Posted on 10/20/2011 8:58:06 AM PDT by 2ndDivisionVet
Sarah Palin warned of government “death panels” on her Facebook page and was nationally ridiculed. Politifact.com awarded Palin with the “Lie of the Year” for that statement. President Obama called her out during a joint session of Congress saying the claim is “a lie, plain and simple.”
I thought of Sarah Palin when I heard the story of Helen Wagner. Helen is 91 years old and is the mother of my sister-in-law Peggy. Give Helen five minutes and she will list a dozen times she has held death at bay. But now she is up against a much greater force: Medicare.
Helen lives with Peggy and my brother Bob. In August, she fell and broke her arm. In the emergency room at Lansdale Hospital, a doctor examined her and determined that the fall was probably caused by a minor stroke, possibly two. He was also concerned about a spot he saw on her lung on an X-ray. The doctor ordered more tests and said Helen would be “admitted.”
Only she wasn’t. Instead she entered a Twilight Zone of new Medicare regulations. Two days later the hospital called and said Helen would have to be picked up. When my sister-in-law asked about the tests, she was told they had not been done. In fact, Helen was never admitted to the hospital. She was just being “held for observation.”
A flurry of dialogue among the hospital, my brother and sister-in-law and doctors lasted four days and ended with a threat that Helen would have to be picked up or she would be transported to a nursing home with an available bed and the family would be billed.
My sister-in-law rushed to the hospital where, she says, her mother was weak and barely conscious. Peggy navigated her Mom’s broken arm and bruised leg as she dressed her and wheeled her out of the hospital. There were no discharge papers. (Lansdale Hospital would not comment on this specific case because of privacy laws.)
Helen and her family are just one of the latest victims of new Medicare regulations, and an even more recent crackdown on those regulations that cause agita for hospitals and heartbreak for families who care for the elderly.
The cost-saving rule is just a few years old and requires hospitals to hold some patients “for observation” instead of admitting them. The difference in terminology means that the hospital is reimbursed far less money than they would have if the patient had been “admitted.” When I asked a spokesperson from the hospital to tell me the difference in care between admission and observation, I was told, “There is none. It is just billing.” And yet, one would have to believe, that hospitals are reluctant to conduct tests that will be under-compensated or not covered at all.
Observation can last up to five days, according to the new rules. That may explain the hurried need to get Helen out of the hospital on day four. If a hospital doesn’t adhere to the Medicare regulations, it will face an audit that could mean a huge loss of federal reimbursement dollars.
The burden on families is even greater. If a patient is not admitted, rehab at the nursing home is not covered by Medicare. Even if you have private insurance, many companies base their criteria on Medicare. If Medicare is not covering, the insurance company isn’t either.
My brother and sister-in-law recently had a meeting with administrators at Lansdale Hospital, including the COO, who called the new Medicare rules “the bane of our existence.” Thousands of families have complained since “observation” started over five years ago.
According to the Centers for Medicare and Medicaid Services, “observation” status claims climbed 26.7 percent from 2006 to 2009—from 828,353 to 1.131 million. The increase in claims for “observation” patients kept for more than 48 hours is startling. It tripled from 26,176 to 83,183.
Observations are supposed to be limited to 24 or 48 hours, with five days being the absolute maximum. CMS believes this shows hospitals believe many patients are too sick to go home and feel pressured into not admitting them under Medicare rules.
So what is the criteria for who gets to be admitted and who gets “observation”? Those who don’t get admitted don’t meet the “evidence-based criteria.” A minor stroke, for instance, can be seen as part of the normal aging process. Helen Wagner, like many people who make it to 91, has a pacemaker and can’t undergo an MRI, the test that would provide evidence of a stroke and its severity.
Helen is now at St. Mary’s nursing home. St. Mary’s is also feeling the Medicare pinch and support Bob and Peggy’s efforts to get the “observation” status changed to admission. The matter is going to an appellate board.
When I heard Helen’s story about a new crackdown on government rules that can impact a patient’s care because of their age. I couldn’t help but think that maybe Sarah Palin was right.
YES! The “Scooter Store” AND FREE Shoes, too! And, viagra, too....buy your own da*n stuff!
They had a living will on file already, they wanted permission to kill me, via a DNR.
They had a living will on file already, they wanted permission to kill me, via a DNR.
