Happy Birthday From Medicare!


BROTHER, HERE WE GO AGAIN. Today, or to be more precise, some time around 4:30 this morning, I officially hit “the big five nine.” I’m really not certain of the exact moment I legally transitioned from fetus to neonate back in ‘58, but I do seem to recall my mother informing me long ago that it was an early morning for us, and 4:?? comes to mind. Why she told me, I don’t know. Unless it was to point out that, owing to the inconvenient hour, we got off to a wobbly start. And I guess when you factor in…say...an hour or two for labor and the various other sundry unpleasantries associated with “birthing” humans, it must have been a long night for Mom. Good thing Dad got some rest. 

I entered the world during the good old days of childbirth. Movies of the era show us how it worked. Mothers- and fathers-to-be would arrive at the hospital in a state of sheer panic, their ’58 Chevy Impala fishtailing to a screeching halt at the front entrance. He'd burst from the driver’s side, rip open a rear passenger door, and lovingly drag precious from her seat to the pavement. His face is a portrait of mortal terror; he’d kill for a cigarette. Her expression is one of utter shock, her lips are pursed, and she keeps making strange “Whooo! Whooo! Whooo!" noises. She’d kill for a drink. 

Once steadied on her feet, hubby would lovingly escort Babs toward the double glass doors. Carefully, as if walking on sheer ice, she waddles wide eyed toward the hospital entrance, cradling her belly with one arm while the other is wrapped around her husband's neck in a sleeper hold. “Whooo! Whooo! Whooo!” As they stumble through the doors, he bellows “Nurse! Nurse! Somebody! Anybody! Ya gotta help me here! Please! It’s, it’s...she’s my wife, you see, and and and...she’s…she’s…” (Picture Jimmie Stewart delivering these lines…it helps.) The staff knows how to handle this. 

A wheelchair appears, within seconds our mother-to-be is locked in and gone. “Whooo! Whooo! Whooo!” She disappears in a blizzard of starched skirts and white coats that barrels on through high-impact swinging doors into a hall that leads to a special room…a room that’s appropriately off limits to menonly obstetricians and women allowed. The husband turns as if to follow the retreating storm, but a pleasant, yet politely firm nurse blocks his path and says “I’m sorry sir, but you’ll have to remain in the waiting area. We’ll let you know when there’s any news."

She smiles, then leaves him alone in the quiet, drab institutional-green waiting area. He sighs, looks at the wall clock, loosens his collar and tie, and fires up a Pall Mall. Just then, barely audible and fading off in the distance...“Whooo! Whooo! Whooooooooo!” Another glance at the clock…let the pacing begin.

Of course, that’s not at all how it worked back in the day. My father slowed the Chevy down to 80, dropped Mom off, and went back to work shouting “Call me when it’s over!" The day after they cut the cord, he drove around West Side trying to borrow enough scratch to bail me and Mom out of Springfield Hospital. It was strictly cash-and-carry back then, folks. No money, no baby. His boss, who was nowhere to be found, hadn’t paid him in months. Fortunately, a very generous, on-the-spot loan from a close family friend made it possible for Pop to spring us.  (Okay, I’ll grant my father probably brought his vehicle to a complete stop at the drop off, but the rest of it’s true.)

Anyway…birthdays. Yes, today is my 59th, and I feel dreadful. Just…awful. No really. Sick as a dog, for five days now, and tomorrow isn’t looking all that promising. I figure it’s either severe bronchitis, walking pneumonia, or the absolute mother of all colds. Whatever. It’s just one of those things you’ve got to ride out. But I look, and feel, like I’ve been sleeping under a bridge for five days. In fact, I had no intention of writing anything at all today. But since morning I’ve been watching notifications pop up on my screen announcing more and more Facebook birthday greetings, just piling up. And I felt, for some odd reason, I had to do something. Not that I wanted to announce to the world that I feel like death warmed over on this anniversary of my birth. Instead, I recalled a rather curious e-mail message I received a few days ago from my good friends at Medicare, and I thought I might share.

As we slide down the razor blade of life, brothers and sisters, most of us eventually reach a point when we’re certain we’ve left more days behind us than we have left ahead. I think, for my generation, that magic birthday would have to be somewhere around 40. But 40-year-olds don’t think that way. I didn’t. Then a few years later, deadly health-related “events” I survived made clear I was lucky to have reached 46. A couple of close calls will change your perspective. We don’t all get to hit every milestone on the road of life. As it happened, I hit a couple of milestones sooner than I’d ever dreamed. For example, I ended up on Social Security and Medicare at least 10 years earlier than planned. That made me part of the Medicare “Family.” And my new “family” never forgets my birthday. 

