Tag Archives: Medicare

Jul 23 2022

Why Medicare Advantage Plans are Bad by David W. Bynon

Right after my last post, I was injured, quite badly, in a fall. While I had read the title above, hubby had convinced me that Medicare Advantage was the way to go, because “we are healthy.” And, I was, until I broke my shoulder and damaged the nerves which traverse the Brachial Plexus. Within a month of my fall, I tested Medicare Advantage and soon found that I wish I had opted for traditional Medicare.

In Why Medicare Advantage Plans are Bad the author begins by explaining Medicare and Medicare Advantage. Even the name sounds good, right? They call it Medicare Advantage because there are certain perks, which vary depending on which insurance company provides coverage. For instance, mine has vision benefits, which I have used, and gym benefits, which I have not. This book also has a chapter explaining why the government actually prefers that people choose Medicare Advantage.

For those about to reach the age to file, this book, especially the opening chapters, would be most helpful. Also very helpful now (although I wasn’t concerned prior to my accident) is the 6th Chapter, which explains the downside of Medicare Advantage plans for those with chronic illness. The answer is quite simple: co-pays. As a holder of Medicare Advantage, I have to pay $25 (or more) every time I visit a healthcare facility. Right now I am seeing multiple therapists every week. Some days I pay $25 to the hand therapist, then walk to another therapist in the same complex and pay $25 again. Then I do it again a couple of days later. Medicare requires that medically necessary therapy be covered for unlimited visits. Medicare would not require those co-pays, however.

Perhaps I will get “better” although I have pretty much given up on being “well.” But, with multiple providers for everything from therapy to tests, this journey will be expensive. I wish I had read Bynon’s book before I signed up for Medicare Advantage. And, although I read this book, I probably wouldn’t have reviewed it if I had not become a victim of what a nurse in the ER described as a “life changing” event. I started out quite healthy, but that can change, and quickly.

For those who are just going down this path, this book is certainly worth reading.

Dec 22 2012

How Hollywood Could Solve America’s Financial Crisis

The topic of America’s fiscal future as a topic is a departure for me, for sure, but this post is writing related. The power of Hollywood, especially series television, but also film, is the most important factor in American culture. No kidding! Generations of moms name their babies after popular characters, for instance.

In American television and film, doctors invariably are able to work miracles. Patients die and are brought back with CPR, and so everyone these days is urged to take CPR training. No one on television has broken ribs from the procedure, which is common in real life, and almost everyone coughs a couple of times and is good as new by the next commercial break. But, in real life, most such heroic efforts are in vain. Hollywood thrives on heros and heroism, so extreme measures are rewarded.

However, in real life (and death) most folks who are at death’s door are going to go through it. One out of one persons on this planet will die. Most doctors, who do know the truth, will not take cancer treatments for late-stage disease. They don’t, because they have seen “good” deaths and “bad” ones, and they want to avoid the latter. But family members, brainwashed by the success rate of heroic doctors on the screen, often insist on the latest treatments for family members, even when the pathetic success rate is clearly stated. These acts of love, which often cause patients to be miserable because of side effects of chemotherapy, radiation, or surgery, cost millions of dollars. Few lives are saved, and if they are lengthened, it might be for months, at best. The most expensive years of life, for many Americans, are the last two.

My husband is a cancer survivor. His illness was treatable; that is, his doctor stated that with treatment, he had an 85-90% chance of living out his normal life. Thus, the treatments, which were grueling, were appropriate. I am not speaking of that scenario. Plenty of people are cured or helped by treatments, but side effects and outcomes need to be discussed frankly.

But, because Hollywood’s fictional doctors can cure even the most hopeless of patients, many Americans have totally unrealistic expectations. And, since our doctors, the real ones, are paid for performing services, the money flows from insurance companies, especially the ones funded by the U.S. Treasury, into their accounts. Doctors are trained to preserve life, and are paid for procedures, so they have incentives to continue aggressive treatments, and well-meaning family members can add more incentives. No one wants to say, “It is time to let go.”

Please, script writers and producers, lets have a new wave of handsome, dignified actors “go gently into that goodnight.” This dose of realism would greatly help families avert feelings of guilt for not doing enough for their loved ones, and it would also save patients from the miserable deaths associated with vigorous treatments. A serendipitous side effect of the Hollywood treatment would be a vast reduction in medicare and medicaid bills for those who are going to die, and die soon, anyway.

Be courageous, Hollywood, and write about death and dying in a manner that is more realistic and, ultimately, more kind.