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Thursday, 20 August 2009

It's Elders For Health Care Reform Day

[UPDATE: Be sure to email me the link to your story (use the Contact link in the upper left corner of this page) so I can post your story. I won't know you've written it unless you let me know.]

category_bug_politics.gif You wouldn't know it from television news, but not all elders are as rude and ignorant as those who shout down legislators and other constituents who have serious issues and questions to discuss. Most elders are smart enough to know that “death panels” are a nasty, little fiction, that no one's Medicare benefits will be cut, and we certainly don't screech “Nazi” when we disagree. Seeing those other elders has been a personal embarrassment to me.

Today Time Goes By showcases elders who have followed the health care reform debate, who have informed themselves and want to make a thoughtful contribution. Keep in mind that we, unlike younger people, lived many decades with private health coverage and now have experience with our single-payer system, Medicare, so we are in a better position than many younger people to intelligently compare how these two systems work.

(By the way, Medicare wins.)

My own contribution to this collection of elder essays in support of health care reform is at the bottom of this post. Here are links to elderbloggers' essays on the subject written especially for this project. More will be added to the top of the list throughout the day as I receive their links.

ELDERS FOR HEALTH CARE REFORM BLOG POSTS

Deciding to End a Life
By Pete Sampson who blogs at As I Was Saying

In Praise of The National Health Service in the United Kingdom
By Ursula White who blogs at Friend of Friko

One American Family
By Mage Bailey who blogs at Postcards

Precious Vase - Thumbs Up For Offering Public Health Care
By Diane Widler Wenzel who blogs at Umbrella Painting Journal

"Government Run" Works, Look Around You
By Peter Lott Heppner who blogs at Alley Patron

Medicare For All Should Be Our Goal
By Robbin Roshi Rose who blogs at Knitting, Singing, the Universe and All

Health Care Reform Reality
By Faith Davis Ferris who blogs at My Muse Mutters

Stop Screaming About Health Care Reform
By Cynthia Friedlob who blogs at The Thoughtful Consumer

Why Health Care Reform is Hard
By Jan Adams who blogs at Happening Here

Slouching Toward Medicare
By Frank Paynter who blogs at Listics

Healthcare Reform - Searching for Facts Through the Noise
By Kimberly Hanson who blogs at The Wild Hare

Onward to Single Payer
By Elaine Frankonis who blogs at Kalilily Times

August 2009 - US Congresspeople Get the Message-Universal Health Care!!
By Betty Hurst who blogs at Oops50!

I'm in favor of Health Care Reform!
By Marion Vermazen who blogs at Marion's Blog

We the People Want Health Care Reform
By George Phenix who blogs at Blog of Ages

Writing About Health Care - Again
By Rain Trueax who blogs at Rainy Day Thoughts

Health Care Reform or Revolt? An Insider's View
By Nancy B who blogs at The Tempered Optimist

Elders for Health Care Reform Day and the Death of the Baby Boomers
By Bobbie Harvey who blogs at Celebrating Time

Setting the Record Straight About Health Care
By Marian Van Eyk McCain who blogs at elderwomanblog

Health Care and the Creative Economy
By Zuleme who blogs at Caturday

What Has Social Medicine Ever Done for Me?
By Lia who blogs at Yum Yum Cafe

Can We Do the Right Thing?
By Lois Cochran who blogs at Guitar Grandma

My Personal View on Health Care Reform
By Alexandra Grabbe who blogs at Wellfleet ChezSven Blog

My Experience with Health Care in Sweden and France
By Sven-Olof Rudstrom who blogs at Distant Mirror Blog

My Tuppenceworth - Health Debate
By Grannymar who blogs at Grannymar

Health Care Reform U.S. Style
By Ian Bertram who blogs at Panchromatica

Questions and Answers on Health Care Reform
By Darlene Costner who blogs at Darlene's Hodgepodge

