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Narrative Matters

Getting The Elderly Their Due

PREFACE: Complexity is a constant feature of our daily lives. Unfortunately, it can be the enemy of efficiency and can, in some cases, prevent important health services initiatives from functioning at all. Being large and multifaceted programs, Medicaid and Medicare easily fall victim to these problems. In the following essays two citizens, one medically naïve and the other medically sophisticated, discover some of the arcane aspects of the Medicaid and Medicare programs. David Carliner, an expert in insurance coverage for the elderly, relates the story of an elderly woman who is struggling to make ends meet, unaware of her entitlement to Medicaid benefits. Gordon Schiff, a physician and health policy veteran, discovers, incredibly, his own ineligibility for Medicare. Although unrelated, together these two stories leave one wondering if simplification is not the most important reform that might be brought to bear on both the Medicaid and Medicare programs.

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It was a typical call. "Please come over and help me go through my papers." Mrs. Smith complains that she does not understand why she gets so much mail "about the doctors." We promise our members a single place to call for questions, so we respond.

Our Baltimore-based organization, a for-profit Medicare HMO, assists elderly people—overwhelmingly poor and female—in applying for governmental health insurance programs. I accompany a colleague from our sales staff to Mrs. Smith’s apartment as part of a program to give senior leaders the chance to witness what other team members do and to see firsthand the . . . [Full Text of this Article]

Overwhelmed And Uninformed

 

Making A Difference

 

Another Kind Of Reform

 

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