How Medicare is Failing Diabetic Americans

Bill was 67-year old real estate agent. He wasin to a diabetic foot infection, you just might wind up
semi-retired. He like showing houses because he hadwith an amputation.
lived in the same small town his whole life. PeopleWhen you are allowed the time you need to talk to
trusted him. But one day he got a diabetic footyour doctor, you would and should talk about all of
infection. He called his primary care doctor and wasyour health concerns. This of course is the way
referred to a podiatrist. But the podiatrist didn't havemedicine used to be. The fact that most patients don't
any more "Medicare appointment slots" available untilknow is that your doctor is obligated ethically and in
the end of the month. While waiting for themany cases legally to hear about all of your health
appointment, the infection got worse. So instead ofproblems that need to be treated. So if you doctor
high quality care, Bill got an amputation. Now he sits in asays, "We'll have to discuss that next time," just insist
wheelchair, wishing he could sell houses.that he hear you out.
Retired Americans often view Health Care paid for by4. Medicare is Decreasing Services.
Medicare as one of the few perks of retiring. After aIf you have diabetes you will be sent to a lot of
lifetime of working hard, raising children, and paying intodifferent specialists. Studies have shown that having
the System, Medicare is one of the few reliable waysdiabetes make you four times more likely to have a
to get a return. But unfortunately for those who areheart attack. You are also way more likely to develop
diabetic, Medicare can be bad for your health. It's justkidney trouble, blindness, or diabetic foot infections that
math; not enough money equals not enough high qualitylead to amputation. To make sure everything is
medical care.working right, your primary care doctor will likely send
The recent attempted resurrection of Presidentyou for "consultations" with other diabetes specialists
Obama's Health Care reform efforts speak to thelike podiatrists, cardiologists, opthalmologists and
broken system. The fact is that Medicare is annephrologists.
expensive program. Since 2002, Medicare has beenA consult is a visit to a specialist requested specifically
short of money. There is only just so much money toby your primary care doctor. The problem is that
go around. All of the federal mandates that have beenMedicare simply stopped paying "consult codes" this
written into law to save money are simply killingyear. So don't expect a specialist to take any extra
diabetics. As long as you understand why, you'll betime explaining your health problems to you or your
able to get quality care even if you do have Medicare.primary care doctor. And don't be surprised if these
1. Difficult to Find a Medicare Doctor.specialists don't work you into their schedules very
Since 1986 Medicare has set all doctor fees. Doctorsquickly. They simply are making money like the once
don't decide how much they get paid, Medicarewere.
decides. Adjusted for inflation, over the last eight years,Once upon a time, house calls were common, but now
Medicare Has reduced fees about 20% every year.very few doctors who accept Medicare can afford to
On March 1, 2010 doctors took another hit whenmake house calls. There is just no way they can take
Congress let another 21.2% reduction in doctor paythe time to drive from house to house with the low
take effect. Imagine if at your job every year you getrates medicare pays. This is obviously a big problem
20% less pay instead of a raise. How long would itfor an elderly diabetic who may have poor eyesight or
take you to look for another job? Obviously youran open wound on the foot. If you can't see because
doctor can't just switch careers, but he can stop takingof your blindness and aren't supposed to walk on the
Medicare.foot with an open sore, how can you easily get to the
In some places this means less doctors are availabledoctor's office?
to accept new patients. If you live in San Francisco, the5. No Diabetes Prevention.
cost of living may be twice that in rural Ohio. ButIt is simply a fact that the problems related to poorly
incredibly, doctors seeing patients in San Francisco getmanaged diabetes are preventable. Blindness, kidney
paid comparable fees by Medicare. So your doctorfailure, and diabetic leg amputations are all preventable.
has to either learn to live poor or see twice as manyDoctors fully understand how elevated blood sugar
patients.levels damage the eyes, kidneys and feet. Doctors
2. Doctors Who Accept Medicare are Swamped.also fully understand how preventative care can
In 2008, the president of the American Medicalprevent this damage. But Medicare won't pay for
Association (AMA) was testifying in front of Congressintensive diabetic foot monitoring programs. It has been
about declining care for Medicare patients and theshown that close monitoring of diabetic foot skin
problem of Medicare cuts. The AMA Presidenttemperatures can prevent diabetic foot sores. But this
informed congress that the vast majority of doctors insort of close monitoring by a diabetic foot expert isn't
the United States would simply opt-out of Medicarea service that Medicare will pay for. As a result, it is a
and stop providing care for Medicare patients. Senatorservice that isn't offered to you by your doctor.
Stark replied that since Medicare started reducingSo now that you know the Top 5 Reasons Medicare
payments to doctors many years ago, doctor's haveis bad for your diabetes, what can you do about it?
simply seen more and more patients each year toFirst keep in mind that most doctors decided to
make up for the lost revenue.become doctors because they really and truly want to
But it is now clear that doctor's can't keep seeinghelp people stay healthy and happy. Remember that
more and more patients. Sixty patients in a day is justyour doctor is on your team. But feel free to remind
plain bad medicine. Seven minutes of time in a roomhim or her that you need help, even if it might take a
with a patient is not enough time to understand bloodlittle extra time. In most cases your doctor will listen.
sugar readings, sugar pills, insulin shots, hypertension,You've got to ask tons of questions. Take a list of
peripheral vascular disease and explain diabetic footquestions so that you can stay on track and get all of
care. It just isn't enough time to practice good medicine.your concerns dealt with in a short doctor visit. Ask
Too many patients and not enough time is ayour doctor about performs house calls. If not, find one
prescription for a diabetic disaster.that does. Even if you have to pay for it, having a
3. Less Pay for Medicare Diabetes Doctors.doctor come to your home is an amazing
Many people don't think pay should have anything toconvenience. Make sure you ask your doctor about
do with the quality of the care. But the reality is, it justany new treatments that are available, but not
comes down to math. If your doctor acceptscovered by Medicare. If you don't ask, many docs will
Medicare, but has to see 60 patients a day, you won'tsimply not take the time to offer all available
get much time. I actually have a doctor friend whotreatments if they aren't covered.
says, "I just tell Medicare patients they get twoDiabetes is a serious disease. Many patients with
problems to talk about during a visit. Just two," she saiddiabetes will die from health complications directly
holding up two fingers.attributable to poorly controlled blood sugar. Given that
But what if you have high blood pressure, diabetes,most of these problems can be managed and
and you also have a little sore on your foot? If youprevented, you owe it to yourself to insist on the very
can only talk about two problems, you'll ignore thebest care from your doctor.
diabetic foot ulcer. And if that diabetic foot sore turns