The Cruelty of Managed Medicare

By HANS DUVEFELT MD Jeanette Brown had lost twenty pounds, and she was worried. “I’m not trying,” she told me at her regular diabetes visit as I pored over her lab results. What I saw sent a chill down my spine: A normal weight, diet controlled diabetic for many years, her glycosylated hemoglobin had jumped from 6.9 to 9.3 in three months while losing that much weight. That is exactly what happened to my mother some years ago, before she was diagnosed with the pancreatic cancer that took her life in less than two years. Jeanette had a normal physical exam and all her bloodwork except for the sugar numbers was fine. Her review of systems was quite unremarkable as well, maybe a little fatigue. “When people lose this much weight without trying, we usually do tests to rule out cancer, even if there’s no specific symptom to suggest that,” I explained. “In your case, being a former smoker, we need to check your lungs with a CT scan, and because of your Hepatitis C, even though your liver ultrasounds have been normal, we need a CT of your abdomen.” I scrolled around in her chart. She was up to date on her mammogram and colonoscopy. She was clearly worried. “We’ll put in requests for the Prior Authorizations for these scans and let you know when they’re approved,” I said. She looked puzzled. “I have Martin’s Point Generations Advantage, that’s good insurance,” she said. I sighed. “Well, it’s managed Medicare b...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy Medicare Hans Duvefelt Managed Care Source Type: blogs