Occupation:: Psychiatrist

I have practiced psychiatry for more than 40 years and during that time I have cared for numerous patients covered by Medicare. I am now covered by Medicare myself. About two years ago my secretary discovered that all of my Medicare claims were being denied. Each month the company which manages Medicare in Florida had a different explanation for the denial but after correcting whatever they claimed was the problem the claims were denied again the next month. This went on for months until late 2009 when someone at the Medicare management company announced that my Medicare Provider Number had been canceled. The Medical Director later said it was because I had filed no claims in 15 consecutive months. In fact I had filed claims each of those months and each time my claims were denied. I was informed I would have to file a new application. I did and the application was “never received.” In April 2010 I again filed an application for a Medicare Provider number and by then part of the application was done online and only a few pages were printed out to complete manually and mail in. Those I sent certified mail and had proof of receipt. Two months later they contacted me to report that I had failed to write in the seven leading zeros on my checking account number on the electronic fund transfer agreement and even though I had had to include a voided blank check they could not enter them and I would have to fill out the EFT paperwork from scratch, not just add the seven leading zeros but fill out all of the remainder as well. I did so even though they were going to have to manually re-enter those seven leading zeros when they copied the numbers into their computer. A few weeks later they informed me that another problem had existed on the EFT paperwork that I had not been told of when I resubmitted it and I would have to resubmit it all over again. On top of that the form for the EFT had changed between April and June and if I could not come up with a blank copy of the earlier form I would have to resubmit the entire application, both the online and paper portions. Luckily I found a passable blank copy and resubmitted only the EFT and it was finally accepted and my Medicare Provider number was re-issued. That happened one week before my financial costs of maintaining an office without Medicare reimbursement for over a year prompted me to decide to retire. I had been assured through the process that once my number was reissued I could resubmit my claims and those that were not older than a year or so would be paid. Now I am told that I will be paid only for services provided since I regained my Medicare Provider number–by that time I had finished seeing my patients and was making referrals. This constitutes Medicare Fraud as far as I am concerned. Apparently a crooked physician is better prepared to cope with the corrupt Medicare system than the well-intentioned one who tries to provide top quality service to his/her patients. Finally, when I tried to find psychiatrists to whom I could transfer the care of my patients I discovered that no other private psychiatrists in the area would accept Medicare because they would not subject themselves to what I have gone through. This is a simplified version of what happened. In fact the problems I ran into in trying to regain my Medicare Provider number were so numerous and absolutely unbelievable you would have had to experience it. I have spoken to several colleagues who report similar horror stories. Yet no one is doing anything about this kind of Fraud against Medicare providers!

Occupation:: Freeman

The thing that is broken is the will to be free individuals and oppose the yoke of slavery. An expediency is not righteousness. The system functions as intended and even so really works very well. The lack of freedom in the choices of all involved, limited by laws and legally enshrined crookedness, are exactly the problem. It should be a cash business, that is the answer. No state has any business telling me that I can’t buy health insurance from a company in another state or country. How absurd. Legalize low cost Freedom!

Occupation:: Pre-Medical Student

I’ve been very interested to read all the comments on this website, and I can see where doctors are coming from, and where unsatisfied patients are coming from. I think it’s silly and unrealistic to expect everyone to have health insurance – for many of us, it’s unaffordable or not worth the cost. To insure my family of 6, it was $1000 a month! At a rate like that, it’s better to save the money and just pay any medical bills out of pocket – which we did, when my dad had a bicycle accident at 40 mph and ended up with a $10,000 ER bill (notice: still cheaper than a year of medical insurance for the family). I don’t think that patients should be required to carry medical insurance. However, you should expect to pay your medical bills. I realize that sometimes they seem unreasonable, and you should hold your physician accountable – check what they’re charging you for and why they are charging that. However, as a future doctor, I think I can say that while there are some people in the field for the money, most of us want to practice because we feel the work is important, that the people are important. However, it’s also very high-stress, and involves long hours and years of debt accumulation. To you, it may seem like they charge a lot of money, but your bill isn’t just paying the fifteen minutes you spent with the doctor – it’s paying the cost of the facilities you saw them in, the cost of their liability insurance, the cost of their secretary’s salary, and then after that, the cost of the 11+ years they spent in school and training, incurring debts, and the high demands of the workload they now shoulder, which includes constant worry over paperwork and covering themselves in case you get angry and decide to sue them.

It’s sad but unsurprising that the doctor-patient misunderstandings basically come down to money issues. If there were a less expensive way for doctors to practice, maybe the exchange could be less stressful for everyone.

Occupation:: Medical Student

I will be in over $160,000 worth of debt from medical school alone… not including college debt. I will have put in an average of 10 hours of work every day (including weekends) for 4 years. I will have sacrificed my own health and put my life on hold to make it through. When I graduate, I will work for at least 3 years of residency on a salary of less than 2 dollars per hour. If I wanted to be rich, I would have gone into business. Doctors are forced to specialize because most of us will not be able to pay back our loans on the salary of a primary care doc. Yes, the system is definitely screwed up. But remember, if you start cutting salaries, medical students MUST get re-imbursed for their years of loans!!!

