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Rationing Health Care for Seniors



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No. 10
from elkpark
Old Aug 08, 2009, 07:47 PM

Default Re: Rationing Health Care for Seniors
I've seen plenty of hopeless, futile cases maintained in ICUs for weeks or more -- "regular" people. I don't think the scenario in the OP is that out of the ordinary, or represents any kind of remarkable treatment.

I didn't realize it's routine treatment to ship (even) 88 year olds to a SNF "to die" within a week of having one or more CVAs ...
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No. 11
Old Aug 08, 2009, 07:48 PM

Default Re: Rationing Health Care for Seniors



Originally Posted by CapeCodMermaid View Post
MY health care decisions are mine alone. Mine and my doctor and my insurance company. I trust either one of them far more than I do the government.
My point was more about preferential treatment given to celebrities.
No one is being condescending OR intending to be that way towards you as a person. One of the goals of PNHP is to preserve the patient doctor relationship. Doctors are spending 8+ hours per week dealing with denial of service issues which is a real concern. Evidence based reimbursement practice guidelines should result in improved care and reduced bureaucracy. I agree with our concerns about rationing care based on ability to pay which is really driven by a profit driven health care system.

I encourage you to read the material available from PNHP.

No. Socialized medicine is a system in which doctors and hospitals work for and draw salaries from the government. Doctors in the Veterans Administration and the Armed Services are paid this way. The health systems in Great Britain and Spain are other examples. But in most European countries, Canada, Australia and Japan they have socialized health insurance, not socialized medicine. The government pays for care that is delivered in the private (mostly not-for-profit) sector. This is similar to how Medicare works in this country. Doctors are in private practice and are paid on a fee-for-service basis from government funds. The government does not own or manage medical practices or hospitals.

The term socialized medicine is often used to conjure up images of government bureaucratic interference in medical care. That does not describe what happens in countries with national health insurance where doctors and patients often have more clinical freedom than in the U.S., where bureaucrats attempt to direct care.
http://www.pnhp.org/facts/singlepaye...php#run_system
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No. 12
from Moogie
Old Aug 08, 2009, 08:04 PM

Default Re: Rationing Health Care for Seniors
Originally Posted by CapeCodMermaid View Post
My point was more about preferential treatment given to celebrities.
It's unfortunate but yes, celebrities and the wealthy do indeed get preferential treatment. I remember one time being assigned to a gentleman who was the wealthy owner of a Fortune 500 company. My head nurse (yep, it was that long ago!) told him that no matter what, if he rang his call light, for whatever reason, his would be the first one we'd answer.

I always aspired to give high quality care to my patients, regardless of their financial situation, their celebrity or their anonymity. I also answered call lights in the order in which they rang unless I knew one of the patients might have an immediate need, such as having to use the bedpan.

The wealthy patients could afford to donate huge amounts of money to the institution, so that's why they often received preferential treatment. I guess I am naive but I should think we give good care to everyone, not just celebrities, for the sake of giving good care---not for kissing up to someone in the hopes of getting a donation.

I would hope the notion of preferential treatment of celebrities and the affluent would diminish with health care reform. Not sure that's going to happen.
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No. 13
from UKRNinUSA
Old Aug 08, 2009, 08:13 PM

Default Re: Rationing Health Care for Seniors
Originally Posted by CapeCodMermaid View Post
MY health care decisions are mine alone. Mine and my doctor and my insurance company. I trust either one of them far more than I do the government.
You would do better to be more wary of your insurance company. Right now, they, along with other healthcare insurance lobbyists are spending $1.4 million per day to block healthcare reform -their motive -to provide you with excellent care? I think not -they want to preserve the status quo so they can continue to post profits made at the expense of the people they insure. How are these profits made?- by denying coverage to those with pre-existing conditions, raising your premiums until they are virtually unaffordable, canceling policies retroactively and denying care prescribed by your physician. Insurance horror stories abound e.g. http://www.truthout.org/article/paul...horror-stories

I get your point about celebrities getting preferential treatment -it irks me too, but you know how hospitals are about their celebrity clients. However, for me its just another example of the health care inequity that affects millions of us in the USA. I get more upset about about things like William W. McGuire, CEO of United Healthcare, receiving compensation of $125 million in 2005. I wonder how many patients were denied care to finance that.
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No. 14
Old Aug 08, 2009, 08:42 PM

Default Re: Rationing Health Care for Seniors
At least with an insurance company you can appeal the process, reversing a decision in Medicare or Medicaid is almost impossible.

