Archives for the ‘Bureaucracy’ Category

Loss

Wheelchair / Library of Congress

Wheelchair / Library of Congress

Stroke patients in the US with government insurance have had their rehabilitation benefit significantly cut. When I first had my stroke, I would see a physical therapist almost every week. Now rehab benefits are down to about 18 visits a year. As I am a veteran stroke patient who does most of my rehab on my own, I can handle this reduction. For new stroke victims, it is a terrible loss.

Have you had insurance headaches?

Bureaucracy

Books / Wellcome Images

Books / Wellcome Images

Right after my stroke, the health care bureaucracy was exhausting. You have to stay on top of it, or more letters will arrive. I don’t know how sick patients with no family support handle this bureaucracy. Now imagine having cognitive damage. One speech therapist I know, who makes house calls, says bills just pile up in some of the homes she visits.

Do you have bureaucracy stories to tell?

Triumph

Sword is Drawn / Library of Congress

Sword is Drawn / Library of Congress

A few years ago, I had a royal bureaucratic mess with Medicare over an expensive brace that they should have paid for. (Medicare is the US government’s health insurance plan for the disabled.) I called my Congressman, my Senator and filed appeal after appeal.

Recently I ended up on a phone call with a Medicare Administrative Judge from Ohio, who swore me in. It was court by phone! His verdict: Medicare would pay for the brace, but it would have to be made again, for obscure legal reasons. I had to mail back my old brace, which was in fine shape.  Then I had to go back to the hospital and get measured again. Then the company remade the brace.  This struck me as a waste of time and money, not to mention environmentally stupid.

I did win, though. Don’t mess with me on bureaucracy. I usually triumph.

Robot II

Robot Man / Library of Congress

Robot Man / Library of Congress

I am trying to get more time with the robot machine at my hospital. You watch a monitor and play video games while a special robot  joystick measures your movements and results. I found it very helpful, but I was in a research study that ended.

The hospital scheduler asked me, “Why do you want extra time on the robot machine?”

I said, “Have you ever seen Occupational Therapy? You move blocks and cones and weights around for an hour at a time. It’s useful, but it gets boring after awhile. I’d much rather play video games with the same results.”

We’ll see if that works. Robots are the future.

Inequality

Justice / Library of Congress

Justice / Library of Congress

US Senator Mark Kirk had a stroke last year. He’s back at work, sometimes in a wheelchair. He has noticed a huge discrepancy in care for stroke victims in the US.

Tell me about it. I had decent insurance for rehab, but lots of patients don’t.  I changed cities to get better care.

Do you have stories of stroke inequality?

Oysters

Oysters / Library of Congress

Oysters / Library of Congress

As a celebration for driving again, my parents sent me a gift certificate to a fine Boston oyster establishment. Perhaps I will drive there.

Pass

Pass / Library of Congress

Pass / Library of Congress

I passed my driving test today – again. I had not driven because of my stroke for awhile. Now I can drive again. Clear the roads!

My evaluator was a man known as Big Peter. He was very large. Apparently, in his spare time he is a preacher. After he passed me, I told him that it was his good deed of the day.

Wheels

Lady Driver / Library of Congress

Lady Driver / Library of Congress

Today I got behind the wheel! It’s been a very long time without driving. A very nice man with a Star Trek tie pulled up at my place in a car with all kinds of equipment in his trunk. He decided I would need a gadget that looks like a doorknob that makes it easier to steer with one hand. He added that to the steering wheel. He added a gadget that moved the gas pedal to the left of the brake. Then I was all ready. We drove around the Charlestown neighborhood of Boston. I thought I would feel weird using my left foot to brake and hit the gas, but it seemed fine. At the end of my lesson he called me a “A driver!” and said he would do paperwork. I will take some more lessons and then go for a drivers license. Vroom!

Drive

Moose / Library of Congress

Moose / Library of Congress

Today I passed the driving learning test! Before my stroke I had a normal drivers license, but it’s been a long time without driving. The state of Massachusetts said I had to take the learning test again.

I only wanted to take this annoying test once, so I crammed this afternoon, filling my brain with the punishments if I block funeral processions, drink alcohol while driving, and other misbehaviors. I also took a sample test. Here is a question:

“If hitting a large animal is unavoidable it is best to:'”

The correct answer was:

“Try to strike the animal at an angle and let off the brakes.”

Good to know.

Jousting with Bureaucracy

Joan of Arc / Library of Congress

Joan of Arc / Library of Congress

My physical therapist recommended a certain kind of brace, but my hospital didn’t carry it. In fact, no hospitals in Massachusetts carried it, even though it is popular at hospitals in California. So I bought it directly though the brace company, out of pocket. I sent the receipt to Medicare for reimbursement. (Medicare is the USA’s health plan for seniors and the disabled.) I had gotten an earlier brace reimbursed.

I was denied, saying Medicare doesn’t reimbursed people for out of pocket braces anymore. Note that if I had gotten the new brace from a hospital, it would have been covered. Never mind that in my state there wasn’t a single hospital that carried this brace model. It would have been cheaper to fly to California and gotten it through a hospital there. I appealed. Denied.

Medicare is supposed to be a national program. Guess not.

I called my Congressman and my Senators. They made inquiries. They told me to appeal it to an external body. I did. Still waiting.

Recently, my hospital started carrying the brace.