Tags: Health Topics | Healthcare Reform | Medicare | Medicare | Medicaid | Obamacare

Medical Systems Need to Be Revamped

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Friday, 21 Aug 2015 04:32 PM Current | Bio | Archive

While Obamacare continues to come under attack from GOP candidates, most of whom label it “a monstrosity,” there's another branch of medicine that needs reining in – one that we're reminded of daily by annoying TV ads.

We've all heard those glib personal injury lawyers: “Protect yourself! My firm has recovered millions of dollars for accident victims!”

While visiting my family in Los Angeles, my daughter Toni and I dropped my 6-year-old granddaughter at a kids' beach party in Santa Monica. Minutes later we were stopped at a red light when, Wham! A 23-year-old girl, who I believe was texting, crashed her Toyota into our stationary Saab.

My usually placid daughter screamed. The Saab's rear inner bumper was cracked and the outside bumper popped right off. The damage estimate is $1,000. The Toyota's hood was crushed inward causing it far more damage than our vehicle's but the driver was fine.

Toni suffered a neck injury and my lower back was extremely painful. Soon after we returned to her condo the phone was ringing. The claims adjuster from the driver's insurance company wanted to settle with both of us for $500.

Knowing we'd need medical attention we turned him down, which came as no surprise as he immediately explained how to send him our medical receipts.

Arriving back in Florida, I chose a wellness center with a staff of board certified professionals.

On my first appointment all I wanted was an adjustment but was told that first I'd have to see the physicians assistant to help find what kind of treatment schedule I'd need. She had me lie down on my back and then raised my legs to different positions to help find the location of my injury.

She then took four or five x-rays. I asked when I could see a chiropractor and she explained how age had caused my spine to degenerate but that a treatment course would help me recover.

Next I met with someone who was introduced as “my case manager.” He was not a doctor or a nurse but he would relieve me of the pressure of handling insurance claims and so on. One of the first instructions he gave me was that I should contact an attorney.

“I don't need an attorney,” I said. “I'm not going to sue anyone, I don't plan to sue anyone.”

“No, you should definitely have an attorney,” he said and thrust a card with an attorney's name and phone number into my hand. “He knows how our facility operates and we definitely would like you to give him a call. It's always best to have an attorney,” he said.

The center did nothing wrong. The firm was going to set up a treatment plan, but still I felt uncomfortable.

My journey through the wellness center continued when I met with the lady in charge of insurance claims. This is all before my first adjustment. When she learned I was on Medicare Part-F she immediately said I should charge everything to my insurance company.

I told her the California insurance adjuster said I should send all my receipts to him, but she insisted it would be far simpler to use Medicare with Plan F. She also recommended that I hire an attorney.

Next I met with a nurse, who asked how I felt about wearing a brace. Anything to relieve the pain. She fitted one onto me and it brought me some relief right away. “That feels good,” I said and she promised to have a brace for me that week. I still hadn't seen a chiropractor,

The next day I was prepared for my first chiropractic treatment. An assistant moved a massage machine up and down my spine, causing me to feel relaxed and then the chiropractor applied several adjustments to the lower spine. My pain subsided somewhat.

Right before I left the nurse with the brace fitted my new one which felt supportive. I was taken aback when she added: “There's something Medicare requires us to tell you and that is we have to charge Medicare $950 for the brace.”

Now the brace felt comfortable and it seemed to relieve the pain somewhat. But at that price?

That night I took the brace off before going to bed but kept thinking about that price. Almost a thousand dollars for a brace. I searched for an identical model on the Web and wasn't surprised to see an identical brace for $277.

The company did nothing dishonest. They went out of their way to say how much was being charged to Medicare. Somehow the whole system needs to be changed.

I didn't go back for more treatments.

Malcolm Balfour worked as a producer for the CBS affiliate in Miami, was bureau chief of Reuters in Miami, and then became an article editor at the National Enquirer in the 1970s. He was a New York Post Florida correspondent for 27 years and worked as a freelance for numerous popular publications and television shows, from "Entertainment Tonight" and "Inside Edition" to "Hard Copy"and "Good Morning America." For more of his reports, Go Here Now.

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MalcolmBalfour
While Obamacare continues to come under attack from GOP candidates, most of whom label it “a monstrosity,” there's another branch of medicine that needs reining in – one that we're reminded of daily by annoying TV ads.
Medicare, Medicaid, Obamacare
852
2015-32-21
Friday, 21 Aug 2015 04:32 PM
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