The City’s Pulse Newsletter, By Mary Souza
Years ago, as a cardiac nurse, I had an “ah ha” moment on the subject of aging. It was a strong lesson that has stayed with me for decades and has provided a clear understanding of old versus young.
My lesson came on a typical, busy day in the cardiac unit. My two patients could not have been more different: One was a 55 year old who was one of our regulars. She had ongoing mild heart problems which were made much worse by her high level of fear and anxiety about dying.
Down the hall was my 99 year old patient, Betsy. She had never been in the hospital before and was in to correct an irregular rhythm problem. Betsy was not worried about dying, she was far too busy living. She was mentally sharp, articulate and socially engaging, describing her elaborate garden and the friendly neighborhood competition over squash production.
Which one was “old”? Of course not Betsy, it was the fearful woman of 55.
This experience comes to mind now as our government proposes to intervene further into our health care system. With government health care will come added volumes of rules and regulations. It happened before when they tried to fix Medicare and ended up changing the nature of health care from nurturing to clerical; attention to patient needs was reduced to make time for navigating the complicated codes of government funding reimbursement . Think that was bad? Just wait until federal bureaucrats run the whole thing.
Rationing of care will undoubtedly be part of any nationalized or public option, and this is where my personal lesson on aging starts bumping up. Who are the federal paper-pushers that will determine how old is too old for certain procedures? Will they set certain age limits, which they will call “guidelines”? Of course they will, and therein lies just one of the many big problems government controlled health care would bring.
Two of our local crown jewels would not fit under the probable age limits of government health care and we, as a community, would suffer a great loss of experience and wisdom. State Representative Frank Henderson is a man of a certain age but he is sharper, smarter and more energetic than three men half as old, combined. Frank has a long and illustrious resume of community service, including Mayor of Post Falls, County Commissioner and now serving at the state level. Last month Frank had open heart surgery. He has never had heart problems in the past and, with his vigor and energy, he probably won’t for many years; he’s recovering fast and is back in meetings as if nothing happened.
But Frank would almost certainly have been denied surgery under a new government health care option.
Another valued elder who would not fit under probable government regulations is Ruthie Johnson. She is the queen of local conservative issues, she’s been the matriarch of the Republican party here forever and serves on the state’s Human Rights Commission. Ruthie is a joy to talk with. She is quick, smart, busy and has a memory I envy at 30 years her junior. You see, Ruthie just turned 85 years young. But thank goodness that Ruthie had her open heart surgery two years ago and continues on, full speed ahead.
Common sense and personal knowledge must prevail over anonymous statistical assays, if we as a nation are to honor individual freedoms. Getting the government out of our health care, or at least fending off further intrusion, will keep important decisions where they belong: Between a patient and their doctor. Please take the time right now, this week, to write, email and/or call Rep. Minnick and Senators Crapo and Risch, and let them know your views on government controlled health care. This is one issue that should be top of mind for us all, no matter what our age.
Several people sent me emails after they received this newsletter yesterday. Some were very supportive and a few were quite upset. I don’t mind if people don’t agree with my views, but I always hope they can express their opinions with respect and clear information. That doesn’t always happen. Here are a few of the more intense comments against my viewpoint:
Here’s one that endorses rationing care for older folks:
And here’s another that thinks rationing is basically patriotic, for the good of all:
And, finally, the person who thinks my prediciton about rationing of care is 100% fiction. Guess this person didn’t talk with the previous two.
Comment by mary — August 10, 2009 @ 11:06 pm
Most people do not understand health or healthcare. What they believe and have been told all their lives to expect from healthcare is curative medicine. At whatever age they require involved healthcare a complete cure is what they seek. For the most part the routine infectious diseases are successfully addressed. So for the majority of our lives this cure myth gets entrenched. Society sequesters the sick. Daily living does not commonly deal with anything but healthy active people. So, when age hits the fan and bodies begin to fail we fully expect medicine to deliver the goods and costs be damned.
That a cure is always certain is incorrect and we both know that. Some problems are curable while others are treatable but will have residual impact. Some are chronic requiring long term continuous care. Some are entirely incurable (at this time). People do need to be better informed about their own health management and to be wiser healthcare consumers. We will all someday face the pearly gates and we alone will determine how much pain, suffering and treasure we invest before that eventuality.
