Our Debt, Our Dollars

“Blessed are the young for they shall inherit the national debt.”
— Herbert Hoover

Every American, male and female, from senior citizen to newborn infant, is in debt today for more than $27,000 each — $27,732.67 (at this writing) to be exact. Where did that vast sum come from? It represents the total amount of dollars that the United States owes to maintain the government — just to keep the country functioning — divided into our entire population. Right now the U.S. national debt stands at more than $8,271 trillion, the highest figure ever owed in our history.

My concern is how can this debt be repaid?

The great number of dollars it costs the government just for interest on the national debt would be sufficient to cover most of the health care needs of the population.

HomeCare magazine is not a financial publication, but every one of our readers is involved. Our industry faces dramatic reductions in reimbursements for the services and supplies provided. There will soon be a competitive bid to become a Medicare provider, and I wonder if enough providers will be attracted to the small profit margins that will then be created.

I predicted years ago that unless a way was found to eliminate a great amount of the fraud and abuse in the system that the money to maintain Medicare would dry up.

What can you do? Please speak to your legislators and ask them what they are doing to bring back some sort of fiscal responsibility. This is not a political controversy, certainly not conservative vs. liberal. This is an American problem that all of us must address.

Ask for answers, ask how they propose to pay this debt — and let them know your concerns and that every one of your clients wants to hear their answer.

The government can never recover the bucks that are disappearing by taking them from DME/HME providers and their patients. Get on the bandwagon.

If you do not, I must ask you one other question: Will you be in business another year? What Is a MAC? Is it a sandwich at a fast food restaurant? Is it the computer in my office that refuses to cooperate with me? Is it a Scottish plaid? No, it is a Medicare Administrative Contractor (MAC).

I see this as another waste of good dollars. The purpose of the Medicare Modernization Act is to save money. But with the new MACs and PSCs (Program Safety Contractors), what I see is another set of confusing rules and regulations coming that will create more costs, more time to be spent by a provider, and, yes, probably more new paperwork.

Efficiency is high on the list of goals they want to accomplish, so I seem to be missing the point. It is said that the MACs will create greater accountability by providers, but after all, aren’t providers paid on a “fee-for-service” basis?

None of the providers I have spoken with throughout the country feel that they are adequately reimbursed for their services; some feel they are not reimbursed at all. E-Mail I am not computer literate. It is embarrassing for me to admit this publicly, but, as we say in Rotary, “Is it the truth?” Yes, it is. However, I now find myself so dependent on this means of rapid information-sharing that I cannot imagine how I did things prior to e-mail’s being invented.

Recently, my computer developed an e-mail service glitch. A picture came up with the message to the effect that it died! Fortunately I was guided to a technician who called me several times each day until he was able to restore my service. I appreciate that extra service I received.

Our industry always gives good service, and we have to make sure that our congressmen are aware of that. Be proud of what you do, and let your legislators know it. Give them examples of the services you perform, and ask the recipients of your extra mile to tell how your company helped them, too.

Sheldon “Shelly” Prial is based in Melbourne, Fla., with Prial Consulting and also serves as the director of government relations for Atlanta-based Graham-Field Health Products. In 1987, he founded the Homecare Providers Co-Op, now part of The VGM Group. He can be reached by e-mail at [email protected] or by phone at 321/255-3885.