The Ramblings of AGIII: April 2013

The Future Of Elder Care

The Obama administration scraps long-term care insurance from the healthcare overhaul. What’s the future hold for elder care now

Dear Listener, I hope you live happy, loved, and strong to 101, robust and healthy all the way. I really do. But the fact is that an awful lot of people end up needing help as they age. A lot need long-term care.
This week, long-term care has been bounced from the Obama health care reforms – by the Obama administration. “Suspended” is the word they’re using, but it’s gone. Too expensive. But the country’s population keeps on aging. A tsunami of boomer elders is coming. And then everybody else.
This hour On Point: what will happen to you when you’re old and need help?

-Tom Ashbrook

Guests

Rep. Michael Burgess, a medical doctor, he represents the 26th Texas congressional district.
Howard Gleckman, a resident fellow at the Urban Institute, he’s the author of Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America’s Most Urgent Health Care Crisis.

Judy Feder, professor at the Georgetown University Public Policy Institute. She served in the Department of Health and Human Services during the Clinton administration.

Highlights

The coming wave of Baby Boomers entering the elder care system is going to put a serious financial burden on the nation. There are currently 10 million people on long-term care today, a figure that will double in twenty years.
“I didn’t realize I was part of such a small group, but I am one of the 7 million Americans that have private long-term care insurance,” said Rep. Michael Burgess, a Republican from Texas. Burgess said that the making private insurance affordable was the only way to sustainably finance care for an aging population. “People of my generation need to be talking about this, talking about this. Many people can’t afford it.”
Howard Gleckman, a fellow at the Urban Institute said that the current state of elder long-term care is “untenable,” noting that many current caregivers for the elderly are hurting their own savings for the future. “We’re stacking this onto future generations,” Gleckman said.
“For the life of me, I can’t understand why Republicans, of all people, oppose an insurance-based model [like the CLASS Act] rather than relying on the Medicaid, welfare-based model that we have today.”
“It absolutely should be an insurance-based system,” Burgess countered, arguing that the CLASS act was unsustainable.
Public insurance for long-term care is the only answer, said Judy Feder, a professor at Georgetown University’s Public Policy Institute and a former Clinton administration official. “People are having trouble putting money away for pensions, let alone private long-term care,” she said. “And those private insurers are not reliable.”

Caller Phil in Clarksville, TN
This is a pretty apropos story for my family: My father’s funeral is, in fact, tomorrow. Dad had a stroke about 15 years ago. He only needed full-time, at home care, for the last month. My mother, my parents were both school teachers, not wealthy people. However, they had purchased long-term care insurance years ago. High premiums, but they believed it was the right thing to do.
My mother was very comforted by the fact that they had long-term care insurance. When it got to the point, a month ago, when my father did need round the clock care, she was very – we were all very disheartened to find that there was a 100 day deductable in the details of the policy. My parents are well educated, but they didn’t understand that there was a 100-day deductible. Meaning, that they had to pay out of pocket at least 100 days before the long-term care insurance kicked in.

Caller Jim from Pittsburgh, Pennsylvania
I would like to mention that one thing people don’t realize is that sometimes this process of getting old is sequential. First of all, I have put money in the bank, in addition to my annuity, which I had hoped would carry me into old age. I lost a lot of it, which a lot of us did. A few years ago, I developed prostate cancer that made me ineligible to get long-term care insurance until I waited some period of time. Then, I developed chronic pain issues, which cause me to be put on narcotics, which I continue to take. I can’t get long-term care insurance as long as I’m on those and I may be on them for the rest of my life. If someone has said to me that I could get it for $150 per month, I wouldn’t mind. Course no one wants to pay that, but I would pay it if I could get it.
I’m 68 now. These issues started when I was 57, when the prostate cancer started. I’m 68, I’m still functioning. I work part time and whatnot. I can’t get long-term health insurance.

Ken in Carlyle, Massachusetts
My wife and I bought long-term care insurance back in 2002, as rich a policy as we thought we could afford. We thought we were reasonably set. And then to our great surprise and really our great displeasure, early in 2008, we got a notice from our company, Monumental Life Insurance Company, of Cedar Rapids, Iowa, that our premiums were going up. The company was not direct in telling us how much they were going up.
I’m an economist by training and started digging around. What I found out was that our division of insurance has allowed them to increase our premiums by 70 percent. The increase didn’t come in instantly, but it was allowed to be phased in three incremental annual steps of 20 percent a piece. It’s enormous.

Mike in Acton, MA
To be brief, I had the opportunity to take of my spouses’ mother and father and they both had long-term care insurance policies that they’d had for many years, with a company called Unum. And he felt pretty good, because he’d planned ahead. He ended up in a nursing home at one point, and a nursing home in Massachusetts costs about $300 per day. Now, the policy had a 100 day deductible, but it also maxed out at $100 per day. It was a policy that he’d had for years and it probably sounded pretty good when he got it — $100 per day. How could it cost more than $100? But it turns out that $100 just doesn’t do it. The whole concept that the Congressman [Michael Burgess] from Texas is trying to push is essentially healthcare for the rich, health insurance for the rich. It has nothing to do with the vast majority of us whose only healthcare policy is not to get sick.

From Tom’s Reading List

The Washington Post “One way of looking at the administration’s decision is that it shows their commitment to fiscal responsibility. “What happened here is that government worked exactly the way it ought to,” wrote Kevin Drum at Mother Jones. “Even though it was a liberal program promoted by a longtime liberal icon, HHS analysts eventually concluded that its conservative critics were right and the program as passed was flawed. So they killed it.””
The New Republic “The Obama Administration is pulling the plug on CLASS, the long-term insurance program within the Affordable Care Act. The announcement came late Friday, most likely because administration officials hoped to bury the news. They did not succeed, as Republicans and their supporters were all over it.”

The Atlantic “HHS, which was required to certify that the program was sustainable, couldn’t, and thus it is no more. The program has taken about half of ObamaCare’s projected deficit reduction to the grave with it. Conservatives are having a field day, but Kevin Drum argues that this is actually good news.”

Terry Tree Tree

Republicans have already told you what they will do “Let them die!” Of course, that is after they scam ALL the money they can get from the unlucky poor slob they want to let die! The Republicans want the poor to work for THEM, for little or NO wages, until the poor workers die! They’ll buy more, like they obviously bought five Supreme Court Justices! If they can buy a war against a country that had NO real links to 9/11, what can’t they buy. When they buy a judge, Justice, or politician, they know they will get a LOT more money!!
- Gregg
  
  Your indoctrination is complete. Congrats.
  - Yar
    
    How does an comment like this add to this discussion? Gregg, what do you believe should happen to US citizens who don’t have the resources to take care of themselves?
    - Gregg
      
      Yar,
      I appreciate your concern and I will answer but I must say it’s Terry Tree Tree who has spewed hateful rhetoric that does not move discourse forward. It has no place in civil debate. It is a view that has been fomented and is wanted. The purpose of my reply was to attempt to make that point without dignifying the hate with a response. I refuse to argue that Republicans actually don’t want people to die, as was the charge.
      Your second question as phased has no answer I can offer. I think it matters why the person doesn’t have the resources. I also don’t look at it as something needs to “happen” to them and infer you mean by government. And by extension the taxpayer. It’s all well and good to debate it but we won’t agree. Maybe we can agree on my main point which is blaming Wall Street, the rich or corporations for your woes is unproductive.
      - CORY
        
        So his point is, if it can be “proven” that it is your fault that you can’t pay for your elder care you are s*** out of luck. Notice how he can’t or won’t say what he means? They want it without having to say it.
  - Terry Tree Tree
    
    That was a quote from one of the Republican debates, by a Republican candidate for President of the United States.�
        Since wages have been worse than stagnant for the last thirty years, and CEO and top executive pay has sky-rocketed, my conclusion is that the Republicans want the poor to work for THEM, for little or NO wages, until the poor worker dies! Please tell me how someone that is skilled labor, who’s money is LESS, and BUYS LESS, would come to any other conclusion?
         As it was five ‘conservative’ Justices that propound that foreign corporations are citizens of the United States, they are either senile, or bought. I don’t see how anyone that cares about this country, humanity, justice, or anything but money and power, could possibly give an extra SUPER-CITIZENSHIP to corporations that already employ a U.S. citizen or two.
        My indoctrination into citizenship, and humanity is NOT complete, but it is FAR more complete than the ones that I railed about!
    - Gregg
      
      “That was a quote from one of the Republican debates, by a Republican candidate for President of the United States.”
      BS! Offer a citation. That’s a line from disgraced former Congressman Alan Grayson.
      - Terry Tree Tree
        
