Healthcare is NOT a basic human right. - page 36
If one were to read the Constitution one would realize that the Constitution does not grant anyone freedoms, liberties, or rights. The Constitution only protects freedoms, liberties, and rights from... Read More
1Oct 7, '12 by cdsgaAs I know some do-they buy the cheapest car insurance in order to get their car tag, then let it lapse after they get the tag/registration for the year.
The same thing will happen with other purchases that are forced. They bet on NOT getting caught, NOT getting sick.
Driving a car is a privilege and a choice. You don't have to drive. You can take public transit and pay to ride, or you can ride with someone else who foots the bill for the car. But you won't have the maintenance, the upkeep, the fuel cost or the insurance to buy.
You don't have to work, you can get public assistance-where the people who do work pay for the ones who don't through tax dollars who fund public programs.
Same thing will happen with health insurance that is mandated.
0Oct 7, '12 by RNfasterQuote from cdsgaHmm...I'd like to see some statistics on that... I would have thought the greatest expenses would be for cardiac surgeries, transplant surgeries, chemotherapeutic drugs, and such. Many of those things give folks quite a bit more time. Maybe you are including those things in the definition of "end of life care"? I would think hospice/palliative care would not be as expensive as the other items.... I could see it being a great expense for some folks who have not been sick much....as hospice towards end of life would require more intense monitoring to ensure the patient is comfortable.The biggest amount of money spent in healthcare is end of life care.
0Oct 7, '12 by RNfasterQuote from cdsgaI think some folks do that already. Makes me wonder about the notion of universal healthcare. I personally have health insurance through my work, but it seems to me that universal healthcare is socially just as I view healthcare as a human right... I also think that if we provide early education/prevention/intervention and have a 100% pool that costs should come down over the long run.Same thing will happen with health insurance that is mandated.
Relative to your other comment about end of life costs... After working in healthcare for a time, my view on heroic interventions at end of life has changed... I am inclined to say that for myself, I would like to be a DNR as the time comes... I am more okay with the concept of palliative care say in the face of certain forms of advanced cancer, as often the cure comes at great costs physically, emotionally, and spiritually. I think we have to look at cost benefits of a procedure (and costs should not just include monetary costs)....especially in a universal system....and even in our current system.
0Oct 7, '12 by tntrn"I could see it being a great expense for some folks who have not been sick much....as hospice towards end of life would require more intense monitoring to ensure the patient is comfortable"
My father passed away on September 2 and was on hospice care since mid-May. He lived in his own home until July 29 at which point he went to a nursing home, because one of my sisters needed to return to her home in Alaska, and i couldn't be there until August 8 from my home in the Seattle area. (He elected to stay there after I arrived.) During his time at home and at the nursing home he was still under hospice care (we will pay the nursing home costs), he had a nurse visit twice a week and a social worker more or less weekly. Thus, very little monitoring of any kind. Pain questions were just that: how are you, where do you feel pain, is it better or worse than before, do you think something else needs to be done. Most of his routine meds were dc'd along the journey for various reasons (his vitamins were too big for him to swallow and useless for what lay ahead. I have no idea what the hospice charges to Medicare were (we didn't get or haven't yet anyway any information on that.) And as I said, we are responsible for his month of nursing home care.
Nothing that will is considered curative is covered by hospice. A patient can decide to go off of hospice to resume curative care, however. But at that point, the costs incurred would not be due to hospice. Possibly end of life and pricey, but not due to hospice.
So I hardly think hospice care accounts for huge end of life costs. I have no figures to back that up, but he was never seen by an MD and except for nighttimes at the nursing home and meds administered there, my sisters and I did everything. Everything.
0Oct 8, '12 by DoGoodThenGoQuote from RNfasterEnd of life healthcare costs:Hmm...I'd like to see some statistics on that... I would have thought the greatest expenses would be for cardiac surgeries, transplant surgeries, chemotherapeutic drugs, and such. Many of those things give folks quite a bit more time. Maybe you are including those things in the definition of "end of life care"? I would think hospice/palliative care would not be as expensive as the other items.... I could see it being a great expense for some folks who have not been sick much....as hospice towards end of life would require more intense monitoring to ensure the patient is comfortable.
