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Saint Thomas More was martyred during the Protestant Reformation for standing firm in the Faith and not recognizing the King of England as the Supreme Head of the Church.
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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!

Oct 3rd 2012 new

This is where we will end up under Obama care.www.youtube.com

Oct 4th 2012 new

(Quote) Paul-866591 said: Just a simple example showing why we must get Government Beuraucrats out of health care. I ...
(Quote) Paul-866591 said:

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!

--hide--


After reading your post, I thought there could be two different problems with your health. One would be that the machine is
not working, or the second could be another medical issue which affects your sleeping.

The simplist way to root it out would be to fix the machine and if that helps your sleeping then it is the machine problem.

But if that does not work, then a visit to the doctor would be recommended.

I do agree that Medicare is not cost effective, so I hope it can be overhauled in the long run.

I hope you are doing better, but it seems you will have to wait awhile to get a new machine.

Oct 4th 2012 new

(Quote) Paul-866591 said: Just a simple example showing why we must get Government Beuraucrats out of health care. I ...
(Quote) Paul-866591 said:

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!

--hide--


I heard some doctors talking about the sleep apnea machines and they said the new machines are much
better and easier to get used to.

Oct 4th 2012 new

(Quote) Marianne-100218 said: I heard some doctors talking about the sleep apnea machines and they said the new machines are...
(Quote) Marianne-100218 said:

I heard some doctors talking about the sleep apnea machines and they said the new machines are much
better and easier to get used to.

--hide--


About 3 years ago, the on-off switch on my machine broke. While it was being repaired, they loaned me one of the newer machines. What a difference! It was a lot less noisy, adjusts itself automatically to any changes that may occur; i.e. adjusting the presssure automatically if necessary, etc.

I offered to buy one on my own without the HMO or medicare being involved. They just looked atme sadly and pointed out that the cost was around $3,500. I told them it was not a problem. And then they said that even if I were willing to buy, the HMO and mMedicare would still have to approve it or they coluld not sell one to mne. And the final shoe dropped, the HOMO and Medicare would not approve it as loing as the old one worked and the manufaturer was willing to repair it.

Bureaucrates, don't we just love them!

Oct 4th 2012 new

(Quote) Marianne-100218 said: After reading your post, I thought there could be two different problems with your health. One...
(Quote) Marianne-100218 said:

After reading your post, I thought there could be two different problems with your health. One would be that the machine is
not working, or the second could be another medical issue which affects your sleeping.

The simplist way to root it out would be to fix the machine and if that helps your sleeping then it is the machine problem.

But if that does not work, then a visit to the doctor would be recommended.

I do agree that Medicare is not cost effective, so I hope it can be overhauled in the long run.

I hope you are doing better, but it seems you will have to wait awhile to get a new machine.

--hide--

The Drs. and technicians already agree that the machine is too old and should be replaced and tell me it should have been repalces when it had broken before.

The machine they loaned me when this one was being repaired did provide a better sleep.

Am already working with my regular Dr. who finds no apparent physical or other health problem. As I mentioned in my initial note, the sleep Dr. can talk to my personal physician as well as revue my entire medical record.

The visit that is scheduled with the sleep Dr. is a mere formality so he can certikfy he has seen me face to face. The visit will be less than 15 minutes, hardly time for him to do anything but say hello.

That is what is so frustrating about this. The best way for the sleep DR. to determine if anything has changed that my regular Dr. has no way of determining would be to order a sleep test. That test would be done by the contracted provider in my own home with the provider's testing machine.

But, under the rules, the sleep DR. cannot order that without seeing me face to face.

Oct 4th 2012 new

This is soooo funny.,...


www.examiner.com



Dr. Barbara Bellar is running for IL senate and many wish she was running for federal....she has summed this up in one hysterical sentence. Someone recorded her and posted it on utube...she didn't even know she was being recorded I guess, but she was great.

Oct 7th 2012 new

(Quote) Paul-866591 said: About 3 years ago, the on-off switch on my machine broke. While it was being repaired...
(Quote) Paul-866591 said:


About 3 years ago, the on-off switch on my machine broke. While it was being repaired, they loaned me one of the newer machines. What a difference! It was a lot less noisy, adjusts itself automatically to any changes that may occur; i.e. adjusting the presssure automatically if necessary, etc.

I offered to buy one on my own without the HMO or medicare being involved. They just looked atme sadly and pointed out that the cost was around $3,500. I told them it was not a problem. And then they said that even if I were willing to buy, the HMO and mMedicare would still have to approve it or they coluld not sell one to mne. And the final shoe dropped, the HOMO and Medicare would not approve it as loing as the old one worked and the manufaturer was willing to repair it.

Bureaucra

tes, don't we just love them!

--hide--


I wonder if your doctor wrote a prescription for you for the machine, then you can buy one on your own at a pharmacy or
whereever they are sold.

Oct 7th 2012 new

(Quote) Marianne-100218 said:I wonder if your doctor wrote a prescription for you for the machine, then you can buy one on your...
(Quote) Marianne-100218 said:
I wonder if your doctor wrote a prescription for you for the machine, then you can buy one on your own at a pharmacy or
whereever they are sold.

--hide--

Since I am on Medicare, that would be illegal.

Oct 7th 2012 new

(Quote) Paul-866591 said: (Quote) Marianne-100218 said:I wonder if your doctor wrote a prescription for ...
(Quote) Paul-866591 said:

Quote:
Marianne-100218 said:
I wonder if your doctor wrote a prescription for you for the machine, then you can buy one on your own at a pharmacy or
whereever they are sold.


Since I am on Medicare, that would be illegal.

--hide--

Why is that?

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