Free
Book Review  |   November 2009
Medicare for Baby Boomers & Beyond
Author Affiliations
  • Susan M. Friedman
    Department of Government Relations; Chair, Health System Reform Task Force, American Osteopathic Association, Washington, DC
    Deputy Director
Article Information
Book Review   |   November 2009
Medicare for Baby Boomers & Beyond
The Journal of the American Osteopathic Association, November 2009, Vol. 109, 573-574. doi:10.7556/jaoa.2009.109.11.573
The Journal of the American Osteopathic Association, November 2009, Vol. 109, 573-574. doi:10.7556/jaoa.2009.109.11.573
Attention, baby boomers! January 1, 2011—the beginning of the year in which the first wave of baby boomers turns 65—is less than 2 years away. Will you be ready? Robert Stedman, an osteopathic physician in private practice in New Jersey, has written an important book—Medicare for Baby Boomers & Beyond—to help boomers understand the Medicare program and its implications for their physical and financial well-being. 
While President Barack Obama has stated that he intends to modernize and transform the Medicare program, any changes will be a huge undertaking and will be implemented gradually over many years. In the meantime, Dr Stedman's book provides the reader with a comprehensive roadmap to navigate Medicare as it exists today. Dr Stedman also describes in his book how to incorporate the Medicare program into personal financial planning for one's retirement years. 
Dr Stedman guides the reader through Medicare's “alphabet soup”—Medicare Part A (hospital insurance), Part B (physician visits and other outpatient care), Part C (Medicare Advantage), and Part D (prescription drug coverage). Each of these Medicare components is covered in its own chapter. Dr Stedman brings clarity to the complex web of rules and regulations governing these components. 
Dr Stedman also discusses the history of Medicare (chapter 1), explains Medicare's billing procedures (chapter 4), offers advice on how to select a Part D provider (chapter 7), and provides systematic instructions for preparing a health insurance budget (chapter 8). In regard to preparing a budget, the author notes that before deciding how much one can afford to spend on healthcare insurance, the following questions should be answered: 
  1. At what age will you decide to receive Social Security benefits?
  2. How much will you receive each month in Social Security benefits?
  3. How much will you depend upon Social Security income for your retirement needs?
  4. What additional sources of retirement income will you receive?
  5. What percent of your retirement income will you spend on healthcare insurance?
Medicare for Baby Boomers & Beyond is a reader-friendly book. Each chapter begins with a list of “objectives,” listing questions that the reader should be able to answer after completing that chapter. The remainder of each chapter provides exquisite detail about the subject matter and a summary of chapter content. Each chapter concludes with a “Test Your Knowledge” quiz, followed by the quiz answers. 
After the eight chapters is an appendix, which contains such useful items as the Medicare fee schedule, toll-free telephone numbers for State Hospital Insurance Assistance Programs, and a Medicare Part D “savings calculator.” The book ends with a glossary of Medicare-related terms, including benefit period, capitation, general enrollment period, point of service, and tiered formulary. 
Numerous helpful flow charts and tables can be found throughout the book. For example, the book contains flow charts showing how Medicare reimbursements for primary care physicians and Medicare benefits to patients are determined in various cases. Among the many useful tables the author provides are one that shows maximum out-of-pocket payments under Medicare Part D while another shows retail prescription drug costs for certain medications. 
Dr Stedman writes succinctly and with a sense of humor. For example, in the chapter on Medicare history, he writes: 

The following evolution of Medicare reads like an Abbot and Costello routine.... During the period from 1965-1977, Medicare was under the jurisdiction of SSA [the Social Security Administration], which, in turn, was under the direction of the Department of Health, Education, and Welfare (HEW).... In 1977, a new agency was established called the Health Care Financing Administration (HCFA), which directed both Medicare and Medicaid.... Don't despair! We are close to the end of Medicare's evolution....

 
Dr Stedman praises Medicare when it serves patients well. However, he points out where the Medicare program falls short in contributing to the ability of physicians to provide—and patients to receive—high-quality healthcare. Examples of such reported shortfalls can be seen in the following two excerpts from the text: 

Both physicians and therapists alike have complained vehemently to the CMS [Centers for Medicare and Medicaid Services] about these caps [on Medicare reimbursements] especially the yearly combined cap of $1810 placed upon speech and physical therapy.

As we indicated in Part A, Medicare seems to discriminate against psychiatric service. Why has Medicare singled out psychiatric services for a maximum of 190 days of inpatient therapy (Part A) and a coinsurance of 50% for outpatient therapy (Part B)?

 
Dr Stedman also highlights the bureaucratic complexity of the CMS by likening it to a set of Russian nesting dolls—once you have opened the big CMS “box,” you find a series of smaller and smaller “boxes” inside. Each of these small boxes conceals mysterious content. 
Medicare for Baby Boomers & Beyond is not just for the baby-boom generation, however. Anyone who wishes to be well-informed about the Medicare program—including policymakers, family members or other caregivers, and medical professionals—will learn a great deal from this book. In addition, the book is an indispensable and practical resource not only for learning about Medicare, but also for learning how to connect the program to intelligent healthcare-related financial planning for retirement. 
 American Osteopathic Association's Health System Reform Task Force
 
 The following book review is part of a series written by members of the American Osteopathic Association's Health System Reform Task Force. This series aims to educate members of the osteopathic medical profession on current healthcare reform efforts as well as motivate them to learn more about the need for comprehensive healthcare reform and the role they can play in achieving it. Members of the American Osteopathic Association may learn more about health system reform by logging into the members-only section of DO-Online and selecting “Health System Reform” under the “Advocacy” tab. For more information on the American Osteopathic Association's Health System Reform Task Force, please contact Susan Friedman at sfriedman@osteopathic.org or (800) 621-1773, extension 8643.Image Not Available
 
 By Robert Stedman, DO. 278 pp, $19.95. ISBN: 978-1-58982-522-2. Salt Lake City, Utah: American Book Business Press; 2009.
 
 Editor's Note: Medicare for Baby Boomers & Beyond is available at special discounts for bulk purchases. More information can be obtained by e-mailing the book's publisher, American Book Business Press, at: info@american-book.com.