Medicare payment system is vexing for one veteran

Warren Scheible fought his way across Europe as a combat engineer with General Patton in World War II in an outfit known as "Patton's Troubleshooters." But the Hamilton, N.J., veteran never saw a skirmish like the one he is now waging with a drug company. Hobbling around his home with a diabetic wound in his foot, the still sharp 91-year-old former financial planner is rummaging through a box of bills, totaling nearly $2,000, which Warren believes he shouldn't have to pay. "Why charge me one price for a shot one time and seven times the price for the same shot three days later?" he asks. "And why does Medicare pay the bill this time but not the next? They tell me to call, so I keep calling. But I can't get a straight answer." 'D' for effort At the heart of Warren's problem is the complex law known as Medicare prescription drug coverage (Part D), which took effect in 2006. It arguably benefits the pharmaceutical companies more than consumers, since it was engineered by then Louisiana Rep. Billy Tauzin, who left Congress to become president of the Pharmaceutical Researchers and Manufacturers of America, a powerful lobbying group. Older Americans like… (continue reading......)

Could that medical 'bill' really be just a 'courtesy' reminder?

My story is all too familiar to those who have lingered too long in the sun. During my annual skin screening, the dermatologist scraped off a piece of skin and sent it to a laboratory to determine if it was cancerous. I should note here that patients really don't have a choice about which lab the dermatologist -- or any medical provider -- uses. When the lab found nothing wrong, it notified my doctor who notified me. And then the fun started. The lab mailed me a "bill" requesting payment for the portion that Medicare didn't cover. The big red letters at the top of the page read, "Make Check Payable To" and in the middle, also in red, "Detach And Return Top Portion With Your Remittance." Red-letter day When I get a bill like this I usually just pay it. Like everyone else I value my credit rating and, in the back of my mind, there's always a recurring nightmare that some nasty creditor will damage my score because of a bill I overlooked. On the contrary, my wife isn't as quick to just pay. "Wait a minute," she said. "Wasn't this bill already paid in full?" She combed… (continue reading......)

Three faces of Obamacare: Why ordinary people are rejecting it

Politicians and broadcasters talk about the health care crisis in sweeping terms. They shuttle back and forth between the Capitol and the White House, searching for the latest "fix" for a system that isn't working … and may be irretrievably broken. That's the bird's eye view. I see it up close and personal because my family and friends are caught in this spider's web with no easy way out. And no one -- health insurers, government, websites - -I repeat, no one seems to care. These are our stories: Entering the system The foundation of Obamacare is to get young healthy people in their 20s and 30s to buy health insurance. Their enrollment is the cornerstone that will support older, sicker and poorer people who also must have this health coverage – spread the risk and spread the cost. A friend's 27-year-old-son is the ideal candidate. He holds down both a full- and part-time job in education just to make ends meet. Using his computer skills, he also launched a website to help others find work. But when he tried to navigate the HealthCare.gov website to review the plan offerings, he couldn't find an affordable one. He didn't qualify for… (continue reading......)

Freelance journalists and sex workers find common ground: Obamacare

What do San Francisco sex workers and President Obama's Affordable Care Act have in common? The answer is: More than you think. While many people are frustrated and complaining about not having access to the health insurance marketplace website at HealthCare.Gov, the website has its fans: this city's so-called "sex workers." CNNMoney reports that they held a rousing registration drive in the City by the Bay recently, signing up at least 40 male and female prostitutes, masseurs, dominatrix and those more politely known as "escorts." Unaccountable And they did it mostly the old fashioned way: Manually filling out paper applications. But let's be honest, they were highly motivated. Most prostitutes don't earn a lot of money, endure an enormous risk of both violence and disease, and operate -- with the exception of the infamous Mayflower Madam -- in an all-cash environment. Since they show little or no income from their work, these sex workers are eligible for the huge subsidies offered under Obamacare. Sex worker "Jolene" told CNN she would likely pay only $36 a month, much less than most of us put out in co-pays alone. And what makes it even more lucrative is that none of the sex… (continue reading......)

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