Recent commentaries on Medicare have missed the long-term, no-cost solutions to fixing problems of patient access to doctors and reducing costs. The "radical" option, discussed in a recent Daily News editorial, to limit doctors' face-to-face contact to five minutes, is unacceptable.
No one has been able to explain why the following logical, simple suggestions that I've been touting for years can't be part of a long-term Medicare fix. Congress and AARP can only come up with putting more money into Medicare.
Instead, what about:
• Allowing patients to pay the difference between what Medicare allows and what the doctor's bill actually is -- if they can and wish to. This would free up more of the limited "slots" that doctors allot for Medicare patients and would allow many of us to remain with our doctors who otherwise wouldn't continue to see us.
• Whether No. 1 is allowed or not, patients must be able to file paper (or electronic or fax ) claims for reimbursement. It is nearly impossible to do this, however, because the Medicare contractor in North Dakota gets to write its own contract; paper slows them down.
• When a doctor opts out of Medicare, patients often have to sign a contract saying they will pay the full bill or they won't be seen. But Medicare rules disallow patients from filing a claim from those "opted-out" doctors. So patients end up paying for Medicare each month, even though they may not be able to use it to see their regular doctor.
• Allow standing orders for lab tests for certain conditions. Currently, patients who need regular tests, such as those on blood thinners, must get a doctor's order each time. This involves unnecessary time and expense for the doctor and patient.
• Allow patients to use (and get reimbursed for) the lab of their choice, even if it isn't one that submits Medicare billing. Some labs are dramatically cheaper (without compromising quality), but patients cannot easily get reimbursed if they use that service.
• Realize that with today's technology, many labs can (and do) run many tests on the same tube of blood for about the price of one test. Should it matter that the doctor does not need all of these multi-test reports to treat a chronic condition if in the end it will save Medicare money? Currently Medicare rules cost taxpayers more -- because they require all lab tests to be done (and billed) separately.
The way to fix Medicare's rising costs and limited access to doctors is to listen to patients' suggestions. Those of us in the trenches aren't doddering, senile fools; but being second-class citizens on Medicare is a fast way to make us so.
Dianne Holmes lives in Anchorage.
By DIANNE HOLMES