Friday, May 30, 2014

I've received a denial, and I don't like it!

Every once in a while I read something that has made me say, almost out loud when I'm alone, "I wish I had thought of that."  I've recently had one of those moments.

I received a letter from National Government Services, the outfit that takes care of Medicare claims and payments.  The letter said that a claim that had been submitted by my doctor had been denied.  The letter went on to say that the NGS's (Seems to me this used to be CMS) investigation showed I either knew or should have known that Medicare did not cover the procedure outlined in the claim.  Naturally, I disagree.  I had been told that the procedure was covered which is the only reason I accepted the doctor's advice.

Among other things, the letter told me that the committee that looks over claims decided I didn't need the procedure.  It would appear that this "committee" which doesn't know me and which has never examined me now knows more than my doctor who has taken care of me for more than 10 years.  So far, appeals have been denied.

Then, perusing a Maine Conservative website, The Maine Citizen, I came across a thread concerning the current controversy in the Veteran's Administration handling of veterans' seeking medical help through the VA.  The member who started the thread directly quoted a column by economist Lawrence Kudlow.  I didn't find a source for the Kudlow information and, I must admit, I've been lazy and haven't searched for it.

(I reread that last sentence and said, "Come on, Dave, that's not like you.  You can do better than that."  So here's a link to Mr. Kudlow's column.)

This what he has to say:  "The VA problem is not Shinseki; it's socialism. The Veterans Affairs health care system is completely government run. It is a pure single-payer program. ...National Review editor Rich Lowry calls it "an island of socialism in American healthcare. . . . The long waits for treatment, with excessive delays resulting in as many as 40 deaths, are a tragically predictable outcome. This is the result of bureaucratic rationing, price controls, inefficiencies and the inevitable cover-ups. ... So if Congress thinks it can find somebody who can tame the VA bureaucracy, it should go right ahead. But the statist VA health care system, which in so many ways mirrors the government-run health care problems in Britain, Europe and Canada, must be completely changed."

The column goes on to say that these kinds delays and medical care by committee, not necessarily medical professionals, is where we are headed with the Affordable Healthcare Act.  I remember back when Obamacare was being debated by Congress I told the story of a friend who has relatives in Canada.  A relative came to Maine for treatment of a potential fatal medical condition and paid for it out of his own pocket because he would have had at least a six month wait in Canada.

Remember when Pres. Obama first ran for this highest office in the land?  He was critical of Medicare then and proposed cuts, many of which have now come to fruition due to the AHC, which put us seniors at even greater risk than nature gives us.  If I recall correctly, those of us over the age of 75 would get the biggest "hits" as we have become expendable.

Sure, the current AHC plan gives us insurance choices, sort of, but the penalties for not following the government's desires are substantial and having insurance is now mandsted.  The government has all but told us its eventual goal is for a single payer medical plan similar to those in Britain, Europe and Canada.  I've now experienced that "medical need by committee" and now I'm beginning to worry about what's ahead for me down the road.  I don't like the vision.

I've never been a single issue voter in spite of my party affiliation.  Now I think my "X" would be in the box before anyone who runs to fight this very costly and dangerous Affordable (not) Healthcare Act and work for its repeal.

With those happy thoughts, I hope you have a great weekend and welcome in a new month on Sunday.  June is just about always a happy month.


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