        I notice that you don’t mention the rest of my comment.�
        With all the Republican calls to do away with Medicare and Medicaid, which many of their contributors are scamming and abusing, it surprises me that the ‘Right’ would disgrace one of their own!
Yar

I watched the republican debate last night and shuddered at the thought that any one of those individuals could end up leading our country. The idea that the ‘unregulated’ free market will solve our problems is ludicrous. In the body unregulated growth is called cancer, the same is true in an economy.
The bible says to respect our elders. Here is what I see as the problem with our current system, we don’t have a living wage! A living wage would pay for healthcare and retirement. I had a long discussion yesterday with a small business owner who believes the problem is government assistance, she said she can’t get people to work. Why would anyone want to work for her, her employees don’t get healthcare or retirement. It isn’t her fault that she can’t pay a living wage, none of her competition pays the total cost of living either.The low wage worker is a slave that creates wealth to make the top 1% rich, don’t they at least deserve a living wage? People are not simply production units, they are living beings, and deserve to live a full life.
We have debts, not to the bankers, those are just numbers, we have debts to our elderly, to our veterans, to our workers, if we say we can’t afford to pay our debts we will lose our democracy.
Wake up America, we have real work to do.
- Terry Tree Tree
  
  Right ON!!
CORY

This is what I do for a living…
I’ve worked in elder care for several years, and I’d like to share a few observations.
1. Once upon a time, nursing homes were government run or TIGHTLY regulated and watched. Patient/resient ratios were low and staff and nurse presence was high.
2. Gradually privatization crept into the “industry”. Enter the birth of the C.B.R.F. (community based residential facility). I began my elder care career at such a place. Usually owned by entrepeneurs without a backround in nursing, looking exclusively to turn a profit.
3. Places like this charge around five thousand dollars a month for a room about the size of a college dorm room. The place I worked had one RN present 8 hrs a day on weekdays, the remainder of the time one or two low skill aides cared for the 20-22 residents.
4. Aides were hired from $8-$9/hr depending on experience. They were a mix of students, dead-enders, and weirdos.
5. State run nursing facilities face a high degree of scrutiny from govt inspections. CBRFs see a state inspector once a year unless specific complaints are received. On the yearly visit, the inspector would follow the med passer once around the building and then out the door. Seeya next year.
These are some of the conditions that exist today, 2011. Now imagine 20 years from now after conservative austerity and declining American wealth, and tens of millions of boomers entering the system. I CANNOT imagine what these places will look like under these pressures. I literally cannot imagine what will be happening in these facilities. Even more frightening is what will happen to those who cannot afford these places. A dark future indeed.
- AC
  
  we do you think of these ‘hmo’ style packages for retirement communities? my company offers one where you pay in now and later there will be ‘retirement living communities’ or something. I’ve had it in the back of my mind to get details but an insiders opinion of what they really may be offering would be welcome…..
  - CORY
    
    If you can afford it, I’d do it. Be sure it is in the form of a contract, not something that is amendable. You need some promise that the conditions won’t be changed on you as external conditions change.
    - Yar
      
      The consumer has little protection when dealing with an LLC. (Limited Liability Corporation)
      They collect for twenty years, spending your money getting more people to join and go bankrupt just when you need their services. The numbers don’t add up for boomers to have a good quality of life in old age. �
      My saying is “so many elderly, so little ice” in reference to the Eskimo stories about putting the elderly on an ice flow in light of global warming.
      - Anonymous
        
        Like I said, a bottle of vodka and a snow bank.
  - Terry Tree Tree
    
    Be very, VERY careful!! I have several family members, and acquaintances that have worked in health-care, including similiar to what you are considering. Good Luck!
- Yar
  
  Cory, I worked in a state run center for the mentally disabled. The current cost per year for one resident at that facility is over 300,000 dollars. Almost all of it paid through medicaid. The direct care workers still only get around ten bucks per hour. The facility has a capacity of 450, with only 100 clients currently. �
  I want to add a brain injury center as part of their mission at the center. Returning VETS with brain injuries need some place to get ongoing care. I see the war wounded as another part of this problem, they need long term care for 50 to 70 years, who is going to pay for that? We pay for veterans care as part of the annual appropriation, they are less secure than elders when it comes to funding.. There aren’t enough able bodied workers to take care of the baby boomers as they need advanced care. My Dad calls his long term care insurance “tickets to hell”.
  - Anonymous
    
    I had a friend, who is no longer with us, who use to say his long term care insurance was a bottle of vodka and a snow bank.
    - Yar
      
      How do we measure quality of life? �
      For the free market types, it means no more assets to mine.My dad has ask me not to let him be a vegetable in a nursing home.
      - Anonymous
        
        Good question. I’m with your dad. I don’t want to be a vegetable or such bad shape that the quality of life sucks. Which was what my late father said in the last years of his life. Old age sucks! He was losing his ability to walk due to diabetes and was in the hospital when he died in his sleep. He just had enough. At what point to we pull the plug or decide to leave. Personally I’m all for being in control of this myself. I think it’s all about control.
      - Terry Tree Tree
        
        Advanced Directives! YOU have to make those decisions, NOW, before you need them. Get them in writing, with multiple copies to multiple people, each time you change them. I’ll leave it to you to get more info.
- Anonymous
  
  Pass me the cyanide.
TheTruth

The only people who will have a sound care in their old age will be the politcians who spent their whole politial career figthing socialized medicine – example: Dick Cheney.
The people who can’t afford care will be the people who are paying for the ploiticians health care.
A prime example of who will get this care no mater how bad their health gets, yes, you guessed it, Paul Ryan…..
Zing

Another day of jail the rich and steal their property.
- CORY
  
  There’s always Rush…
  - Gregg
    
    Thank God.
- JP
  
  Here here!
  Finally, a worthwhile comment from you!
- Anonymous
  
  This statement makes no sense whatsoever.
- nj
  
  More zing-less dreck.
Gregg

This provision was to provide 40% of the “savings” in Obamacare. It’s unraveling.
- Yar
  
  I support a single payer system, I would like to see insurance companies turned into electronic medical record companies. They already collect the information, they should make it useful for patient care. I prefer to pay for healthcare through a 10 percent VAT. With single payer we can reduce the cost of care and provide care for all. A 10 percent tax is a reduction from the current 19 percent GDP. Figures don’t lie but plenty of liars figure.
  - Gregg
    
    That is not the vision I have but if you can make the numbers work within the Constitution and get the support of the public then you have a valid position. God bless you. But I would say figures can lie when there are so many factors to weigh.
    My point is Obamacare was a lie from the beginning and is unworkable and unconstitutional. It was not honestly debated and the public was not properly informed. The economy and jobs suffered while the travesty took place. We may not agree about that either but it is a separate issue from the health care debate. The Obama administration yanked the CLASS act. They said it was unworkable. It proves my point.
    - Anonymous
      
      Health care cost are part of the economy.
      From what you are saying then national health care in your view is against the Constitution. Is this what you are saying?
      - Gregg
        
        No not at all. I am saying Obamacare savings were a lie and the mandate is unconstitutional.
    - Terry Tree Tree
      
      NEITHER was the Patriot Act honestly debated!! We are stuck with it, even though Congress and the Senate, only got blank pages, in the middle of the night! This is NOT the way our government is designed to work!
      A stinking DRUNK AWOL DESERTER said I, and a lot of others that served honorably, were not patriots, because we didn’t support his war to get Iraqi oil for Halliburton, and his other cohorts!
- Anonymous
  
  It is another example of why trying to address our nation’s health care issues can not be solved by utilizing the existing broken system. Requiring the common good to be met by the unbelievably complex, confusing and inefficient mess that is our “best health care in the world” (lol) will never work. And making the government the purchaser will be, as it is in every other effort at privatization, ineffective, more expensive, and just another opportunity for corrupt crony capitalism to flourish.
  The most insightful commentary by your guests began with “every other developed nation in the world meets these needs by . . . . “ We don’t need to reinvent the wheel.
http://www.facebook.com/profile.php?id=1816544 Dan Trindade

I think the issue comes down to what are we as a society willing to pay for. While I understand the point of view of those who would prefer to pay fewer taxes, I have to question the assertion that service levels can be maintained while doing so. Police, Fire, EMT, Trash collection, elderly care, national defense, all these require funds to operate and a reduced tax base is always going to result in reduced services. Americans as a whole have been unwilling to pay for that which does not directly affect them, the NIMBY argument (Not In My Backyard). Without a sense of unity, shared sacrifice, and political leaders williing to clearly and calmly discuss the pros and cons of government involvement in our daily lives this is never going to change. If we want a system that provides all of the services we require then we are going to have to pay for it, no two ways about it. In my opinion, Oliver Wendell Holmes Jr. said it best, “I like paying taxes, with them I buy civilization.”
- Markus
  
