William Tells Healthcare system is broken – InsuranceNewsNet – Insurance News Net

Today I write about healthcare in America. I am a 77-year-old man, and I know stuff. One thing I know for sure is that the healthcare system in America is broken.
Though I didn’t know it at the time, my first brush with medical reality likely occurred when I was six or seven years old. At the time my mother (the best in the world) supported my brother, my sister and me by working as a maid at the iconic Tremont Hotel.
This was in the early ’50s, and hotel maids were not fortunate enough to receive medical insurance along with their 20-cent per hour wage.
I am not sure why, but later for some reason, I needed to see a dentist and when I grew old enough to value my less-than-impressive, mediocre looks, I realized that said dentist had pulled several teeth rather than fill them with gold—which was the practice of the day.
To this day I have always suspected that jerking out my teeth had more to do with financial expediency than it did with best medical practice.
I was fortunate when I signed on as a government employee in 1968. Along with a regular paycheck, my family and I received medical insurance coverage for the next 30 years.
I am fully aware that other professions did not then, and still do not, offer medical coverage along with a paycheck.
I feel sorry for those who have to go through life without the security of knowing they can receive medical care if it is needed.
As the administrator of the Probation Department and Juvenile Hall in Tehama County, I was responsible for providing medical care to in-custody juveniles. When a juvenile was transported to the hospital for treatment, I often negotiated a lesser cost than what was first billed. It was then that I first realized that medical costs are not set in stone.
Fair or not, one of the perks associated with government employment is the ability to retire early. As a general rule, employees qualify for a government pension at age 50 with a minimum of five years’ service.
Often times the primary reason government employees and others in the private workforce continue to work until age 65 is to retain work-related medical insurance.
This is one reason I accepted a job working for the State of California after retiring from Tehama County. It is also sometimes the primary reason government retirees serve on public governing boards and city councils.
As you are likely aware, under our system when a person reaches the age of 65, he/she qualifies for Medicare—and what a system it is.
For those of you out there who totally understand the Medicare system and all its potential components, I congratulate you—for the rest of us schmucks, good luck to us all. Let me summarize.
When you turn 65 in age, you sign up for Medicare and the government withholds about $150 per month from your paltry social security check with a guarantee that they won’t let you die.
It is then they tell you always to make sure your provider will fix whatever ails you for 10 cents on the dollar.
That is if you can find a provider who has real doctors rather than only physician’s assistants.
If you are smart like me, you always buy a supplemental plan to cover medical stuff that you know will occur because you are going to die pretty soon, which is always preceded by costly medical problems. This is where it gets tricky.
Each year you will have an opportunity to change your plan. Plan changes have to be selected by December 5, (or is it December 7) of each year. You have a choice to add or change Part A, Part B, Part C, Part D, and I think Part F (or is it Part M.)
You can also pick an “Advantage” plan or a “Medi-Gap” plan. I prefer the Advantage plan because it gives me a free silver slipper gym membership which I do not have to feel guilty about never going to.
The best thing about Medicare is that even though you have until December 5, (or is it December7) to select your plan, they start advertising around February 1st of each year.
I especially appreciate Tom Selleck, who always recommends the best company and plan on television over and over and over—and how about those daily phone calls by someone speaking broken English telling you what plan is best? Breaks up the calls about extended car warranties, for sure.
The worst thing about our medical system and the best thing about Medicare is the negotiated rate structure attached to the program. I say this from personal experience.
A few months back I foolishly played golf on a Tuesday afternoon with the temperature reaching 108 degrees. After completing my round (I shot a78—or was it a 105) I passed out in the clubhouse.
The next thing I remember was a 10-mile ambulance drive to St Elizabeth Hospital where I spent two hours in the emergency room receiving two bags of fluid for heat exhaustion.
The invoice I later received for services rendered is typical of our broken medical system in America today. The charge for a 10-mile ambulance ride to the hospital was listed at nearly $8,000. The hospital bill for two bags of fluid and an evaluation by the emergency room doctor totaled more than $10,000.
While the Medicare-negotiated cost of these services was only about 10% of the total bill, and was covered in total due to my wise choice of supplemental coverage plans, charging nearly $20,000 to provide two bags of fluid to an old fart who passed out on the golf course is absolutely insane.
No wonder so many folks head to Canada or Mexico when needing treatment for an ingrown toenail.
Have a great Wednesday, everyone.
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