The Medical System is broken!

I finally made it to Medicare!

Medicare is mine and the government's joint funded health care program that has 4 basic component health insurance parts.  I have paid into Medicare Part A my entire working life through years of my Medicare withholding income taxes and there is no cost to me at this time for that one (it has already been paid for).  There are 3 other parts with out of pocket costs.  They offer higher and more specific health coverage.  Pretty easy concept…. right????   But as typical government red tape, they can confuse the hooey out of even the simplest concepts but throw in a mysterious Managed Medicare “middle man” and insecurity and chaos take over!

All of the sudden there was a massive inundation of unsolicited sales phone calls, mailed advertisements (2 and 3 a day for months), even salespeople knocking at my door (ala fuller brush salesmen) to “help” me make the “right” Medicare choice (theirs of course).  Every major health insurance company and many I never heard of were aggressively pursuing me and my Medicare business. I had to stop and ask myself why?  Some of these were the same companies that canceled my coverage and turned me down because of a preexisting condition.  Chronic advertisement, TV, mail, salesmen’s commissions, and other sophisticated marketing programs are huge business expenses.  They all tell you their service “costs you little or nothing”!   Why are they putting the “full court press” on me (or any 65 yr old) unless there was significant profit to be made over and above these costly marketing expenses?

So…. who is paying for their services?  How do they get paid?  There is no such thing as “something for nothing” and my suspicions kicked in. WHY are these companies pursuing me so aggressively?

Here is what I learned…and it scares me!  These Medicare management companies have negotiated with large healthcare service providers at a significantly reduced price.   Hospitals, doctors, independent testing facilities, outpatient surgical centers, etc. etc.  have agreed to accept lower fees for services.  These healthcare facilities are depending on the increased volume of patients and tests that are submitted through these specific Medicare management providers to make up the financial difference.  It is “wholesale” healthcare! There is a great deal of money to be made from medical testing, necessary or not.  Guess who keeps the difference in the 2 numbers (the payment the testing facility, doctor, etc. etc. has agreed to accept and the amount of money Medicare has agreed to pay)?  The answer is NOT the doctors, not the hospitals, or testing facilities, here is another hint…it is not me or you either.  It is your Medicare management company.   If you are of an age…and all of the sudden your “Managed Medicare Doctor” is recommending many more medical tests and smaller procedures… more than you have ever had.  It is probably not your health and/or welfare that they are concerned about, but now you need to begin paying for their services.   This is how the managed Medicare company is getting paid…at your health expense.

When we ask and complain about the price of healthcare, it is the managed care companies and insurance companies “in the middle” between you and the actual medical diagnosis and health care that are all making a profit from our health issues.  And since medical tests have the least amount of medical-legal “liability” to both medical and managed care companies, they become a financial bonanza and you will be getting a lot more of those.   This is how you pay for your managed Medicare services. Can you believe they are more concerned about your health or is it their profit margins?  The system is broken!

"Doctor My Eyes"  Jackson Browne