Rehabbing Medicare

There has been a lot of talk lately about the concern of severely curtailing Medicare benefits. Some of us who are years away from the curse of old age do not appreciate the situation. Medicare takes care of the rehabbing that a senior citizen endures in an authorized facility as long as the patient shows signs of improving.

Knowing this Federal largesse, everyone who recovers from hip or shoulder or knee surgery and bone injuries in general tries to get placed in the best care facility possible.

Ma was no different. She knew about the excellent rehab center three blocks from my condo and we lobbied with the social worker at the hospital to get her placed there. Luckily, there were several bed openings and for at least one week she had the pleasure of having the room to herself.

Another quirk in the Medicare laws apparently is that if one has surgery on the injured bone, Medicare will pay for two therapy sessions a day. Without surgery, the patient receives only one session. When two sessions are involved, one session covers some occupational and not only physical therapy.

Once the patient’s doctor and therapist agree that the person has plateaued, Medicare cuts off funding. At the place that Ma is at, this means that the patient is either sent back to their own residence or to a long term care facility in which chances are they will never be able to leave. This is because there are a percentage of facilities that recognize it is in their own long-term interest to keep the patient, now called a resident, there as long as they can.

Of course, not many people are able to pay the six to seven thousand dollar a month cost to stay at a nursing home. If they do not have long-term care insurance, which most people do not have, then they may have to apply for Medicaid, in which the State agrees to finance their stay but requires the patient to pay down all their assets befre getting assistance. This will include, of course, the sale of the house. Exceptions are made if a spouse is still living in the house.

One day I visited Ma while she was in the therapy room with several other patients. As she was going through her proscribed exercises, another heart-wrenching scene was occurring not more than ten feet away. A lady was being asked to do the same walk-thru on the parallel bars as Ma was. However, this lady was somewhat disoriented and continuously asking, “where am I?”. Despite that her son and teenage grandson were with her encouraging and trying to explain what the therapist expected her to do, she continued to be non-cooperative. After several minutes, the therapist said something to the son and walked away abruptly concluding the session.

I felt bad and was sure that the lady would be made to leave the facility, to give up her place to one willing to cooperate. However, to my amazement, Ma told me two days later that the lady was still there and this time was doing a modicum of exercise. Both her son and grandson were with her at the followup session and were showing much devotion and encouragement. Ma thinks that the lady may have been confused not because of senility but due to still trying to wean off the drugging she had received while still in the hospital.

The Federal Government has a conundrum. Each year we will be breaking records for the number of people eligible for Medicare at the same time for the next thirty years or so. The Government cannot abandon its citizens in time of need but struggles to find ways to pay to keep us as healthy as possible.

Medicare needs rehabbing. But let’s also remember that sometimes before we jump at a solution that it helps to wait a day or two to let the overdose of opinions wear off.

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