But, any fool can see that we do not want the payor gov’t to be in the role of meting out healthcare based on cost. For those who think otherwise all they need do is examine existing state systems and those in other countries. Socialized medicine is never, ever managed with a carte blanche policy. It is frugal. It has to be frugal. We do see this framework in all the proposals sitting on the various tables around DC.
Make no mistake. Our healthcare system needs help. But we do NOT need a bunch of partisan elected attorneys determining how that should best be done. One thing missing from all proposals is malpractice litigation reform. That is not coincidental. That is intentional. There has been no plan laid down that won’t make healthcare a serious nightmare. That is especially true for the elderly most of whom involuntarily paid dearly into the social security system all their lives.
Healthcare reform is needed. But this rush to jam a quick fix into practice is flawed and very suspect.
Comment by Wallypog — August 11, 2009 @ 6:13 am
Good analysis, Wallypog. Thank you.
Comment by Bill — August 11, 2009 @ 7:06 am
Good arguments from your readers, Mary. The issue that they’re avoiding, of course, is who makes the decision. While they may be comfortable letting themselves fade away, others will not be. Is it right for us to take away that individual’s decision? And, if true, then what other health care decisions can the majority take away from the individual?
Like most political hot potato issues, health care is not about health care, it’s about control.
Comment by Dan — August 11, 2009 @ 7:49 am
I agree Wallypog, our current health care system does need reform. But, as you so clearly pointed out, having the government in charge is not best for individual freedom of choice.
Here’s another personal story: About a year ago I had an injury (apparently it’s not good for an old lady to fall while roller blading!). Anyway, I consulted with 4 different health care professionals over the course of the year, all of whom told me there was nothing out of place and just to give it time to heal. Meanwhile I was in pain every day and walked like I was 9 months pregnant. Finally, almost a year later, out of desperation, I tried another professional who came highly recommended. He was excellent, said I was out of alignment five different ways and was able to readjust over the course of a couple months. Now I’m back in business and pain-free. What would have happened in a government-run system? My guess is I would not have had the option to access the system multiple times for the same injury, and/or would have long wait times to be seen.
Some people we know who live in England tell us that they, along many people they know, pay for a private insurance policy that covers only the first diagnostic visit to the doctor. They say that if you find a lump or have chest pain, etc. the wait to see a doctor in the national system is very long and the problem can get much worse before it is ever diagnosed. The extra insurance just helps you know if anything is wrong, then you have to “que up” as they say, and wait for the government system’s treatment.
Comment by mary — August 11, 2009 @ 9:01 am
Dan as usual, is spot on with his observation about who decides. Let those foolish people, like the 77 year old, donate their place in line, if they wish, to someone else. It’s still their decision.
Comment by Gary Ingram — August 11, 2009 @ 11:53 am
Sometimes, I wonder if we had health care reform, it would get the bill collectors off our backs.
I am dirt poor. In Dec of 2007 I had to go to the ER because I broke my foot and there was 6 feet of snow. I needed a walking cast. If the weather had been decent, I would have drove to Plummer where they do not financially rape you. It took 3 months to heal.
I did not have 120 bucks to go to an urgent care, and I was not qualified to go to the Dirne Clinic because I had an income – not much, but an income. The medicine and the crutches came out of my own pocket.
I have paid the debt down, but not fast enough. I asked about payment plans to KMC but they told me not to pay anything while they tried to bill the insurance company that took months to work with and was extremely hard to deal with. The employer could not even work with these people -AIG. I paid DMC some money anyway. In short, I tried, and they neglected to inform me of any payment plans, even though I am on record and asked about one, instead, they turned me over to NICC who is now sueing me in Court for more money and attorney fees. My point is I made several calls to work with the debt as well as to NICC, North Idaho Credit Corporation, who is asking for and demanding unreasonable amounts. They have asked for a summary judgement and claim that the judge has to give it to them because it is against the law for a judge to set up reasonable terms for the defendent. They were going to get it anyway, so I have answered and plan to go before the judge. I get 10 minutes. They (North Idaho Credit Corp) did not even send me the full statement of the manager’s affidavit. I had to go to the record’s court clerk to get that copy. I think they did that on purpose.
I view this as deliberatly denying the client the right to pay the bill so they can extort more money out of dirt poor people over medical bills and make a profit to pay for their attorney. I have two other medical bills, neither outfit has treated me like they have, here.
