How is Medicare not a single payer program?
It’s a single payer program unless you actually use it.
Four days in a hospital gets you 120 (or maybe it’s just 100) days of paid rehab, after which you’re on your own. So the incentive is to get so sick that you need another four days in a hospital, which re-sets the clock. Otherwise …
Mrs E was in the hospital for three days in March. She was released to a rehab center, which they said they could only keep her for ten days because … the Medicare clock didn’t get re-set.
Then they released her to an assisted living facility that ended up costing more than 12k out of pocket
just for one month, and did nothing to improve her condition. I took her home, and now wish I could find something - ANYTHING - even if it cost 12k, that could help her and give me a VERY needed break (“respite”).
Medicare did approve a couple visits per week from a PT and an ST, but then pulled the plug on that too. After a fight they now permit 1 PT visit per week, and I feel like it’s futile.
The system is designed to first protect itself, like most systems are. But in this case it means abandoning its primary mission in favor of its own perpetuation. Sadly, that means encouraging people to die if they represent a disproportionate burden on the system meant to keep them alive.