Medicare: One Size Fits All
Possibly one of the most controversial issues coming up in today’s discussions is healthcare. Although this touchy subject has undoubtedly been the root of many a heated argument, healthcare is hardly novel talking point, especially since the introduction of Medicare several decades ago.
Like many ideas, Medicare sounds like a fantasy on paper, in theory. A benefits package to help support the elderly and disabled sounds formidable, an idea that few would argue – after all, who doesn’t want to help the elderly, our parents and grandparents and aunts and uncles that have served us for the majority of their lives? In a perfect world, Medicare would work seamlessly and benefit those for whom it was created but unfortunately, this is not the case.
Medicare is a deeply complex program with a seemingly endless list of ever-changing and ever-expanding rules and regulations. For large hospitals and institutions, training and hiring the right individuals to code and to keep up with the nuances of the program is only a small bump in the road. However, small practices do not have access to the same resources or personnel and thus suffer great losses each time the program is amended. For instance, a small practice in which two doctors see a handful of patients each day may spend countless hours preparing documents and ensuring that they meet Medicare’s guidelines which in turn, takes away from the amount of time each can spend working directly with patients.
This is not the only way that both patients and physicians alike suffer due to the convoluted processes associated with Medicare. Medicare attempts to enforce a “one size fits all” policy regarding the types of treatments that are approved. As most should know by now, such gross generalizations are never effective and one size hardly fits all. Instead of offering patients individualized treatment plans, physicians often choose a treatment that is covered in lieu of a treatment that might be better suited for the patient but that is not covered under their insurance. What Medicare deems “medically reasonable and necessary” may not always be the appropriate treatment but deviating from this path may come with a hefty price tag for all parties involved.
Trying to simplify an already complicated plan with even more labyrinthine amendments and procedures is senseless at this point. As physicians in small practices struggle to meet the requirements in fear of being investigated for fraud, even for simple errors and honest mistakes, Medicare patients jump through hoops in order to provide proof of their ailments and simply begin the drawn out process of getting “medically reasonable and necessary” treatment. While Obamacare might not be the panacea for healthcare reform, at least we can acknowledge that a reform might be both “reasonable and necessary”.