Still Clickin

As a country, America’s self image has always tried to stake out the high ground. We are there to “Do Good”. We are for “Freedom” and against the “Oppressors”. We are quick to condemn “Injustice”. We consider ourselves to be a nation built upon moral principles.

Are we?

At the end of 2010, our Congress struggled with, and finally passed, healthcare reform, i.e. the Patient Protection and Affordable Care Act. Those against these changes kept to the theme that “socialized medicine is bad”. Apparently, they would prefer their medical treatment to be asocial, and that is exactly what a twelve-minute exam gets you.

Last year, a very interesting book was published named The Healing of America. It is a delightfully readable description of this very complex subject. Its author, T. R. Reid, is a Washington Post correspondent with a problematic shoulder. To get his shoulder fixed, and to discover the realities of medical practices in today’s world, he traveled to France, Germany, Japan, Great Britain, Canada, and India. In each country, he sought out the finest doctors and medical practitioners and asked for their advice. He also assessed the cost and the timeliness of the various remedies that were proposed. From this first-hand medical marathon, he developed an assessment of the national medical experiences from a patient’s point of view.

Then, he compared these systems to the medical practices found in America. He discovers that the myth we have the best healthcare in the world is challenged by the statistics. America ranks – 24^th for healthy life expectancy, 37^th in healthcare system performance, and 47^th for average life expectancy at birth. The only measure in which we can claim that we are number one is cost.

Rather than be negative, however, Mr. Reid presents a very clear and concise description of the various types of health systems in the world and compares them to what America is doing. The comparisons are both instructive and revealing. In addition, he adds the systems that Taiwan and Switzerland have recently enacted. He argues that America should be able to study these systems, pick the best elements from each, and change to these more effective practices.

But the book ends where it begins, i.e. with the sobering message that more than 20,000 Americans in the prime of life die each year because they cannot afford healthcare. At the beginning and end, the question is a moral one. How moral a nation are we if we allow this to happen?

For more information go to -

• The author’s website
• The wikipedia summary
• Business Week’s review
• Amazon listing

NB. Click below to make a comment. Even better, expand on the original article by going to wikiSenior and clicking on ‘edit’.

Once you are called “elderly”, there is only one form of dependence that you care for, IN. Independence is treasured by the elderly because it validates their worth as a person. You despise the thought of moving to the “Home.”

Once you become a burden to others, especially family members, the chore of living escalates. You are delighted whenever family members come to visit until you realize that the main purpose of the visit is to check up on you. This threat to your independence can become terrifying.

But today, technology can provide facilities to extend independent living. There is a small, but growing, technology sector aimed at this need, and any savvy senior should become aware of it. Taking the time to learn about it, and implement a solution while you are still in control, is as common sense as installing a grab bar in the shower. It is important to think ahead. This NYTimes article is a good place to start.

Technology moves fast enough that these words are likely obsolete as they are being written. But they should give you a sense of what is happening. At this point, Caregiving Technology can be broken down into three sectors – measure, monitor, and manage.

Measure – This involves devices that quantify aspects of health status. For example, they can dispense medications or actually take blood pressure readings. These results can be automatically sent to family members or health professionals if desired. To get an idea, look at -

• Phillips Medication Dispensing
• Ideal Life

Monitor – Essentially, these are home security systems in reverse. Motion sensors are installed throughout the residence, and alerts can be sent if a door is left open or if too much or too little activity is observed at certain hours of the day.

• Phillips Lifeline
• Grandcare Systems

Manage – Once in a while, everyone needs a helping hand at any age. However, older people can be more reticent to ask for it. This technology establishes a network of local friends and neighbors that permit members to ask for help, e.g. a trip to the doctor on Thursday at 3:00 PM.

• Lotsa Helping Hands
• Beacon Hill Village

There really is an amazing number of choices. Some can be expensive, and others quite modest. The point is to learn about them now and become aware of new developments as they occur. Check the UCLA’s Wireless Healthcare Projects that will undoubtedly revolutionize Caregiving Technology within the next ten years.

Now, maybe it is time to get that grab bar mounted in the shower.

NB. Click below to make a comment. Even better, expand on the original article by going to wikiSenior and clicking on ‘edit’.

Just like real estate and insurance, the rules for Assisted Living and Nursing Homes vary by state. The comments and concerns mentioned here pertain to the State of Washington. Your state may be different. But the issues raised are real and are a concern to everyone. If someone you love is in a care facility, you need to be aware of the issues.

