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Politics : View from the Center and Left -- Ignore unavailable to you. Want to Upgrade?

To: Katelew who wrote (130431)	2/8/2010 11:33:54 AM
From: Lane3	Read Replies (1) \| Respond to of 542023

You're on Medicare, as I now am. What's to rail about? I wasn't railing. At least I didn't mean to. I think Medicare is an OK system. It does what it does well enough and is a boon to lots of people. But it doesn't cover everything my Blue Cross does. It doesn't cover shingles vaccinations, for example, or annual physicals. Those are just a couple of items I encountered since I've been in it. It doesn't pay for screening heart scans. I had two under Blue Cross. Paid for my own this time just to save the hassle. My doctor is always wary of the testing that I suggest as Medicare limits frequency and she has to think up excuses. You may not have run into any shortfall yet but it's there. The coverage is definitely not as complete. Not that that's a bad thing given that rationing is necessary. Just pointing out that it rations more than Blue Cross. [Which reminds me. Remember out discussion about my having to have my colonoscopy in a hospital rather than the gastroenterologist's surgery and the extra cost of that? Well, I just just this morning listening to a ReachMD podcast about the impact on cardiology of the 2010 Medicare Physician Fee Schedule. One of the points they made was that the drastic cuts in SPECT payments were driving those tests and their cardiologists to hospital practices where Medicare could bundle costs but that those tests were more expensive in a hospital than in an office. Which reminded me of our colonoscopy discussion.] You mention the issue of "choice" all the time. This doesn't resonate with me. So what am I missing? I don't suppose that resonates equally across the population. Some folks are more comfortable with one-size-fits-all than others. As a practical matter, it doesn't matter unless you're an odd size. Now we were never offered or were put into any kind of HMO plan during our employment years. Maybe that is the difference. Indeed. I have always had a fee-for-service plan but I've heard complaints from those who had to go through their primary care physician or had to use participating doctors. Me, I don't want to be relegated to an also-ran. I don't want that for anyone else, either. You can read on SI posts from smart people who rail against Kaiser. And Kaiser has to compete to get business. What would it be like if it had no competition? I simply cannot see how 95% of folks in this country couldn't be quite happy (not feel stifled) with the benefits coverage of our single-payer Medicare. Could be. Many people are content with good enough. Or have enough money to supplement Medicare. Or are simple sheep. Or prefer to have their decisions made for them. Or aren't educated enough to know that they're not getting optimal care. At least not until it's too late, if ever. You know, we don't have data on how many people suffered because Medicare didn't pay for this or that. The people, themselves, probably don't know that for want of a shoe the horse was lost. Remember, too, that how happy folks are with their benefits is not the only metric in evaluating a system. There are cost, cost effectiveness, vitality, and viability.