Occupation:: Self Employed

I went to an Urgent Care doctor in November. I have a $35.00 co-pay through my insurance. I have just received a bill in the mail for the balance of $68.85. This is crazy! #1 – the Doctor’s Assistant came into the room, told me that I needed to see a specialist & left the room in under one minute. #2 – they turned the bill in under Urgent Care instead of Doctor Visit, that is the explanation that I got for the difference from the insurance co. But the first time that I went to this Urgent Care, they asked if I wanted them to be my Primary Care Physician. When I tried to explain this to billing, they just kept saying it was turned in as Urgent Care. I have been having such a hard time trying to find affordable insurance and then to actually be able to afford getting sick. This great nation that I live in & health care is going by the wayside. Apparently, there is too much greed to leave healthcare up to private industry. I have always believed in smaller government & private industry, but I am learning that the necessities in life should not be left to the greedy private industries. We need help with medical expenses & President Obama saying that everyone must have health insurance is not going to do a thing to help. I have health insurance, the best that I can afford to have and yet I cannot afford to get sick. We need help, I am getting to be in an age group that cannot gamble with my health or health insurance.

Occupation:: Small Business Owner

Reform of health care must start with eliminating the trash – all the over utilization and unnecessary treatment that burden our health care system. Estimated at over $600 billion in a $2.2 trillion health care system, clearly it impacts on our ability to provide all citizens with quality care.

Who is creating $600 plus billion in health care trash? The medical community, of course, who must prescribe the over treatment. Don’t blame them thought, they’re just playing in the current system. But if we want to save health care, we better get some active trash haulers.

Let’s face it, the only people who can fix our health care problems are the trash makers – the doctors. They have to want to provide appropriate care and not over treat. Insurers have tried coercion and that hasn’t worked. The insurers pay them less for services but the number of services just goes up. We’ll never get control of health care costs by pushing down on the doctors. We need their willing cooperation.

Let’s look for ways to get doctors to voluntarily reduce over treatment. Let’s be realistic and address the problem where it begins.

Occupation:: Disabled

In May of this year I took my mother for a routine mammogram. They found a few masses in both of her breasts. Her doctor contacted me with her results a couple of months ago and wanted to schedule an MRI of her breast due to the findings on the mammogram. I went and picked up the films from the mammogram as requested by my mother’s doctor and scheduled her appointment for the MRI.

My mother is 78 years old and had to have her colon removed due to colon cancer a few years ago and therefore she has to wear a colostomy bag. She also has emphysema and severe scoliosis of the spine.

A couple of weeks ago I took my mother for this MRI. First of all, they didn’t have a clip board for me to fill out the paperwork. I had to stand up over a ledge to fill it out. Then the person who collected the co-payment (who is probably close to 80 years old herself), forgot to give us a receipt. We had to ask her several times for her to give it to us. We waited there for over two hours for find out that their MRI machine was not working so they sent us to their other office. Needless-to-say, we had to wait another hour in that office as well. This test consisted on her lying on her belly for about 45 minutes. This test was very difficult for her to take because she wears a bag on her stomach and because she has severe scoliosis. She got through the test and I took her home. She has been in pain with her spine ever since.

Her doctor called me again to tell me that the MRI showed as benign but she needs to go back for an ultrasound to double check the results. I received a call from the Center on Monday, August 16th to schedule this appointment. I asked the woman on the phone if I needed to bring anything with me and she said “No, we have her MRI reports here and they will be compared to the ultrasound while she is taking the test.”

I took her for her appointment today, Wednesday, August 18th. I was told to get her at this appointment at 12:45. We were there at 12:30. At 1:15 a women walked out and asked me if I had her films. I told her what the scheduler had told me on the phone and then she went back in her office. Later she calls us and tells me that they need the films. I was angry so the scheduler came in to see me. She told me “I never read the report and therefore I don’t know what you need to bring with you.” She then called and requested my mother’s records on a CD. I had to leave my mother there to pick up this CD.

Time was of the essence because when you have a colostomy bag, it fills up whenever you eat or drink anything and therefore, my mother didn’t eat or drink anything in order to get this test done. If she does not drink anything for a long period of time, she dehydrates quickly and will need to be rushed to the hospital before her kidney’s fail. Therefore, I had to break all the traffic laws to get this done as quickly as possible. I had to wait at for 20 minutes because the girl who was burning the CD was having some problems. As soon as she was done I rushed back to the Center to find my mother crying because her bag was leaking. She had to drink a little water when she was waiting for me and therefore the bag filled up quickly. She had gone to the rest room to empty it, but it had already leaked.

They took us in and we waited for about another 20 minutes. Two of their manager’s came out and told us the CD was blank. By this time I had to leave with my mother to get her something to eat and drink and to take her home to calm down and relax. They did offer to go pick up the actual films, but we would have had to wait another hour or so. We couldn’t due to my mother’s condition.

Editors Note: (names edited out per editorial policy)

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!

Health Care is the country’s largest economic sector, accounting for over $2 trillion in annual expenditures—four times larger than national defense! Why aren’t Republicans crafting bills that will address problems in the current health care system? I believe the American people would support bills that:

Address private insurance coverage
Address insurance portability
Address pre-existing conditions
Provide for the digitizing of medical records
The sharing of medical records between physicians (with patient consent)
Crack down on Medicare fraud
Crack down on welfare fraud

Let’s start making some common sense decisions about health care without rewriting the entire universe of health care. This list can be a starting point, but there is plenty of opportunity for bills addressing other problems in the system. We need a targeted approach to health care problem solutions.

Occupation:: Retired

Medicare,medicaid and insurance cost reduction.
I’m aware of doctor shortages in US.I did not have any prostate problems.Under the pressure of more that one doctor and my family too I ask my primary doctor to refer me to an urologist. He checked me physically and said at my age of 70 is normal. But just to be sure there is no cancer will do a biopsy.He took 12 samples and said that results show one sample has a possible 1% cancer. As conclusion he sent me to an MRI to be sure that the cancer has not spread all over my body. He also stated that he wants to see me in 6 month.
I said that will not be home because traveling to Europe and will see him in about an year.Than he said 9 months.
I hope this example will help find how to cut cost.

Occupation:: Retired

I am now retired and on Medicare but several years ago I found myself suspecting I was ill, and without insurance. I tried to purchase Blue Cross/Blue Shield but was denied for the most ridiculous reasons such as I failed to follow up on a doctor’s visit although nothing wrong was found. I had to go through a very large chunk of my savings in order to get treatment. When one is low income, older or unemployed, savings can never be replaced.