subject: Top 5 Reasons Medicare Is Bad For Your Diabetes [print this page] Martin has three kids and eight grandkidsMartin has three kids and eight grandkids. As a recently retired engineer, he though he would we sitting on the beach sipping drinks with little umbrellas in them. But instead his is sitting in a wheelchair after a diabetic foot infection ended with an amputation of his left foot. It all happened because his primary care doc couldn't get him to see the podiatrist right when the problem started. The real problem, is that Martin has Medicare.
Retired Americans often view HealthCare paid for by Medicare as one of the few perks of retiring. Given that there are no more real pension, Medicare is one of the few retirement benefits today. But unfortunately for those who are diabetic, Medicare can be bad for your health. Its just math; not enough money equals not enough high quality medical care.
The recent attempted resurrection of President Obamas Health Care reform efforts speak to the broken system. The fact is that Medicare is an expensive program. Since 2002, Medicare has been short of money. There is only just so much money to go around. All of the federal mandates that have been written into law to save money are simply killing diabetics. As long as you understand why, you'll be able to get quality care even if you do have Medicare.
1. Difficult to Find a Medicare Doctor.
Since 1986 Medicare has set all doctor fees. Medicare decides how much physicians get pain, doctor's don't. Adjusted for inflation, over the last eight years, Medicare Has reduced fees about 20% every year. On March 1, 2010 doctors took another hit when Congress let another 21.2% decrease in Medicare physcian reimbursement take over. Imagine if at your job every year you get 20% less pay instead of a raise. I'll bet you would start searching the want ads for a better position right away? Obviously your doctor cant just switch careers, but he can stop taking Medicare.
In some places this means less doctors are available to accept new patients. If you live in San Francisco, the cost of living may be twice that in rural Ohio. But incredibly, doctors seeing patients in San Francisco get paid comparable fees by Medicare. The only two options for the physician is to cut expenses or see patients faster.
2. Doctors Who Accept Medicare are Swamped.
In 2008, the president of the American Medical Association (AMA) was testifying in front of Congress about declining care for Medicare patients and the problem of Medicare cuts. The AMA President informed congress that the vast majority of doctors in the United States would simply opt-out of Medicare and stop providing care for Medicare patients. Senator Stark replied that since Medicare started reducing payments to doctors many years ago, doctors have simply seen more and more patients each year to make up for the lost revenue.
But it is now clear that doctors cant keep seeing more and more patients. 60 patients seen in a day is a bad idea. Seven minutes of time in a room with a patient is not enough time to understand blood sugar readings, sugar pills, insulin shots, hypertension, peripheral vascular disease and explain diabetic foot care. It just isnt enough time to practice good medicine. When docs see more patients than they can handle, diabetics can wind up in a terrible situation.
3. Less Pay for Medicare Diabetes Doctors.
Many people dont think pay should have anything to do with the quality of the care. But the reality is, it just comes down to math. If your doctor accepts Medicare, but has to see 60 patients a day, you wont get much time. I actually have a doctor friend who says, I just tell Medicare patients they get two problems to talk about during a visit. Just two, she said holding up two fingers.
Let's imagine you've got hypertension, high blood sugar and an open sore on your big toe? If you can only talk about two problems, you'll ignore the diabetic foot ulcer. And if that diabetic foot sore turns in to a diabetic foot infection, you just might wind up with an amputation.
Healthcare shouldn't be rationed; you have to make sure that you get to talk about ALL of your health problems with the doctor. This of course is the way medicine used to be. The fact that most patients dont know is that your doctor is obligated ethically and in many cases legally to hear about all of your health problems that need to be treated. So if you doctor says, Well have to discuss that next time, just insist that he hear you out.
4. Medicare is Paying for Fewer Medical Perks.
If you have diabetes you will be sent to a lot of different specialists. Studies have shown that having diabetes make you four times more likely to have a heart attack. You are also way more likely to develop kidney trouble, blindness, or diabetic foot infections that lead to amputation. To make sure everything is working right, your primary care doctor will likely send you for consultations with other diabetes specialists like podiatrists, cardiologists, opthalmologists and nephrologists.
A consult is a visit to a specialist requested specifically by your primary care doctor. Medicare decided to just stop allowing specialists like podiatrists and endocrinologists to bill for consultations ordered by your primary care doctor. So dont expect a specialist to take any extra time explaining your health problems to you or your primary care doctor. And dont be surprised if these specialists dont work you into their schedules very quickly. They simply are making money like the once were.
Once upon a time, house calls were common, but now very few doctors who accept Medicare can afford to make house calls. There is just no way they can take the time to drive from house to house with the low rates medicare pays. This is obviously a big problem for an elderly diabetic who may have poor eyesight or an open wound on the foot. If you have a diabetic sore on your foot and can't walk, your doctor can't really expect you to get to the office for an appointment?
5. No Diabetes Prevention.
It is simply a fact that the problems related to poorly managed diabetes are preventable. Loss of eyesight, renal failure, and diabetes foot sores can be avoided. Doctors fully understand how elevated blood sugar levels damage the eyes, kidneys and feet. Doctors also fully understand how preventative care can prevent this damage. But Medicare wont pay for intensive diabetic foot monitoring programs. It has been shown that close monitoring of diabetic foot skin temperatures can prevent diabetic foot sores. But this sort of close monitoring by a diabetic foot expert isnt a service that Medicare will pay for. As a result, it is a service that isnt offered to you by your doctor.
So now that you know the Top 5 Reasons Medicare is bad for your diabetes, what can you do about it? It is important to remember that you doctor is on your team and really just wants to provide you with the very best medical care. You have to keep in mind that your physician is your ally. But feel free to remind him or her that you need help, even if it might take a little extra time. Usually the physician will hear you.
You should also ask lots of questions. Take a list of questions so that you can stay on track and get all of your concerns dealt with in a short doctor visit. Ask your doctor about performs house calls. If not, find one that does. Even if you have to pay for it, having a doctor come to your home is an amazing convenience. Make sure you ask your doctor about any new treatments that are available, but not covered by Medicare. If you dont ask, many docs will simply not take the time to offer all available treatments if they arent covered.
Diabetes is a serious disease. Many patients with diabetes will die from health complications directly attributable to poorly controlled blood sugar. Since we know that most of the complications from diabetes can be avoided, it is critical that you get the very best diabetes treatment that your doc can provide.