  I really wish this were true. We had a cop sitting in his car in a cul de sac (mine this summer) while two workers fix a drain grating taking up 1 foot of roadway. Cop gets a day’s overtime for sitting there for two hours. Head of school board got a 25% raise, 4 months before he retired with a 60% pension, then immediately became principal of another school. A friend picked up a part time job as letter carrier. Had to find ways to kill time during the day because they required him to go so slow. NYC has thousands of teachers (or is it tens of thousands) on leave being paid because the city can’t fire them, yet they’re not fit to teach. A cop on disability on a ski vacation. Firefighters trading time slots so they could no-show their jobs and run other businesses. I could go on for hours. And then of course, there’s the data on the gross inefficiency of government at the federal level. Libraries are filled with books on this. And since you brought up defense, read Peter Van Buren’s recent book on the rebuilding of Iraq “We meant well”. Whether for or against the war (I’m against it), it’s a wonderful reminder of what the 50% that pay federal taxes are getting for their money.
  That taxes are what you pay for a civilized society is a nice phrase. And I don’t mean to say that all money for government is wasted – not by any stretch. But I’ve seen how the internals of government work at many levels. I am positive you could reduce the internal costs for 40% and improve service.
  - Yar
    
    I bet if you took all the examples everyone for find of waste, it wouldn’t amount to more than the percentage of fees charge by banks on credit and debt card transactions. Why is OK for private industry to gouge, and intolerable for any inefficiency in the public sector? The financial sector has taken far more wealth from the worker than the tax man. They are just much better at hiding their fees.
    - Markus
      
      Well, I was just trying to stay on the point that someone else made about police, fire, defense, etc. and what I think is a naive argument that you get what you pay for. I never said it was ok for the private sector. Interesting that you would have jumped to this conclusion as I think Wall Street is a big part of the overall problem.
      We might disagree on which group is worse, but that isn’t much of a defense for the public sector being as inept as it is.
      - Yar
        
        I am for an honest day’s pay for an honest day’s work. Why is it that the worker who takes care of the elderly is not earning enough to be able to pay for their own care when they get old? The market doesn’t demand a living wage. �
        The right says the market should dictate the wage. �
        The left says we must care for all regardless of income, but doesn’t know how to pay for it. �
        We can argue polar politics all day and not get any closer to a solution. We spend 19 percent of GDP on healthcare and receive less quality than countries that provide universal coverage. The economics of healthcare demands we do something different. That is why I am advocating for a VAT targeted to pay for healthcare, at least then everyone would pay something. My child who works in South Korea went to the doctor for a sore throat, the cost both the visit and medicine was 7 dollars US currency.
  - Anonymous
    
    You make some interesting points and I too have seen the cop hanging around on my dead end street while they dug up about 4 square feet of it. A flagman would have been a good idea. I’ve also seen cops on details on cell phones when it was clear that they should have been directing traffic. It’s infuriating how this segment of the system works. However I’m glad we have a police force, and a fire department. The tale about the principal is disgusting and that kind of stuff should be illegal as should the way pensions are figured out. I think this is going to happen as a society we need to change the “wheres mine” attitude most of us have. I will leave you with the story of the fireman who caught a small boy here in Boston last week, he seemed to be the kind of people one wants in a fire department, humble and just doing his job. I think he earned his overtime.
    I think what you are alluding to is the system needs to be cleaned up. I could not agree more. I want good efficient government, not less.
    - http://www.facebook.com/profile.php?id=1816544 Dan Trindade
      
      I could not agree more Jeffe68. The argument should not be over big government or small government but how can we make our government more efficient to better serve the people and make every tax dollar worth the hardwork that created it.
  - nj
    
    There’s no shortage of such stories; i have plenty of my own. We shouldn’t dismiss or ignore waste, inefficiency, or fraud in any context.
    But, while important, these are anecdotal. On the whole, public agencies render services more cost efficiently than the private sector:
    http://www.ombwatch.org/node/11865
    “Study Shows Private Contractors Usually Cost More Than Public Employees”
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

One of the most demanding jobs in the Healthcare world is A Caregiver.
The American elderly are badly needed of help to buy groceries, house chores and a lot more. We rarely hear the invisible career of Caregivers but the demand is very high in America. We should encourage more nurses to be Caregiver or Unemployed American help the elderly or baby boomers.
- Anonymous
  
  Much of the care giving is done by family members, usually women. This care is unpaid. AARP did a study of the dollar amount of unpaid care giving: It was in the millions.
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

The Problem is not sending the elderly to Nursing home or how many nursing home we should built.
The problems are how many elderly people are willingly wants to live in their own home and how many people are to be Caregivers?
Some elderlies will pay decently to caregivers with free housing and food.
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  This a great job if you are unemployed. There is nothing wrong being a Caregiver, it puts food on the table and you take care of the needy.
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

http://www.caregiving.org/data/04finalreport.pdf
Here is the National Alliance For Caregiving and AARP web site
Information. The pdf will explain almost everything about Caregiving.
Anonymous

The majority of caregivers are family members, who are this silent majority in what is part of this mess we have for health care in this country. Health care cost are the largest problem in this country and the debt we have. Nothing is really being done about it. Nothing. The insurance and pharmaceutical lobbies are going to make sure we never have a decent National Health care system based on need and not profit.
As the baby boomers age and this population increases watch how this segment of health care becomes a huge for profit entity equal to the Big Pharma.
We have met the enemy, and it is us.
- Yar
  
  What do Medicare and Flood insurance have in common? Private insurers don’t want the business. It is not a profitable product, actually by having health insurance tied to employment only the healthy (healthy enough to hold a job) have private insurance coverage. The industry has been shifting the sick off on the government for a long time. Many government employees keep working for simply for access to healthcare. Privatize the profits while making the liabilities public. Where have you heard that before?
  - http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
    
    Yar the only goal of the HMOs are for profit. They rarely care for their customers. If you see a Blue Cross or Harvard Pilgrim tv commercials those are Props. They mean it but not necessarily for us it is for them. The people who DO CARE for the patients are the Hospitals, Doctors, Nurses, Patient Accounts and other medical fields.
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  A Family members cannot take care of other families not all families take care of their elders.
  Still the most important is Real Caregivers who are willing to work almost 40 hours a day. A family member cannot do that.
  - http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
    
    correction almost 40 hours a week or more.
  - Anonymous
    
    And yet this is what is being done at this very moment in tens of thousands of homes across this nation.
    - http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
      
      Show me the stat and show me how many are Asian families?
      - Anonymous
        
        I’m not sure of the stats. You seem to have some kind of agenda here. I’m not sure what your point is. Anyway I found this article, it’s a few years old but there are millions of people in this country caring for elderly parents or relatives.
        http://www.usatoday.com/money/perfi/eldercare/2007-06-24-elder-care-cover_N.htm
        In this article it states that nearly 10 million adult children over the age of 50 care for their aging parents. Which is not to say they are not getting some form of additional care from paid care givers, but most people can’t afford this full time.
        http://www.caregiving.org/
      - jem248
        
        We tried caring for my mother but it was too difficult and she ended up in assisted living where she spent every cent she had (over $150,000 plus social security) over six years. She died just as her money ran out and I would have had to apply for Medicaid.
        My husband’s mother is also in assisted living to the tune of $3,500 per month. We just sold her condo which will go towards that until it runs out.
        Give up any hope of leaving money to your kids; just hope your money holds out until you die!
- CORY
  
  On Point, Jeffe!
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

http://www.caregiving.org/data/04finalreport.pdf
Here is the National Alliance For Caregiving and AARP web siteInformation. The pdf will explain almost everything about Caregiving.
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  Majority of Caregivers in America are Filipinos. I know 50 of them that are caring for American families. Some of them don’t get paid a lot, some travel almost 50 a miles day with less pay, some do it for free and some do it part time.
Anonymous

Obamacare used the ponsi like scheme to account for 40% of Obamacare savings!
Is anyone talking about how Obamacare just got 40% more expensive!
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  please!!!! Medicare and Medicaid are SOCIALIZED MEDICINE.
  Before Nixon pass the bill about HMO listen to tapes from the White House how Kaiser Permanente pushed for Nixon to pass the bill. (research that bill passed by Nixon that turn healthcare into profit)
- Terry Tree Tree
  
