getting back on the blogging bandwagon

The New York Times published an article today about how the GAO is citing the "Bush Administration" (that is, the Centers for Medicare and Medicaid Services, or CMS) for not properly overseeing the administration of Medicare Parts B, C and D and overpaying private insurers with Medicare contracts who are neither providing the best benefits to their subscribers nor passing along "savings" (from overpayments?) to the subscribers OR the government. (In theory, at least, any savings the Medicare insurers have are supposed to result in either lower government payments, lower premiums, or both.)

The GAO abstract can be found here.

This is bad enough, but there's more.

The Times article reports that

the Bush administration is vigorously pursuing money that it says is owed to insurance companies by Medicare beneficiaries. The Medicare agency has sent letters to more than 135,000 people saying they still owe premiums for prescription drug coverage provided in 2006. In most cases, the premiums were supposed to have been withheld from monthly Social Security checks, but the government withheld the wrong amounts or nothing at all. (italics mine.)

So what we have here (and thank you for putting up with the policy-lingo summary) is a case in which the CMS has failed to keep prices down for beneficiaries, failed to achieve savings for the government, failed to make sure that services were what insurance companies said they would be, and failed to make sure that people on fixed incomes were having the correct premiums deducted from their SSA checks. However, they are hellbent on making sure that these same beneficiaries, to whom savings have not been passed on, are going to pay back premiums to the very contractors who are cheating the beneficiaries and the government.

Way to go, guys.

This is something that was predicted by many who work with Medicare, including the Medicare Rights Center in New York. Partial privatization of Medicare has always looked like bad news to the grass-roots, and to those who work with folks whose health has been compromised by the way Medicare HMO's have functioned.

It seems that the fear that Medicare Part D was mostly going to be good for private insurers has been realized.

The really sad thing is that while traditional Medicare's fee-for-service program has been breaking down for years, to the detriment (primarily) of physicians, it was a great baseline service. The problem with traditional Medicare from both the patient and physician perspective was that payments didn't keep up with inflation or with increased cost of service provision. Because the pay for Medicare patients became so low (and I saw this happening when helping an uncle in his podiatry office as a young adult), physicians were reluctant to take on as many Medicare patients as needed care.

But regular increases in pay for medical personnel could take care of that. Heaven knows, the insurers are keeping their own payments as low as they can without losing doctors willing to participate in their programs. And doctors know that all they can do is try to find insurance companies that pay them okay for most of their procedures. (Not visits; check-ups pay virtually nothing.)

On the other hand, traditional Medicare meant that docs didn't have to choose a smaller percentage of elderly patients to see (that is, you either accepted Medicare or you didn't; you didn't have to elect Medicare Advantage plan x, y, or z).

I am once again calling for a single-payer health care system, along the lines of traditional Medicare. Because even at the financial/economic level, Medicare Advantage has been a fiasco for doctors, patients, and the federal government.

The Story Thus Far

Once upon a time, I had employer-sponsored health insurance.

Then I became ambitious. I decided to go back to school, to get a Master's degree in Divinity. I wanted to spend time following God more intentionally than I had in my previous job. I knew that I could get COBRA when I left my place of employment, and also that there were options for university-sponsored health insurance with most seminaries (which, though the ones to which I applied were not part of the universities, had affiliations with local universities to allow for the universities to sponsor their students for health insurance).

So, for the past 3 years, I have been insured, first via COBRA, then via the university-sponsored health plan.

I finished school in May, and have been working part-time as a hospital chaplain ever since. There are a number of reasons that this is not a permanent job, most significantly because I am both still underqualified for it (I haven't done a residency yet, and am unsure whether I will) and because I'm filling in while the hospital finds a qualified rabbi for the position. The agreement was to work on a per diem basis for a few months.

Needless to say, while I can pay my rent, pay my bills, and buy my groceries (amazing in itself on three days/week of work!) I am not receiving the benefits that would accrue to a full-time, permanent employee.

My school-sponsored insurance is about to run out, so at beginning of the month, I called my insurer (Aetna) to see whether I would be able to purchase COBRA or an individual plan.

Let me be clear: Aetna's basic student plan (what I could get while in seminary) was NOT sufficient to my needs. But it was better than nothing. Let's just say that for part of each year (after I've exhausted large parts of my benefit) my health-related expenses exceed my rent.

Of course, without insurance my health expenses would exceed any money that I earn.

More tomorrow. This story is one for installments!

The beginning of the blog

Today my sister and I were talking, and I was, for the umpteenth time, whining in frustration about my own difficulties with finding affordable health insurance now that I am out of school.

"You should start a blog," she said.

Joanna had several reasons why she thought starting a blog about my health care travails would be a good idea. These included the possibility that I might gain some publicity and be able to raise money to fund such a thing. "You could write about it, and become famous!" she said.

"If it were me, I'd write a song. But I think that blogging is a better medium for you."

I'm a bit hesitant to start a blog just about my own issues with health care. Not that I feel shame about it; I'm fairly public about my health issues, feeling like hte more information is out there, the more likely it is that those of us who are sick won't be considered totally weird.

And before you ask, my appropriation of the term "sicko," as in "Frustrated Sicko," is less inspired by Michael Moore's movie than it is by my ever-fabulous activisty friend 'becca, who started queering diabetes a number of years ago.

But I digress.

My hesitation about starting a Frustrated Sicko blog is more due to feeling like I don't have the right to complain. I actually am insured at the moment, and am going to remain so, thanks in large part to my parents, who have generously offered to front me the money for my continuing coverage plan through the university whose plan was covering me up until the end of this week.

I can't afford it by myself, but at least my parent's are well-off enough that I have an option.

Which is better than having no affordable option at all. Even if I can't personally afford that option.

So this is the opening post. More substance to come, perhaps even today (!).

For my personal stuff, please visit my livejournal. I expect that I am a lot more interesting over there.