These comments are merely reactions to a series of investigative articles that appeared in the Seattle Times under the name of “Seniors for Sale”. Just the title can scare you, but the details are even more arresting.

For example –

• Because of the Baby Boomers, Senior Care is seen as a growth industry.
• Referral services now exist that can route candidates for nursing care to homes that are enrolled but never monitored.
• Homes pay about one-month of their caregiving charge (c. $3,500) for each successful referral.
• Homes can be established by nearly anyone.
• There is very little oversight. No specific staffing levels are required.
• Homeowners are not required to have adequate training.
• Although abuses can be, and are, reported by the Department of Social and Health Services, these are after-the-fact.

It must be extremely frustrating for the careful, loving, well-established homes to be accused by implication in this scandal. These are the homes that don’t want or need referral services. These are the ones whose relationship with their clients is as personal as it is financial.

The question is, “How do you find these good places?”

The obvious answer is, “It takes effort.”

• Research, research, research. – Start early before the need is immediate.
• Learn about and observe – cleanliness, staffing levels, training certifications, scheduled activities, and references.
• Visit and observe at both scheduled and unscheduled times.
• Perform internet and local inquiries about any report of abuses.
• Talk to the employees. Are they happy?

Although the best home is absolutely your own, any of us could become candidates for another “Home.” The natural inclination is to ignore or delay the thought of it. But our own network of friends and acquaintances may be the best place to start our research. People talk, and it is wise to listen. If you do some of the legwork now, it will give your family a place to start if that day actually arrives.

Don’t wind up “For Sale.”

Although some individuals are still covered by company and union health plans once they start Turning Age 65, fewer and fewer people have that opportunity. By far, Most US citizens discover that they have come under the Medicare umbrella. Whatever other insurance they may consider, it is all influenced by Medicare. Or, if your income level provides that alternative, Medicaid. (A few qualify for both.)

What do these choices mean?

Original Medicare Part-A provides hospitalization coverage for no charge. It doesn’t cover everything, but it does cover a lot. The key words for coverage are “medically necessary” procedures, i.e. those required to keep you alive and functioning. Once you get in to “elective” or “experimental” procedures, you are no longer covered. For example, it does not cover private rooms, private nurses, or even TV and phones in the room because they are not “medically necessary”. Basically, during each year it covers hospital stays for -

• days 1 - 60 after $1,068 deductible,
• days 61 - 90 at $267/day,
• days over 90 at $534/day, which are deducted from a 60-day pool of “lifetime reserve days”, and
• days beyond the pool of “lifetime reserve days” at full coverage.
• Charges for blood as well as home, hospice, of skilled nursing facility care are determined separately.

Original Medicare Part-B provides coverage for doctors, lab work and other medical services. There is a monthly charge for this coverage which amounts to $96.40 during 2010. The coverage is limited to the Medicare-approved amount for the Medicare-approved services. For example, a colonoscopy is limited to once every ten years, or two years for high-risk patients. Basically, after an annual deductible of $135, Part-B covers -

• 80% of doctors services and medical devices,
• 100% of clinical lab and home health services, and
• other “medically necessary” services after a co-pay or co-insurance deductible.

Original Medicare Supplement policies, Medigap fill in some of the gaps left by deductibles and co-pays. The coverage offered by these policies is strictly formulated by Medicare and specified by the letters A through N. (Plans E, H, I, and J are being phased out.) Until now, F has been the most popular. Although the coverage of each lettered plan is specific, the companies and charges vary by state.

Medicare Advantage, i.e. Part C plans, are privately run HMO alternatives to Original Medicare. Your care is generally restricted to the doctors and facilities that are members of that organization. Essentially, the government pays your Medicare allocation directly to these plans. The plans then set up their own internal rules for coverage as well as any additional charges that may apply. These plans vary on a state-by-state basis, and must be reviewed in that context.

Medicare Part-D Drug Plans, which also vary state-by-state, provide coverage for prescription drugs. Unless you have other drug insurance, you must sign up for one of these plans within four months of turning 65 to avoid being charged a late penalty.

Medicaid programs offer more extensive coverage to people with limited income and resources. This program is jointly funded by both federal and state governments, so it also varies state-by-state.

Go to the government’s Medicare Web Site for more information and for links to individual state programs.

NB. Click below to make a comment. Even better, expand on the original article by going to wikiSenior and clicking on ‘edit’.