  Remember ‘W’ and his administration saying that the Iraq war would be paid for with Iraqi oil money? Eight years, and WE are still paying for it!! Will for thirty to fifty more years!!
Khayford

I think we can cut spending on defense and redirect much of those resources to essential things such as this. This is the truly American thing to do but there is so much lobbying and politics involved that any true progress is hindered.
- CORY
  
  Can’t cut defense. We’re at war with somebody or another. Comments like yours are un-patriotic.
  - Terry Tree Tree
    
    Please explain to this new name, that you are being sarcastic, but stating the Republican party line!
- Anonymous
  
  We’d be better off if our military personnel were deployed stateside helping care for the sick and infirm, along with other pressing needs. You can be all you can be without someone trying to kill you. And live with and provide support for your family at the same time too.
Michiganjf

So long as Republicans have enough seats in Congress to affect policy, EVERYTHING will ALWAYS be in CRISIS.
… hasn’t this been PROVEN to everyone’s satisfaction by now??!!!
Winston Smith

Any new long term care plan for senior citizens involving the federal government will create losses that make the Medicare shortfall look like pocket change. just as we have been sending social security checks to people who are deceased, I’m sure that the government would be making payments for beds, heart transplants, etc. for people who are either dead or never existed in the first place. Government efficiency at its best!
- TFRX
  
  Remember when Republicans gave a sh!t about doing anything like governance? It wasn’t so long ago.
  Medicare is run with less overhead than private systems.
  And SocSec will only be in real crisis if you and yours “reform” it.
  - Winston Smith
    
    Are you including the $68 BILLION per year of Medicare fraud in your overhead number? Or is that an acceptable and excusable cost of doing business?
    Also, under unnecessary procedures that I cited, I forgot to mention breast implants and liposuction on the list that the federal government will be billed for and pay.
    - TFRX
      
      Nice scare numbers; I guess they have an effect in your tunnelvision.
      Medicare is run more efficiently than private insurance. It has been shown by studies that it has lower overhead. There is simply nothing to back you up.
      - Winston Smith
        
        60 Minutes had a story on all of the strip mall medical provider facilities that are set up, fraudulently bill Medicare, and then close up shop and move to another location before the federal government can catch up with them. The $68 Billion figure was theirs, not mine. And if you believe that the government can run anything more efficiently than a private company, I have a bridge that I would like to sell you. Talk about being out of touch with reality!
      - TFRX
        
        …and that’s where enabling government to, y’know, govern comes in. Of course, the right wing is all about enforcing laws and persectuing white collar criminals, right?
        Otherwise,
        http://healthaffairs.org/blog/2011/09/20/medicare-is-more-efficient-than-private-insurance/
        -Medicare Has Controlled Costs Better Than Private Insurance
        -So-called “competition” in the private health care market has driven costs up.
        -Medicare Is Publicly Accountable, Private Plans Are Not
      - CORY
        
        What is worse, waste by the government or outright theft by the private sector? At least the government is theoretically answerable to the electorate.
      - Terry Tree Tree
        
        A ‘Bridge to Nowhere’??
    - CORY
      
      Ah yes. Waste, fraud, and innefficiecy. The three legged imaginary monster. Wish I had a bug every time a politician said they’d lower costs by eliminating the big three.
    - Terry Tree Tree
      
      The last administration STOPPED all that fraud, while they were in power? It seemed to SKY-ROCKET!! Most of the regulators, enforcement officers, and others that should be concerned with this fraud, were there during ‘W’s 8 years. They didn’t stop it then, why do you expect them to stop it now? You have more respect for a Democrat President? You trust a Democrat to do the ‘right’ thing, when the ‘Right” didn’t?
    - Terry Tree Tree
      
      So FIX the FRAUD! That is a crime that hurts all of us! I will bet that MANY of the frauds are financial supporters of the Republicans! Tennessee even sent one to Washington as a Senator!
- CORY
  
  What’s the alternative?
nj

Just wait until all the problems with Obummer’s Insurance-company-enhancement Plan become evident.
xray

Sounds like the people who wrote this provision did not have a grasp on reality; what would work and what cannot be done within the framework of the law. Sad. Sounds like most of Obamacare is similarly poorly thought out.
http://www.facebook.com/people/Tim-Brown/1227104716 Tim Brown

Wait, how is an insurance plan, where you pay in for benifits, somehow more “socialist” or “lefitist” than leaving the expenses to medicare where the tax payer eats 100% of the costs?
Dave in CT

Our eyes are bigger than our stomach.
Entropy and Death can’t be bought off, much as we wish, and much as we are willing to confiscate others “wealth”, or try to debt-spend to achieve it.
Our assumptions that we “need services” for everything is just nuts.
We will always have challenges, and have to make trade-off decisions, as individuals and families.
Dying with dignity with some loved ones around, and something like morphine to take the edge off if need be, does not have to be a complicated, outrageously expensive event.
Yes, we might have to take some time off work to be there for friends/family, and thus cut something out of our personal budgets.
We don’t need the government to try to provide a comfortable death, and more than we needed them to provide the pipe-dream of housing for all.
- nj
  
  “Small government” cultism rears its ugly head.
  - Dave in CT
    
    Did you have a point? A resources/expectations comment?
  - Dave in CT
    
    I want it all entitlmentism rears its unsustainable head.
    - nj
      
      Right, Dave, i “want it all.”
      I want basic health-care services provided by a single-payer system as a basic right of citizenship like every other developed country in the world.
      - Dave in CT
        
        If the numbers add up, lets do it.
    - CORY
      
      Are we entitled to anything in America? Can you give me a list?
      - Dave in CT
        
        Equal protection under the Law would go a long way. We should get the 2-party cronies out and give it a try.
- Tess
  
  What about people who do not have a terminal illness and need help? Many people in long term care are medically stable and nowhere near dying, but need help because of disability.
  - Dave in CT
    
    I don’t have all the answers, just as I don’t have all the money. I can accept that. How have we addressed that question for thousands of years, before we reached the brink of bankruptcy expecting more than we can pay for?
    - Terry Tree Tree
      
      Most previous societies, in many parts of the world let their old and disabled die, or killed them.�
      The brink of bankruptcy comes from scam organizations selling ‘life-long’ health-care, then going bankrupt, or just dredging up some ‘small-print’, that was waved away as ‘not important’, by the sales-person, or their supervisor, when the policy was sold. The person that bought, was left without the services they paid for, putting them on Medicare.
  - nj
    
    Don’t ask Dave about details. He only knows about “rule of law,” stealing “wealth,” “building a better Tea Party,” and other Libertarian cult talking points.
    - Dave in CT
      
      Still waiting for your detailed budget, and your non-communist solution.
      I’ve been searching for legitimate, sustainable, realistic, non-communistic solutions this whole time, with very little specific proposals from critics.
      I may have to quit and just go communist.
      People can’t seem to accept the “good enough” or “about the best we can do” of liberty/Rule of law, and living within our scarcity of resources means, and instead keep searching for a utopian “perfection”, that makes all of our challenges disappear, that is bankrupting us financially and politically.
      Why are the European Socialist models in financial trouble? Libertarians or scarcity?
      The real cult is the cult of entitlement, in a very broad sense.
      Economics is about how we deal with the reality of scarcity, not to invent some magical plan that makes it disappear.
      Too many people. No connection to actual sustenance (at least in Western world). Tough choices.
      I’m just not ready to throw out our liberty tradition, for utopian promises.
- CORY
  
  What about those who plan poorly or do not have the priceless resource of family and friends to lean on?
- PZ
  
  BS, Dave. Dr. Kevorkian got put out of business a long time ago, by our lovely government to boot, and unless you’ve been diagnosed as having less than 6 months to live and are on hospice care, every doctor who can prescribe morphine is legally obliged to keep you alive as long as possible unless you’ve signed a DNR, and that only applies once you’ve about stopped breathing. I reiterate my first point — yes, Dave, government is supposed to be of, by and FOR the people — that means ALL of us, Dave, not just the healthy, the young, or the rich (however they got that way). Time to regulate business and banks again — did you know that we first had to do that in 1792 for the exact same reasons we need to do it today? The trouble is that some folks keep deregulating them again, usually in return for nice campaign donations.
Ndgaud

I have not purchased long term care insurance. The reason is that a few years ago Consumer Reports studied the available plans and how they worked and found that much was not covered. Insurance companies have written long term policies that often leave people with many expenses that they thought would be covered. How good is this product today? I don’t have much confidence that insurance companies are looking out for anything but the bottom line.
- Erin in Iowa
  
