Just a simple example showing why we must get Government Beuraucrats out of health care.
I receive my health care through an HMO, with Medicare. As a result, my health records are available to any Dr. who is part of the system who needs them. The Drs within the HMO have free access to each other to discuss a particular patient's needs. Within the HMO, I can refer myself to any specialist in the system. I do not have to be referred by my primary care Dr.
Ten years ago, I was diagnosed with sleep Apnea. As a result I was proivided a CPAP machine to use while I sleep. Periodically I need to obtain supplies such as filters, tubes, masks, etc.. And that has not been a problem.
Those supplies come through a contracted provider. All I have to do is call them and ask for what I need. They send the supplies to me and bill me for any required co-pays.
Lately I have not been getting the quality of sleep I should. My primary care Dr. can find no immediate problem to explain the poor sleep quality. So he told me to call the sleep clinic and ask for a retest. Sounds simple doesn't it?
It used to be I would call the sleep clinic and they would authorize the contracted provider to come to my home and install one or their test machines and give me any necessary instructions for its use. After one or two nights, the provider would pick up the machine, extract the information and send a report to me and the sleep clinic. The sleep clinic would call me with any instructions. The only time I would have to go into the sleep clinic is if there were an indication of any serious problem.So I called the sleep clinic. Looking over my records, the sleep Therapist/technician, concluded that my CPAP machine probably needs to be replaced since they should be replaced every 5 to 8 years anyway.
So I said fine, have the contracted provider come in with their test machine, run their test and then give me the new machine with appropriate instructions.
His answer, "that is what we will end up doing in the end. BUT, new Medicare rules require that if I have not been seen by a Sleep Doctor within a specified time period, I must be seen by one or else Medicare will pay nothing" In my case. I am well beyond the specified time period.
A simple phone call by the sleep clinic to the provider authorizing them to test me and provide me with either instructions for new settings on my current machine or a new machine as appropriate, would have resolved my problem by the end of next week. Instead I have to be scheduled to go to the sleep clinic, have a technician check my machine, say hello to the Dr. so he can certify that he has seen me, and then they will make the call to the provider to effect the solution.
So now, in addition to any co-pays I might be responsible for, I have two expensive Ferry tickets to pay for, plus having to wait until the end of the month to get into the clinic and probably well into November before the problem gets resolved. Thank God, its not an immediate threat to my life.
So a bureaucratic rule that serves no useful purpose; unnecessarily increases Medicare costs, my personal costs, my time and the time of a technician and a Dr. just to satisfy some useless paperwork of the CYA (Cover Your A__) variety for some Medicare paper inspector.
Welcome to the world of Government Health Care!