Unfortunately, Medicare fraud is outrageously profitable and rather low risk.  Miami is the current Medicare fraud capital of the country.  Schemes that are launched there are perfected and then exported to other parts of the nation.  Situations could involve setting up health care clinics (many often just empty storefronts or post office boxes) and then charging Medicare millions of dollars for therapies that were never actually performed.  Criminals learn to submit their bills correctly for bogus claims, and they are compensated in full and in a timely manner by a computer, with no human interaction at all.

Individuals running these scams obtain Medicare numbers by stealing or buying them from doctors, clinics or patients.  In one documented circumstance, one Medicare number in the wrong hands triggered payment of more than $1 million for phantom care.

Estimates of losses due to national Medicare fraud range from $11 billion to $60 billion.  Arriving at an exact figure calculated by industry experts is difficult.

Medicare’s vulnerability to crooks is due somewhat to the fact that the enrollment program is based on an honor system that is evidently broken.  Medicare’s anti-fraud budget is obviously inadequate.  This year Congress is allocating an additional $200 million for that budget with another $300 million scheduled for 2010.  Hopefully, this money will help the agency upgrade its computer software to flag suspicious bills, to call for more investigations of dubious claims, and to make more random visits to providers.  The Obama administration feels that health care reform can be significantly financed with anticipated savings derived from cracking down on Medicare fraud.

Gerri Tyber, Operations Manager
Barton Home Care

Because the future is imprecise, every adult, regardless of their age or health situation, needs to write down the exit plan they want implemented for themselves. If it is not written down, how can anyone be sure they are fulfilling your health care choices? This plan or advanced directive allows you to make your health care choices known before an accident happens or an incapacitating illness affects you. An advance directive is a legal document that states how you want to be treated if you become very ill and there is no reasonable hope for your recovery. Laws vary from state to state but there are basically two kinds of advance directives. They are living wills and durable powers of attorney.

An advanced directive can help establish what life choices are right for you. Do you want mechanical respiration or cardiac resuscitation? These are personal decisions that no one else should make for you. You can have your end-of-life decisions be a matter of record.

You can register an advanced directive with or without the help of an attorney. There are many websites that will help you do this. Terminally ill patients have another option for establishing their end-of-life path which is called POLST. It stands for physician’s order for life-sustaining treatment. It is a simple document that converts a patient’s treatment goals into medical orders. It can complement an already existing advance directive by addressing more specific preferences for end-of-life options such as transference from a hospital to a nursing home.

Marcy Cox, BS Gerontology

One thing that I have learned in life is that it’s full of surprises. Life has a way of keeping us on our toes. Surprises can come in the form of illnesses; one of the most common illnesses in today’s world is “Diabetes.” People think that if you have it you suddenly have limitations. It’s not that you can’t do certain things; it is just that you may have to better prepare yourself.

When going out for extended periods of time, you need to take your meter, your testing supplies, your medicine and maybe a snack bag with different foods should they be needed. Taking such measures can give you a sense of security. Imagine going into a convenience store while you are experiencing a low blood sugar level, and you have a need to consume sugar in order to bring your level up. You might be looked at like you are a shoplifter for eating the food while you are standing in the aisle. Or, on the other hand, if you have a high blood sugar, you might pass out or be confused. This could all justify the need for a medical alert bracelet to provide your vital information to anyone attempting to help you.

Many famous people with diabetes, including actors, politicians, and athletes, have lived “normal” lives with the disease. Diabetes, like many other medical conditions, may have other problems associated with it. You need regular checkups for your eyes and feet. Diabetics seem to heal slower when their glucose level is raised. By eating right, getting proper rest, exercising, drinking plenty of liquids, monitoring your sugar levels often and taking your medicine as prescribed, you can help yourself lead a more normal and free life. Sometimes this is a more difficult task for the elderly who have diabetes. They may need to count on assistance from family, friends or various other services to do the necessary things to keep them healthy.

Living with a person who is a diabetic can be challenging. When your emotions run from anger, sadness, depression, all the way to happiness, you may turn to food. The one thing that you might have turned to for comfort is now the very thing you need to control. Eating habits need to change. It becomes necessary to eat small meals all day long and to watch what you eat. To confuse matters, your doctor, family and friends may have suggestions for what you should be eating. You can get some control over your food if you make the right choices and there are many sources including books and websites to help you with those choices.

Anger and denial are common emotions encountered when one is diagnosed with diabetes. You are forced to become an expert on a disease that you previously knew little about. Personally, I have struggled to come to terms with this disease. It is almost like being in a club since both of my parents as well as some other family members have diabetes. At least we support each other in trying to cope with the disease. One of my uncles recently told me to take cinnamon pills to help lower my A1C average. (Your A1C is a blood test that reflects a three month average of your glucose levels). In six months, by following his suggestion, I have effectively lowered my level. The result is that I feel so much better.

Just remember this–in life many of us may have health problems. Thus, we might have to do things a little differently than planned. Having the freedom to live in this amazing world is worth all the effort.

Marcy Cox, BS Gerontology