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Posted: June 08, 2005

Professional Caregiving

Helping the Consumer Understand Medicare

Honestly, every time I see an article about Medicare I almost fall asleep. Its not that I don't see the trainwreck coming down the tracks, as a matter of fact I have heard experts say that the discussion about social security is front and center, because no one wants to face the bigger problem which is Medicare.

Anyway, I surmise that the reason my eyelids get heavy when I begin reading about Medicare is that it's so darned confusing, even the people at the other end of the phone who are hired to answer questions about Medicare fared miserably when their answers were tracked for accuracy and consistency. So what are our seniors to do? To whom do we send them to get the information they need to make informed decisions? Caregivers, especially the adult children of the retired and soon to be retired need the answers, as care demands put on them may be affected at a later date due to healthcare coverage decisions made hastily.

Maybe the answer to the mess we are in is right in front of us.

Consider this: anyone buying a house out there? Are you working with an agent? I know most people do because learning all that you need to know is overwhelming and we usually only need this information a handful of times in our lives. How about those who are trying to get famous, get published, get hired, get insured? Who do you have greasing the way? Your adult daughter? Your neighbor? Your bridge club? I hope not. You use an agent for these important tasks because you will not be as informed or get the inside picture that you need to be successful if you depend on brochures, 60 second ads or friendly advice.

The point here is that unless Medicare wants its beneficiaries to really BENEFIT from its offerings, selecting the plans that work the best for their particular situation, Medicare administrators should take the advice of Ed Lawlor, PHD and Dean of the School of Social Work at Washington University who has recently published a book called Redefining the Medicare Contract. He has studied Medicare and Medicare policy for over 20 years and has some very interesting suggestions, the main one being the concept of Medicare Agents, to facilitate the decision making processes of older adults, just like we are assisted on other important purchases in our lives, our homes, our cars, our life insurance, legal and financial concerns.

Dean Lawlor started off his remarks at a lecture the other week, with a cartoon entitled "Rising Longevity Hobbling Future of Social Security."  In it you see a physician, who looks remarkably like Dr. Greenspan, checking out his patient -- our economy -- and remarking that "with increased stress, weight, fast food consumption and decreased exercise, and if you continue to follow these instructions, you will be able to go out and enjoy your tax cut."  IF the only way to cut the cost of healthcare for seniors is to encourage unhealthy habits, to diminish the years our seniors are living, then we are in trouble.

Our Medicare budget is like a modern economy. There are 42 million subscribers, with a cost of $333 billion dollars each year, and the instructions for participating in this program a mere 125,000 pages long. How complex need it be?

Just looking at the 42 million subscribers, the demographers have found that 30% don't have a high school education, 12% have vision problems, 18% are cognitively impaired. Just these folks alone account for more than half the beneficiaries and WHO is helping them through the maze of plans, programs, benefits?

When we help our "new to retire" boomers with their questions regarding health insurance, Medicare and the new pharmaceutical drug benefit, advising them first to contact their legislators to advocate for Medicare Agents will be in everyone's favor. Consider this the best advice I have heard so far in the quagmire of information.

_____

Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

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