As we have had more and more difficulties dealing with Medicare, we started looking up information we thought would help us to deal with these situations more easily. Here are a few facts we came across that we did not know and you may not have known either*…
MEDICARE IS MANDATORY- If you refuse to join Medicare Part A, you will not be allowed to receive Social Security Benefits. Anytime a social program is mandatory like this, it is hard to believe someone is not getting kickbacks from the system. The most profitable business opportunity is the one the government makes mandatory.
Currently there is an attempt to remedy this situation underway in Congress.
MEDICARE PATIENTS CANNOT HAVE DIRECT ACCESS TO THEIR DOCTORS- A 1997 law forbids Medicare recipients from having a direct relationship with their doctor. Instead, the patient must go through Medicare and the doctor must treat the patient according to Medicare guidelines.
This means that the Medicare guidelines are your “real” doctors, making your decisions for you. If you do not like it, there is nothing you can do. If you have Medicare, and are receiving a procedure that Medicare covers, you have to go through them – you cannot simply pay the doctor directly and tell him or her to do what he or she thinks is best and not file your Medicare insurance.
There is a provision that allows the doctor to refuse to take Medicare, but most doctors cannot afford to do this, and this provision does not apply to Chiropractors – we are required to take Medicare no matter what.
THERE ARE PENALTIES FOR REFUSING MEDICARE PART B- Seniors are automatically enrolled in Medicare Part B. Those who refuse to enroll and later change their minds will pay a premium for the rest of their lives that is 10% higher for each 12 month period in which they failed to enroll. So, for example, if you delayed your enrollment in Part B until you were 70 (5 years), your Medicare premium will be 50% higher than the current rate for the rest of your life.
MEDICARE IS NOT A CERTAINTY- Even though taxpayers are the ones footing the bill, there is no actual binding contract between the government and the taxpaying citizens for future payment of Medicare benefits. Congress can alter or eliminate Medicare benefits if they wish.
MEDICARE DEPENDENCE IS GROWING- In 2003, there were 40 million Medicare recipients. In 2010, there were 47.5 million. In 2011, the first of the 77 million baby boomers began entering Medicare.
MEDICARE COVERAGE- Medicare does not pay for hospitalization longer than 150 days, and there is no limit to out of pocket expenses. “Medigap” insurance is often purchased by patients to protect against huge Medical bills not covered by Medicare.
Medicare also does not cover the cost of long-term care and nursing home care unless it is related to hospitalization or other urgent care.
MEDICARE FREQUENTLY DENIES PAYMENT- We can vouch for this one. Medicare is denying more and more payment, yet will not specifically say why the visit was denied, making it impossible to correct any mistake they may be accusing the doctor of in paperwork management or patient treatment.
In addition, any visit denied by Medicare is a visit we don’t get paid for. With Medicare, if they deny payment, we cannot ask the patient to pay. With Medicare denying more and more visits, it is becoming harder and harder to accept Medicare, since all the visits Medicare denies are visits we simply do not get paid for – ever.
We believe this is intentional by Medicare. We think they are trying to make taking Medicare so difficult that doctors stop accepting Medicare. This way the politicians can place the blame on doctors for not taking Medicare, instead of taking the blame themselves for cutting Medicare for those services. This is only our opinion, however.
MEDICARE HAS NOT DECREASED THE AMOUNT OF MONEY SENIORS PAY ON HEALTHCARE- in 1964, a year before Medicare went into effect, the average senior citizen payed an average of 20% of their income on healthcare. In 2000, AARP (American Association of Retired Persons) found that seniors were paying 19% of their income on out-of-pocket expenses. This does not include home care or nursing home care.
In other words, seniors today have to pay Medicare premiums plus 19% of their income on health expenses, while in 1964, they had no Medicare expenses and payed 20% of their income on health expenses.
ALL PROVIDERS WHO TAKE MEDICARE ARE AT ENORMOUS RISK- There are over 130,000 pages of Medicare regulations that must be meticulously followed by doctors and other providers – and even that doesn’t mean they have done everything right. There is a lot of individual interpretation of these rules and regulations, just like with the IRS and taxes.
In 1996, Congress made health care fraud a felony. Even minor billing errors can now be considered fraud, and again, depends so much on the interpreter. Recent administrative changes raised the fine from $10,000 per violation to $50,000 per violation.
MEDICARE FUND USED FOR OTHER PURPOSES- Medicare dollars do not just go to Medicare recipients. It is also used for medical education and research, leaving fewer dollars for Medicare Recipients. In 2008, Medicare paid $9 billion to train doctors.
Hope this helps,
Dr Matt and Dr Robin
*Source: Citizens’ Council for Health Freedom. November 7, 2003.
This week’s bit of Useless Information: In the 1700’s in London, you could purchase insurance against going to hell.
This email is courtesy of Matthew Barnes, D.C. and Robin Barnes, D.C. Neither this nor any of our emails are intended to be medical advice and should not be taken as such. They are opinion and are for informational purposes only. None of the nutrients discussed here are meant to diagnose, treat, or cure any disease.