My Father's Healthcare Conversation
By Ruthe Karlin who blogs at Studio Ruthe

Alternatives to Helpless Rage
By Jan Adams who blogs at Happening Here

Health Care, Aug 20, Time Goes By Challange
By Anne Gibert who blogs at 20th Century Woman

Give Me Your Tired, Your Poor - Your Uninsured
By Cowtown Pattie of who blogs at Texas Trifles

10 Things You Need to Know About Health Care Reform
By Paula H. Cohen who blogs at Birds on a Wire

German Medical System 101
By Lia who blogs at Yum Yum Cafe

If It's to Be, It's Up to Me
By MissDazey who blogs at Elder Generation

Do You Remember November?
By Cile Stanbrough who blogs at cilesfineline


It's Not Reform Without a Public Option
By Ronni Bennett of this blog

Here is my question for elders who have Medicare and younger people who have private coverage who oppose health care reform: why is it all right for you to be well cared for by your physician while tens of millions of other Americans are not? How do you justify that?

The American health care system is broken. Insurance premiums are off the charts and continue, as they have for the past ten years or so, to increase at about seven percent annually. For those who want to keep our current system, remember that you're lucky to get a three percent salary increase each year. How long can you continue to afford coverage at these increasing rates?

More than sixty percent of personal bankruptcies are attributable in full or in part to catastrophic health care costs. Each of you covered by private insurance is only an auto accident or terrible diagnosis away from the same disaster.

Median family income in the U.S. is a little more than $50,000 per year. Health coverage generally costs a family of four about $12,000 a year leaving $38,000, before taxes, for everything else. How is it possible to raise two children on that?

That 46 or 47 million figure that is bandied about as the number of uninsured Americans was released in 2007. Since then tens of millions of workers have lost their jobs. Currently, 6.2 million are collecting unemployment checks. How many others have run out of that benefit? How many have had to drop their health coverage? Some sources, including the president, say 14,000 Americans lose their coverage every day.

Meanwhile, Republicans in Congress and some Blue Dog Democrats are trying to kill the public option in the health care reform bills. Even President Obama has implied that it is not necessary to reform, although with all the various pronouncements this past week, it is hard to know who in the federal government stands where on the public option.

The idea behind it is that it would keep the for-profit insurers honest, force them to keep premiums at a reasonable level to compete. The insurers are screaming bloody murder about the public option (and contributing millions of dollars to the campaign chests of our legislators to influence them) saying that a public option from the government would dominate the market, even put them out of business.

Is that true, do you think? A good comparison is government Medicare versus private Advantage Plan Medicare. Even though those plans cost more than traditional Medicare, they have captured 20 percent of the elder market.

Insurers would argue that 20 percent isn't enough. Of course not. They want to retain the 100 percent of the non-Medicare market they have now. But they have priced themselves out of the pocketbooks of most Americans. Someone must put a brake on their greed and the public option, along with other changes to the system, would help do that.

Without a public option, there will be no reform in the health care bill that finally emerges from the committees. It will be the same old system, more unaffordable than before and will leave more than one-sixth of Americans still without coverage and therefore without access to a physician.

That is – or should be – morally unacceptable to every American citizen.


At The Elder Storytelling Place today, Barbara Fifield: Elegy to Another Barbara


Posted by Ronni Bennett at 02:35 AM | Permalink | Email this post

Comments

Helping my Mother Die

Loren A. Olson, MD DLFAPA


When did I start getting old? I’ve worked since I was nine years old, and at 66 I’m still practicing psychiatry, with no plans to retire. I’m writing my first book. I’m going to be married in September. I look forward to every day with enthusiasm.

But the flesh is weak. I enjoyed good health for all those years I paid into private insurance, but now I need a knee replacement and a shoulder replacement. I am beginning to use my government managed, single payer, Medicare now, more than I ever used my private insurance.

I want to tell you about my mother’s death. She was 83 when she had the last of a series of strokes, this one a rather massive one which left her unable to speak or swallow, paralyzed, conscious but only communicating with her eyes.

