assistedlivingconcerns

When you or a loved one reaches the time best to check into an assisted living facility, you will be offered a residence only after you are judged by the provider as qualified and upon your willingness to sign an agreement prepared by the provider.
In essence, the agreement must be accepted with no caveats leaving you with two options, sign or leave. After you have signed, you acquire two more options, you can complain and or you can move out.
Let’s say you have a complaint, which you feel deserves attention and resolution. Best to submit it to management in a written form. As an example you regard the policy of raising rates as unfair because since you signed on, the staffing levels were reduced meaning that you are paying more for less care and services.
Management ignores your complaint. You hire a lawyer, apprise him of the issue, and after looking into the matter, you receive a report indicating that you have no recourse because the law sides with the provider. Attached to the report is a bill. Next, you appeal to the government agency that licenses the provider, only to learn that your lawyer was right. Not willing to accept defeat, you begin the long, tedious process of documenting how the reduction of staffing has had deleterious affects on the residents. Next, you solicit the aid of your elected officials, only to hear a repetition of the information you gained from the lawyer and the licensing agency.
At this point you fall back and take a look at your options. Two come to mind: 1. You can complain, and 2. You can move out. Health care in America is determined by the age-old practice of providers scratching the backs of lawmakers with contributions to their reelection funds. The message is clear: “If you want to stay in office play along with those that have the most money.”
Wouldn’t it be nice if lawmakers were required to carry a sign revealing how much mullah had taken in relevant to the issue before them at voting time? But don’t hold your breath before that happens. There are web sites that tell you how much a particular elected official has received from contributors. So what? It’s all legal since the very people who stand to benefit from them created the self-serving rules. You gotta love this country!
Getting back to the matter of assisted living, bite your lip when you sign the agreement with your senior care facility and remember, you have two options once you’re on board, You can complain and you can move out. Personally, I have stopped stewing over my disappointment with management, but I will never stop complaining.
Believe it or not, I have obtained some needed changes, but only when it was a matter of complying with building codes that it would have been illegal to ignore.
Maybe management views me as a modern “Don Quixote,” nevertheless; I accept the role of advocate despite the fact that it engenders no monetary emoluments. One thing of which I am certain, it’s that the Peter Principle is alive and well in today’s society. You can see it in our Congress in full array and every other place that you care to examine. Think of our auto industry, fighting improved emissions, safety belts, air bags, crash tests and radial tires all of which handed the auto industry to the Asians. And then we have the American health care industry, which offers some of the people some of the benefits of modern medicine, while ranking 35th world wide as a health care provider at twice the cost of the providers that rank above us, all the while those providers offer health benefits to all of its citizens, not to just some.

Daniel Goldhill, a business executive, wrote an essay about how his father was killed by a hospital-borne infection in the intensive-care unit of a well-regarded nonprofit hospital in NYC. Admitted as a pneumonia patient, he acquired sepsis and died five weeks later, becoming one of the 100,000 Americans whose deaths are caused by hospital-borne infections each year.
According to the author, about a week after his father’s passing, he came across an article in the New Yorker about a procedure developed by Peter Pronovost who offered a checklist of ICU protocols regarding hand washing and other basic sterilization procedures to reduce the incidence of fatal hospital-borne infections. Hospitals that have introduced Pronovost’s plan have seen a reduction of infections by 2/3rds. However, many physicians have rejected the plan as demeaning and un-necessary.
The author was at a loss to understand how Pronovost has had to literally beg hospitals to implement his simple cost-free procedures; especially since the health industry loudly protests the high cost of liability insurance and the injustice of the tort system.
The author has expressed amazement that our government will shut down a whole industry for a single illness from a suspicious hamburger while tolerating the wholesale death of hospital patients from infections. He cited a Wall Street Journal article claiming 200,000 patients die in hospitals from blood clots after surgery or illness each year, calling it the leading cause of preventable hospital deaths.
After doing as much research as possible, this grief stricken son concluded that the hospital industry has missed out on the revolution in quality control and customer service that has swept all other consumer-facing industries in the past two generations. He wondered why the health care industry continues to get away with poor customer services, unaffordable prices, and uneven results –a reason his father and so many more are unnecessarily killed from preventable deaths in hospitals.
After examining the business end of the health care system, he believes that the incentives used by the industry emphasizes health care over any other aspects of health and well being, which emphasizes treatment over prevention, that disguises true costs, that favors complexity and discourages transparent competition based on price or quality. The result, he contends, is a generational pyramid scheme rather than sustainable financing, removing consumers from our irreplaceable role as the ultimate ensurer of value.
For these reasons, our health care system has produced the national dilemma of runaway costs and poorly covered millions and, sadly, the health industry believes that these conditions don’t need to be solved, but rather are papered over, worked around and patched up. He goes on to conclude that the current health care reform effort in Congress essentially cements in place the current system—insurance-based, employment centered, administratively complex health care.
He recommended that the foundation of our health system must be fixed, which is, largely problems of incentives. To accomplish this, health care must ne subject to the same forces that have boosted efficiency and value throughout the economy with the end result that the consumer becomes the ultimate guarantor of good service, reasonable prices, and sensible trade-offs between health care spending and spending on all other good things money can buy. We need to step back and examine our basic assumptions about health care—what it actually is, how it’s financed, its accountability to patients, and finally, its relationship to the eternal laws of supply and demand, all of which are considerations outside the emerging political consensus about reform.
My personal reaction to the above information is primarily one of disbelief. The article was featured in the Atlantic, a well-known international magazine that has enjoyed an impeccable reputation. Surely, someone has brought this matter to the attention of the proper authorities, especially to those currently engaged in the reform of our national health care system at Congress. But, alas, it is apparent that the health industry has imposed its will, once again, on the lawmakers with generous financial aid to their reelection funds. Senator Baucus, a former president of an insurance company, has put his stamp of approval on the bill with his position as Chairman of the powerful Senate Finance Committee. Let us hope his intentions are in the interest of the consumers of health care and not insurance companies.
It is strange that when a child gets sick from a hamburger or canned tuna the government starts shouting for all to hear, “Here I am to save you from further harm. I’m your ever vigilant protector.” But, an alarm about unsafe practices in our hospitals is met with total silence from that same self-proclaimed protector, our government. Strange indeed!

