Showing posts with label Medicare Advantage insurers. Show all posts
Showing posts with label Medicare Advantage insurers. Show all posts

Thursday, February 4, 2021

Opuscula

It’s not 1984:
Big Brother
Has Arrived

THE GOVERNMENT IS TRYING to protect us.

The question is: Who is protecting us from the government?

Government exists to protect us from each other. Where government has gone beyond its limits is deciding to protect us from ourselves. Ronald Reagan

 

IT STARTED WITH FDR.

Before Franklin Delano Roosevelt, FDR, people generally took care of each other.

Granted, the country found itself in a depression brought on by greed and lack of concern for our neighbors. The whole world suffered.

So FDR initiated a number of social programs, including Social Security, the TVA, WPA, and a host of more “alphabet soup” organizations, many of which linger on even today.

    (At the same time FDR was creating “make work” programs for Americans, he kept Jewish refugees from Germany at bay by closing the borders to them.)

Another three-initial president, Lyndon Baines Johnson, LBJ, gave us Medicare, a social service into which citizens pay and pay and then, when retired, CONTINUE to pay — more every year.

Unfortunately, we — Americans — brought some of this on ourselves.

We allowed technology — that “miracle” that was supposed to save us time and money — to take over our lives . . . and our wallets.

Doctors DON’T know best

I am about to travel overseas for six months.

My Spouse and I have a Medicare Advantage plan that is SUPPOSED cover our prescription medicines, BUT when my Spouse tried to get a Vacation Override so she could get two 90-day supplies — enough to last six months (180 days by my count) she was denied.

    The insurer also claims we will have emergency coverage while out of the insurer’s coverage area. But only for five (5) months. I’ll bet the insurer collects from CMS for the sixth month!

After going around and around with the insurance company, she discovered that the most she could get would be a 5 month supply of medications. The insurer told my Spouse that it would terminate her coverage if she was outside of the company’s service area for six months.

Understand, that she could be back on day 179 and needed her pills until she could get a refill from the pharmacy.

ONE DAY and the insurer refused to give the override.

None of her medications are narcotics.

To be fair, there was a person at the insurance company and another at the pharmacy that did their best to help my Spouse. The insurance clerk was about the 15th clerk with whom my wife spoke. Getting to the helpful clerk was a several-day process.

MEANWHILE, SEEING THE PROBLEMS MY Spouse encountered, and knowing that I have far less patience that she, I contacted my Primary Care Physician (PCP) and asked that he write a script for double the number of pills — from one-a-day to two-a-day. That way, my normal 90-day supply would last 180 days.

The pharmacy refused to honor my doctor’s order.

The insurer told the pharmacy that what my doctor did was “unethical.”

Again, no narcotics. Nothing to sell and I’m certainly not about to OD on a diabetes pill.

Still, it failed to meet some esoteric law in place to protect me.

The insurer knows better than my doctor how many pills I need? My insurer has never examined me and I doubt it ever has seem my laboratory results.

I’m 78 years old and I don’t think I need protection from myself; but I’m not so sure I don’t need protection from The Powers That Be.

Something new? Hardly

There was a time when a committee of prudes determined what made-in-America movies could include. Married couples had to sleep in twin beds or, Hollywood forbid, if they managed to share a double bed, each bed partner had to have one foot on the floor. (How did movies ever have babies in them?)

Go to the library and, if lucky, the book you want won’t be on some blue list as “unsuitable” for you. Lady Chatterley's Lover made the list. In some places, Tom Sawyer was pulled from the shelves. Disney, in its corporate wisdom, locked The Song of the South in a vault, never to see the light of day again. (Uncle Remus’ wisdom was denied to generations. Zip-a-Dee-Doo-Duh.) And this was BEFORE the Black Lives Matter riots.

    Personally, I thought Uncle Remus was a pretty good example to follow. I also thought the 1950s Aunt Jemima made great flapjacks and Uncle Ben’s rice was, properly cooked, delicious. Now I find that, per BLM and other leftists, I am a white racist! ‘Course I’m so out of it that I thought BLM meant Bureau of Land Management, the Forest Service’s nemesis.