  Great point! Another example of paying too much money for a product that is sold as a “coverage” when most things are not actually covered. Sounds like it works like most insurance products.
http://twitter.com/kidmuseumnh Children’s Museum NH

We’re so glad you are focusing on the complex issues of elder care. We have been thinking about them to, and the role that we (Children’s Museum of NH) can play in the community. We are launching the first Alzheimer’s Cafe on the East Coast this week, an opportunity for people with dementia and their family/care partners to socialize in an engaging public setting each month. It’s an informal, non-clinical way to get out and meet others in an understanding environment. This concept is widespread in Europe and there are several programs on the West Coast. We felt it was an important way to work toward our goal of being a community resource across a full span of ages. More info at http://www.childrens-museum.org/cmnh2010/programs/content.aspx?id=986
Jackacme

50 years old, 8 years of un-or-under-employment wiped out most of my savings. We’re just getting by in my household. No way we can afford private long term insurance.
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  We in the Healthcare industry are finding a solution to manage this crisis for retirees. The Hospitals in Boston are trying eradicating HMOs and creating our own affordable insurance plan for everyone.
  The problem is old and the solution is new but we are succeeding with this new idea and to present this solution to the American people soon. Affordable Universal Healthcare for everyone.
- Anonymous
  
  Rep. Burgess would tell you that you should have planned better. You know, take all that into consideration in your budget and estate planning with your legal and financial advisers.
  Of course, every one of his comments made it abundantly clear that he, who is one of the few who has true responsibility to address this issue, is utterly clueless about the problems facing a huge number of our citizens.
Shari Gouwens

What the parents of many of my friends discovered when it came time to use this long-term insurance is that much of it could not be applied in their situations. Many have advised us that we are better off saving those premiums in a safe investment than pouring money down the drain, especially if we do not live to need it/collect it.
Shari Gouwens
Fort Worth TX
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  Money under the bed is always the best idea.
  - BHA in Vermont
    
    Except only the rich have a mattress big enough to handle the costs of long term care, either in a facility or at home.
- nj
  
  Private insurance companies are always going to scam, scrimp, cheat, and shortchange policy holders.
  This is why the Obamacare private-insurance-based legislation will prove to be an utter disaster.
  Single-payer, universal coverage is the only workable, accountable solution.
- CORY
  
  What is a “safe investment” for those who live in a former superpower in a tail-spin?
  - Dave in CT
    
    Root Cellar, and kissing the a$$es of the elites.
Michiganjf

There was only ever one hope for Health Care in our country, and that was a Single Payer health care system managed by the government.
Unfortunately, Republicans succeeded in obfuscating the issue enough that it was untenable politically, so we’re now all screwed again long-term, until Republicans are history and another generation comes in which avoids similar conservative brainwashing.
- CORY
  
  Michiganjf, I’d like to buy you an ale or lager of your choosing…
  Concise and dead on.
http://profiles.google.com/rickevans033050 Rick Evans

Remember Kate Michelman, former head of NARAL? After he got Parkinson’s and her daughter was disabled in a horse accident she found out the hard way how many landmines and loopholes were hidden in the fine print of private long term health insurance.
http://www.npr.org/templates/story/story.php?storyId=103250580
Andrew from Cedar Rapids, IA

With the current system as it stands, the only way to prevent bankrupting my spouse and children with my care when I get too old will be to commit a serious felony when I turn 70. Food, housing, medical care will be covered as a guest of the state.
- Terry Tree Tree
  
  See why prisons are so full?
Ellen Dibble

The caller says he cannot deduct his long-term care premium on his taxes. Well, I heard yesterday from the guy who set me up with my long-term care insurance, and he points out again that I CAN deduct that premium, along with my health insurance premiums, and currently also that reduces my FICA taxes. I think there is a limit on the amount of long-term care premium I can deduct, but it’s nowhere near what I pay. Anyway, the insurer my guy found for me is no longer opening new similar policies but is continuing to support those opened in the past. My premium is about $100 a month, but I started in my 40s. I believe it kicks in after 3 months, but allows me maximum flexibility in getting resources to get me back on my feet if possible. I’d really like to know why the insurance is no longer available.
BHA in Vermont

The reason the Republicans don’t want a long term insurance care plan instead of letting the pain fall to medicare and medicaid is because they have every desire to gut medicare and medicaid.
- Jasoturner
  
  I would take issue with this. I don’t think republicans dislike universal healthcare in principle. I would propose instead that for-profit healthcare entities and executives make very substantial political contributions largely to republicans, and the republicans don’t want this gravy train going away.
  So their motivation is not even (wrongly) ideological. It is purely self interest at the expense of the majority. Morally indefensible.
AC

that caller just confused me; you can’t get ‘long-term’ insurance if you have pre-existing conditions? What about the insurance you’re with now, how ‘long’ do they have to give you?
- Yar
  
  You can’t get any insurance if you are expected to actually use it.
  - AC
    
    i’m not going to bash insurance companies, i’ve had to be hopsitalized every few years, go through chemo etc and I have never had to pay a lot of money – part of me knows I’ve been lucky because it’s a rare condition and Boston is full of teaching hospitals so I’ve been welcome ‘paper fodder’, but now I’m concerned they’ll just suddenly ‘cut me off’ at some age, I thought there was a law against this…..I pay in to the system so I don’t feel guilty about using it when needed….i wasn’t aware I could just get ‘kicked off’….
- Anonymous
  
  You can, You just have to pay much more since the insurance plan factors in paying for existing medications.
  So if you are paying $400 / month for chronic conditions and want to buy insurance to pay for it, the insurance can’t cost less than the $400 / month that the insurance already knows about.
Ellen Dibble

I want to know about where home health care fits into this picture. Looking at gap insurance available those 65 and older, I didn’t see home health aide on any policy, so I called the providers, and they say in the last few years, they are ONLY allowed to be paid by Medicare. Well, I suppose I could pay out of pocket. But again, it seems that the gap insurance I want is being forbidden to me. It’s like another deductible; be prepared to pay for your own nursing for the first 3 months, or something like that.
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  Ellen paying out of pocket will drive you nuts. there are health insurance plan that are covered by commercial insurances
Anonymous

Tom, your caller that wanted to buy long term care insurance at the age of 67 and after having cancer is not very realistic. He should have bought long term care insurance at the when he was 50 or 55 or even 60 after that you are on your own.
Can you buy car insurance after you total your car?
- Anonymous
  
  Do you have one ounce of compassion in your being? And you call yourself a Christian?
  And yes you can buy car insurance after you total a car. Your premium goes up.
  - TFRX
    
    Now, now, the workhouses are going to open soon, and he’ll be happy for their inhabitants.
- Jasoturner
  
  Interesting take. Human health should be vouchsafed by the same methods by which we insure our cars. Somehow, matters essential to our very existence seem far too valuable to me to allow markets to decide.
  - Anonymous
    
    I am sorry for your lack of education but you should really look up the definition of insurance. Insurance pays for the some unknown loss when it happens. You can’t buy insurance on a house after it burns down and expect the insurer to pay for the past loss.
    - Jasoturner
      
      Ah, and I am sorry my point seems to have completely eluded you. But thank you for writing. Your judgement about my education is both unwarranted – since you know nothing about me – and gratuitous. I hope you are less inclined to insult others so cavalierly.
- Anonymous
  
  Shoulda, coulda, woulda. How does this help anyone?
  The difference between car insurance and health insurance, is not every one has a car, but every one has health care needs. You’re making a false equivalent, dude.
  - Anonymous
    
    Both are the same since they are insurance and insurance can only be bought before a loss. If it is purchased after the loss, the insurance policy will not pay for prior loss due to personal injury or a house burning down.
- Anonymous
  
  Also, because health insurance is currently a commodity, there is the conflict of profits over people. We should have universal health care in this country, not a profit based system that favors those who can afford it.
- CORY
  
  The important question is… what do people who haved made poor decisions do at the end of the day? The fat, the stupid, the lazy… What is their final destination? Homelessness and starvation?
  - TFRX
    
    Useful stuff, but let’s not forget that the rich have, by definition, made the right decisions, and they get a pass from “fat, stupid and lazy” to “well-fed, common-sensical and unstressed”.
    Yip Harburg was all over this.
    - PZ
      
      How about the rich who have gotten that way by inheritance (dumb luck as to who your parents are) or by committing fraud (many but certainly not all financiers), or by war profiteering, or by criminal activity?? Did you know that what happened on Wall Street in 2007-8 first happened in our nation in 1792? Google or read up on “The Panic of 1792″ and you’ll be amazed.
Tess

