Sunday, October 9, 2011

Whose Government is it Anyway?

By D.H. Daniels, II, JD, CAE - Houston, TX

I have found that when dealing with a governmental agency, whether federal, state, local or even special taxing district, one is really only interacting with one of three divisions, regardless of title: Surprise Party division, Practical Joke division and Fairy Godmother division. This latter is generally staffed by a little old person generally out on sick leave.

I mention all of this as government is or will shortly be keeping me from utilizing health care coverage that has been provided by my employer or paid for by my “Medicare taxes” over the years. Case in point: When I call my family physician, whom I have known for well over 20 years, his staff is carefully trained to ask immediately if my injury or illness happened while at work. Luckily, I am familiar with workers compensation laws and know that if I answer “yes,” I will be told the doctor won’t see me. My employer has a workers compensation policy that provides health care coverage. But, SURPRISE, the system is so convoluted and difficult that many physicians will not take a patient with a workers compensation injury or illness, including my longtime friend and family physician.

To obtain health care when injured on the job, my options are to either lie and, SURPRISE, shift the cost of the workers compensation injury to my private health care insurer or to endure the horror of trying to find a physician who will take a workers compensation injury.

Unfortunately, I am also starting to enter my “golden years.” This means that I will be retiring and entering the Medicare program. I have paid for this benefit for years, yes? Well the PRATICAL JOKE is that the federal government used my (and admittedly my employer’s) tax dollars to balance the federal government’s budget. The program is getting expensive and the easiest way for the government to “cut costs” is to lower reimbursement to physicians. Perhaps even cut the reimbursement fees as much as 30% in January 2012. I now fear that my family physician (and his practice partners) will be unable to take any additional Medicare patients. This includes me. I know that many physicians already limit their number of Medicare patients and some only take a few Medicare patients as a “charity care” payback to the community. I have worked for years, paid my taxes and earned my benefits ---- only to find that if I do manage to obtain care after I retire, it may well be considered as “charity.”

So, the advice I have to give from a lifetime of experience in the health care industry? Don’t get old, poor, sick or injured on the job. But, hey, the Fairy Godmother department has provided that I will be able to (eventually) get care in the Hospital Emergency Room.

Mr. Daniels has been practicing health law in Texas since 1983.

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