Generally, folks assume that when bills get to a certain stage it is the debtors fault and in this case, while I have made an effort to pay it down and I have called them, they are hostile and refuse to accept 50 dollars a month claiming I need to send no less than 149.00 and now 239.00 because they want to force stipulation by intimidaitng me to keep it out of court to pay more for their attorney and form letters. This kind of communication process breaks down the relationship and you actually are afraid to deal with these type of people. That’s how they play – they extort money by abusing and tieing up the legal system, by going after folks who cannot fight back.
I wonder if the collection outfits actually sees this coming, as far as government run insurance and they are trying to cash in as fast as they can.
Even when I pay them, they send back a nasty note that says the amount is unacceptable.
The bill was 1000 bucks, I have paid it down to around 800.00. They just want it all NOW and do not care about how they affect the quality of a person’s life by refusing to be reasonable over a MEDICAL bill that was caused through no fault of my own. It did not matter what I did, they were going to do it anyway, that’s how they make their money. These are actions that really hurt poeple.
Comment by Stebbijo — August 11, 2009 @ 1:15 pm
I do not know who writes the stuff Obama blurts out but he really stepped in it at his town hall presentation today. Obama just informed all of America that medical doctors intentionally withhold appropriate medical care in order to make more money. The example he gave was astounding.
Obama claims that medical doctors intentionally mistreat diabetics so that their limbs require amputation. I am serious. According to Obama medical doctors know that they will make less money treating diabetes than they will if they do an amputation surgery. First off the economics is wrong. Amputate a foot and it is a one time shot. Keep a hard to manage diabetic healthy and you have a chronic patient for decades and then you still get to amputate the feet. Oh, I guess that the doctors also do profit sharing since it is the orthopedic surgeons who do the amputations and internists who usually manage the diabetes.
The man is NUTS!
If the AMA does not jump down Obama’s throat with cleats on it will be astonishing.
Comment by Wallypog — August 11, 2009 @ 1:16 pm
Stebbijo… Sadly your story is not uncommon. There does need to be oversight regulations put on the insurance industry and other things that can be done to help avoid this. For starters they can end free emergency care for the indigent. If you were just a little more dirt poor you would not have to pay one cent, even if you had quadruple bypass cardiac surgery. If you ever watched those ER television actuality shows you see loads of druggies, etc, flowing into the ER for care like an unending river. No bills for those folks, or illegal aliens, and so forth. Who pays for their care? You and I do. That is why a Qtip costs the paying customer $42.00 apiece.
Next time you go to the ER, look confused, mutter a little spanish, have no ID, then get cared for and leave.
Comment by Wallypog — August 11, 2009 @ 1:26 pm
Wallypog, those statements the president made about doctors are horrifying! Can you tell me where to find the presentation?
Comment by mary — August 11, 2009 @ 1:29 pm
Mary,
You can see Obama’s presentation on the townhall(dot)com blogs.
Comment by Wallypog — August 11, 2009 @ 1:43 pm
Wallypog, You can believe it, the last thing I wanted to do was go to the KMC ER. We need oversight on dirty collection practices – especially over medical bills.
Why end free care for the indigent? What else are they supposed to do, do you just want them to drop dead at the doors? That is heartless – Wallypog.
Additionally, I have worked as an ER trauma clerk in two different hospitals so, I really do know what it is all about. The two jobs in Idaho which included KMC as a registration clerk and St Al’s were both casual positions and that means they provide no insurance wwithout guaranteed hours. Some of us have no choice but to take what’s available, and they know that. One hospital in Nevada, where I also registered fols, was already denying at the desk unless you had insurance or could pay with cash. This included denial of essential medications for pregnant mothers who were carrying babies that are not compatible with the blood make up of the mother. ER visits without money were slim to nothing exams and out the door they went.
I also used to work in Tulsa, OK and I saw my share of illegal aliens. The hospitals there – 5 years ago – were torturous to work (probably still are) in and undoubtedly saddled with overwhelming costs. Workers were turned over like leaves in the wind with injuries, including myself.
Dirt poor people work for hospitals all the time.
