This is part of an ongoing series in which Bronx writers share their personal stories on the state of healthcare in America.

By Sandra O. Rossoff, April 1, 2019

Today’s piece involves a retired licensed social worker on Medicare who reports how the system has not been adequate for her and how (when she was working) she saw how it failed her clients. 

Medicare Doesn’t Care 

Despite the fact that I am well beyond 65—and have Medicare–I have foregone regular check ups, mental health care, dental treatment and done without hearing aids. Each of these necessities are beyond my limited means. When I have sought treatment, the costs have been a burden. Some of the providers didn’t accept Medicare so I had to pay the bills out of pocket. I don’t have voluntary prescription drug care (Part D) because the premiums are so high that I am forced to ration my pharmaceutical intake. 

But primarily, the outcomes of the care I’ve received over the years has resulted in my present painful situation. When I suffered my first post-menopausal bone break,the hospital failed to recognize my osteoporosis, misdiagnosing my broken bone by not connecting this to a decrease in my bone density. During all these years since then, I have had two broken shoulders, two broken knees, two broken vertebrae, two broken ribs, a shattered femur, broken metatarsal, and a trimalleolar ankle break. I’ve been in treatment with a local bone treatment center, which is a research center. . Now I am on Prolia, which is a shot given twice a year at a prohibitive price. Luckily Medicare pays for it. But I had to wait until my doctor received prior authorization. My fear is that, under new rules suggested to save Medicare money under which certain drugs are protected, Prolia may no longer be approved. Fosimax costs much less and, while it prevents osteoporosis, it does nothing to treat the pain that I have It’s a pay or suffer approach to medicine. …

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