Recent changes to Medicare are drastically reducing the ability of the most vulnerable people with disabilities to communicate.

As of April 1, 2014, Medicare began denying payment for many of the medically necessary speech generating devices used by people with ALS (Lou Gehrig’s Disease), Cerebral Palsy, Spinal Cord Injuries, and other impairments, when they enter a health care facility, such as a skilled nursing home or hospice. Taking these highly specialized devices away leaves them no way to communicate at a vulnerable and terrifying time.

On September 1, 2014, many severely disabled individuals will have all contact with the outside world cut off. For many years, Medicare allowed individuals using Medicare-provided speech generating devices to use their own funds to “upgrade” the devices. This allowed them to communicate beyond the confines of their room through email, internet, and text messages. After September, Medicare will no longer pay for any device that has the potential to be upgraded to allow communication outside the room

Currently, Medicare routinely denies coverage of the critical eye-gaze technology necessary by some people to operate these speech devices, even when its medical necessity is well documented.  They have no way to communicate as a result. After years of waiting for an appeal to Medicare, the eye-gaze coverage is routinely allowed, but individuals should not be forced to wait years without a voice. 

We need your “voice!” […]

BREAKING NEWS: Today, an independent review panel in the U.S. Department of Health and Human Services ruled that Medicare cannot categorically exclude treatment for gender dysphoria, including transition-related care. This decision eliminates the nationwide rule that transition-related surgeries cannot be covered by Medicare. Learn more here:

It’s unbelievable to me how expensive top surgeries are… Which is why it’s also such a shame that there are so many guys who aren’t lucky enough to have money or good insurance and may never even see the procedure. I can’t imagine the struggle…I see it all the time in Jordan, it kills me…. Thankfully with this Medicare ban lifted it should be possible for him to get his surgery.. I can only hope that others will one day be able to see the dream.

10 reasons against Abbott's GP fee

The Abbott Government is introducing a $6 GP fee in the next budget. Ten reasons why this is a bad idea:

  1. $6 is a lot for the disadvantaged. The dole is about $35 a day.
  2. It discourages the disadvantaged - pensioners, Aboriginal people, disabled people, poor people - who, ironically, have the most health concerns.
  3. It is hard enough getting people to see a doctor to check that spot, or discuss weird weight loss, or feel that testicle. We should not add disincentives.
  4. The money saved is minimal.
  5. In fact, it may ultimately cost us more. If people are less inclined to see their GP early, that spot/weight loss/testicle bump may turn into a big/costly/devastating problem. A stitch in time saves nine.
  6. We simply don’t have a problem of people going to the GP needlessly.
  7. The AMA is against it.
  8. We have no assurance that this fee will stay at $6 - the fees may keep increasing over time if we don’t nip it in the bud.
  9. More incentive for people to go to (already overcrowded) emergency departments.
  10. Let’s call a dog a dog: The Liberal Government do not like welfare for ideological reasons. They don’t like the idea of people getting a handout. I suspect this is less about saving money and more about them cutting something they don’t believe in, even if it is proving to be working.

In move against #Obamacare, 25 governors are denying millions of poor Americans coverage

A vital provision of the original health care reform law mandated that states accept federal funding to expand Medicaid eligibility for any adult with an income under 133% (now 138%) of the federal poverty line. The requirement was there to make sure that the poorest Americans, some 17 million who could not afford insurance even with new subsidies, would still be covered in some form. But, according to the Supreme Court, the federal government couldn’t require states to accept the cash or implement the expansion. If a Governor felt like denying health care coverage to the poorest among their constituents on principle, that was their call. Rick Perry decided to make it.

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LBJ Signs the Medicare Bill On This Day in 1965

When President Lyndon B. Johnson signed Medicare into law at the Harry S. Truman Library on July 30, 1965, he told the nation that it had “all started with the man from Independence.”

Harry S. Truman, LBJ said, had “planted the seeds of compassion and duty” that led to the enactment of Medicare, a national health insurance for the aged through an expanded Social Security system.

Truman was the first President to publicly endorse a national health insurance program. As a Senator, Truman had become alarmed at the number of draftees who had failed their induction physicals during World War II. For Truman these rejections meant that the average citizen could not afford visiting a doctor to maintain health. He stated:

“that is all wrong in my book. I am trying to fix it so the people in the middle-income bracket can live as long as the very rich and the very poor.”

Truman’s first proposal in 1945 provided for physician and hospital insurance for working-aged Americans and their families. A federal health board was to administer the program with the government retaining the right to fix fees for service, and doctors could choose whether or not to participate. This proposal was defeated after, among many factors, the American Medical Association labeled the president’s plan “socialized medicine” taking advantage of the public’s concern over communism in Russia.

Even though he was never able to create a national health care program, Truman was able to draw attention to the country’s health needs, have funds legislated to construct hospitals, expand medical aid to the needy, and provide for expanded medical research.

In honor of his continued advocacy for national health insurance, Johnson presented Truman and his wife Bess with Medicare cards number one and two in 1966.

-from the Truman Library

Talk about stimulus, I think every dollar you give to a senior citizen gets spent right away. They have to buy food with it. They are not going out perusing a yacht or an airplane they could or could not buy. They need to eat. They go to the corner drugstore; they need to get their medicine. They spend it. Yes, we give money to the poor on the Democratic side and the middle class because it is the right thing to do. It actually happens to be also the smart thing to do for the economy and for jobs.
—  Senator Mary Landrieu
CMS and its Data Dump

I am someone who is very much in favor of transparency in medicine.  In fact I recently pitched the idea of increasing hospital transparency to a state representative.  (I highly recommend this book about that very topic.)  However, the way that CMS released the Medicare data was ignorant and potentially damaging to physicians.  

One of the biggest issues for healthcare right now,  especially physicians, is its public image.  For years doctors have been pegged as greedy, rich, and negligent.  Our own president has not-so-subtly hinted at physician greed as a driver of healthcare costs.   While there are few broke doctors, I believe the public’s belief about a doctor’s earnings is ill-informed.

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NT Indigenous health services have announced they will not charge their patients a $7 GP fee, because their patients simply cannot afford it. This isn’t a happy ending. This means up to $750,000 a year will have to be made up in cuts to Indigenous health services to make up the difference.

These are the types of decisions that are being made so that Hockey can have a GP fee.