Posted on 06/20/2006 6:45:05 AM PDT by newgeezer
Georgia Lewis' feet were so swollen with fluid that she wore sandals throughout the winter. Lewis, a diabetic who lives in Bellefontaine Neighbors, was giving herself five insulin shots a day but still couldn't regulate her blood sugar.
Years after being diagnosed with diabetes, Lewis, 61, had never learned how to manage her disease or shield herself from its most debilitating effects.
Under the traditional Medicare system, it wasn't in her doctors' financial interest to teach her.
But now, as part of a expanding Medicare program that could transform how the nation cares for its elderly, Lewis' doctors will be responsible for the cost if her health problems turn into expensive complications.
Typically, physicians get paid only when their patients receive care, and more complex care often brings bigger paychecks. At the same time, doctors complain that paltry payments for office visits force them to rush through checkups instead of educating patients about their illnesses, medications and healthy living - all of which might lower future medical bills.
It's a system that gives doctors little financial incentive to keep patients well. And, experts say, it might be contributing to dangerous, unnecessary care as well as high medical bills.
...
Medicare, the government program that provides health care to 42 million older Americans, is experimenting with paying private insurers a per person rate. It's similar to how health maintenance organizations, or HMOs, work. Under this program, called Medicare Advantage, the fee is used to cover the patient's medical expenses, and the insurer keeps the rest. The hope is that the plans will encourage better management of illness to avoid expensive flare-ups.
...
In Lewis' case, the private insurer...was created by a group of St. Louis-area physicians. In theory, the healthier Lewis stays, the bigger the profits for her doctor. ...
(Excerpt) Read more at stltoday.com ...
Whether they care or not, Doctors are not trained in "health", they are trained in disease....most don't know more then superficial nutrition and I've never met one who exercises much......
In this day and age, if you're not looking out for your own best interest with a doctor, it's time to find a doctor who will.
lift weights
It's just hard for me to imagine this. My husband was diagnosed with diabetes in January. We've been swarmed with info from lots of different sources. First of all, his doctor's office has several nurse practictioners who instruct patients with certain illnesses, diabetes being one of them. We weren't convinced by all she told us, so we went looking on our own. After my husband received his first diabetic medication, we received info from the drug company, with lots of additional resources. Then we've been reading up on our own. Yes, we did take our own initiative, but we also received help from "the system." Lots of it.
I work for the state medicaid system here in texas, and we get complaints at least (just on my calls) about 12 a day and I take on average 150 calls in an 8 hour period. That is way too many. The doctor refuses to give care or the doctor will tell them they sent authorization for a surgical procedure when they know full well that they did not. It is an ongoing cycle that the doctors find amusing and they keep doing it because medicaid only pays an allowable amount for each procedure that is rendered to the client. If they bill 150 dollars for a office visit and the state only say 32 bucks that is payment in full and they lose that money. The doctors know this when they sign up and contract with medicaid, but we have some numbskull doctors and this perpetual cylce keeps on going.
My Hubby is a Doc, is very diet conscious and works out 3-4 times a week with weight lifting too! but then again, he is an EM Doc!
Your husband is on Medicare?
Based on the prescriptions we receive, Blue Cross Blue Shield sends us lots of information about preventive care, etc. But, BCBS is not Medicare.
I'm guessing Georgia Lewis (in the article) may have no idea what's available to help her help herself. She may be operating under a false assumption that, if there was anything she could do, her doctor would naturally be telling her about it.
No. But even the mail-based medicine delivery system sent us lots of info when he ordered his first diabetic medicine. This woman needs to pick herself up and trot over to a library or bookstore. And she needs to stop whining.
This story is saying that a Doctor never gave this woman a diet? Never told her not to eat sugary foods? Never told her to check her blood sugar? I dont believe that.
More likely she prefers to not change her life style by diet and following her doctors orders.
Could some kind soul explain to me, an Englishman, the difference between Medicare and something like the National Health Service here in the UK?
Who pays for Medicare and who is elligible to receive it? What types of care are covered and which aren't?
Cheers.
yes we have that problem to. They always call to whine about how medicaid will not pay for some insulin strips and they cry because the doctor did not want to see them.
It is the clients responsibilty to take care of their health when possible, but when you have client's taking their children to the hosital or the doctor because my head hurts (take some aspirin) my nose is stuffy (get some decongestants) my nose is running (get some dimetapp and some kleenex and wipe your nose). It is pitiful. What I see when someone calls me and says that that they do not have 3 dollars to get some antibiotics but you can hear tyhem in the background ordering a big mac and fries from Mcdonalds. Or one person told me "I am tired of my kids. Does medicaid pay for me to go on a vacation and to send my kids to the ymca while I am gone?"
Go figure!
Taxpayers.
and who is elligible to receive it?
The elderly. (We also have Medicaid for the poor.)
What types of care are covered and which aren't?
As far as I know, just about everything except elective procedures (e.g. breast enlargement). Recently, Congress added prescription drug coverage to Medicare.
Someone else can probably better answer your last question.
My advice is to try and stay healthy.
I'll reserve my opinion on this until I hear what Terri Schiavo has to say about it.
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