As a physician myself, I was the family spokesperson with the doctor. When I saw him for the first time, he told me that she would not recover from this stroke as she had from her earlier ones; it was too massive. He said, “Do you want a feeding tube?”

I immediately said, “No” to that. Then I checked with my three siblings. We'd all had conversations with my mother about end of life issues. She had been a vibrant and energetic woman, fully engaged in her life, a strong belief in an after-life, and we all agreed, “No feeding tube.”

“What about antibiotics?”

Again, we all agree that we knew she wouldn’t want to live as she was, and we said, “No.”

“Then what about I.V.’s?”

The questions were getting progressively harder, but again we said, "No," fully understanding her wishes and in complete agreement with each other.

She died more slowly than any of us wished. Each day we would swab her mouth several times, and she would suck on one of the swabs to extract all the lemon flavored liquid. Then she would accept another to relieve the parched mouth, but she always refused a third, her way of communicating to us what we already knew was true.

She died as peacefully as she had lived, surrounded by a family that she loved and that loved her, and she died the way she wished.

As physicians, we must advocate for our patients, and often that means offering feeding tubes, intubation, antibiotics and other interventions which prolong the dying process. End of life counseling could put patients, families and physicians at ease about respecting the wishes of the dying. Families struggle with these decisions and physicians are ethically obligated not to make these important decisions alone.

But how could anyone wish to deny the elderly and their families counseling about how to make these difficult decisions? I know as a physician that we do spend way too much money as a society on extending the lives of some of the elderly who are prepared to die.

Re-labeling this counseling as “death panels” is immoral propaganda. I was horrified when my Iowa Senator Charles Grassley speak of this as "pulling the plug on Grandma," and I thought, “I’ve pulled the plug on my mother, but because our family had the forethought to have these discussions, I knew we were making the choices se would have made for herself.”

One day a pharmaceutical rep visiting my office asked me, “Would you want to wait six months for your knee replacement like they do in Canada?”

I responded quickly, “If it meant offering more and better care to children and pregnant mothers, I certainly would. However, what you’re saying about Canada isn’t true, either.” I have visited with Canadian and European physicians who are quite pleased with their distribution of medical resources.

Yesterday, I heard a Libertarian say, “I believe in personal responsibility; each person must take responsibility for themselves. I know that sounds harsh toward poor people, but that’s what I believe. Given an inch, they’ll take a mile.” Has he never been exposed to someone who was incapable of taking care of themselves, or has he no capacity for empathy. Are we so self absorbed that we cannot recognize and respond to the pain in other peoples' lives? How will he react if his mother has a stroke?

I’m putting off my knee and shoulder replacements. I’m not desperate yet and even though I’m fully insured, I can deal with the pain through conservative management for a while longer. It is harder and harder however to deal with the pain of those who are uninsured and those who are being denied end of life counseling.

"Is that true, do you think? A good comparison is government Medicare versus private Advantage Plan Medicare. Even though those plans cost more than traditional Medicare, they have captured 20 percent of the elder market."

Actually, I don't think that's a good comparison, because the higher cost of the Medicare Advantage plans is for the most part paid by the government - allowing the newer, especially private fee for service, plans to offer themselves for little or nothing in the way of premiums. If they didn't get that government subsidy, their premiums would rise, along with copays, and some of the extra services they cover would disappear.


I have never been prouder to be part of the elderblogger community then today. Well done bloggers and commentators. Great blogs. I am trying to go to as many as possible to comment to assure we move up in google and other search engines when healthcare reform is put in as search term.

I urge you all to do this also. I have gone to some media sites to post comments on their reports naming blogging sites (no urls allowed) so others will find us all.

Have posted on Twitter and on Facebook also.

Great job: Ronni, thanks for starting this. We can and will make a difference.

