BP #2: Failure to Improve Is Still Being Used, Wrongly, to Deny Medicare Coverage

In recent health news there continues to be problems with Medicare beneficiaries being denied for coverage they are entitled to. The centers for Medicare and Medicaid services don’t exploit the statistical claims that are/were denied; therefore, individuals aren’t told why millions of beneficiaries are told inaccurate information regarding their Medicare coverage. An individual by the name of Edwina Kirby, from Livonia, Michigan, fell and broke her femur resulting in surgery and rehabilitation. Post-op her health got worse when her kidneys failed, combating diabetes and heart disease, resulting in her needing dialysis. Edwina couldn’t even dress herself, she was completely dependent on nurse aide assistance. After Edwina’s daughter saw how immobile her mother was, she was dumbfounded by an email she received from therapists at the Glacier Hills Care and Rehabilitation Center, Ann Arbor, MI, saying that “Edwina has reached her highest practical level of independence.” In other words, Edwina would no longer receive Medicare coverage for any further therapies and/or for a nursing home. Though, if she chose to stay then she would have to pay out-of-pocket. Edwina’s daughter didn’t believe that her mother would be denied these services and decided to take this circumstance to another level.

Edwina Kirby is an example of what McFall was talking about with having integrity. He says that a person with integrity believes that their own beliefs have to be in something that any reasonable person could take to be important. In this specific case, Edwina did have integrity, but wasn’t able to do the physical work of settling this issue. Her daughter, had a strong sense of identity, and took it into her own hands to take care of the issue. Without question, she considered this circumstance to be very important—as you would think that any reasonable person would think so as well.

However, in relation to core-commitments and the moral identity it consists of, in my opinion, was described as continuing with whom we are and not allowing exterior situations impact with whom one defines themselves. So, in this case, it was up to Edwina and her daughter to determine if they were going to allow this exterior complication take over with whom they identify themselves as.

To me, I think there are options and different avenues a person can take to defend themselves, what they believe, and what they feel is morally acceptable. Though you could be wrong in whatever the circumstance may be, an individual’s identity is different and unique in the way that is chosen. Therefore, maintaining and continuing to live with identity and not allow other people or a horrendous circumstance take away your identity and your morality is incredibly significant throughout one’s lifetime.

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Edwina Kirby, right, with her daughter Deanna at home in Livonia, MI.

 

Resource:

http://www.nytimes.com/2016/09/13/health/medicare-coverage-denial-improvement.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=rank&module=package&version=highlights&contentPlacement=7&pgtype=sectionfront

 

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