Medicare for All? Not Really

by: diannah

Fri Sep 04, 2009 at 10:18:21 AM PDT

I'm sure the insurance companies are tickled pink to hear that.  That means that if you still want complete coverage you still need insurance!

Now don't get me wrong, I am for a Public Option! and I'm More For Single-Payer.  But I'll take what I can get this round.  I can't be choosy.  But using the slogan Medicare for all is a real misleading statement.

How to explain the public option for healthcare reform. Really.

by: los anjalis

Fri Aug 21, 2009 at 09:00:00 AM PDT

The speaker is Chris Hayes, DC editor of The Nation magazine, and the setting is the Netroots Nation blogger/media conference in Pittsburgh, August 2009.

After the conference, a blogger named Nicholas Beaudrot transformed Hayes' flowchart-gesturing and converted it into an easy to read and share flowchart about the public option. Click on the image to enlarge it.

FINALLY, easy to understand, right?  Precisely why you should share it with your colleagues, friends, and foes alike.  

Death by HMO

by: diannah

Fri May 29, 2009 at 19:29:38 PM PDT

The most disturbing detail is that the home that Kaiser kept insisting that he be sent to, the one that they contracted with, the one that they had checked out so carefully, was already named IN A CLASS ACTION LAW SUIT!

The Fight Will Be Dirty

by: cameronpage

Tue Apr 14, 2009 at 12:13:32 PM PDT

"I did not write a letter to the editor. It's not from me," said Gloria Gosselin, 75, of Lawrence.

Gosselin's name was on one of three strikingly similar letters touting the Medicare Advantage program that were sent to The Eagle-Tribune.

...

The letters were, in fact, composed and sent by the Boston office of [Dewey Square], a national political consulting firm, attempting to create the appearance of a "grass-roots" movement for Medicare Advantage.

America's Health Insurance Plans, an industry trade group, hired Dewey Square to defend the Medicare Advantage program.

It gets worse:

The Eagle-Tribune received a call from a man who turned out to be an intern at the Boston office of the Dewey Square Group, a national political marketing and consulting firm.

The man, who identified himself as Noah, wanted to know if Gloria Gosselin's letter had been published. Asked what interest he had in the letter, Noah replied that he was Gosselin's grandson.

Gosselin does not have a grandson named Noah working in Boston. Her only grandson is a student at Central Catholic.

Got it?  The fight will be dirty.  AHIP knows that to block healthcare reform, they will have to get rough.  And they're not going to sit back and let the groundswell of support for healthcare reform wash over them.

Conservative estimates are that AHIP has $100 million set aside to fight against healthcare reform.  And they seem to have every intention of playing dirty with it.  

So this is it.  We've been warned.  Consider this a shot across our bow.  It's going to be a serious, heavy-duty fight.  

And if we fail to reform the system because we don't fight back hard enough.... well, i was going to say we have no one to blame but ourselves.  But we can always blame the big bad insurance industry.  We can fail, and then we can comfort ourselves that they had more money, and they played dirty.

But I'd rather not comfort myself.  I'd rather win.  And we can.  We have the truth on our side, and better arguments, and oh yeah, history is on our side too, both in the U.S. and around the world.  Those are far more powerful than a willingness to play dirty.

Smears can always be defeated by the truth. But someone has to speak that truth.  Unfortunately, it never speaks for itself.  

A Shortage of Healthcare Professionals

by: diannah

Sun Feb 01, 2009 at 18:22:27 PM PST

I have nothing against foreigners.  I embrace the diversity of the world and my family reflects this in it's make up.
But when English is the professional's second language and they are dealing with older English speaking people it's a recipe for miss communication.

And to extrapolate this further, any time the health care provider's primary language is not the same as the patients,
and the patient is older, has hearing loss and can become confused more easily and frustrated, it's a potential disaster.

So why aren't more English speaking Americans going into Health care? or rather why are there so many foreigners in American in health care?

CONTINUITY OF CARE

by: diannah

Wed Jan 28, 2009 at 13:25:25 PM PST

The question is patronizing at best and condemning in it's assumption.  

NO HE HAS NOT!

But they have no way of knowing.  There has been no continuity of care, no one physician who has followed him through his life, who know the man and of what he's capable.

So they turn to the family.  And we tell them.  But the fear is that their assumptions about who he is and why it is the way he is will do more harm than good.
   

DID ANYONE NOTICE THE ALARM?

by: diannah

Fri Jan 23, 2009 at 21:01:52 PM PST

If we don't do something about this the baby boomers are going to be in for a rude awakening as they start overflowing the system.  WE'RE NEXT!  Do you really want this happening to you or your Mother?  