In fact, there has not been one job in the state of Idaho that has afforded me any insurance. I am lucky, that I have moved on to another state, where I am represented by a union that protects my benefits. It is the best job I have ever had with the best working conditions, I have experienced. After being part of a Mom and Pop business for years in Idaho, that crumbled from divorce, I can attest to trying to make a living and starting over again at the age of 40 – 15 years ago here in Idaho. It’s been a struggle.
I have been denied health care for years. I cannot afford it. I don’t have a couple of kids and I don’t qualify for Medicaid. I have been lucky in that I have been healthy or at best, unaware that I may have undiagnosed conditions – like a tumor in my brain. 🙂
I understand a lot of the concern over this reform, and I don’t doubt that it will be ugly. There are a lot of poor people who just want help and then we also have the small business that will be forced to comply. I understand why folks would be against this.
My husband has insurance which costs a pretty penny out of his check but only covers 80 percent, so if he were to go to KMC for anything major and we were stuck with let’s say, 5K, KMC would most likely try to bury us into the grave, for a debt we could not pay off fast enough for them, and then turn us over to bigger sharks. There are thousands of people like us here in Idaho.
Comment by Stebbijo — August 11, 2009 @ 2:17 pm
Stebbijo, if your husband has medical coverage through his work, why aren’t you on the policy? Everyone that I know has spousal coverage available. Sometimes they have to pay extra, but it is at group rates which are less than individual rates. As far as turning a debt over to a collection agency, as long as you are making a payment on a regular basis, most will not incur the large loss that occurs when a debt goes to collection. When a debt goes to collection, they charge a large fee. That certainly doesn’t benefit the group to whom the money is owed. I think you are making a harsh judgement based on zero facts. I would like to hear KMC’s side of this story.
All of my friends in England have private insurance. They go to their “local” for “jabs” and that is about it. Socialized medicine is terrible. Too many people go too long without treatment for fatal diseases, with the result that they are proven fatal. We know that when the govt. gets into anything, they gum up the works. I would rather treat myself than be a victim o9f govt. run health care. And believe it, I know nothing about medical treatment. But even that ignorance is better than the govt. It is no secret that most doctors won’t take Medicare patients. Because they are mean? No, because they simply cannot afford to. The reimbursement is an unfunny joke. Just what does anybody think will happen if it is all govt. run medical care. The median mortality age will plummet. We have had some pretty scary people in the White House……but this guy is everyonews worst nightmare.
Comment by Faringdon — August 11, 2009 @ 2:41 pm
Stebbijo… Heartless or not, there is NO free ride in life. I cannot walk into any attorneys office and expect free advice. When you worked for the hospital you expected your paycheck and if you did a good job you expected raises. How can any business hand money away and make ends meet?
This is a free country where people can choose to succeed. That is one reason we have so many immigrants who come here legally or otherwise. If medical care was not free then perhaps people would work harder to be able to afford it. Perhaps they would take better care of their own health. It would definitely cost less because everyone would be paying their own bills.
Requiring ERs to give away care to the poor was a nice idea but it has been abused. That is exactly where this mess all started, a gov’t mandate without any gov’t control. They have been told for decades to control illegal immigrants using our health services and did nothing. Now you are personally being pursued to pay an inflated bill because of it. Do not complain about that if you insist that the poor get free healthcare. It isn’t free. It is coming out of your wallet.
Comment by Wallypog — August 11, 2009 @ 3:18 pm
Farringdon, none of this health care is really going to hurt me because I am not in the bracket of income that is going to get stung. If I had a fatal disease now, it would be the same. I would lose everything that I don’t have.
This is my case. I have the facts. I have the dates. I tried to call. I have the amounts I have paid, it’s just not good enough for them. I want to make it clear, they have refused to accept any payment from me as “acceptable” and they demand amounts I cannot give them. They refuse to accept $50.00 a month. They do this on purpose so they can force a judgement and make more money off of a person. When they add 300 dollars and more to a debt, it does benefit the agency or they would not be doing this, they would take my money and be decent.