I don't want government to control my health care.
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No. 15
from UKRNinUSA
Old Aug 08, 2009, 08:58 PM

Default Re: Rationing Health Care for Seniors
What do you believe is Obama's motive for healthcare reform?
What do you believe is the healthcare insurance lobbyists motive for resisting healthcare reform?
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No. 16
Old Aug 08, 2009, 10:23 PM
Updated Aug 08, 2009 at 10:29 PM by caroladybelle

Default Re: Rationing Health Care for Seniors
Originally Posted by CapeCodMermaid View Post
Shriver was admitted to the hospital after suffering a series of strokes, the Associated Press reported early this morning. The Special Olympics spokeswoman would not confirm that report.

If this were any 'regular' 88 year old woman on Cape Cod, she would already have been sent to a local SNF to die..not kept in the ICU. I am truly sorry for the Kennedy family, but this is just one example of how health care is being rationed already. It'll get even worse if Obama's plan goes through.
I have seen plenty of 90 something year olds s/p a cva, with several comorbidities spend weeks in the ICU. I have had 88 year olds with dementia, whose family insisted that they get chemo for pancreatic cancer, and would have had a whipple done if a surgeon would have done so. I have had patients that were contracted into the fetal position, have had dementia for years, whose families have insisted on them being kept on the vent for weeks. And none of them have had celebrity, money or any undue connections.

My 95 year old Grandmother, who had a living will specifying DNR status, was transferred without notifying her family, and had a pacer placed, ending up on the vent. Her private MD REFUSED to make her a DNR, despite her stated wishes, families wishes....and was kept on the vent until her death. She had no connections and little money.

-----------------------------------------------------------------------------------------------------------------------------------------------------------
And right now, I am so tired of both sides/parties. The nation needs healthcare reform, but it does not need it "immediately" and no program that comes out this abruptly will be workable. And all this talk of death squads/fake birth certificates make the other side look even worse. They are too busy competing with one another, to actual do any good anymore, and make the whole nation look bad.

If one is going to complain about bias....there really should be some actual bias involved. And in this case, there is not.
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No. 17
Old Aug 08, 2009, 11:05 PM
Updated Aug 08, 2009 at 11:12 PM by HM2VikingRN

Default Re: Rationing Health Care for Seniors
Originally Posted by MedSurg32RN View Post
At least with an insurance company you can appeal the process, reversing a decision in Medicare or Medicaid is almost impossible.

I don't want government to control my health care.
Government through its police powers is involved at every level of health care. Gov't regulates licensure, professional training /certification, drug safety, etc. It bears repeating that the proposed structure of health care reform has absolutely nothing to do with government control of service delivery. if anything the reform proposal will bring transparency and real competition into the process. If you pop over to the activism thread you will find post after post about patients having needed care denied. Our system is seriously broken. If you look at where we are headed by 2020 family coverage will cost over 20,000/year. That money comes out of YOUR pocket.




Equity: The U.S. ranks a clear last on all measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick, not getting a recommended test, treatment or follow-up care, not filling a prescription, or not seeing a dentist when needed because of costs. On each of these indicators, more than two-fifths of lower-income adults in the U.S. said they went without needed care because of costs in the past year.



Healthy lives: The U.S. ranks last overall with poor scores on all three indicators of healthy lives.
The U.S. and U.K. had much higher death rates in 1998 from conditions amenable to medical care?with rates 25 to 50 percent higher than Canada and Australia. Overall, Australia ranks highest on healthy lives, scoring first or second on all of the indicators
http://www.commonwealthfund.org/Cont...can-Healt.aspx

We can definitely design and implement a better system through the political process. Health insurance companies make money by delaying/denying care...........

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No. 18
Old Aug 08, 2009, 11:26 PM

Default Re: Rationing Health Care for Seniors
I guess we are reading the situation two different ways.

I live in MASS where health care is mandatory or you pay a fine. Our state is in rough fiscal shape. All our taxes have gone up including our sale tax.

Several of our critical access hospitals are in bankruptcy and may close. Nursing jobs are hard to come by. We have the longest waits for MD appointments, last I heard it is about a 90 day wait to see a specialist.

You would think it would be wonderful if everyone had health care. Do I think it is time for this to go Nation wide ? I don't think so.


I also hear that cancer survivorship is greater in the USA than the UK or Canada.

Yes, health care needs to change, but to rush through a 1000 page plan without questioning it would be stupid.
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No. 19
Old Aug 08, 2009, 11:41 PM

Default Re: Rationing Health Care for Seniors
http://finance.yahoo.com/insurance/a...surance-health

1. Freedom to choose what's in your plan

2. Freedom to be rewarded for healthy living, or pay your real costs

3. Freedom to choose high-deductible coverage.

4. Freedom to keep your existing plan

5. Freedom to choose your doctors


Unfortunately I had to buy a car last week. It was the first week of cash for clunkers. I did not have a clunker but it was the most painful delivery of a car due to the government program. All the computers ground to a halt due to the government's mis management of one simple program.......all my husband kept saying now they want to manage healthcare ?
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