The median income for a household in my county is $36,010 – half the people here have income *lower* than that. Where are we supposed to get $2000/yr for long term care insurance? What kind of budgeting would do that?! I just looked it up and Congressman Burgess makes $174000/yr, and says he made more as a doctor, no wonder he thinks it’s just a matter of discipline! My county (Schuyler Cty NY) is strongly Republican and has been for years, but if the Republicans don’t start to understand these things, we will have to find other people to vote for!!!
- CORY
  
  No cable, no meals out, meat once or twice a week, patch your clothes and cobble your shoes instead of replacing them. Work multiple jobs and sacrifice your personal life and relationships. Share a dwelling with relatives and wear two sweaters in the winter. This is what conservatives would have for 75% of us.
  - Dave in CT
    
    Sounds like a commune. I thought the left volunteered for that? At least it was honest and morally defensible.
    Our current consumptive/entitlement culture is unsustainable and immoral.
  - nj
    
    I already wear two sweaters in the winter. Haven’t eaten meat since 1976. Nothing wrong with patching clothes.
    Your proposed measures need to be more austere.
    - Dave in CT
      
      Why not encourage more people to follow you lead, instead of demanding the Government keep up with our unsustainable masses?
      Heck, you guys like central planning, why not just legislate we live the correct life?
      (Currently wearing a sweatshirt and have solar-hot water/heating system, and organic garden.)
      I think I probably really share alot of your goals/outlooks, but really disagree on the means to have them realized.
  - Tess
    
    The reality for most of us in relatively low income rural areas is that we already do most of those things, but without the irony: my family has never had cable, we rarely eat meat, I mend our clothes, we often have shoes resoled or new heels put on. My husband and I both work more-than-full-time jobs, and I am wearing a sweatshirt over a sweater right now! He does all our home and most of our car repairs (both cars are over 5 yrs old), we share the cooking, and rarely eat out. Only thing we lack is live in relatives … .
    A *lot* of people live this way although most probably don’t listen to public radio. But there is such a gap in what I aspire to materially vs. most people I see blogging, commenting, etc. Since the people who live around me also live similarly, and my mortgage gets paid and there’s always food on the table, I definitely don’t feel deprived (maybe because I don’t have cable to see how the other side is living!), but this gap in income and possessions seems largely unappreciated – and allow the Congressman to make foolish assumptions about how we live and budget our money.
    I am quite content to live without cable, fancy meals out, and new shoes, but I do worry about health care costs should one of us fall ill and lose our insurance, and about what might happen if we needed long term care.
- jem248
  
  You should have started voting for someone other than the Republicans a while ago. Wake up! They are not on your side.
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

We in the Healthcare industry are finding a solution to manage this crisis for retirees and elderlies. The Hospitals in Boston are trying eradicating HMOs and creating our own affordable insurance plan for everyone.
The problem is old and the solution is new but we are succeeding with this new idea and to present this solution to the American people soon. Affordable Universal Healthcare for everyone.
Scott B, Jamestown NY

Budget what? How? Salaries are stagnant, if not headed downward, and that’s if they have a job at all, especially the older workers that are loosing their jobs and not expected to find work again.
People don’t buy health insurance now because they can’t afford it, not simply because they don’t want it because they think they won’t need it. This is especially so when it goes up by double-digit percentages every year.
Studies show that most of our health costs come in the last few years of life. More studies show that there’s virtually no difference in health and vitality between 65 (standard retirement age) and 75, and many people will put off getting insurance just trying to pay of the costs of living, and the cost of that only goes up. But you can’t get long-term insurance after age 73!
Let average Americans be able to buy into the super-cheap, but gold-plated, insurance Congress gets. We pay for it, why can’t we have it?
Janet

I applied for long term care insurance when I was about 56 years old. I was turned down because of having mild asthma. I was really hoping that the CLASS Act would supply a viable alternative.
- CORY
  
  A periah because of mild asthma. Does this excuse seem as lame to you as it does to me?
Dave in CT

How did the Native Americans afford long term care?
The native central bank?
Or did they have a more healthy/realistic view of the world, cycles of life/death, and act within their means?
Why do we think we can pay for everything we wish we could do?
That’s an honest question. Can someone honestly answer that its possible?
- Jasoturner
  
  Actually, native Americans were surprisingly free of the chronic diseases of modernity such as diabetes, cancer and coronary disease. They also had good teeth. If they ate the same crap that modern Americans do, it is unlikely there would be enough left to run a casino. New times, new remedies, my friend.
  - Dave in CT
    
    What does that say to you? We need to debt spend ourselves into financial chaos to maintain our junk-food habit?
    At some point we need to face the real need for personal responsibility and the failure of government bailout.
    If bankers don’t go to jail, they will keep doing the same.
    If junk food eaters and there families don’t feel the health expense, they will keep doing the same.
    Bankrupting Bailouts do nothing but encourage more of the same while enriching the “dealers”, be it toxic mortgages or toxic food.
    - Jasoturner
      
      My first point was that your comment regarding native Americans was not particularly applicable. Their health burdens were vastly different than ours and they were able to live differently than us.
      That does not imply that I think it appropriate for America to spend itself broke providing cutting edge healthcare to a population that is overweight, sedentary, and nutritionally ignorant (though I would contend the disastrous food pyramid and low-fat voodoo promoted by our government is itself a big source of our problems regarding nutrition.)
      I guess you can consider provision of healthcare to it’s citizens a “bailout” by the United States. I think you could also consider a for-profit healthcare industry to be, among other things, a very low-risk means by which certain individuals and entities can make an awful lot of money.
      I think you are laboring under an illusion that the participants in the industry today are widely benign and that the government can only screw things up. That is not necessarily the case.
      - Dave in CT
        
        I trust neither, and wish we would self-govern accordingly.
        The “bailout” healthcare idea is in reference to bailing out our horrendous diet, that you agree with. That bailout analogy is fair IMO.
        We only change when we feel the pressure/need to. Thats the feedback that organic pricing provides. Bailouts and subsidies remove the feedback and slow our necessary changes, be they in banking or diet.
      - Jasoturner
        
        Not sure what “self-govern” means when you need an MRI to detect a tumor, and you don’t have the money or insurance to pay for it. Though there is legitimacy to the philosophy that basically, even if you work hard, sometimes life isn’t fair. It’s just brutally indifferent.
      - Dave in CT
        
        I didn’t say self-medicate. Usually you see a doctor for that and pay for the services.
        What if the gravitational levels of the moon were shown to increase longevity by 5 years. Should we use single payer to send everyone to the moon? Why not? All or none, equity or bust.
        Look at the cost of medical care, and that is not a fallacious question.
      - Dave in CT
        
        Self governing means electing representatives to legislate a dispassionate Rule of Law that provides ground rules, but does NOT legislate specific ENDS, and an executive to enforce that law blindly, without corruptible discretion.
        http://www.thefreemanonline.org/headline/diversity-ends-rules/
      - nj
        
        More Libertarian dreaming.
        The link gives the example of “money” as an “ends independent” function that is supposed to somehow level the playing field for everyone.This strikes me as simplistic. “Money” as a functional entity doesn’t exist or function without an infrastructure, much like electricity as an energy source needs generation, transmission, regulation, etc.The money infrastructure (printing, circulation, banking, interest rates, etc., etc.) necessarily requires an authority that sets standards, guidelines, rules.The question is how those rules are set, who has participation and influence in setting them, how they are are monitored, etc.Either representatives accountable to the needs of the majority of the citizens control the system, or representatives accountable to moneyed interests control the system. The People have the ultimate power, should they choose to actually exercise it.The Libertarian view seems to think the “Free Market” will somehow magically do the right thing. What nonsense.
      - Dave in CT
        