Occupation:: Student/Employee

I work retail and go to school as well, I found out after being hired that because I was short of being considered full time (5 hours at most), I could not get full time employee benefits which included health care coverage. My job also did not make this apparent to me when they hired me, even with me asking questions regarding this topic. Since then I have had an emergency room visit, (which I have to pay out of pocket) and because of my anger of the situation refuse to pay it. It’s been about 2 years now.

Occupation:: Unemployed

I am recently unemployed after I had medical problems that prevented me from being able to do my job description anymore. I was first diagnosed with herniated disk in my neck that causes severe pain in arm and shoulder. While I was out I had a stroke in my left eye that took my vision, I have gained a little over half of it back thanks god. When I was employed I had insurance which led to about 28 different appointments within a 45 day span, since then I have not been able to even get into my doctors no insurance no money no appointments. I am 51 years old, no job, not eligible for medicaid, disability or any other sources so I have not been able to get treatment, I live in constant pain that at times have made me suicidal, and have no where to turn. Where is there help for someone like me that does not want to live off the system, I just want help to get medical treatment so that I can work again. I am tired of all the doors being shut in my face.

Occupation:: Homemaker

My husband wants a divorce. My health insurance is through his job. Will I lose my health insurance when we divorce or will I be able to continue to be covered under him?

Occupation:: Medical Office

There is no website that really mentions the real cause of the healthcare nightmare. In January 2010, 1 farmworker clinic received 10 Million dollars to build a Taj Mahal for illegals! Unbelievable. At first it was to be built in 2009, but since so much controversy was happening, they held off until now. At the site of this new building Farmworker personnel told the contractors not to worry if a issue was not “spelled out” in bid specs, because the Federal Gov’t will pay for it. The funding it shall receive in 2010 is 11 million. Remember this is one clinic. Also, reimbursement for Farmworker clinics vs. Private practice is Farmworkers receives at least 3x the amount from taxpayers.. Now the new reform, per Obama, plans to increase the poor underserved clinics by 7x the current funding. How is an illegal person more important than our American elderly? I am utterly confused. Also, Interpreters are paid 100.00+ dollars per hour. Usually they are there 15 min. and receive the full 100.00. For no show patients they receive 80.00, and the Physician will be fined 5,000.00 dollars if they try to collect any money for this!! All physicians should be reimbursed the same. All federal funding should be divided fairly, not because you are a Federally Qualified Clinic. Americans, research facts, pull the scales off your eyes. Socialism and Communism are already here, almost 100% government.

Occupation:: Registered Nurse

I grew up in a 2 bedroom home, we always had elderly and/or ill individuals to care for and did a good job of caring for them. I have been a nurse for over 30 year and have seen multiple changes. When I first entered nursing we took care of people, now we take care of paper work. I am assuming overall (I work in a nursing home) there is close to 10 times as much time spent with documentation as there is patient care.

Another issue that really annoys me is to hear commercials encouraging families to file suit of negligence or abuse. I invite any individual to work one day in a nursing home. It takes a very dedicated person to do this type of work. Yes, negligence occurs, yes abuse occurs. For example, you have two workers (CNA’s) and a nurse per hall of 30 plus patients. Baths must be done, (hopefully you have a bath team working today) most patients must be spoon fed, most of them are incontinent, most are confused and angry about being at the nursing home. The worker is daily abused as they struggle to keep from being hit, bit, spit on, pinched, kicked, cursed at and told how much “I hate you, you old……” Yes there is negligence, the two workers on the hall have 4 – 5 call lights blinking, state regulations say these must each be responded to within 5 minutes, or you are negligent, there are approx. 15 – 20 of these patients who have had incontinent episodes and the longer each one has to wait the greater the chance of that patient having skin breakdown. At least 2 – 3 of these patients become impatient because you did not get to them quickly enough and attempt to go to the bathroom alone, and will likely fall and sustain a fracture. (Don’t forget to report all injuries.) State regulations discourage any type of device to keep confused residents from getting up on their own. Oh yeah, and the resident that fell (injury or not) an incident report which takes about an hour to complete must be done and that patient must have complete vital sign and neurological assessment every 15 minutes for a period of time. Families and doctors must be notified (hopefully the family or responsible party still has a valid phone #). In the mean time a new patient is being admitted which requires total assessment and hours of documentation. A few rooms up there is a patient dying and you really need to be at their bedside. One of the other rooms has a patient which has just passed away, a minimum of 2 hours time. Another patient on the hall is turning blue and must be suctioned immediately. Oh, we haven’t had a fire drill on this shift, state requires a certain # of drills. Two confused patients are in an altercation which must be interrupted promptly, oops two more incident reports to do. Mr.____bumped his arm on the door knob and his arm is bleeding and must be attended to, another treatment and incident report to complete. One of the CNA’s has already been working 12 hours because someone called in sick. And mercy forbid you go overtime to get your job done, and you can’t work off the clock, this is a liability issue. You should have left work 4 hours ago but a disgruntled family member doesn’t like the nurse on duty now and they are demanding that YOU hear them out and get the concern resolved. Be sure you chart everything you did, if it’s not charted it’s the same as not done.