Good Grief, that is a special converation between you and your doctor. Not a policy. We have come a long way lately.
She was particularly vocal about it almost every time she was interviewed.
The way to handle it is stop all liberal/progressive/socialist policies. This is very simple to explain, and it is the absolute solution.
If you didn’t hear this from Palin, it’s because you were mistakenly listening to Tina Fey.
This is the kind of comment that makes me want to run away screaming.
It is NOT simple. Start a thread here on FR about how we should simply "stop" Medicare and Social Security, and wait for a third of the Freepers to start whining about "we paid in" and "we were promised".
Think of it this way. Complex topics (like economics or politics) can be organized by varying levels of specificity. In the big picture, you have the general principles such as individual liberty and limited government. More specific ideas for example include things like the individual mandate of Obamacare.
General concepts are for the most part simple to explain. This is what I meant.
What needs to be pointed out is that the general principles are always the most important, in that they are the starting point and the foundation. Palin’s unique strength is that her consistent advocacy of the general principles of conservatism are backed up by the specifics of her successful record as Mayor, Commissioner and Governor.
As for the claim about Freepers, it seems as though the premise of your argument is that all people ultimately want handouts so we shouldn’t even bother with conservatism.
There are a lot of Freepers (not a majority, but I would guess at least 20-30 percent) who think that somehow we have to find and refund "their money" that they "paid in" to SS and Medicare.
They don't understand that the money's gone, and only by a massive tax hike on the next two generations will they ever get their "return".
They also don't understand that these programs do not have any guaranteed payback - Congress (Dem or GOP) can cut them by any amount, any time.
It's not like I have despaired of conservatism.
Rather, it's that with so many people on this hard core conservative forum who have self-deluded themselves about what they are "entitled to receive" I do despair of convincing a majority of the public at large, who are even more deluded by far.
“only by a massive tax hike on the next two generations”
I have good news for you. Lowering taxes will bring in more revenue due to increased productivity. There are ways to lower taxes that would in all likelihood more than compensate for current deficits. And fix the job problem.
Conservatism works every time it’s tried.
“only by a massive tax hike on the next two generations”
I have good news for you. Lowering taxes will bring in more revenue due to increased productivity. There are ways to lower taxes that would in all likelihood more than compensate for current deficits. And fix the job problem.
Conservatism works every time it’s tried.
You need to run the numbers...we would need economic growth in excess of eight percent per year, without a break for 30+ years, to cure the SS/Medicare deficits.
Ain't gonna happen, and I'm sick and tired of using "growth" as a way of pandering to the "don't cut MY benefits" crowd.
My personal idea for solving the Medicare and Soc Sec problems is something like a "Medicare lien". When the amount you've taken out of the system exceeds what you've paid in (with a reasonable allowance for compounded interest) the government gets a claim on your estate for any additional money paid to you or spent on your medical care.
The Death Panels will be a la Canada where they would not only not treat the child they would not let anyone else treat him either.
I think similar things have happened in the UK. That is a death panel. They have decided you should die not that they will not treat you.
Not paying for your treatment is a valid option for the government or insurance company although it may be breach of contract. In the case of Medicare since the government forces you to be on it there might be a case to be made.
Except the death panel is called the Independent Payment Advisory Board.
Supposedly an "Independent" "board" comprised of politcally appointed members who "advise" which doctors get which "payment" for which services.
BEFORE the services are rendered.
It's too bad none of the current crop of candidates is talking about this. Michele Bachmann alluded to it during the last debate but she didn't go into detail.
The IPAB is The Death Panel Sarah Palin is talking about.
What they wanted was for the Government to pay for it so they wouldn't have to.
A lot of the people who rail about "death panels" don't seem to grasp this distinction.
It's a "death panel" only when you are told you can't have a particular treatment even if you pay for it yourself.
Failing to fund costly services on the taxpayer's dime is just good conservative budgeting.
I question your numbers for one particular reason: when taxes are cut significantly, the resulting economic growth will be exponential, not linear.
This distinction is critical to understanding the potential to solve our economic crisis.
But the greatest obstacle to overcome is the resistance from the permanent political class, who oppose tax cuts because (despite the fact that tax cuts bring more money to government) they represent a transfer of power from the government back to individuals.
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