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Medicare Needs Fixed

Help the poor and elderly

We pay into it. We support it. We expect it to be there when we need it.

But Medicare, as we know it, is broken.

The Medicare program, the U.S. national health program for the aged and needy, takes care of certain medical and hospital needs and is paid from federal funds, mainly those we put into it through Social Security.

It’s a system that is supposed to work. But what if doctors don’t accept it?

What if primary-care doctors say no? Turn patients away? Refuse it?

Where’s help when you need it?

A former friend, a mentor really, died a year ago in January from cancer. He once told me he had to drive to the Kenai Peninsula to see his primary-care doctor because his doctor moved there and nobody in Anchorage would see him. That is until he became ill enough to need specialists and emergency services.

On HealthReform.Gov, on a Web page titled HCCD Report Alaska 99516, a woman wrote that her husband paid nearly $100 a month for Medicare, but couldn’t use it because his doctor “opted out.” Why? The answer is simple. It costs more to see a Medicare patient than primary-care doctors are reimbursed for services.

The woman, who lived in Anchorage, at least in December 2008 when her statement was made, went on to say, “My doctor can’t keep the doors open if her Medicare clients comprise more than 20 percent of her clientele.”

How bad is it?

The Institute of Social and Economic Research, better known as ISER, conducted a survey in 2009 to see just how many doctors were taking Alaska’s 26,000 Medicare recipients. The results were astonishing.

Only five primary-care doctors in private practice were willing to take new Medicare patients in Anchorage, the state’s largest city. The problem is “major” in Anchorage, and a “noticeable problem” in the Mat-Su Borough and Fairbanks. Rural areas had fewer problems.

About one out of every 10 doctors opted out of the Medicare system, meaning they will not accept any kind of Medicare payment but will see Medicare patients who pay the full amount out of pocket.

Medicare needs fixed. How? I’m not sure, but I know making cuts in the program is not the answer. One solution would be to pay doctors more for their services to Medicare patients. Another option would be to allow those who have Medicare to pay part of the bill themselves if they go to a doctor who takes Medicare patients. Another is a complete overhaul of the system.

Yet another are the efforts by Sen. Kevin Meyer, other legislatures and Dr. George Rhyneer, an Anchorage cardiologist, who have been working on opening a nonprofit clinic in Anchorage to serve Medicare patients. Start-up capital will be about $1.7 million and it is hoped some will be allotted in this year’s Legislative budget.

One physician, three nurse practitioners and several medical support personnel will staff it and fundraising is under way.

“I think this is a huge opportunity both to succeed, set ourselves as a national example and build a model that will be copied across the country in years to come,” said Rep. Mike Hawker, co-chair of the House Finance Committee, in a press release dated Feb. 12, 2010.

It will take a village to correct this problem. Let’s start thinking of solutions today. Before it’s too late. Before more find themselves without means to get medical attention.

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