        Your getting closer, you just have to keep your mind open a little longer.
        “The question is how those rules are set, who has participation and influence in setting them, how they are are monitored, etc.Either representatives accountable to the needs of the majority of the citizens control the system, or representatives accountable to moneyed interests control the system. The People have the ultimate power, should they choose to actually exercise it”
        That’s right. Thats a more complicated restatement of what I said:
        “Self governing means electing representatives to legislate a dispassionate Rule of Law ”
        We make the laws, to protect our liberty from the historically proven worst tendencies of human nature.
        We don’t jump from recognizing their are bad tendencies and bad actors, to removing our freedom and giving it to “better informed, better intentioned” central-rulers, the benevolent dictator. I don’t think you want that.
        The next step is understanding that the classical Rule Of Law I keep harping on, is the idea of blindly and equally applying the Laws we have set, so as to maintain a dispassionate, LESS CORRUPTIBLE, rule of LAW not MEN.
        The more DISCRETION (well intentioned or not) we give our legislators or executives to tinker with the enforcement of what we had deemed necessary to protect our liberty (loopholes, back scratching, picking winners and losers with subsidies and micro-managing tax policies) THE MORE CHANCES WE HAVE OF CORRUPTIBLE PEOPLE DOING CORRUPT THINGS that skirt the intent of the core laws we wanted.
        Is that “simplistic”?
        Do you prefer a complicated system, complicated like the hidden credit default swap market? Complicated like the shenanigans that went on between legislators like Frank, regulators, and Public/Private tax-payer backed entities like Fannie Mae?
        I think self-described modern “liberals” misguidedly embraced the idea of Discretionary Rule, thinking it would be a good way to achieve well-intentioned ends.
        But it corrupts the system, and leads to a tangled web of promises, influence peddling, and centrally-managed market inefficiencies and poorly managed schemes, that in the long run, DO NOT SERVE THE GOOD INTENTIONS.
        This is what I mean by Progressive Values, Libertarian Principles, that some of you like to disparage.
        So many of us in this country probably agree on the type of world we would like to see, but we are so divided and confused about the ENDS we should use to get there.
        That is what that piece was about.
        Its also what informs pieces like this one about Libertarian/Progressive alliances.
        http://www.thefreemanonline.org/headline/getting-taken-seriously/
      - Modavations
        
        Native Americans are tourists from Mongolia.They crossed the land bridge, 19,000 years ago.
      - nj
        
        Native Americans, as well as the rest of the human race, originated in Africa.
        Most estimates put the crossing by Asian sub-groups at 13,000–10,000 years BP.Another pointless and erroneous Moda-troll post.
- CORY
  
  Tell that to the 92 year old with congestive heart failure who is demanding a double knee replacement.
  - K8te
    
    THAT is the problem with our current system. The system makes money on OVER providing care for the very elderly. (your example of a 92 yr old wanting a double knee replacement is not unusual). Doctors/Hospitals/Nursing Homes/Healthcare Equipment companies fleece Medicare/Medicaid on a daily basis in this country. We can’t keep this up. Our nation is going broke. Basic care is good but excessive care is not.
- nj
  
  Why stop there? Let’s go back to the roaming, pre-agricultural tribes roaming free of any government intrusions on the plains of Africa. That’s real freedom!
  - Dave in CT
    
    Sure was.
    What’s your point? Some red herring Luddite vs. Unsustainable spending/expectations thing?
- Terry Tree Tree
  
  Native Americans, Africans, Polynesians, or any of the others had hospitals, nursing homes,etc…? Evidently you know little of history, U.S., World, or any other. Please read up on it, as it takes books, not blog-spots, to explain. Without the $68 Million or more of Medicare fraud, we could do better. Without the Medicaid fraud, we could do better. Without insurance fraud, we could do better. I’ll bet you can find a LOT more ways we could do better, and TAKE CARE of our people!
  - Dave in CT
    
    The beginning of your statement was my point. They also didn’t have a $14,000,000,000,000.00 Debt. Pesky little thing.
    Death with dignity doesn’t have to be another expensive industry. The market will continually feed us things we demand and consume, and demand payment. That is normal. If we can’t figure out how to to say “No, thank you, Market”, and deal with death and dying without a massive price tag, as people have done, with all the grieving of a difficult time, throughout human history, then there is really something wrong with us.
    Once it’s a government program, saying “No, Thank you” is not an option anymore, particularly if it had a mandate. You can say NO in a free market, but not to government decree.
    These ideas are not that radical or complicated.
    It is simply immoral to require all citizens to contribute and participate in every well-meaning plan that some other people come up with.
    Do what you think is right, and leave others alone. If you can’t build a voluntary critical mass for your plan, tough luck- but don’t use your particular judgement of “good intentions” to force things down other’s throat who have a different view point. It is not peaceful!
    http://newsbusters.org/blogs/noel-sheppard/2011/10/17/carter-national-security-advisor-lists-rich-people-should-be-publishe#ixzz1b3gCM42h
Michiganjf

The moral of today’s show:
YEAH, the free market is the answer… they won’t ONLY be interested in ripping everyone off with woefully inadequate coverage despite high premiums and deductibles.
Mike

Again, the first and most necessary thing that this country continues to need is a heavy duty overhaul of it’s healthcare system. There is no reason why we can not have healthcare that is affordable, accessable to one and to all, and of good quality in this country. There is so much waste in healthcare, much like in education, where we spend more than other countries in the world and yet, we end up with a product in the end that is far from quality and grossly expensive. And why do we not have the quality healthcare we need and deserve is because the poloiticians will not stand up to the grossly overpaid insurance company’s, healthcare organizations and all the other ‘special interests’ who don’t want to see the kind of overhaul that O’Bama wanted and we need, because healthcare would no longer be the profitable industry that it is today. I support Occupy Wall Street.
- Zing
  
  Special interests…..like doctors? Obama didn’t want an overhaul; he never pursued nor mentioned an overhaul.
Fjg47jr

Why didn’t Congressman Burgess just say what he meant: “Let them eat cake!” Anyone who still doubts that the privileged few are building lifeboats against the coming economic tsunami – and using us to pay for them – need to wake up and smell the coffee. It’s also useful to recal that Pres. Obama never even invited universal single-payer proponents to the table when crafting his non-health care health care plan!
- Dave in CT
  
  I loved that C-SPAN roundtable he did, where we could see where everybody’s interests were….
Dave

Tom, several callers have identified the drawbacks to these long-term care policies. I am a responsible middle-aged guy who plans for the future in many ways. But I will not buy long-term care insurance for exactly this reason. I don’t trust that the companies will pay out when the time comes. I won’t pay $2000 per year only to be rejected when I need to go into a nursing home. I’d rather take my chances and remain uninsured.
- Michiganjf
  
  The same exact thing applies to medical coverage, for which insurance companies charge exorbitant premiums, have high deductibles, yet attempt to use any trickery they can devise to cheat people out of coverage when the time comes to collect.
Dar34

Shouldn’t daily limits, total limits, etc. increase with the cost of living. The cost of insurance follows at least the cost of living, if not a great deal higher percent increase.
This doesn’t just apply to LTC
Mark

I am 40 years old with a wife, a 6 month old healthy baby. I have 2 bachelor degrees and professional licencesure. I make $50,000 a year, my wife makes $18,000 a year. Our employers don’t offer affordable coverage so we pay $15,000 per year for health insurance and an additional $2,000 per year deductible. We are filing bankruptcy for $17,000 worth of credit card debt because we simply can’t pay for rent, credit cards, health insurance, vehicles, heating oil, fuel, food….etc. I expect to work until I’m dead and die poor.
- Tina
  
  Mark, meanwhile, our tax dollars are going toward the purchase of major armaments that will kill and maim people worldwide, including our own citizens in collateral damage. Can you imagine if we were a TRUE WORLD LEADER, suggesting by word and deed that ALL countries act in service of Life rather than in service of Death, Injury, and Disease?!!! It COULD be done; but there is so much profit in arms dealing, and so much money that must be raised for political campaigns. It COULD be done. Your taxes could be lower, yet you could be paying for something that would serve you and your family thruout the Lifespan (single-payer health insurance; social security credits for your wife if she is staying at home with your baby instead of paying someone else to do it; good education, including for adult re-education; long-term care; good infrastructure NOT tied to contributions to political campaigns). Sadly, SO sadly, I have found that President Obama is NOT at all about CHANGE. We COULD have a country that spread the ideas and structures of Peace and Lifespan Support throughout the world, but, sadly, so sadly, we do not have Change at all.
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  SO SORRY to hear that You are not the only one. We will do our best to pass another healthcare reform for the American people but the American people should support the new bill with fingers crossed that there will be no diversion from the Tea Party.
- CORY
  
  Hey! Me too! 40 yrs old, two kids, two working parents, no retirement possible. The American Dream.
  When you decide it is time to retire, walk into a bank with a squirt gun and a robbery note. The government can sponsor you retirement in a penitentiary. You laugh, but I hear this “joke” from more and more people.
- Zing
  
  As we all should; our founders did, and what did we do before pensions, retirement, and ltc?
  - CORY
    
    The strange hopr that our lot be better than our parents? Some call it the American Dream. A jingoistic conservative such as you should know that.
Ellen Dibble

