My Knee, part 2. Medicare Facts and Rumors

How much do you think a major New York City hospital charges per night for a bed,  in its 22-bed rehabilitation section, exclusive of professional services such as doctors, nurses, thereapists, etc.? Take a wild guess.

Anyone  say $7,100? If so, you are the winner. Unfortunately, there is no prize other than pride in being accurately cynical.

I know this figure to be true, because I received it today in a phone conversation with the assistant director, or maybe director, of  admissions at a major NYC Hospital with a rehab service.  It was in a conversation about why I would probably be sent to a nursing home for rehab after my knee replacement. Medicare, she said, will probably deny payment for me when they get the bill from the hospital because I am not 85, am having only an “uncomplicated, single-side” joint replacement have no other medical complications such as recent heart attack or stroke, and have no stairs in my home.

Knee replacement, by the way, was once described to me as having your leg cut off except for the ligaments and muscles and replacing the knee with titanium and plastic.  The recovery is reortedly long and painful. Call me crazy, but I feel as though I need a week afterwards, secure in the knowledge that there’s a doctor in the house, which is not the case in a nursing home.

So I canceled the surgery yesterday. Last night I got a call from the doctor (a first, actually) assuring me that it”s the surgery that matters, that rehab is ancillary, that the real work is after you get home and are in out-patient therapy, that the reality is that Medicare is broke (small wonder at $7,100 a night!), that if I go elsewhere and they botch the surgery, I can’t come to him for the repairs.

A few questions–If the surgery is primary and the rehab is ancillary, how come the surgery costs $2,000 and the rehab costs $7,100 a night, exclusive of professional services? I have more questions. But I have another doctor’s appointment (I’m limping along in the search for a new surgeon and a new hospital.) Meantime. memo to Senator Alan Simpson: It’s not the elderly who are sucking at the government tit; it’s the big hospitals—are any of their board members among your campaign donors?

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