Feb 3, 2009

Can't Get Heart Transplant Because Of Social Security -- Medicare Spokesperson Calls Two Year Medicare Waiting Period "Insane"

From the Spartanburg (SC) Herald Journal:

Brandon Palmer, a 24-year-old from Gaffney, needs a heart transplant. He was diagnosed about two years ago with a condition known as severe cardiomyopathy, which means - in his case - the muscles on the left side of his heart aren't strong enough to pump blood the way they should. His doctor said that side of his heart is likely operating at less than 30 percent of capacity.

But Brandon hasn't been able to get on a transplant list.

He was denied at the Medical University of South Carolina, the family says, because he didn't have insurance. He's been denied access to Medicaid because he has not been classified as "disabled" by the Social Security Administration. And he's been denied disability coverage - and status - by Social Security because twice he's been deemed able to "perform some ... type of work." ...

Brandon's family recounted the story recently as they stood around his hospital bed. He lay there, writhing at times, hooked up to various machines, breathing labored, often able to talk for only a few minutes. ...

If the Social Security Administration classifies someone as disabled, then that person is eligible for two different types of benefits. One is a cash payment that's often just enough to price someone out of being eligible for Medicaid. That benefit, however, does allow a person to qualify for Medicare - after a two-year waiting period."

Congress designed it as a way to save money," said Mary Kahn, a spokeswoman for the Centers for Medicare and Medicaid Services, part of the U.S. Department of Health and Human Services. "It's insane."

A spokeswoman for Medicare says the two year waiting period for Medicare after going on Social Security disability benefits is insane! Now that is change!

Update: The newspaper has a hard-hitting editorial about this case.

6 comments:

Anonymous said...

Isn't there a bigger issue here of him not having access to any forms of insurance? SSA and Medicare waiting period just seem like easy targets.

Anonymous said...

Um, so he was denied DI, right? What does this have to do with the waiting period?

Oh wait, nothing. It doesn't affect this poor guy at all. But it's an easy fight.

Stop being a shill.

Anonymous said...

What's insane is that the CMS spokeswoman thinks it's insane not to spend an asinine amount of money.

Anonymous said...

Okay, am I missing something, or is the real issue that someone who needs a heart transplant to live has been denied dib? again, the media has gotten it wrong, and the critics of the govt had their heads up their a@@.

Anonymous said...

The waiting period for medicare made false assumptions about workers having insurance through their employers and the employers extending those benefits after an employee became disabled. Just as the waiting period for social security disability cash benefits (5 months) assumed that employers provide short term disability benefits. Some employers provide both health insurance and short term disability insurance. Most employers provide neither which is why the government must step in to help the uninsured find affordable insurance.

Anonymous said...

If the news article is correct, and his doctor says his heart is working at less than 30%, and IF the doctor means by this that the patient's ejection fraction is 30% or less, than this poor soul meets the Listings and should be receiving benefits. That, of course, only starts the 24 month waiting period, which he is unlikely to survive