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.
It’s Obvious Day over at Philadelphia Magazine. Palin nailed Obamacare for what is is.
This has been ongoing for a few years now in hospitals.
The difference between observation and admission status is the acuity of the patient.
Acuity of a patient has to meet two criteria now- 1. How sick are they 2. What intensity of treatment is the hospital giving the patient.
There are programs- mainly by two companies- that have devised these criteria.
A fractured elbow would not meet inpatient, because that can be taken care of as an outpatient.
If a hospital bills a patient incorrectly- inpatient or observation- Medicare will penalize the hospital by not paying the hospital bill at all.
Also, Medicare is auditing the hospitals (retroactive)-this audit is called RAC- and fining hospitals millions of dollars.
This sounds like it was implemented before Obamacare. I imagine it will only get worse.
Newt Gingrich stated in the last debate that Palin was essentially correct on death panels.
Thanks to governmental meddling in health care, we now have a health care system that is far too large for the society. I give you the analogy of the excessive number of McMansions.
We cannot afford to pay for all the health care we have developed for if we did, all the wealth available for future generations would be consumed to keep someone alive (but not living) for a period of months to a few years.
I went through this with my mother and with the wisdom of hindsight, it would have been far better for her and the family if we had less medical care. But you can't ask that of the children, even if they are also old.
Did anyone think it would be anything different? Really?
I have asked a lot of liberal aquaintences, “What does ‘Free Healthcare’ look like to you?”
Answer: “It’s exactly like care is now except it’s FREE.”
;O(
Of course she was! The G does not create health care; it can only ration health care, and somebody somewhere will be doing the rationing. Not too extremely complicated.
The real moral: Never leave a loved one alone in a hospital death panel or not.
Of course Sarah was right above death panels. We all knew it instinctively like she did.
Being biatchslapped by reality is the only way some folks will ever get it, over the din of endless media propaganda, I’m afraid...
Maybe?
She might be wrong on Kate Plus Eight and whether or not to run, but the woman is a seer on policy and politics.
Caveat - liberals will point out “this is Medicare, not UhbamaCare”.
Thus, they’ll say the new bill had nothing to do with Medicare rules, and will try to claim that thanks to Uhbama, such Medicare holes will be plugged by his new rules.
ALWAYS have someone there....even if they are in ICU...
Yes, Palin was right and it’s not rocket science to know that Palin is/has exposed the corruption of the gov’t and that is why she was attacked. Do we see anyone else being the warrior that she is - nope. Palin is pro America and has put herself on the firing line because as a Patriot that she is - someone has to do it.
She’s been trying to wake up America to join in that fight. Those who have come against her are our enemies. Then we have the wusses of the world whose emotional issues surface when they see someone doing great things - they trash to bring her down - it’s a quicker way of feeling good instead of dealing with their own inner issues. Jealousy is like a cancer.
I knew Sarah was right before she even said it. All I had to hear was that there would be a govt panel that would make decisions on patient care, and I knew it meant deciding who was “worth” saving and who wasn’t.
A 68-year-old friend of mine is having shoulder surgery today. It’s a three-hour procedure, and it’s extensive enough (much tendon and ligament damage from a fall) that her right shoulder and arm will be immobilized for at least three weeks. However, she’s not being kept at the hospital for even one night to make sure there are no post-surgical complications. Her daughter will be taking her home a hour after the surgery.
Because American taxpayers are forced to pay for medical care for the uninsured, including illegal aliens, people who ARE insured (my friend is a military retiree and has decent supplemental isurance) get insufficient care.
In my judgment, the government should get completely out of health care.
But the media demagogued her, and they won.
So we'll never know what she'd be like in national office.
Bump
And they will continue to grow regardless of who is elected in 2012, or 2016, or 2020.
Because Medicare will be out of money by then.
Why??
Although I obviously don't have access to Helen Wagner's medical or financial records, I think we can safely assume that at age 91, with a pacemaker, and a history of strokes, she has received far, Far, FAR more in government funded health care than she and her employer ever paid in between 1965 and 1985 (her 65th birthday).
Multiply Helen by several score million and it's easy to see that in another twenty years, Medicare is likely to consist of outpatient clinics and hospices.
Obama can't change the inexorable demographics. Neither can Paul Ryan, Sarah Palin, Rick Perry, or Herman Cain. Get used to it.
President Nixon came back after two defeats. President Reagan ran for the White House 3 times.
Anyone with an IQ above 30 could see that coming. During the last republican debate,(turkey shoot) that very question was posed, trying to get the RINO's to say limit care for old people, since most of the health care expense comes in the last two years of life.
Newt to his credit blasted that moron.
Then in a totally unrelated move the UN decided that the right to die is a health care right. You can count on that right quickly morphing into an obligation.
Most people don't remember Governor Lamb saying, Old people have an obligation to die, and fertilize the soil.
Everyone should know after all, the cheapest health care is None.
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