Sometimes I Feel Like a Piece of Bologna

Thursday, June 28, 2012

Medicare Managed Care Chronicles: After all, she’s 91… … (Part 4)




When I again spoke to the HMO clerk, she was clear that the decision was hers and she was not willing to reconsider, even though she had considered only the selective portions of the medical record that upheld her opinion. She (who had never seen my mother) declared that Mom had reached her plateau (contrary to the PT notes) and after all, she is 91. The fact that she could transfer from bed and walk with standby was sufficient for to make this decision, contrary to the professionals who know my mother and were working with her! Too bad--there was nothing more she could do.

I was appalled! This is clearly a case of age discrimination and of an insurance clerk overriding the professional opinions of the staff treating the patient – the very thing Americans have feared with national health insurance now happening before my eyes with a private pay patient.

Photo Credit iStockphoto  

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