In my diary NO ROOM AT THE INN I wrote about the elder abuse that my step-father endured in one of these places.  The over medication and lack of attention to his wounds and his eventual contraction of a staff infection.

But, the next home proved even more deadly.

NO ROOM AT THE INN

by: diannah

Wed Dec 24, 2008 at 15:53:29 PM PST

Kaiser filed discharge papers for him yesterday with no bed available.  Today they finally found one for him in a below average home, which we have yet to see.  They said they were looking all week, but I've talked to several today and Kaiser had never called them.  One administrator, emphatically, wanted me to know that.  And she had just made arrangements for her last bed minutes before I called.

It will be the 3rd home he's been in since this saga began back in June of 2008.  It is a saga of mismanagement, confusion, misinformation, malpractice and finally elder abuse.

What's even worse is that since I've begun telling my story to family and friends and whom ever would listen I've gotten nothing but empathy and sympathy from other children of elderly parents.  Sounds like a 12 step group.

The fact is that care for the elderly and poor is atrocious in this country.  I've had a whirlwind education in the ratings systems for convalescent homes.  Reading the ratings system and reports on each home is down right scary.

It all started back in June of 2008.  Norm fell after work and broke his hip.  He'd been working a night watchman job at 75 years old because he and my mother couldn't manage with just their social security checks.  Before he hurt himself he had done most of the shopping, and driven my mom to all of her Dr's appointments.  She's 81.  They live in a small one bedroom apartment in Santa Monica, under rent control.  They could never afford to move, the way rents have skyrocketed.  And Norm, used to sleep on the couch, because he had restless leg syndrome and it would keep my mom awake.

One day he fell at Albertson's.  But he got back up and kept going.  He was in horrible pain, but could still walk and he needed to keep working, or at least that's the attitude that drove him.  But a week later when leaving work, he stumbled and fell again on his way to the car, and he could not get up.  

They brought home, but my mom's brother told her to call 911.  She did and the took him to Santa Monica Hospital ER where they did the initial diagnosis.  Kaiser immediately wanted him transferred to their West LA facility.

Once there the Dr said he needed a half hip replacement.
He made it sound so easy, and everybody was at ease.
(NOTE: around that time I heard about a hip replacement that had been recalled by the FDA or some agency because it had a tendency to dislocate a lot...but this was a half hip and...they wouldn't used a bad implant...or would they)

After a few days in the hospital and Norm in extreme pain they told him he had to go to a recovery home to heal and get some physical therapy.  Again, all this sounded so easy
and healthy.  But, there was a problem.  The hip kept dislocating.  The home kept sending him back to Kaiser in great pain.  They kept resetting it.  The Dr was getting very angry with Norm, saying he was doing it to himself.
I wonder.

He lost his bed at the recovery home and had to be sent to another place that was 20 driving miles across town from us.
It made it almost impossible for my mother to take the bus to see him and force me to become her driver.  She took the bus once and got rides from neighbors a few times, but he was so far away we couldn't keep and eye on him.  AND I was still under the impression that they were taking good care of him.

He started loosing weight.  He wasn't eating.  The new home was noisy and loud with a loud speaker going off all the time so one could barely keep your thoughts together.

He kept calling my mom in great pain.  I called and asked why he was in such pain and they put him on more meds.
But it turned out that his hip had dislocated again and nobody caught it.  There he was in acute pain because of a real condition.  He should have been transferred back to Kaiser immediately.

Finally, during a regularly scheduled appointment he was sent back and they found the dislocation.  We were all mortified.  Why hadn't the home discovered it?  There are supposed to be skilled physical therapists and nurses there to catch these things.

The Kaiser Dr, put him in a body cast up to his chest.
Turns out he had threatened Norm with this after the last dislocation.  They were accusing Norm of doing this to himself.  I highly doubt it.

Once in the cast he could no long be rehabilitated so he was put in a different category of custodial care.  Norm lost more weight.  They cut the cast down so he could sit up.  They promised him a Cardiac Chair because of his heart failure, but never delivered.  And he began loosing more weight.  I remember one day I could see a huge gap between the cast and norm.  Almost big enough to put my hand in.
He'd lost 20 pounds or more.
And nobody thought to recast him.  We asked and they said, oh he might gain weight again.  He didn't.

When they took the cast off he had deep wounds in his foot and knee, caused by pressure and friction.

Not too long later he got a staff infection from the home.
Nobody noticed.  They brought him back to kaiser for a check up and when the blood tests came back they brought him back from the home and put him in Kaiser West LA and called us.

He now also had foot drop.  But even though the Kaiser Dr told us about it the Dr at the rest home denied that he had any such thing.  

Several weeks later, perhaps 6, we met with Norm at Kaiser West LA to be there with him when he got his cast taken off.
I began to take pictures of the wounds that were still bleeding.  