My husband has his own policy. I have mine. I work for a nice hospital. If I lose this case, and most likely I will, because the area is overly biased and everyone works in cohoots, they will garnish my husband’s check and he will lose his job. It’s that simple. I then will be able to put him on mine which will cost some, but it’s better, however, we will be living off of one income, which is part time – mine. We have tried to get ahead and now that we are starting to recover, Idaho refuses to be reasonable so they can sock it to us and get their money NOW. Most people will not fight these things because generally, folks just assume that the person is at fault by not paying their bill. In this case, I believe the collections practices were unreasonable. KMC could have set up a plan for me (I asked about it) and informed me that if there was any trouble to call them so they would not force it to collections, but they did not. They probably do this to a lot of people who are too embarassed to say something publically or who most likely don’t have any legal recourse and I bet they are getting as many people as they can right now, before this reformed health care goes through.
Comment by Stebbijo — August 11, 2009 @ 3:22 pm
Well, I guess I am more compassionate than some of you and thank God, you have people like myself working in some of these hospitals. Say that to folks who have a child dying from Cancer and all they want is a bone marrow transplant. And, for the record, I have picked up AIDS pts in my arms so they could have a bath and cared for drug addicts – they did not pay either. I made dog wages and I have cared for many rich people, who were thankful for my attention.
As far as attorney advice. You are, right there isn’t any free advice. No argument from me there.
With that aside, I can see where the small business if forced to comply may get hurt. Hopefully, that will be ironed out. In the meantime being without compassion or empathy gets a society no where. Someone is always next – even the folks who can afford it all.
I am not complaining. It’s not going to hurt me any less or any more, either way. Have a great evening.
Comment by Stebbijo — August 11, 2009 @ 4:19 pm
Here’s an entertaining description of the new government health care proposals, written, surprisingly, by admitted Obama supporter, columnist Camille Paglia, on the very liberal Salon.com. Even she is dismayed by the legislation and the process:
To read her whole column, click here: http://www.salon.com/opinion/paglia/2009/08/12/town_halls/
Comment by mary — August 11, 2009 @ 9:21 pm
Interesting letter in todays paper. The writer quotes chapter and verse, as well as page number of the health care bill. Dictator in Chief Obama apparently believes seniors are throw-aways. No longer beneficial to society. This in spite of the fact that today many of those seniors are the same individuals that, as young men, fought for their country and were correctly called the greatest generation. That those seniors are the people who fought for equality in this country. That equality that enabled him to be elected. A panel will decide on whether or not you are entitled to curative or any medical treatment. Say what? As for Obama, he is under the “what me worry” umbrella as his health care will now be not only the best, but free for life. At exactly which age we become useless is ambiguous. I guess that is up to the panel as well. Will this decision also encompass other than seniors? Perhaps the mentally and physically challenged. Perhaps the autistic child, or the child with MS…you get the point. The policies of Nazi Germany springs to mind.
What a state of affairs.
IMO, CDA and Kootenai County have much that needs to be corrected. But I simply do not believe that everybody is in “cahoots” to cheat the public. And you cannot add an arbitrary amount to a debt. You can charge interest. However that rate must be within the legal perameters as set by law.
Comment by Faringdon — August 12, 2009 @ 9:46 am
“Dictator in Chief Obama” Faringdon.
What?How outrageous a comment is that?I thought he was a despot? 😉
Anyway, don’t we already have social
medicine.The poor can either go to the Dirne Clinic and pay $20 or go to
Panhandle Health and pay on a sliding
scale or go to the ER if they are completely,broke.Either way the gov’t and or the taxpayers have to cover the difference.Right?
Comment by kageman — August 12, 2009 @ 12:09 pm
Hey kagey, you scared me there for a minute. I feared you had fallen under some evil mind control. 🙂 Dictator…despot…interchangeable. On a serious level, this administration is near dangerous. Arlen Spector made a joke out of the dissenters of health care. So we are back to dictator and despot. No dissention allowed. Now, I could write any number of scripts for late night on this subject. And I’m sure the liberal mucky mucks will make any number of jokes on this subject. But as much as I enjoy a good laugh, nothing about this is amusing. We have the President of the US and his lockstep liberal Congress pressing for a medical system that decides who and who is not elegible for care. This is America….isn’t it?
And yes, you are correct. Nobody is turned away from emergency medical care. And there are places for those who can’t pay. But if one is able bodied and has an income, I see nothing wrong with expecting them to pay for services rendered.
Comment by Faringdon — August 12, 2009 @ 1:40 pm
Oops….medical system that decides by coimmittee who is elegible or not for care.
Another oops….parameters (post 18)
Comment by Faringdon — August 12, 2009 @ 1:43 pm