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Now Bernie-care?

September 15, 2017

You can’t really blame Bernie Sanders for hanging in there over single-payer healthcare. It’s such a huge part of his pro-socialist agenda, along with free college for everyone and his free – well, everything.

So how well would it work?  If Medicare is the gold standard, not that well, at least once you get beyond routine medical situations. That’s a problem in any kind of socialized medicine.

There is a reason why people come here from Canada or the U.K. for specialized or time-sensitive care.

Just for fun, let’s look at one person’s Medicare experience.

“Mark” is 72 and has Medicare, parts A, B and D. for which he pays about $185 a month (deducted from his retirement income payment) plus a 20% co-pay, sometimes up to 50% of his drug costs and a relatively small annual deductible of just under three hundred dollars.

Flash…that isn’t free.  His premiums and non-covered costs amounted to about 18% of his social security check, pre-injury.

Mark is just an ordinary guy who had put in his 40 or more hours a week all of his life. He is very proud of never having been on unemployment.

Mark was very physically active until slipping on ice while crossing the street three years ago, landing squarely on his tailbone.  He jogged at least three miles once a week, and played doubles tennis. He had a once a week part-time job as a loss prevention employee that augmented his Social Security.

After the accident and 30 months of “conservative treatment” that he says mostly just kept the physical therapist and chiropractor in business, he was told he needed a relatively common type of surgery to relieve pressure on a nerve in his back. The procedure has been in use for over twenty years, so it is hardly experimental.

He had radiological proof of the condition, and two doctors had independently certified that the only treatment to actually “cure” the condition was a type of outpatient surgery.

The problem? Medicare would not pay for it, deeming it “ineffective and unnecessary” under something called an NCD (national coverage determination).  He had reached the lifetime limit for physical therapy visits, and his only recourse for pain relief was opioid painkillers. Unfortunately, he is unable to take them,  as they make him violently ill.

After the accident, he could barely walk to the car to go to the doctor.

He had some savings, but the 15 to 30 thousand dollars he was quoted to have the surgery and aftercare would all but wipe it out. That saved money and the little income his part-time job generated was what he used to pay for minor repairs to his house and car, and pay his property taxes.

After watching their Dad suffer for almost 30 months, Mark’s  three kids got together and scraped up almost $12K.  Mark kicked in another four thousand. They found a qualified local surgeon and a surgical center who agreed to accept that amount and four weeks ago, he had the outpatient surgery.

Mark walked out of the hospital on his own and has been pain-free since.  He hopes to find another part-time job as soon as he builds his strength up again. Yes, it sounds like a promo for a bad commercial, but it happened.

There are two problems here. One is for sure the initial cost. There is no doubt that healthcare is kind of a racket in many cases.

The other is how coverage is determined, i.e. who makes the decisions on how the  Medicare payment system works, what is and isn’t covered and transparency regarding that facet of the program.

Mark notes that until he started doing some digging on his own, he had no idea why every doctor he visited told him he wasn’t a “viable” surgical candidate. He notes his “viability” improved dramatically when he mentioned he could pay cash for the procedure.

Mark was lucky.  He had some resources and a loving family. He doesn’t have a lot of good things to say about Medicare, and notes the program had spent thousands of dollars on “conservative” but ineffectual treatments, and would have spent a lot more had he been able to utilize pharmaceutical pain management.

The point?  Once your health is at the mercy of government-run healthcare, your choices are no longer your own. And unlike Obamacare, “Berniecare” will shut down the private insurance market for good.

Mark notes that he has to pay extra for less coverage on his Part B and prescription coverage plan than he paid when he was working,  and has vastly reduced vision and dental benefits. The prescriptions that he used to get for a five to ten dollar co-pay now cost triple that or are not covered at all.

Mark’s  advice for Bernie Sanders? Retire and quit lying to America.

From → op-ed

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