“Sick Sob Stories”? Or A Sick American Health Care System?

John Stossel co-anchor of the long running ABC-TV news magazine"20/20.” takes issue with reports in Michael Moore’s movie "Sicko," that has been commented on in this blog in an earlier post.

Stossel’s column, appears on the Op-Ed page of today’s Wall Street journal http://online.wsj.com/article/SB118964470258225901.html?mod=opinion_main_commentaries

The column carries the headline “Sick Sob Stories”. One such story Stossel takes issue with is that of a widow named Julie Pierce, who, Stossel says “…tells a tearful story: Her husband died of kidney cancer after their health-insurance company denied payment for a bone-marrow transplant that might have saved his life. Ms. Pierce's rage is palpable as she repeats the word her insurers used in response to her husband's request. "They denied it," she sneers. "Said it was 'experimental.'"

Stossel objects to the way this tragic story is portrayed in Mr. Moore's movie, "Any payment for a claim is referred to as a medical loss," he says. "and when a claim is denied, "it's a savings to the company. Viewers of the documentary are meant to understand that "experimental" is health insurance code for "expensive," and that Ms. Pierce's husband was left to die for the sake of profit.”

Stossel, a staunch defender of the status quo in America’s health care system,(watch him in action on an ABC special tomorrow night.) argues that the national health care systems in Europe, which are presented in Moore’s documentary as a better alternative to what passes for health insurance in the U.S., actually offer inferior care. “When government is in charge of health care,” says Stossel, the result is… “that people get less of the care that is absolutely necessary. At any given time, just under a million Canadians are on waiting lists to receive care, and one in eight British patients must wait more than a year for hospital treatment.”

Stossel cites an example that he implies is typical of neonatal care in Canada. “Karen Jepp, a Canadian who gave birth to quadruplets last month, had to fly to Montana for the delivery: neonatal units in her own country had no room.”

“Patients in countries with government-run health care”, says Stossel “can't get timely access to many basic medical treatments, never mind experimental treatments.”

In sharp contrast to Stossel’s defense of the American system of health care, is another article that also appears -in the same issue of the Wall Street Journal- paints an almost unimaginable horror story of cancer care for a woman with breast cancer and how she was treated here in America.

To read about this patient's four-year journey through what the Journal reporter describes as “…the Byzantine U.S. health-care system”. The full article, “MEDICAL MAZE: Legal Loophole Ensnares Breast-Cancer Patients” can also be read at the Journal’s web site at http://online.wsj.com/article/SB118781024289705455.html?mod=home_health_right

Be forewarned, this is one of the grimmest and most outrageous descriptions of the farce that passes as a health care system in this country. “It was an odyssey” the WSJ writer says “that would take her to five hospitals, two clinics, two charitable organizations and two nursing homes in two states. She was denied assistance or care at least six times along the way, for reasons that ranged from not being poor enough to not being sick enough.”

“Ms. Loewe eventually got treatment, but at personal cost and great aggravation. To qualify for charity assistance, she had to reduce her $15,000-a-year income as a hairdresser by cutting back on her working hours and giving up her home.”

Comments about any post in this blog are encouraged and may be sent directly to me at bob@elderlifeplanning.com

Stay Away From That "Free Lunch" Seminar. It's Likely to Give You Serious Indigestion.

I have called attention in earlier posts to fraudulent and misleading sales tactics used to exploit older Americans.This blog will continue to provide ongoing consumer alerts on these deceptive practices, which are becoming an epidemic. They not only result in the financial exploitation of elders, but they create distrust among millions of Americans that discourages them from meeting with well qualified, honest and experienced financial professionals to take important planning steps.

Earlier I reported on what Investment News has called "the Easily Credentialed” That publication reported that, “State securities regulators have begun to view easy-to-get "certified senior adviser" and various "senior specialist" designations with alarm.”

The head of the Wisconsin Division of Securities is quoted as saying “People may use the designation "to create a false level of comfort among seniors by implying a certain level of training on issues important to the elderly," and the "alphabet soup of letters after their names" can be deceptive, she said in a press release.

In todays Boston Globe an article in the business section points the spotlight on another notorious practice- the "Senior Seminar" to lure in elders with the promise of a "Free Lunch"Regulators target fraud against older investors.

