A Geezer Encounters Obamacare

Although some major provisions of the much-discussed Affordable Care Act don’t kick in for another year or more, a few things are in place now. I had my first encounter with Obamacare last month.

The pleasant lady on the phone said, “It’s time to schedule your Medicare wellness exam.”

“Is that a new name for my annual physical?” I asked.

“You’ll find it’s a little different,” she said, “and one nice difference is that it’s free. Medicare now is required to provide a yearly wellness assessment, so you won’t have any copay or other cost.”

I like free things. We agreed on a date and time very quickly.

The preliminary stuff conducted by our favorite nurse was same old, same old. She got my weight, pulse reading, and blood pressure recorded and settled me in to wait for our family doc. He has been conducting my annual physicals for the past four years. I’ve been pleased with his professionalism and genial manner. Usually, he spends 20 minutes to a half hour with me.

This time, our meeting was more than a little bit different. The doctor was with me for a solid hour. He ran through a lengthy checklist item-by-item, including questions regarding home safety and my mental state. I’ve been getting annual physicals for more than 20 years from highly competent doctors, but never was one nearly as extensive as the new Medicare exam, which is required by Obamacare.

When we finished the exam, my doctor handed me a copy of the form he filled out as he went. With it, I can tell precisely what my major office test readings were, the names of two additional tests he would arrange for me at a local hospital, and his recommendations for the future.

I know from earlier talks that my doctor has not been a fan of Obamacare. I tried tactfully to get a handle on his current opinion by asking him if the new requirements caused any big changes in his procedures. “Well,” he said, “there’s a whole new emphasis on prevention, and that’s a good thing.”

As one element of prevention for me, he scheduled a bone density test, something the new system recommends for people my age. My Medicare and Blue Cross insurances would have covered almost all the cost of the test in the past, but a $65 co-pay charge would have come out of my pocket. Obamacare requires that Medicare cover all the costs if the test results from an annual wellness exam. The co-pay was waived. We can always use an extra $65 around our place, and the free exam added another nice bonus to our modest household budget.

Obamacare also requires health providers to join the modern world by automating their systems to better track and share data. My doctor has been ahead of that game for some time. He conducts his physical exams with a lap-top computer up and running. However, getting exam results has been another matter. That often involved several phone calls and some minor delays, which could cause important misunderstandings.

This time, the results of my bone density test and the doc’s advice to make a little change in my lifestyle because of it appeared as an e-mail notice that the message was readily available to me on a secure site.

The message was clearly written and invited me to start a computer dialogue with the doctor if I had questions. I liked that a lot. In addition to pleasing patients, the quick, accurate communication probably will reduce some administrative costs at his clinic.

We are told that Obamacare does need some improvements, especially in the establishment of insurance pools by states. However, so far in my book it gets an AAA rating.

Biden Lands a Solid Counter-Punch

We expected a battle with the gloves off last night as Vice President Joe Biden and challenger Paul Ryan debated, and we got one.

Biden was expected to come out swinging hard after President Barack Obama appeared listless in his first debate with Mitt Romney. Biden did just that. Ryan is trying to establish himself as a strong voice for conservatives, and he banged away at the Obama record trying to highlight what right-wingers consider to be faults in administration policy

I had never heard either man give a speech or participate in a debate, although both had plenty of experience. Biden has been an elected official for most of his life. Ryan has served in Congress for 14 years. Both men have run for election many times, presenting their views and arguing with opponents. Despite their similar backgrounds as professional politicians, they came across as two different people last night.

Biden reminded me of a neighbor citing his experiences as he passionately argued an important issue across your kitchen table over coffee or a beer. Ryan looked like a newly minted MBA giving a lecture about theories he learned from a maverick professor.

When Biden or moderator Martha Raddatz asked Ryan to provide specific actions he and Ronmey would take to further their “five point plan,” the Congressman had none to offer. Biden defended Obama’s actions by describing why the decisions were made, often noting he was present when policy was formulated.

Raddatz, in contrast to the inept Jim Lehrer who moderated the Obama-Romney debate, was crisply professional. She kept control even when Biden got over-enthusiastic and interrupted Ryan, laughed at what the challenger said, or made unnecessary comments about time allotments.

Raddatz asked some tough questions, but they were ones we viewers wanted answered—abortion (Biden thought it was a matter between a women and her doctor; Ryan believes it never should be condoned), how they viewed their Catholic religion (both said it is important in their lives; Biden said he did not believe in foisting his religion on others), and Medicare and Social Security (Biden said neither he nor Obama would support any form of privatization; Ryan favored plans that include privatization).

I thought Biden delivered the sharper blows, citing more facts and giving logical reasons for administration policies. Ryan mostly dealt in generalities, and when asked for specifics he often was unable to produce any.

Raddatz at the end did not challenge viewers with the most important question--one none of us likes to confront. If something happened to the President, which one of these guys would you want leading the nation?

Based on what I saw last night, I’d go with the more experienced and grounded Biden, who it appeared could best be depended on to act responsibly on the world stage and pursue policies at home favoring the majority of Americans.