The Cost of Dying: End-of-Life Care - CBS News
Medicare Beneficiariesâ€™ Costs Of Care In The Last Year Of Life (slightly older data)
0Oct 8, '12 by cdsgaWhen you are talking end of life care you take into effect the percent of cost overall. I would suppose that the least amount of money would be spent on younger people, who are healthier. Of course catastrophic illness/trauma is very expensive but when you take into account vast population spreads-these situations are not as prevalent as elder care who need extensive therapy, continuous care, massive amounts of medication and are not ready for hospice or able to be taken care of at home. This is pretty general knowledge.
0Oct 8, '12 by RNfasterQuote from tntrnI'm sorry about your father... I am glad you and your sisters were able to be such a comfort to him."So I hardly think hospice care accounts for huge end of life costs. I have no figures to back that up, but he was never seen by an MD and except for nighttimes at the nursing home and meds administered there, my sisters and I did everything. Everything.
I would like to learn more about where all the money in healthcare goes... Googled this..
Medicare Gaps Leave Many With Big Bill at End of Life, Study Finds: MedlinePlus
EXCERPT: "In the last five years of life, out-of-pocket co-payments and deductibles, and the high cost of home care services, assisted living and long-term nursing home care cause 25 percent of seniors to spend more than their total non-housing assets, the study found.
"The biggest problem for many families is covering long-term care," said study author Dr. Amy Kelley, an assistant professor of geriatrics and palliative medicine at the Mount Sinai School of Medicine, in New York City.
Kelley and her colleagues found that the average out-of-pocket health care spending by households of Medicare recipients in the last five years of life was nearly $39,000. And 10 percent of recipients spent more than $89,000, while 5 percent of recipients spent more than $139,000.
More than 75 percent of households spent at least $10,000, while 11 percent of single and 9 percent of married households spent more than $100,000.
The amount of spending varied with the person's illness. Those with Alzheimer's disease or dementia spent the most for health care, averaging about $66,000, more than double that of those with cancer or gastrointestinal disease, who spent about $31,000.
"To be 90 percent sure your expenses [at the end of life] will be covered," Mitchell explained, "you would need about $400,000, plus the cost of purchasing Medigap," an insurance policy sold by private insurance companies that supplements Medicare benefits, in an effort to cover the gaps in health care coverage."
I sure would like to know where all the money goes in long-term care... I worked in long-term care for a period...we were chronically understaffed and under-supplied...we were also in an old decrepit building...and we were underpaid... (at least I was...but it was good to have a job...)
I keep remembering the purpose of this thread..."is healthcare a human right?" Doesn't it seem that we should have the right to die with healthcare? Doesn't it seem that it's the right thing to do as a society?
0Oct 8, '12 by cdsgaRNFaster-great entry. It's a sobering thought-and I too wonder where the money goes. I know when you put someone in a nursing home-someone has to be made power of attorney and all that person's assets with the exception of house and car are liquidated to be able to go on medicare/medicaid-any savings, investments etc, go to the long term care.
With the new ACA, even though they say there won't be death panels. I think it will be a matter of time, they may change the name, but the financial issues will prohibit large amounts of money spent on fruitless efforts to extend life. It will be called something like "Quality of life Panel" or something like that to make it sound politically correct and more sensitive, but no longer will they be able to put gobs of money into the terminally ill just so the family can adjust to the reality of their loved ones passing on.
It makes advance directives and durable power of attorneys so much more important. People don't want to face it-but each of us will have to make that determination one day, the more you discuss it the better everyone has a handle on how their loved one wants to live out their last days/months/years.
0Oct 8, '12 by RNfasterQuote from DoGoodThenGoTHank you for the articles... I found the CBS story and the "Medicare Benificiaries - Costs of Care in the Last Year of Life" especially compelling. With regard to the CBS item, I think they presented several valid arguments that I better understand now that I have worked in healthcare and seen what I consider excessive interventions....things that end up just decreasing quality of life towards end of life... Here's a quote from the CBS article:
"Often the best care is saying 'Let's see how you do on this particular treatment for a couple of days. And see if you respond.' Not necessarily doing a lot of tests," Fisher said. "The best care may well be staying home with a trial of a new medication, rather than being admitted to a hospital where you can be exposed to a hospital-acquired infection. We have a system that rewards much, much more care."
I think we as a society should ensure the dying are cared for....
In the other article - Medicare Beneficiaries, I was struck by the fact that the poor were disproportionately affected by ESRD (something that significantly escalated costs).... I can't help but wonder if better care and education through their lives might alter those statistics.
I think it is good for us as a society to take the lead in intervention...and to provide healthcare... I can't help but think it will ultimately lead to lower costs if we are receive better care early on...
Looks like everyone is waking up and making some posts...