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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsFuck Medicare for all
My mother in law was diagnosed with Lynch Syndrome after her third bout with cancer. This most recent battle required her to have a kidney removed. They ignored doctors orders and had her come home 60 days ago (the doctor was ultimately fine with it, because of my wife's training). My wife is a nurse and has been essentially living over there, taking care of her. She got a bad infection a week ago and my wife and father in law have been taking care of her. Two days ago, the doctor said she needs to go to the hospital, but she has made it clear she does not want to go in until tomorrow, as Medicare won't pay until she has been out of the hospital for 60 days. They were forced, under Medicare, to decide between waiting two days for coverage, or send her in and bankrupt my father in law.
Say prayers, as they are taking her in at 12:01 tonight. Fuck Medicare for making them decide between bankruptcy or potential death.
Until we have government run, free healthcare, we have a system of politicians continuing to line people's pockets.
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elleng
(141,926 posts)Medicare is my 'primary' insurance, but haven't had any hospitalizations. I wonder if the assertion that she not return to the hospital for 60 days is correct, in light of a serious infection.
I suggest that you look into all the rules/ins and outs, as with a serious illness, there may be numerous issues to deal with. Post a 'Seniors' and 'Health,' maybe.
kelliekat44
(7,759 posts)joeglow3
(6,228 posts)She has been non responsive since noon today. But, we are certain it is her kidney and she has said she won't do dialysis.
Hoyt
(54,770 posts)We need a real overhaul of healthcare system, but don't see it happening anytime soon.
Cleita
(75,480 posts)health plan. Sure, it had gaps and could have been better. But now I'm an old lady on Medicare and I know it has even bigger gaps, thanks to our well fed Republican legislators who have fancy health care we can't even still think of having even though we were promised it. Try not having any at all.
Hoyt
(54,770 posts)especially if you don't have supplemental or drug coverage.
LiberalAndProud
(12,799 posts)Although without Medicare, my mother could not afford the dialysis that has kept her alive these last 14 years. So there's that.
KMOD
(7,906 posts)receiving the care she needs. That is wonderful. 
However I'm sure joeglow is concerned about his own MIL at the moment.
LiberalAndProud
(12,799 posts)I do appreciate your reminder that there are very real emotions involved in the "Fuck Medicare for all" thing.
I am rather defensive of Medicare, even having come up against it's frustrating limits in our own family. The cost of elder care is astonishing. Including the younger set might cure some of what ails it.
KMOD
(7,906 posts)It can be a blessing, or a curse, depending on the situation.
Cleita
(75,480 posts)with the end stage renal disease. Otherwise he would have died an awful death because of health care we wouldn't have been able to afford.
LiberalAndProud
(12,799 posts)My own MIL endured a 30-day long term care, 60-day home stay rotation for months before she passed away. She desperately needed permanent long-term care. Our extended family couldn't afford it. Medicare doesn't provide for it. It's frustrating and heart rending.
And then on the other end of that same spectrum are the people, like my parents, who receive necessary-for-life care because of Medicare.
Imperfect, not evil.
hunter
(40,852 posts)We've been tickling that dragon forever it seems. More than a decade now
But bloody fucking hell, I'd really like to live in a civilized nation with a national health care service, a single payer plan, or any other "First World" medical system.
Medical problems are frequently bad shit that falls out of the sky on random people. Hah, hah, life's lottery.
And even when it's not random shit, even dealing with our self-destructive siblings, it's our human obligation to care for all our human brothers and sisters.
yeoman6987
(14,449 posts)They will have rules and limits on medical. In fact I am sure of it.
hunter
(40,852 posts)At the very least gentle hospice care, I'm sure.
Recursion
(56,582 posts)Stuff like this happens with single payer plans just like it happens with private insurance. It even happens with NHS's, since the actual resources to the NHS are finite.
hunter
(40,852 posts)I don't like a system where ordinary death kills every last dream.
I sure as hell know my last dreams will have nothing to do with money or faith.
My safe deposit box is full of thermo-nuclear rat poison.
sabrina 1
(62,325 posts)Here? People, unless they are Cheney (who paid for his heart I wonder, no doubt WE did?) or Congress whose HC we also pay for while unable to pay for our own, can just die. Over 44,000 a year die in this country for lack of HC. I would think we could shift some of those trillions we spend on the War Machine for 'national security' (what is that anyhow, if it doesn't mean protecting Americans from death) and provide a civilized system of HC for ALL Americans.
Enthusiast
(50,983 posts)
SickOfTheOnePct
(8,710 posts)When my mom was in the hospital (Medicare), they told her that if she had to be re-admitted within 60 days, it would be considered part of the same benefit period, and she would not have a new deductible. However, if she was re-admitted more than 60 days after release, it would be a new benefit period, and a new deductible would be due.
She ended up back in the hospital for the same condition 3 weeks later, and Medicare covered her costs.
Best wishes to your mother-in-law and your family.
