I have Medicare for primary insurance and BlueCross/BlueShield Federal as secondary insurance. Many physicians in my area — especially specialists — refuse to accept Medicare patients because of the lower reimbursement rates. However, many of the physicians in my area are BlueCross/BlueShield Federal participating providers who are bound to accept their negotiated rates which are greater than Medicare’s but less than if I had no insurance. I review the explanation of benefits statements for erroneous billing by the physician and potential insurance fraud. While Medicare has a publicized low operating cost its computation does not include the billions of dollars they pay for fraud, waste and abuse.

A common misunderstanding by younger people is that Medicare is free. While there is usually no premium for Part A (hospitalization) most hospitals avoid admitting a patient so Part A does not apply. This year’s monthly Part B (doctor services) premium is $144.60 and there is a deductible and copay. There are monthly, deductible and copay costs for Part D (prescription medications). My Part D coverage for myself and my wife is included in my supplemental insurance plan that costs $581 per month. Because of the high and ever increasing costs of prescription medications some hospital groups are considering establishing their own manufacturing capability. Many prescription medications used in the U.S. are being manufactured in China and may contain toxic additives.

The U.S. is in great need of improved medical care efficiency and quality. Unfortunately, I doubt that the federal government is capable of providing either.