I call your attention to the image below. (It might be difficult to see it clearly, depending on the device you’re using, so click here or on the image itself to get a good look at the original document.) In essence, my new friends at Medicare have sent me a greeting card saying: "Happy Birthday, George! Have a colonoscopy, on us!”

Verbatim, it reads:

"Dear George Rossetti,

Happy Birthday from Medicare!  We wish you well in the upcoming year and want to remind you of the preventive services Medicare offers to help you stay healthy.

Our records show that you have not taken advantage of the preventive services which (sic) are available to you now or in the future and listed in the table below. Please talk with your doctor to decide which ones are right for you.”

Happy Bday Medicare

Wasn’t that thoughtful? Medicare, apparently, has been keeping an eye on me and took time to put together a Birthday Table of generally unsavory procedures and screenings they want me to consider, most of which I wouldn’t permit at gun point. And their selection makes clear that even Google knows more about my health history than Medicare does. (What am I saying? Google knows everything that’s worth knowing about all of us.)

Let’s just run down the list quickly and see what they’ve planned. 

Obesity Counseling 
I’m not obese. I don’t need counseling. When I’m ready to become obese, I might give ‘em a call. (Though I could probably figure it out on my own.)

Annual Wellness Visit
I haven’t been well since 2002. I can’t very well go for a wellness exam if I’m not well enough.

Alcohol Misuse Screening
What? And miss Happy Hour?!

High Intensity Behavioral Counseling
Okay, now this one intrigued me; I had no idea what it meant. So I checked. It turns out that Centers for Medicare and Medicaid Services (CMS) will ... cover up to two individual 20- to 30-minute, face-to-face counseling sessions annually to prevent sexually transmitted diseases. The cheek! I’m a married man; how dare they presume I’m sexually active!?

Depression Screening
It would only bum me out. Besides, if you don’t know whether you’re depressed or not, you probably aren't. 

Cardiovascular Disease (Behavioral Therapy)
Here’s another one that puzzled me.  It’s explained as follows: "Medicare covers one visit per year with your primary care doctor in a primary care doctor's office or primary care clinic to help you lower your risk for cardiovascular disease. During this visit, your doctor may discuss aspirin use (if appropriate), check your blood pressure, and give you tips to make sure you're eating well.” In other words, the usual banal chitchat you can expect to hear during just about any dreary clinical encounter or at a health fair. It just sounds a little fancier.

Abdominal Aortic Aneurysm
Medicare will cover a one-time abdominal aortic aneurysm ultrasound. But you must get a referral from your physician, who must have good cause to think it might be a good idea. So, don’t think you can just stroll into any diagnostic clinic and demand an abdominal aortic aneurysm ultrasound without a referral.  

Colorectal, PSA, Prostate Screenings
Thanks, but no thanks. Off limits: I’m not that kind of birthday boy. 

Well, okay. I mean, not for me; I’m not a candidate. I don’t have diabetes. Believe me, my “team” and I would know. For those who are at risk, it’s generally caught during routine visits, but…fine. 

It turns out this is nothing more than cholesterol screening. Again, part of any routine bloodwork panel. 

PPV (pneumococcal vaccine)
Well, if Medicare had been paying attention, they’d have realized they’ve already paid for my shots. 

What I really find irksome is that CMS closes their odd birthday “card" with “Remember, Medicare is your partner in health.” Whatever gave them that idea? I have no partners in health care. I am sole owner/operator of George A. Rossetti, Corporeal. Aside from matrimony, no pathways to partnership exist. And when it comes to Medicare’s role in my health care, here’s how that works; I become sick or injured, they pay the costs, as per a long-standing financial arrangement I’ve had with Uncle Sam. It’s that simple; write the checks and butt out.

I wish I could have coughed up a better piece, gentle readers, especially after being tied up with other projects and away from TRQ for so long, but I’m coughing up way too much as it is, pun intended, and I just feel rotten. (I’m not even going to double back and edit. I feel devilishly reckless!) Moreover, it gets worse. As I just wrote above, the only path to partnership in me lies in matrimony, and my only partner, our beloved Director of Domestic Tranquility, started showing symptoms two nights ago. As of this moment, she’s pretty much in the same wretched boat as I am, up the same creek, and neither of us can find the paddle. So I must bid adieu now and tend to my poor bride. 

But I’ll be back.

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