Public Option Health Care Option

Professor Jacob Hacker of Yale University is regarded as the patriarch of the Public Option. Long an idea to establish a government-run insurance program, an idea met with apparent death this past Monday when the quixotic U.S. Senator from Connecticut, Joe Lieberman, changed his mind and opposed it. Anxious to get a health care bill through no matter what, the Democrats buckled and bowed down to Mister Switcheroo. There is little hope that the conference between the Senate and the House will include the Public Option, nevertheless there is always the possibility that somewhere down the line it may come up for consideration again.

I support the Public Option proposal because it will serve as a competitor to the profit driven health insurance industry. Competition is the soul mate of progress in a democratic society. Competition will encourage the introduction of better health delivery systems, reduce the paper trail and promote better medicines. Without the Public Option benefit, the current proposal is a trillion dollar gift to the private health care system. Various presidents since Abraham Lincoln have favored the idea of universal health care for its citizens, but every time the insurance industry has risen up and funded enough legislators to persuade their support to kill the idea in spite of the fact that the majority of our citizens have wanted change. And today is no exception.

Aside from Lieberman’s conduct, even important Democratic Senators opposed the Public Option, namely: Baucus, Nelson, Landrieu, Lincoln & Kent Conrad. Each has received substantial contributions from the healthcare industry that also opposes the Public Option plan. It’s no surprise that Baucus was president of an insurance company before becoming a Senator, while Joe’s connection with the insurance industry has been so close that he is often called the Senator from Aetna because that company is located in his state.

The basic idea of the Public Option is to have a single source of financial aid to fund the program, usually the government though some countries that have universal health coverage use a joint private/government fund. Most universal health programs have decentralized systems, dividing the operation into sub divisions like states or counties. Each of those districts administers the program independently, receiving funding according to its population and special circumstances.

In June of 2009, The New Yorker carried an article called ”The Cost Conundrum,” which compared the Medicare costs per capita for two poverty stricken towns in Texas: El Paso and McAllen, both border towns with similar poverty rates 27% and similar median household income along with overwhelmingly Hispanic populations (between 76 and 80 percent.) The cost conundrum lies in the the fact that Medicare costs per enrollee at McAllen are $15,000, while at El Paso, those costs are $7,500, half as much with no indicators that shows much of a difference in health levels. The difference between the two entities seems to lie in the accountable care system each city has employed.

How do opponents of the Public Option continue to support the current system in the USA when it ranks 37^th among world health care programs with France #1 and with every European nation, Japan and Singapore rated above us? In Sweden, e.g., every community has a health care facility that contains a first aid center, an adult day care service and underneath the building a bomb shelter. Despite all the additional services rendered to its citizens in Sweden and other European countries, they spend far less than is spent in the USA where 16% of the GDP (Gross Domestic Product) is spent on healthcare. In Europe, the costs range from a high 10% down to 4 %. Translated into dollars, $6,000 per capita is spent here in the U.S. while among European nations costs run as high as $3,000per capita down to $2,000. We spend more on health care and yet our health care program is ranked 37^th in the world

In 1980, President Ronald Reagan declared “Let free enterprise reign” and every health insurer switch from a non-profit to a for-profit organization making them profiteers who care more about the bottom line than they do about healthcare and research.