Does it matter to surveyors, lawyers, administration if the job gets done as long as it is documented? Oops false documentation. Be real, do these people really think everything that was supposed to be done in 8 hours and everything documented as done, actually was?

Everytime I hear “we are changing__________it will cut down on paper work,” I think “who are you kidding?” Why can’t we take care of people instead of paperwork?

CNA’s can work at fast food restaurants and make as much money as they can working in the nursing home. In addition they wouldn’t have to be worried that before they get off work someone is going to ask them to work another shift. Neither would they have to worry about being called to come in to work on their day off just as they have fallen asleep after working a double shift. Nurse’s, CNA’s, firefighters, policemen, emergency medical personnel have very stressed lives, put their lives and their families lives on hold to sacrifice for others, and for what salary? Our entertainers, ballplayers, moviestars, singers, and many other titles far exceed the salaries of those who sacrifice for others. And although we don’t expect thanks, we do it because we want to help others. The thanks we get is to live every moment of our lives worried about liability. O h h h-the price of liability insurance.

Granted, you do not have a patient die every day you work, a fall, patients in an altercation etc. However, there are more things than you could possible imagine I haven’t mentioned which must be done. Make rounds with the doctor, get to the end of the hall and get paged for a phone call, and multiple, multiple little things. And don’t forget to smile.

I wonder if a grocery selling selling oranges in its home state can be charged with selling oranges under the commerce clause because it impacts the selling of oranges in all the other states. And this is precisely how stupid the constitutional commerce clause is.

Since buying health care insurance across state lines is prohibited there can be no interstate commerce involved. Not buying insurance is not commerce of any kind. But if one were to buy insurance in one’s state that is intrastate commerce. Congress cannot mandate that intrastate commerce is interstate commerce as if buying a policy affects the commerce of all the other states and this is precisely what they do under the commerce clause. This is what we call an absurdity.

The commerce clause was to regulate commerce among the states meaning that there would be no irregularities and that commerce would be legal and legitimate. So the legal and legitimate was to be first determined by the states engaging in interstate commerce. The states have a free hand in regulating their own commerce. Commerce is both natural and necessary. The states do their own regulating both between and among themselves. Congress was not to make a endless series of laws telling states how to conduct their own trade or even what was to be traded.

The 10th Amendment prohibits Congress from interfering with interstate commerce.

Over the decades the courts have given Congress unlimited say,sway, and control over interstate commerce to which it is not entitled. Congress was just to oversee that nothing was improper or irregular in interstate commerce and it doesn’t even have to be necessary.This centralized power was given to Congress because no single state could do this and in giving it to Congress serious conflicts would not arise between the states due to petty envy and jealousies.

Congress regulates AMONG the states and not BETWEEN them.In other words it was to see that interstate trade was fair and just. The commerce clause is toothless and there is very little cause for Congress to be interfering or managing interstate trade between and among the states.

Invoking the commerce clause as a means for the states to participate in health care is fraudulent.

Thoughts on Illegal Immigration

A large part of the cost of the health care problem is illegal immigration. There are 12-20 million illegal immigrants in this country.
1 There are already proper immigration laws on the books.All they need to do is enforce them.Immigration reform is a joke because it is unnecessary.The border patrol for years has been prevented from enforcing the laws.
2 If the federal government will not defend our borders and do its constitutional duty expressed in law and the Constitution then the federal government itself is breaking the laws framed from the Constitutional powers under Sec1 Art8. These are criminal acts.We no longer have a rule of law but a rule of men.
3 A sovereign state has the right and obligation to its citizens to defend its borders from invasion of any kind and doesn’t need permission to do what is right, and necessary, and this is obviously self evident..NECESSITY IS NOT SUBJECT TO ANY LAW! Arizona is doing what is NECESSARY!
4 The President has sworn an oath to uphold the Constitution and under Art2 Sec3 he is charged with making sure the laws of the land are enforced. By not enforcing the immigration laws he perjures himself,breaks the law,and is subject to criminal prosecution.and criminal charges.
5 Under the 9th and 10 Amendments Arizona and every other state bordering on Mexico has the right to defend its borders.If the state of Maine broke out in smallpox neither Canada nor Massachusetts would allow immigration or emigration and rightly so. Mexican immigration has become a harmful and costly disease to this country.Every state has the right to defend its borders when its safety and security are threatened.