Recursion
(56,582 posts)Which is a big part of why Part C is so popular.
WillowTree
(5,350 posts)But there are other considerations. After the inpatient deductible ($1,260), Medicare pays all inpatient charges in full for the first 60 days in each "benefit period". For day 61 through day 90, there is a daily copay of $315. Beyond that, the daily copay jumps to $630 if the lifetime limit of 60 "reserve" days are to be used, after which there is no further inpatient hospital coverage.
Regardless of where a patient is in that 150 day stretch, the clock gets wound back and a new benefit period begins if the patient remains unhospitalized for 60 consecutive days.
So much would depend on where she was in that process when she was last discharged. If she was pushing up close to day 60, then if she was re-admitted within 60 days, there wouldn't be a new deductible, but she'd soon be responsible for $315 per day. That may have played into the decision to wait the additional days before admitting her again. Or not.
joeglow3
(6,228 posts)She had four days left.
KMOD
(7,906 posts)It is much appreciated.
nikto
(3,284 posts)In a wealthy country that can certainly afford it...
This is unequivocal.
Recursion
(56,582 posts)Medicare is government run (and for that matter a majority of private insurance plans are not-for-profit). Is the hospital for-profit? Possibly, though that's also still a minority of hospitals, and for-profit hospitals get the same reimbursement from Medicare as non-profits.
nikto
(3,284 posts)If the coverage isn't there, then on some level, I have to think,
the money is not there, either.
i.e."not there" = not being provided.
WillowTree
(5,350 posts)nikto
(3,284 posts)Last edited Fri Jan 23, 2015, 01:13 AM - Edit history (1)
Gotta' be money-related, 1 way or another.
Guess we need that money for more drones, eh?
In Amurka, it's all about priorities.
DesertDiamond
(1,616 posts)Recursion
(56,582 posts)You have 50 million Medicare beneficiaries and a finite amount of payroll levies with which to pay for their care.
onecaliberal
(36,594 posts)I'm sorry for what your family is going through. Sending positive thoughts for the best possible outcome.
ellennelle
(614 posts)luv me some bernie, but his plan to offer medicare for all is - hopefully - just a stepping stone to single payer.
i just signed up for medicare, and was frankly stunned at how complicated and unnecessarily confusing it all is; worse than the tax code. and i have a phd!! i can't imagine the average joe, possibly beginning to dement, or just poorly educated, whatever; it still makes no sense to me, except as an exercise in insanity for the benefit of insurance companies when you sign up for the supplemental.
grrr. good luck to your mother in law.
Vattel
(9,289 posts)Demeter
(85,373 posts)With all the advances in knowledge, diagnosis and treatment, Medicare needs to be brought up to 21st century funding, costing, and compassion. Universal single payer would be my first choice, though.
Cleita
(75,480 posts)Demeter
(85,373 posts)BECAUSE:
Everyone would have identical coverage of all illness, and identical care
Drug and test suppliers would be under nation-wide pricing
Cost would TRULY be borne on the basis of ability to pay (tax reform)
Doctors would not be shafted while serving the poor, elderly, disabled
Monoliths like VA could be repurposed to deal with the unique war-related mental and physical injury our armed forces incur.
All these Medicare Part D rip-offs would be outlawed.
Insurance coverage could be reduced to vanity cosmetic services.
project_bluebook
(411 posts)in the for profit world of health care. Even a European version would not work here as long as the filthy rich get away with not paying their fair share of taxes.
still_one
(98,883 posts)WillowTree
(5,350 posts)It's a Medicare rule and it's not subject to exceptions. Once a Medicare patient is hospitalized, a new "benefit period" will not begin until that patient has been outpatient for at least 60 consecutive days. That's just the way Medicare is structured. Always has been that way so far as I know.
Cleita
(75,480 posts)My prayers are with you. I wonder though if you are with a Medicare Advantage program rather than real Medicare.
pnwmom
(110,323 posts)this is the type of situation where a "medigap" policy can cover what Medicare doesn't.
My thoughts and prayers for your family.
LiberalAndProud
(12,799 posts)
Sending my sympathy and my hope that your mother-in-law comes through this.
IronLionZion
(51,549 posts)I've actually worked in the program and have told DUers many times that conservative politicians deliberately fight to block policy reform/funding/coverage/etc. trying to weaken the program to make us think government is bad for us. This happens with any single payer program. Unfortunately we in the US have more conservative politicians than some other countries.
With any government program, we are going to run into policies that we don't like.
Prayers for your mother in law
Response to joeglow3 (Original post)
Corruption Inc This message was self-deleted by its author.
Enthusiast
(50,983 posts)In the case of medicare it enrolls only the most vulnerable citizens. So it is necessary to save wherever they can, even if it is wrong. By enrolling everyone, as in Medicare for all, it would be far more cost effective than it is now.
bigwillq
(72,790 posts)Hope everything turns out ok. 
sendero
(28,552 posts).... but it is better than what we have now.