There are many serious questions to be ironed out in the process of seeking the way to improve health care while cutting costs. One area that needs attention is the difference in pay between primary care doctors and specialists, which is huge. It is no surprise that many primary care physicians are leaving the field of medicine altogether or are entering the specialized sector. Paper work is also a major factor in the discontent of the primary care physicians. Although the health care industry rants against a government run system, most doctors depend on the military or Medicare grants to become doctors. It seems that the citizens of America have a convoluted opinion of governance, angry about taxes but wanting more from the government at the same time. What they get from their elected officials are unfunded programs that strap communities. Everyone wants good health care, but they grouse about paying for it and at the same time fall for the stories being spread by the health industry funded extremists as well as the politicians who keep office by cow-towing to the groups that stuff their reelection coffers, insuring their continued service in Congress to the detriment of their constituents.

There are so many challenges to the health care industry that it boggles the mind. How to convince people that by abusing their bodies they are creating a self made risk to themselves and to the public at large. Engorging themselves with fatty foods while believing diet drinks will solve their problem of obesity, solution they pass on to their children. But by far the greatest challenge facing the healthcare system is the overuse of drugs, especially antibiotics, which has seen the growth of drug resistant killer infectious diseases. We all breathe the same air making the problem of reining in these killers even harder. Incredibly, most of the patients plagued with drug resistant infections go untreated, a circumstance that under the present health insurance program makes such afflicted souls ineligible for insurance or care. In short, our current system is shooting itself in the foot because what goes around comes around.

In honor of the death of the Public Option, let us pay tribute to the man that killed it.

Friends, Romans and countrymen, lend me your ears;

I come to bury the Public Option, not to praise it;

The evil that men do lives after them,

The good is oft interred with their bones.

So let it be with the Public Option – The noble Lieberman

Hath told you that the Public Option was ambitious:

If it were so it was a grievous fault,

And grievously hath the Public Option answered it …

Here, under leave of Lieberman and the rest,

Come I to speak at the Public Option’s funeral …

It was my friend, Faithful and just to all:

But Lieberman said it was ambitious;

And Lieberman is an honorable man,

He has brought many bills to the floor,

Whose contributions did his general coffers fill:

Did this of the Public Option seem ambitious?

But Lieberman is an honorable man …

When that the poor have cried, the Public Option hath wept:

Ambition should be made of sterner stuff:

Yet Lieberman says the Public Option was ambitious:

And Lieberman is an honorable man.

You all did see that on the Lupercal (a Roman annual festival)

Where thrice the Public Option was presented a kingly crown,

Which it did thrice refuse; was this ambition?

Yet Lieberman says the Public Option was ambitious.

And, sure, he is an honorable man.

I speak not to disprove what Lieberman spoke,

But here I am to speak what I do know.

You all did love the Public Option once, not without cause:

What cause withholds you then to mourn for the Public Option?

O judgment thou art fled to brutish beasts,

And men have lost their reason… Bear with me;

My heart is there in the coffin there with the Public Option.

And I must pause till it comes back to me.

You wont find it in this world, nor will you find it in an old timer’s home, which now goes by a fancy title, namely, an Assisted Living Facility for seniors. But when push comes to shove and you have little option left, finding a nice one can be as good as it gets, if. So be careful that you check it out carefully to make sure it’s right for you and or your loved one. I. Personally chose the help of a professional to find a suitable place to bed down for how ever long it will take for me to move on to the real paradise.
Kira Reginato is a professional Geriatric Care Manager operating under Living Ideas For Elders (LIFE), who gave me good advice and recommended a small group of places that she knew to be among the best places in San Francisco for seniors that were most suitable for my particular needs.
Although my new digs are comfy and homey, for me there was a period that I needed support to cope with special circumstances, Kira was there to help with recommendations that put me in touch with a therapist who gave me the advice and support I needed.
People in this senior facility are as gracious and caring as anyone would hope to find anywhere. And the staff couldn’t be better. It’s my belief that this residence is an icon as far as a home away from home can be, but that doesn’t mean it couldn’t be better. If you’re looking for paradise, you wont find it at a senior facility, but if you’re looking for the best that a place such as this can be, that is possible and my personal experience has proven that such a search is achievable.
To sum up, when and if you face the moment when change of venue comes knocking on your door; get professional help to aid your search for the right place. Testing places with a series of temporary stays is a bad alternative from the stories I have heard from those that pursued that route or by walking into a place cold and being sold a bill of goods by a sweet talking salesperson. Most places will give a guided tour and a lunch for the prospective resident and the family. Speak to residents, ask to visit a resident’s apartment, not the showcase one on exhibit. Look at the calendar of activities and try to attend a social function where a performer is scheduled to entertain the residents. Read the agreement with someone that understands contracts. Watch out for clauses that allow rent increases without being specific.