Dear Mr. President,
I am what you might call an "average American woman". I am married, live in a suburban American town, have 2 children, and work as a social worker at a local hospital. What I know about politics, I learn by watching television and reading friends' walls on facebook. I have to admit, I have not read the lengthy healthcare reform bill (is it really over 1,000 pages? I barely have time to read my children a bedtime story admist all my other responsibilities!) As a hospital social worker, I know a lot about how health care and medical insurance directly affect peoples lives. I understand the problems of insurance coverage, Medicare criteria and eligibility, Medicaid, medical care for undocumented immigrants, and the rising cost of health care. I guess you could say I know "where the rubber meets the road" when it comes to health care. And from what I have heard, I do not believe many politicians understand this aspect.
For example, did you know Medicare does not cover IV antibiotics at home for patients? Most Part D plans don't cover it either. This presents a real problem for elderly patients who have pneumonia, cellulitis, or some other infectious disease who need a course of 1-6 weeks of IV antibiotic care. The cost for IV antibiotics and supplies is very expensive for someone living on a fixed income. We often have to come up with "creative" solutions for patients to receive this needed and prescribed treatments. Patients basically have 2 other options: 1. receive the antibiotics through an outpatient clinice (covered under Part B of Medicare at 80%) OR 2. stay at a Skilled Nursing Facility for the duration of their antibiotic treatment (covered under Part A of Medicare at 100% for the first 20 days). If a patient needs IV treatments every 8 hrs, which is common, this presents a difficult problem because our Infusion Therapy clinic is only open during business hours. One elderly woman who I worked with required such a regimine and the only option was for her to come into the Emergency Room at 1:00 A.M. for her third antibiotic dose. Can you imagine an 80 year old woman coming to the ER in the middle of the night for 7 consecutive nights to get treatments?? Not to mention the cost incurred to Medicare for this nightly ER visit. Needless to say, she was readmitted to the hospital (likely due to exhaustion) because this regimine was just not possible. Another patient I worked with needed 6 more days of antibiotic treatment. She could not afford the $138 a day the IV antibiotic medication would cost at home, so she went to a Skilled Nursing Facility for her treatment. It would certainly be the most economical and convenient option for Medicare to cover the IV medications at home rather than paying for a patient to stay at a skilled nursing facility or paying for treatment at an outpatient clinic. In the second case mentioned above, the cost for home IV antibiotics would have been approximately $138/day. The cost for her to stay in a Skilled Nursing Facility and receive her treatment was approximately $750/day. It doesn't take an economist, lawyer, or politician to see the benefit of providing IV antibiotic treatment as a covered benefit for Medicare patients.
I realize this is just one small example, but there are literally hundreds of other loop holes in Medicare coverage and benefits. I really believe these types of issues need to be addressed as part of the larger health care reform bill.
Thank you,
Kathryn R.
