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He Acts Like Everything's Fine Because He Thinks It Is Dear Annie: I am a 55-year-old woman, the youngest of three. When I married 30 years ago, we moved away for my husband's job. Over the years, we have returned for summer visits, especially since our daughters are close in age to their cousins. We …Read more. Scoutmaster But No Saint Dear Annie: My husband and I have been married more than 40 years. He rarely calls me by my name and never uses terms of endearment. He just talks at me. I've put up with his emotional neglect and his forcing me to have sex when I didn't want to. He'…Read more. Friendly Fire Dear Annie: My best friend's husband is having an affair with his sister-in-law. I have firsthand knowledge of this and also heard it through several different, unrelated sources. They are pretty blatant about being seen together. My friend needs to …Read more. From the Frying Pan to the Fire Dear Annie: I met the man of my dreams at the workplace. At the time, I was in an abusive marriage and had given up all hope, and then I met "Howard." Here's the problem: Howard is 45, still lives in his parents' basement and works from home. He …Read more.
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Annie's Mailbox®, October 24

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Dear Annie: Yesterday, my doctor said I could no longer be her patient because I was on Medicare and the reimbursements were too low. She told me not to bother trying to find another doctor because they were all doing the same thing.

I am now at a stage in life where having a doctor is extremely important and I don't know what to do. Can doctors be required to take patients on Medicare? What about the ethics of tossing old people out even when the patient has medical coverage? When a doctor takes the Hippocratic oath, is the oath valid only as long as a substantial profit is made? I used to worry about those who have no medical insurance, but I should have been worried about this. — Have Medical Coverage but No Doctor

Dear Have Coverage: It's true that doctors are not reimbursed for Medicare at the same level that they are reimbursed by private insurance companies. We're sorry to say, for many physicians, it is simply not cost-effective to treat Medicare patients.

However, there are still many physicians who will, so don't give up. You also can ask your doctor about setting up a sliding-scale fee so you can pay for some of the treatment yourself. This is going to be a tremendous problem in the near future, and we hope our next president will add it to the long list of issues on his plate.

Dear Annie: October is Domestic Violence Awareness Month. According to the Maine Family Violence Project website, nearly one-third of American women report being physically or sexually abused by a husband or boyfriend at some point in their lives. Love should never hurt. The National Domestic Violence Hotline says you may be in an abusive relationship if you answer yes to any of these questions:

Does your partner: Embarrass you with put-downs? Look at you or act in ways that scare you? Control what you do, whom you see or talk to, or where you go? Stop you from seeing your friends or family members? Take your money or Social Security check, make you ask for money or refuse to give you money? Make all of the decisions? Tell you you're a bad parent or threaten to take away or hurt your children? Prevent you from working or attending school? Act like the abuse is no big deal, it's your fault, or even deny doing it? Destroy your property or threaten to kill your pets? Intimidate you with guns, knives or other weapons? Shove you, slap you, choke you or hit you? Threaten to commit suicide? Threaten to kill you?

Perhaps this letter will empower one person to leave a harmful relationship.

I did (with three children), and the rewards are — Priceless in Maine

Dear Maine: Thank you for the excellent information. Anyone who believes she (or he) may be in an abusive relationship should contact the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233).

Dear Annie: The letter from "No Name as It Will Cause Arguments" struck a chord with me. My husband's father is 86 and no longer drives. His 71-year-old mother is in fine health but never learned how, so for the last four years, my husband has been driving them to doctor appointments, grocery stores, church outings, etc.

I don't mind that he helps his parents. In fact, I think it's respectful and considerate. However, he has a sister who lives five minutes from them, plus nieces and nephews who could help, but my mother-in-law refuses to ask any of them to drive her. She only wants my husband to do it and it's taxing his job and our relationship. We have a 10-month-old baby at home. What can we do? — Florida

Dear Florida: Your husband must learn to say "no" so Mom will be forced to rely on others. The next time she requires his services, he should reply firmly, "I wish I could, but I can't make it then. You'll have to ask someone else." Period.

Annie's Mailbox is written by Kathy Mitchell and Marcy Sugar, longtime editors of the Ann Landers column. Please e-mail your questions to anniesmailbox@comcast.net, or write to: Annie's Mailbox, P.O. Box 118190, Chicago, IL 60611. To find out more about Annie's Mailbox, and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.

COPYRIGHT 2008 CREATORS SYNDICATE, INC.



