Sunday, November 30, 2008

The Quiet Privatizing of Medicare

I have linked the information on this topic to the title. The quiet privatization of Medicare is very carefully spelled out in the linked article. But I want to tell you how this effects a disabled person receiving Medicare parts A B and D.

For an American with a disability that eventually makes working impossible, the process of applying for State Disability Benefits is arduous, expensive and slow--very very slow. It took two years for my application to work its way through the Byzantine bureaucracy that is the disability maze. Their policy is to deny benefits on all first applications. Six months after my first application, I got my first denial. And, in the end, the only way to make it successfully through this process requires a disability attorney, but nobody tells you this ever at any point in the process. Yes, Dorothy, they do require an attorney to accept your application, and even then a judge can say, "Sorry, I'm not feeling the love today, and so, fuck you and the attorney you walked in with, waited hours with, and besides that I hate the look on your pathetic face anyway. Try again next year." It is humiliating, demeaning, and expensive. By the time you do get through the process successfully, you are bankrupt anyway. I sold my mother's antique furniture to stay afloat at the end, just to be able to eat and pay utilities.

My attorney was very skilled. And it was my lucky day that the judge seeing my case was filling in for the usual judge, who was out of town. The judge who saw my case lived in Las Vegas. I think it was his experience with crazies even worse than I that made him compassionate toward me. And once you do make it through that part of the process, you must then deal with your local Medicare and Medicaid offices. There you will face long lines and, once you get to the little window, you find the real obstructionists at the heart of any bureaucracy. They do not tell you over the phone what documentation you will need. But once you get to the little window, you will no doubt be missing one small bit of crucial documentation.

So, finally, two and a half years after my first application for Social Security Disability, I'm in the system and have received my first piddling little check. I have my Medicare Card. I have been referred to Valley Mental Health, and I have a good Psychiatrist. I've been tested and placed in a group of other women with bipolar disorder. And for several years that was as complicated as it got. But not so fast. We now have a new wrinkle in the Medicare system and guess what, you fine upstanding tax payers? Congress has quietly been doling out contracts to private insurance companies to give you less for more. And not only do they give the hapless senior or disabled person less service for more money and add another layer of bureaucracy on top of the one that has existed for a very long time, they also charge you guys a bit more because they are in the business of making money.

So, about four months ago, I got a packet in the mail about medicare coverage. This packet claimed it marked a change in the way medicare would be provided and that my account would now be covered by a plan called Evercare. I do not do well with reading the small print, but I should have called Medicare to check it out. This was the first salvo in the privatizing of Medicare. It duplicates what Medicare does, adds a new layer of bureaucracy, an enormous amount of paper--all very high quality glossy lists of this and that to confuse the elderly and disabled who often have a bit of trouble dealing with one layer of bureaucracy, let alone layer upon layer. It's smoke and mirrors. And it isn't continuous coverage. So when I go to my doctor's office with my new "medicare" card that now says Evercare, and the doctor's office makes a note of that, I start getting bills that have not been partially paid by medicare, and when I call Evercare, after going through phone mail hell, I get some jackass who tells me that on the billing date I was covered by traditional medicare. "Yessss? So you aren't medicare?" "Yes, we're your new medicare provider." "Well, I liked my old medicare provider better." "Just tell your doctor's office to bill medicare this time. Then they can bill us next time, and you'll be covered then."

What the Fuck? Is this what is meant by a ponzi scheme? I called medicare and asked why I was no longer on traditional medicare, and was told that I could indeed keep my traditional medicare, pay less and get more coverage. That it was the Bush administration's early work with a republican majority in the House and Senate to gradually, quietly privatize medicare. Holy mother of god! Just the paperwork alone must have cost millions. You should see the five pounds of booklets and formularies, and drug coverage, and exclusions, and networks, and favored hospitals, and on and on just to switch from what worked perfectly to what did not work at all.

The nice young woman at medicare spent almost an hour on the phone with me finding the best possible medicare part D drug package for me by having me give her a list of all my drugs and then checking them with all the insurance company options and found that Eatna covered all my drugs, even the diazipam and triazilam, drugs not covered by my old part D carrier. So next time you hear someone talking shit about the government bureaucracy making you have to see their doctors and how you'll get terrible care, tell them to talk to me. Bureaucracy is bureaucracy whether it's run by the government or a private, for-profit corporation with K Street lobbyists.