By Bloomberg News | September 11, 2007

The globe reports that US regulators are "...stepping up efforts to rein in securities fraud involving seniors,(they) found that more than a third of "free lunch" seminars aimed at older Americans focused on unsuitable or fraudulent investments.

The Securities and Exchange Commission, the Financial Industry Regulatory Authority and state regulators said in a report released yesterday 50 percent of the 110 securities firms investigated made exaggerated claims at the meetings, including promises of adding $100,000 to participants' net worth.

Twenty-three percent of the firms offered inappropriate advice, and 13 percent may have committed fraud, the regulators said.

"The stakes for our investor-protection mission couldn't be higher," SEC chairman Christopher Cox said yesterday at a meeting of federal and state regulators to discuss ways to protect the elderly from fraud. "If we fail, millions of more seniors will be at risk of falling victim to scam artists."

To read the full article click here
http://www.boston.com/business/articles/2007/09/11/regulators_target_fraud_against_older_investors?mode=PF

Improving the Quality of Life in American Nursing Homes is Possible

As I've noted in earlier posts, a major concern related to the future of elder care is whether nursing homes, which are largely owned by private, for-profit companies will be able to survive the continual shrinking of public funding available to pay the nursing home bill.

While those with enough money to pay for their care privately can usually afford to get care at home or at other, more attractive alternatives to nursing homes, 70 percent of most nursing home beds are paid for by the Medicaid program for the very poor.

When the President signed the Deficit Reduction Act of 2005 (DRA)in 2006, the Congressional Budget Office (CBO) predicted that the Act "is expected to reduce federal Medicaid spending by $11.5 billion over the five-year period and by $43.2 billion over the next ten years."

The National Academy of Elder Law Attorneys issued a statement saying that the DRA creates “A health care crisis of unprecedented magnitude for our most vulnerable citizens.”

The nursing home industry, strongly opposed the bill. Many of its members are already facing serious budget constraints. The American Health Care Association, a group representing nearly 11,000 long-term care providers, said the change" leaves the nursing facility (not the state) to collect from individuals who have no funds to pay privately and are not Medicaid eligible during their penalty phase." As a result, some are referring to the start date change as the “The Nursing Home Bankruptcy Act of 2005.”

Hyman Darling, a NAELA attorney from Massachusetts agrees with that assessment. Darling, an estate-planning specialist with the Springfield-based law firm Bacon & Wilson asks, “Who’s going to pay those bills? A lot of times, they simply won’t be paid, and the nursing homes will really suffer.”


It's been more than a year since the law was passed and the number of nursing homes that rely primarily on Medicaid for payment continues to shrink, there are still some emcouraging efforts to improve the quality of life in America's nursing homes.

In yesterday's Daily Herald, a Chicago based newspaper there is an article about the "Pioneer Movement", which advocates changing conventional notions of nursing homes as a place for the dying.


You can read the complete article at this link http://www.dailyherald.com/story/?id=34134


"Increasingly, suburban elder-care providers are adding activities, such as interactive games, happy hour, breakfast clubs and gardening, converting traditional cafeterias into dining rooms, turning bathing into a spa experience and introducing household comforts to a sterile medical environment."

"The Lutheran Home in Arlington Heights, Elmhurst Extended Care Center, Paradise Park Assisted Living and Memory Care in Fox Lake and the Wealshire in Lincolnshire are among those with such changes in place."

"Experts say it signals a growing trend to offer residents more choices and fewer restrictions. While part of the aim is to stay competitive in a growing senior services market, the larger goal is a healthier psychological and social environment for seniors."


"I think eventually it's going to catch on," said Robyn O'Neill, the state's regional long-term care ombudsman representing suburban Cook and Lake counties. "The hope is that it should dramatically change elder care. It certainly is a growing movement, but it takes a long time because people have to rethink (traditional ways)."

"The Pioneer Movement informally began in 1997 when 33 health care professionals, researchers and educators from throughout the country met for three days in Rochester, N.Y., to share their isolated efforts to modernize elder care."

"It has grown into the National Pioneer Network, which brings together a variety of innovative elder care concepts under its umbrella. The coalition's recent national conference in Minnesota drew 1,100 elder-care providers from 46 states, England and Canada."

A short video "The Pioneer Movement: The Changing Face of Eldercare" is available at the following link http://www.dailyherald.com/multimedia/?category=16&type=video&item=1

Lake County elder care