Comments

8 Comments | Post Comment
Dear Annie, In regard to your response to LW1 whose doctor won't treat her because she only has Medicare and it doesn't pay enough. You said she should see whether she could get a doctor to accept a sliding scale fee to supplement the medicare payment. Did you check out the legality of this? It's possible that it's not legal to make the patients pay an additional amount. My dentist will accept private insurance as partial payment for his bills, but for many years did not accept medicaid/medicare because it doesn't pay enough and he couldn't charge the patients an additional amount over the medicaid/medicare. The current health care costs remind me of our family doctor in a small town in upstate New York in the 1960's. She was elderly herself when my family moved to the area. She would still do house calls. She also only charged $7 for an office visit. Medicare paid $10 for office visits at the time. This wonderful doctor actually gave her elderly patients on Medicare the $3 difference when they came to see her. She said they needed the money more than she did. It may have been illegal for her to do this but she was truly one of the most caring physicians I ever knew. I'll always remember the story that a few years before we'd moved to the area, there had been a terrible snowstorm. All the roads were closed even to emergency vehicles. Someone on a farm some miles distant had had a terrible accident and this doctor put on a pair of skiis to get there to save his life. She wasn't a young woman even then.
Comment: #1
Posted by: Pat
Thu Oct 23, 2008 10:30 PM
People looking for a doctor who will accept Medicare should call 1-800-Medicare (1-800-633-4227), or go online to www.Medicare.gov.

Also, just hoping the politicians will work on this isn't enough--people need to get informed and express their opinions.
Comment: #2
Posted by: Anne Haehl
Fri Oct 24, 2008 7:25 AM
"Accepting Medicare" is a legal agreement between doctors and the government. Part of the agreement in that they will accept the Medicare payment as satisfaction of the debt (other than mandated co-pays and deductibles.) Some doctors don't have good billing systems that go after the additional monies, so they just give up. They forget that Medicare and Medicaid patients contribute to the overhead, and should not be brushed off as a loss. California hospitals that decided not not accept MedicCal in the 1980s learned that to their regret.
Comment: #3
Posted by: Carole
Fri Oct 24, 2008 8:03 AM
Dear Annie, in regards to the lady whose doctor won't accept medicare. She needs to find out if there is a clinic in her city. We have clinics that do give excellent service according to income. These type of clinics are designed for low-income people that cannot afford to pay their own medical bills. Also if she has to use drugs for any of her medical problems she could conntact the drug providers sometimes they will also help people who cannot afford to pay. Please don't let this person have to choose between her health, food or heat for the winter.. It is so sad and I am 62, working full time and also worried because at some point I will have to retire and go on Medicare. Please tell her good luck. Worried in Vermont.
Comment: #4
Posted by: Jean Parker
Fri Oct 24, 2008 8:06 AM
Sounds like you equate Medicaid with Medicare??? Believe that is a real gaffe! Do not understand this article. When I tried to respond according to the online address at the end of the article I was informed that it was non existent. Please correct this article and let us know what you are writing about, is it Medicaid or Medicare?? Also include a legitimate email address. Thank You. Jan
FYI The article was titled, 'Doctor dumps Medicaid patient'. It can be found in the Peach section of The Toledo Blade, Section D, Page 7. dated October 24,2008.
Comment: #5
Posted by: Jan Monarch
Fri Oct 24, 2008 8:07 AM
In reply to your Medicare patient. It is illegal to have a sliding scale for patients. You cannot charge patients different fees based on their insurance or lack of insurance. In our area, there are still many physicians that accept Medicare, but a physician does have the right to opt out of Medicare if they choose.
Comment: #6
Posted by: Lisa Fry
Fri Oct 24, 2008 9:34 AM
My doctor of over 20 years takes all insurance that is available in our state. He is one member of a family practice unit. However, he says that with the agreements that insurance companies make for doctors to accept less than their actual fees and with Medicare, he sees that there are very few medical students who are going into family practice. He accepts 68 insurance agreements with probably 68 different requirements for filling out forms. His practice has dropped having a person handle prescription refills - the nurses do that because the doctor was already being checked with on this - and the practice decided to drop their mammogram service because of the cost of better equipment needed to do a good job.
In the 1960's, having just moved into a new town and having a fever of 106 degrees, I found that no doctor I called would accept me as a new patient. Luckily, the manager of our apartment complex stepped in and contacted her own doctor who saw me at the end of that day. It took over 7 days for my fever to go down and 3 months for me to stop coughing. It never occurred me to go to an ER. I guess she will have to get on the phone and contact every doctor in the area. If she joins a program like angies list, they now have medical recommendations. I wish her good luck.
Comment: #7
Posted by: BB
Fri Oct 24, 2008 10:46 AM
Dear Annie
Regarding the Doctor who wouldn't treat the patient who was on Medicare. At least the Doctor was honest and upfront. My father passed away with cancer 2 years ago. During his illness he saw several Doctors at a well known and highly regarded Medical Center. I could not understand the missed diagnosis of his disease and delays in treatment until I started to attend appontments with him. Every Doctor he saw had one eye on their watch as they rushed through the appontment, and it was obvious they had little interest in their patient. My father spent a lot of time needlessly suffering because of their short cuts and lack of interest in caring for a Medicare patient.
Comment: #8
Posted by: Dan
Sat Oct 25, 2008 7:53 AM
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