“Western” religions have been censoring our reading material for centuries. Likewise art.

History is being revised again (and again).

And then there is “political correctness”

Once upon a time colleges and universities taught students two things: critical thinking and a profession.

Even in my time, the schools of higher education were beginning to tell students what and how to think at the expense of critical thinking. If a student wants a good grade, the student simply parrots the teacher.

After graduation, if the now employed person wants to keep his or her job, he or she must agree — kow-tow — with the boss (or boss’ offspring) on all matters.

I suppose abandoning “critical thinking” in university was the right thing to do; no one wants critical thinkers today.


PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Truth is an absolute defense to defamation. Defamation is a false statement of fact. If the statement was accurate, then by definition it wasn’t defamatory.

Web sites (URLs) beginning https://tinyurl.com/ are generated by the free Tiny URL utility and reduce lengthy URLs to manageable size.

 

Comment on Big Brother

Thursday, November 21, 2019

Opuscula

Pay me now
*  And  *
Pay me later

MEDICARE WAS SIGNED INTO LAW on July 30, 1965 by President Lyndon Baines Johnson in Independence MO.1

I HAVE BEEN WORKING AND PAYING INTO Social Security since 1957, and Medicare since its inception.

Each month, Social Security deducts an ever-increasing amount from my stipend for Medicare.

Why?

Didn’t I pay into Medicare enough from 1965 until I signed up for Medicare in 2008?

Is the government such a bad steward of my money that at almost 77 years old I STILL must pay into Medicare?

Social Security and Medicare were supposed to be inviolate; untouchable.

It is — “sort of.”

Medicare and Social Security funds were put up as collateral by U.S. governments to cover loans from China.

In other words, China owns the Social Security and Medicare I paid into for decades.

The government will tell me the funds are still here and that the money is safe.

I fear I have no faith in the government; not with Democrats in control and not with Republicans in control.

Since the politicians in the House, the Senate, and the White House have special plans for things Medicare supposedly covers and their own retirement plan separate from Social Security, why should “our” elected representatives care about these two funds.

Sometimes I feel like Diogenes of Sinope, looking for a politician who cares.

 

Diogenes looking for honest man (https://tinyurl.com/tkvlw5c)

 

I know not all politicians are self-centered, but given how hard they campaign to stay in office — and complain about the cost of living in the capital, be it D.C. or Montpelier (VT) — there must be some benefit to the job beside “prestige” and a desire to perform a public service. Color me a skeptic.

I won’t say that each year my monthly Medicare contribution has increased, but it seems to have gone up every year recently.

(I have a Medicare Advantage plan, a money-maker or the insurance companies but one that provides better benefits that “original Medicare.” I live in an area heavily populated by “geezers” and, because of competition, I get more benefits than someone who lives in the tulies or boonies — six of one, half dozen of the other. People who live one county south get more benefits; people who live one county north get less. It's all about competition for the shrinking dollar.)

I understand having to pay tax on my Social Security benefit. It was “pre-tax” income. I don’t LIKE pay tax on my Social Security stipend, but I understand why.

    As I understand it, Social Security never was intended to replace retirement savings, and the Social Security number was never supposed to be a national ID to be shared with just about everyone.

    When I joined the Air Force in 1960, I got a unique Air Force ID number (that I can recite to this day); sometime later, the military decided to make ever soldier, sailor, and airman’s ID the person’s Social Security number. Some states, e.g., Virginia, used a person’s Social Security number as the person’s driver’s license unless the person complained. So much for making identity theft easy.

I’m glad I HAVE Medicare, but in my heart I resent having to continue paying into a fund to which I have been contributing since its inception.

Pay me now AND pay me later.

Somehow that doesn’t seem fair.

Sources

1. Medicare law: https://tinyurl.com/y3mq74x7

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Truth is an absolute defense to defamation. Defamation is a false statement of fact. If the statement was accurate, then by definition it wasn’t defamatory.

Web sites (URLs) beginning https://tinyurl.com/ are generated by the free Tiny URL utility and reduce lengthy URLs to manageable size.

 

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