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Nothing speaks to the truth like the acrid odor of reality. The bite can be surly leaving us with nowhere to go except to work with it. So it was today when I faced our new Medicare reality. It’s ugly. Beware as you read on.

No, there are no death panels. It is worse.

Today, my patient was transported by helicopter to an ER from a cruise ship where she fell and was unable to ambulate. She came to the hospital where I practice specifically so I could care for her. I have known her for well over 20 years. But, upon admission to the ER, she was evaluated and sent home in an ambulance unable to walk with her 85 year old husband. No call to her doctor. No call to her children. Oh, and did I mention that she was given opiates for her pain? Had the ER doctor called and asked, I would have told him or her that opiates make most seniors crazy and put them at risk of falling but my patient can't take them at all.

Her daughter called me today having found her mother lying in her own urine. The ambulance company had delivered her to her bed and left her there where she couldn't move. I called the hospital and learned, this is the new Medicare. As a matter of fact, I learned that twice today. My patient's daughter was so concerned about her mother's condition she had her mother transported to an ER where her orthopedist was on call. Evaluation there demonstrated no fractures and again she was sent home having been told that this was a custodial issue and hospitalization was not covered by Medicare. Nothing was done to assure her safety. No call was made to her doctor. No follow up was expedited.

No tears … I will call a home health agency in the AM and make sure she has a Foley catheter so she doesn't have to lie in her own urine. Her family has already paid for 24 hour care giver to stay with my patient until we can arrange for PT to help her bear weight. Then, we will get her into rehab and get her walking again, provided that her hip and knee are really okay. In seniors, we often find tiny chip fractures or other abnormalities on MRI when we thoroughly investigate why they can't bear weight or walk. Thank goodness, my patient has a wonderful family who will help. But, millions of seniors have no family and no committed doctor. They are left to lie in their own urine… the new Medicare. No its not a death panel. It really is worse. Sometimes, death comes as a matter of respect to our integrity as a human. Being left to lie in our own urine is disrespectful and not human and when executed by the medical community as a matter of course, it is unconscionable. Welcome to government run healthcare. Welcome to a morally if not fiscally bankrupt Medicare system.

I fear it will only get worse. As 2012 approaches, I have already received notification from Medicare Part D about my patients’ medication coverage. So sad, too bad… the meds your patient has been taking for 20 years to keep him or her alive is not covered. Doctor….. Take care of it. Now it is in my hands and depending on my patient's bank account, I will or will not be able to provide the help they need. And I have 3 days to find a solution before the New Year.

And we all understand that Medicare cannot cover custodial issues. But, when did we stop providing for the safety and welfare of our seniors? When did it become okay to leave them to lie in their own urine? Congress is busily debating the SGR and what they are going or not going to pay me. Does that really matter if we have lost sight of human dignity? Isn't it about time we put our patient's life and safety as our focus rather than how many benefits Obamacare will cover? Medicare is not just fiscally bankrupt. It has been stripped of any decency. It is morally bankrupt.

This is the Medicare that Congress promised not to change. This is the Medicare that President Obama promised to preserve. Perhaps we would be better off if those in charge just showed our parents and grandparents some respect. That would be priceless.

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Dr. Marcy Zwelling-Aamot

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Dr. Marcy Zwelling-Aamot is a respected member of the California medical community and a prominent voice in the crusade to improve the broken healthcare system.

Dr. Zwelling-Aamot is a quadruple board-certified physician, a notable achievement even among...

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