Norm was still in a diaper and a catheter. And although he was joking around and laughing he had a cough and very wet cough.

He told my mom that night on the phone that the man in the bed next to him had died of pneumonia.  The next day she asked the Dr to check his chest.  The Dr. said, he'd just checked Norm and he was OK, but Norm said, he came back and took a chest xray.  We called the home later.  My mom asked the nurse how Norm was, she said, "oh the same."  My mom said, "so he has a cold?"  The nurse said, "oh you know, yes he has pneumonia, but we're treating him."

We got there that night to have Norm sign and Advance Health Directive so that my Mom would be maid aware of what was going on.  We had an Ombudsman there with us.  Norm was un-responsive.

We stayed there for 4 hours trying to talk to Norm.  He would wake and start and open his eyes and fall back.  Two assistants came in and woke him when we requested that he be fed his dinner.  He now only weighed 150 pound.  He was 190 when all this started and 220 not too long before that.
He only ate 4 bits of mashed potatoes, a little milk and a bite of fudge.  Then he was out again.

Finally, around 8pm the charge Nurse came in to give him his meds.  We asked her if this was normal.  We'd never seen him so out of it.  She indicated that it was and we couldn't believe it, because my mom would call him all the time.  Then the charge nurse, slapped him hard on the very knee where he was wounded in order to rouse him and give him his meds.  When we asked her what she was giving him she said it was his sedative he was supposed to get every 4 hours.  He was also supposed to get a breathing treatment every 4 hours and he wasn't.  He didn't want the meds, she put it in his mouth, he didn't want the juice and she made him drink it.  We were shocked.

We asked for his vitals, I couldn't believe this was how you treated someone with pneumonia.  His pulse Oxy was 94,
she said that was great, I know better, his bp was 110 over 40 his pulse was 89. His breathing was labored, when he did cough it was very wet.  I felt he should be on oxygen and in a hospital getting treatment. So my mom called the Dr. on call. He said he could admit him for observation for a few hours.

When we got there the Nurse told us that what we had witnessed was Elder Abuse.  That was the last straw for me.
I never wanted him back in that home again.  We are filing a complaint.

But, when we started to look at what was out there we discovered the rating system for convalescent homes. Where Norm had been was only 2 Stars out of 5.  The description online of the inspection was horrifying.  
HOW CAN FACILITIES LIKE THIS GET LICENSED?

THIS SYSTEM IS BROKEN AND WE NEED TO CHANGE IT NOW!
BECAUSE WE'RE NEXT.  I'm going to do everything in my power to change the way the elderly are treated in this country.
It's obscene that we warehouse our parents like this!
It brings to mind the final scenes of "Soylent Green,"
only not as humane.

I don't have time now, but next I'm discuss Good Cop/Bad Cop discharge coordinators and Kaiser.

Obama says health care is a "right", slams McCain's plan

by: los anjalis

Sun Oct 19, 2008 at 16:00:10 PM PDT

The fire quotes of this past week on health care were these two by Senator Obama.  On McCain's health care plan:

It's like those ads for prescription drugs. You know they start off, everybody's running in the fields, everybody's happy. Then there's the fine print that says, "Side effects may include..."

And on right vs privilege:

I think every single american has a right to affordable, accessible health care.

Of note, this statement received the largest roar of support from the crowd he was speaking to.  Some video footage of a speech Obama gave last week:

Some things that Obama mentioned:

Senator McCain wants to pay for his plan by taxing your health benefits for the first time in history...

But the Wall Street Journal recently reported...it turns out Senator McCain would pay for his plan by making drastic cuts in Medicare -- $882 billion worth.  $882 billion dollars in Medicare cuts to pay for an ill conceived, badly thought through health care plan...

Time and again he's opposed Medicare.  In fact, Senator McCain has voted against protecting Medicare 40 times.

When you've worked hard your whole life, and paid into the system, and done everythign right, you shouldn't have the carpet pulled out from under you when you least expect it...

McCain's health plan too Radical (and out of touch)

by: los anjalis

Sat May 03, 2008 at 16:31:52 PM PDT

"There are those that want a massive government takeover of the health care system in America," Mr. McCain warned Thursday in Des Moines, as he made the case for his more market-based approach...

"But before you decide to sign on to that kind of a program, go to Canada, or go to European countries that have government-run health care systems," he continued. "My friends, they don't work, they're inefficient, and they end up in a two-tiered system where the wealthiest can afford to pay for their own health care and those with low income sometimes wait six or eight months for a routine kind of treatment. And that's what I'm not going to let happen to the United States of America."