ONE MORE THING: SHOW YOUR SUPPORT:

http://www.healthreform.gov/support.html

the above is a signature support that goes right to Obama on this

About 4 years ago I got a copy of a health advisory booklet made available by the MO Bar Association, and went through it line by line with my very elderly mother. Later, when she updated her will, the attorney made a new health advisory. Still later when we moved her to CO, we consulted another attorney about legal issues, and the new attorney asked my mother verbally about end of life issues. If you prepare a will, or set up a living trust, you will be given the chance to deal with your own end of life issues. This is not a new thing.

Once in assisted living, she signed a form directing any emergency responders to allow her to die. This is in line with many of her past statements.

I think it is important to talk with family about end of life issues and to revisit the issues periodically.
These decisions are hard to talk about, and it is very easy to put them off. I do not see why a mechanism to visit, and later revisit them for the elderly and their families is a bad thing.

When decicions are made, all family members should be told. And all legal bases should be covered. as it stands now, this might mean consulting an attorney, an expensive & perhaps daunting thing. Properly designed procedures could make doing this easier and less expensive. For many of us, deciding end of life issues for ourselves gives an element of control over how we die.

Ronni, are you doing a press blitz on this event at all? Letting AARP and NYT and USA Today, etc, know it's going on? It's such an important work.

How are we supposed to pay for this? If Obama really wanted a solvent health care policy, he would not be trying to cram this down our throats without careful consideration of the fiscal components. He can't explain, in full, how this thing will get paid for. He obviously has no intention of leaving Irag or Afghanistan. In case you haven't heard, our country is the hole to the tune of TRILLIONS of dollars. WE can not afford this plan, that no one can explain nor do they have the time to read it. If Obama really wanted to do this right, he would not have turned it over to the Congress...he has shown no leadership..he just wants to take the glory of getting something that the Clintons couldn't pass as a feather in his political hat. The Universal Healthcare in Mass. has failed. No cost containment. Economics is boring, but really, we don't have the money to do this. Enough is enough.

stacie says "How are we supposed to pay for this?"

Maybe you should just adopt the UK system - it costs half what yours does after all and gives universal coverage. You would then have a few dollars left over for other things.

(and no - I'm not joking)

We are senior citizens, and farm for our living - a physically demanding lifestyle. Without health insurance we would not be able to work, and our small isolated community would have one less source of locally produced food.

The Unemployment rate in our county is over 20%. Employer Based health insurance leaves all those families behind. Most businesses here are small operations. They barely keep their doors open in this economy, and few can afford anymore to offer health insurance to their employees. So even those families lucky enough to still have work, don't have health insurance. Our State balanced their budget by shorting payments owed to counties for the few safety net services available to the most vulnerable of our citizens. This economy will not heal fast. More and more folks will find themselves 'retired' well before they qualify for Medicare. Ill health is wasteful of human resources that might otherwise be used for the common good. Support for universal public health is the conservative thing to do.

I don't know what I am more ashamed of - the fact that the richest nation on earth still doesn't have universal public health services for it's citizens, or the fact that demagoguery has replaced civil discourse in a country that prides itself on democracy.

Thank you for organizing this, Ronni. The more voices that are heard in Washington, the better the chances of getting real health reform.

I've asked this question on another blog, but it bears repeating.

How can anyone be happy with a system
*that costs twice as much as most of the developed world,
*that leaves 47m (and rising) people uninsured,
*where costs associated with illness are the biggest cause of bankruptcy
*where, when compared with an insured white patient, black patients with equivalent injuries but without insurance had a 78 percent higher risk of dying; for uninsured Hispanics, the risk was 130 percent higher (Newsweek) and
*that puts the richest country in the world at 72nd in terms of the quality of health of its citizens?

Follow the money - who stands to gain from preserving such a state of affairs?

Thank you, Ronni, for planning this outpouring of common sense in the face of the misrepresentation and lies we are getting from the other side...

Thanks,too,to NancyB for the link to let the President know we are behind him in his efforts to give everyone good health care.

Thanks also to Dr.Olson for his compassion and love for his Mother and for telling us to make sure we also have told our families what we expect of them when it is our turn to need love and compassion.This was good solid advice about a very touchy subject.

