating dog food because they did not have enough money to buy food for their table (of course, that was before dog food was so high priced!). If we give Seniors the "choice" (read switch the cost to Seniors), it will be deja vous.

Apr. 07 2011 10:28 AM
Edward from NJ

@francesca, GE didn't pay taxes because they didn't owe any taxes thanks to all the loopholes both parties have built into the tax code. There are no back taxes to go after, but we could close those loopholes to get more future tax revenue.

Apr. 07 2011 10:28 AM
Stella Katz from Manhattan

It's outrageous that the Republican Party has been allowed to politicize the budget debate by making Medicare the central issue, and has endorsed the Ryan Plan - the fever-dream of a Tea Party freshman with no moral compass.

Apr. 07 2011 10:27 AM
David from West Hempstead

I have this crazy idea--what if we started letting younger and healthier people into Medicare as well?

Apr. 07 2011 10:24 AM
francesca from nj

I want to know why the government is not actively pursuing the large companies for back taxes. GE was cited in the NYT recently for not paying ANY taxes. If this revenue was received, we would not have to, once again, stick it to the poor, elderly, and struggling middle class to fund the government or get out of debt. Obama seems to just stand by and let the rich get richer and try to please the Republicans. This country is no different from Greece when it comes to tax collections, especially from companies and the wealthy.

Apr. 07 2011 09:30 AM

Leave a Comment

Email addresses are required but never displayed.

Get the WNYC Morning Brief in your inbox.
We'll send you our top 5 stories every day, plus breaking news and weather.