My dear friend McCain:

ALL YOUR LIFE you have relied on the government to provide top-notch insurance to you.  When you were a kid, your father was an Admiral and you received health insurance under the military's plan. When you were in the military you received health insurance through the military, and in your many years in office you have benefitted from the comprehensive health insurance packages that the state and country have provided for you, on the taxpayer dollar (read: McCain has not experienced private insurance, and if he has, it has been for a very short time).

Mccain, if you seethingly hate government-funded health insurance so much, you should have long opted for private insurance yourself.  

And please stop twisting the Democratic health insurance plans as "socialized medicine".  That they are not, to the excitement of many, and to the dismay of many others.  There is no room for lies in this very important life-and-death issue facing Americans.

I don't care for your double-talk.  Please put your money where your mouth is.

- - - - - -

As a primary care doc at a county hospital, where most folks don't have insurance or have medicaid, it's a DAILY REALITY for people with painful gallstones have to wait 9-12 months for a cholecystectomy (surgery to remove the gallbladder), or where people with severe debilitating neurological disorders have to wait 9-12 months for a first appointment to see a neurologist.  

A few of us who traveled to Seattle and Vancouver in 2004 interviewed folks who were going about their daily business in the downtowns of both cities.  OVER AND OVER again, I heard about stories like the Canadian who was traveling in America and who tore his ACL (a ligament in the knee) and went straight back to Canada for surgery that same week ($0 in out-of-pocket costs);  the woman who noted a lump in her breast, who called her primary care doc's office -- saw him within 2 days, and saw a breast specialist within a week, and was under chemotherapy treatment within two weeks after a mammogram, all for free;  or the man who had a severe headache, took a cab to the emergency room, had a head CT, saw a neurologist, stayed in the hospital for two days, and left with just a $40 cab bill.

There are many things wrong with the health care systems in other countries, i'm not absolving them of all criticism.  But it shows how absolutely out of touch McCain and his cronies are for spewing garbage like this.  It really does.  And this kind of talk actually incenses more and more Americans on a daily basis, as they increasingly face the harsh realities of the american health care system and its  tiered healthcare systems.

Apparently, McCain also wants to destroy the employer-based health insurance system and force millions of Americans to buy individual private health insurance plans.  Again, while he'll never make mention of it, all his life McCain has been provided health insurance through government funding and is COMPLETELY out of touch with the realities of purchasing private health insurance through the uncompetitive markets with no bargaining power and great scrutiny of "pre-existing coniditions".

Again thanks to Smintheus for the link to the editors' commentary at the Des Moines Register:

The proposal [by McCain] should scare the heck out of the millions of Americans who rely on employer-based coverage...Buying individual policies means having your health history reviewed. It means not having the bargaining power and protections that come with being part of a plan offered by an employer. And it's expensive...

The senator is correct that the employer-based system of health insurance in this country isn't working. Businesses are saddled with the high costs of coverage, putting them at a competitive disadvantage in the global marketplace. Insurance shouldn't be tied to jobs.

But the more reasonable solution is to offer everyone what Medicare already offers: health coverage financed by a combination of tax dollars and participant contributions, thus allowing the huge bargaining power of millions of Americans to leverage down costs.

That idea is nowhere near as radical as forcing millions of Americans to shop for their own coverage in a profit-driven, private-insurance sector.

Now we're talking.  I like the use of the word "radical" in the editorial, contrasting the radical right wing thoughts on health insurance to the more reasonable solutions on the table (and those that a growing number of Americans are embracing.

(cross-posted at the National Physicians Alliance blog)

Formulary Time: Parody of Auld Lang Syne and Invitation

by: nightowl724

Tue Jan 01, 2008 at 08:50:46 AM PST

Auld Lang Syne is at least 250 years old, so some of the lyrics do sound a bit "peculiar" to the modern ear. My parody, Formulary Time, follows the same odd patterns and rhymes as its inspiration. After a "cup 'o kindness" or two, however, it makes nearly as much sense as the original!

Should old prescriptions be forgot,
And never brought to mind?
Should old prescriptions be forgot,
At formulary time?

Wander across the auld fold to be educated and entertained and to share your formulary stories.

Medicare Part D Christmas Medley

by: nightowl724

Mon Dec 10, 2007 at 18:06:10 PM PST

Wait.  Did I just say study?  Don't I know that it's the holidays and that you already have countless things to do?  Yes, I do.  However, millions of people will be making these daunting decisions while making their holiday plans this month.  

If nothing else, at least you will be more prepared when it comes time to help a loved one (or yourself) choose a policy, if this convoluted program remains in its current monstrous form.

Here's a little something to hum while you fix that drink...

Hark!  It's Medicare Part D!
Glory to the new drug kings!
High net worth and earnings wild.
Record profits they have filed!

Dash through the snow with me for some facts and fun...