And, finally, to Stacie. Two words;
STAY WELL......

The day isn't over. I'm hoping more people will post and more will comment. Ronni, you are right. Without a putlic option there is no reform.

Allow me to join in with the others to congratulate you in what you are doing here. I can only hope that more people read and become better informed as to what’s at stake here.

For those who talk about not wanting a public option because government bureaucrats will come between them and their doctors: Right now they have insurance company bureaucrats making those decisions -- and their bottom line is saving the insurance company money.

A public option is imperative!!

"Free market" believers are always quick to tell us that free and open competition benefits consumers. So why not now?? I guess the prospect of losing those outrageous profits trumps the free market philosophy.

A PUBLIC OPTION IS IMPERATIVE!!

Private insurance companies have rationed care for a long time. When I almost died of pneumonia, my doctor was furious about the amount of time he had to spend getting my ins. co. to approve two more days in the hospital, which he said were crucial.

Private insurance doesn't ensure choice, either. When a family member injured her eye, her parents' HMO made them take her to a hospital miles away on the other side of a large city instead of to the nearest one.

I am so tired of hearing that the government will do it worse. Since I've been on Medicare, it's been better. Those angry shouters would never give up their own Medicare.

Thank you, Ronni, for helping get the word out.

We can not afford universal health care until we get three things straightened out:
A. Tort reform - we must put a sensible cap on malpractice suits so that our doctors can earn an honest living and pay for malpractice insurance.
B. Put the brakes on unnecessary tests and surgiclal procedures (e.g. most by-pass surgery and the like)
C. Progressive income tax on everyone making more than $250,000.00 a year (including members of the Senate who killed this proposal earlier this year)

It is great to see so many voices speaking out here. I think the health care side is forming and understanding that President Obama cannot do it alone. If we want change, we all have to step up to the plate.

Eventually, elders will be denied care. It's not Obama. It's not Fox News. The government will run out of money and will decide we just are not worth it. I've heard many say that the largest percentage of dollars are spent in the last few years of life. They'd like to change that. I just know it will happen, especially after we become a smaller voting block.

Stacie & John seem to be under the influence of the last 8 years of doing business.....I hope they "recover...

You are absolutely right about without the public option it is not reform. What wonderfully thoughtful, insightful, reality-based comments almost all of you made!

Thank you again, Ronni! You are a treasure!

Ronni,
I have been out of the country, working in Denmark, where Health Care is an accepted part of their country's system (although they tell me that it's not nearly as good as it used to be and they wish they had a system as good as it is in Italy), and have been too busy to keep up with all my reading. But your courageous and outstanding work on behalf of all Americans inspires me, so I had to let you know that now that I'm home I'll catch up and read all about what you guys did on August 20. Congratulations!

Congratulations to you, Ronni, and all those who responded to your effort. I haven't kept up with blogging and reading recently so am just now learning about this. Given all the plans that are still floating around in the House and a couple in the Senate, am sure we'll have plenty of opportunity to keep writing on health care issues.

I've been appalled by all the same idiotic fallacies some believe believe that you've mentioned in another post.

My Congressman holds telephone conference calls, but declined to attend a town hall meeting on health care. I've been invited (recorded message) to participate in these approximately hour long conflabs and have a couple of times. I've had to listen to what I've concluded is propaganda from other constituents who mostly seem to agree with his positions. I've not been given an opportunity to talk on the group conference. Last time he called on health care, but I didn't join his call, instead choosing the option of calling his office to express my views. His recent news release said an overwhelming majority of his constituents mirrored his position against many of the health care issues. Duh! I wasn't surprised. I wonder what others are experiencing with their Reps. and Senators?

Hubby and I experienced what you did with our representative. He's a republican and it's their agenda to see healthcare reform fail; that's the only way they can rally and seize control of congress again. We're still trying but Utah is sooooo red and conservative.

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