Listening to the last caller, with the people on Unum long-term care discovering it doesn’t cover till after 100 days, and then only $100, not the $300 — that confirms that what I should be looking for in gap insurance as someone on the cusp of 65 is a policy that covers that crucial period, where if you can get the right boost, you’re back off and running again. If not, please pass the overdose. Come ON. People with a lot on their plate can get extinguished by a couple of relatively manageable physical splats, even with Medicare, Medex or other gap insurance, AND long-term care insurance. If you’re permanently flattened, I figure that’s curtains for me, since my body doesn’t lend itself to anything a nursing home could provide. So I accept that. But meanwhile, I’d like to be functional.
JoeK – Vermont

How can the average educated consumer understand and fully comprehend legal contracts (filled with loopholes benefiting the provider) that have been compiled by some of the highest paid corporate attorneys? So similar to the mortgage contracts that the banks used to befuddle the american public. We the people are constantly being taken advantage of. Enough! We need to regulate these corporate crooks.
Jasoturner

I would like to believe that, were I diagnosed with a terminal illness, I would have the moxie to kill myself before ruining my family financially. I think the fact that I feel that way says quite a bit about how well American health care works. Or perhaps it would be better to say, it reflects how much compassion is embedded in our approach to health care.
- CORY
  
  Suicide and euthenasia are both illegal in the United States. Are you a criminal?
  - Modavations
    
    No,but I’ve got a handful of “Percs”and a bottle of Tequila.
  - Jasoturner
    
    Perhaps it is America’s approach to my health and my autonomy that should be illegal…
Anonymous

This is why we simply must go to a single payer system:
Profit-driven plans do the exact opposite of what is needed — they exclude the very people who need it most, and they must be limited by definition, if they are designed to earn a profit for the underwriter.
Everybody *must* be in the system automatically, so that we all share in the cost — because no one will pay into a system voluntarily *until* they need it.
We need to realize that healthcare cannot be a profit driven business, period.
Neil
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  it will go to a single payer system. We are just eradicating little by little the insurance companies. Did you noticed some of them are merging with Hospitals.
ray – boston

The insurance companies are organized as ‘for profit’ entities. There is no incentive to provide insurance to people that will need high outlays and hurt their bottom line.
Why is health insurance in this country based on profit? We need an alternative.
- Jasoturner
  
  Yes, but for-profit healthcare =>> Rich executives =>> generous political contributions =>> promotion of status quo =>> average schmuck pays twice what s/he’d pay in most other industrialized nations with equal or better health outcomes.
  The system works! Just not to our advantage…
AndyF

We were once a country that prided itself on “Americans” working together to make a better world.
Today, we are country where “Americans” means nothing – what matters is Rich/Poor, Conservative/Liberal, Republican/Democrat, etc. and we have ensured that we have no real future at all since these days, we dont care about our “fellow countrymen” as much as we care about someone’s politics.
And, as Mitt Romney pointed out so well, Corporations are people. What he didnt point out is that those “people” are the wealthy executives, the rest are just “worker bees”.
What a sad and sorry state we are in, already amidst the downfall of the great American idea, but even that we refuse to admit in the face of overwhelming evidence in every corner of what used to be “America”.
Dave in CT

Scarcity and Mortality.
Tough being an earthling.
Which political party do we blame?
- Anonymous
  
  What does every other developed country in the world know, that we don’t know?
  How are they paying less than half what we are, and yet they cover everybody? Hmmm…
  Neil
  - Dave in CT
    
    I think they are going bankrupt, and don’t even have the same medical technologies/expectations as us.
    No financial crisis?
    - Anonymous
      
      You *think* they are going bankrupt? Are you basing your opinion on a guess?
      They have the same needs as we do, and they are doing a lot better than we are — they get more coverage exactly when they need it; not less.
      Neil
      - Dave in CT
        
        Did you get the financial crisis memo? What part of the developed world spending/wanting more than it can afford and now facing global bankruptcy do you not believe?
        If the numbers add up, lets do it. Have not seen the numbers adding up.
      - Anonymous
        
        Dave, That is a dodge — the financial crisis has it’s own root causes. You said you “think” that the other country’s healthcare systems are going bankrupt; not the financial institutions.
        Neil
      - Dave in CT
        
        The societies are going bankrupt. More debt than production. Not addressing that is the dodge, isn’t it?
        Why does everyone want to sweep this under the rug?
  - http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
    
    France,England and Germany are doing it.
    In France there is a On Call Doctor that visits you in your house not you visiting him in the hospital and it is paid by the government.
  - Jasoturner
    
    Yes, but our insurance and hospital executives are much richer! We’re number one!
- Anonymous
  
  Dave, Scarcity is hardly a problem in the US. We are resource-rich — resource-stinkin-rich, you might say! The issue is who has access to the resources. We took them away from the original people who lived here when we migrated to this land. Then, slowly, we created — using force as necessary — a class structure which assigned the benefits upward and the costs downward.
  In a declining democracy like ours, those who have the resources are trying to convince us that if we demand equity, we lose prosperity and freedom. In a other democracies we’re familiar with, inequity has been addressed very successfully without sacrificing either prosperity or the freedom.
  - Dave in CT
    
    I want to believe that, but just am not convinced it’s that simple.
    The amount of consumer demand we now demand, requires an incredible amount of work and productivity to bring such things into being in the market.
    If we don’t like the side effects of what our corporations produce, we need to change our lives and stop consuming it.
    I do believe we can live comfortably within our means, including having the time to spend with our dying friends and family.
    If you want to maintain our level of consumption/entitlement to comfort/pleasure, you WILL have to give up freedom and personal prosperity to have it. We are already doing that, giving the freedom up to both the government and corporate world that tries to meet our demand, consequences be damned.
    We the consumers of goods and government have to live the sustainable lives we need to, if we want to preserve both resources and freedom.
    We are too quick to keep up with the Jones’s and not make the materially tough choices not to go along with the lifestyles the corporations and politicians want us to continue as it enriches and justifies them.
    New iphone every 6 months like a good progressive hipster for ex.
    - nj
      
      Dave wanders further into the woods.
      What in the world does over-consumption of material goods have to do with the reasonable expectation that government provide a base level of health care?
      - Dave in CT
        
        Because I think we operate as a society from a mind-set or world view, that influences most of the decisions we make.
        Please show the numbers that demonstrate Long Term Care for the coming baby-boomer elderly would not break the bank, especially if in as most things, the government management leads to higher prices, when you include the subsidy cost, which like it or not, is a cost to all of society in the long run.
        I’m not even talking about basic health care access, or catastrophic coverage. What we seem to be talking about is in addition to full health care for all, and additional Long Term Care program.
        If the numbers add up, lets do it.
        But if they don’t, well I guess we will have to face some aspects of the human condition as humanity has since its dawn. Some suffering, some hard choices, alot of grief in the face of mortality.
        I wish we had a magic wand but we don’t.
        Show the numbers and your necessary rationing plan, and I am happy to re-examine my charge of financially not sustainable.
Ren Knopf

A national program for long-term care would be a responsible course for Congress to take. But could they do so without the “benefit” of $3+ billion in lobby money or the “help” of the industry writing the bill for them? I think that unlikely. Just another sad aspect to our current political situation. Ren Knopf, Framingham
Kathy

I wish I had had a mother or someone to tell me that I should get long term insurance at 50 as the congress man did. I didn’t. By the time I knew about it I was ineligble because of medical problems at 49.
Potter

So did Sebastian ( Health Sect’y for Obama) given in ( capitulate) without a fight? sound familiar?
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

Mitt Romney’s Massachusetts Universal Healthcare is working properly for now but his plan is not for the Nation to follow it is a Massachusetts healthcare plan.
Modavations

To quote Ms.Pelosi,we have to pass the bill,to see what’s in the bill.
- CORY
  
  Huh?
CORY

Here is a followup to my earlier post. A happy ending if you will:
A year ago I was hired to do similar work for a similar population at a top flight regional hospital. It is a NON-PROFIT company, and all it’s sizable profits are re-invested in facilities and care. I am treated well, and my patients are treated even better.
Many problems could be soved in the field of elder care by requiring any such facility to operate as a non-profit. No more shareholders or entrepeneurs to skim profits or cut food and activity budgets. In fact a great model for all of health care. Why does money need to be made off of the sick and elderly? Operate all such entities as public utilities.
- Tina
  
  Cory! THANK YOU! Yes! Non-profits, as public utilities! Let’s get those simple words OUT THERE into the public discourse! That IS where the President should have stood and what he should have said if he were really all about Change! But, he didn’t, so we will have to. We need to spread the word! Thanks!
  - Zing
    
    You and the mouse in your pocket…..
  - Modavations
    
    The guy is a fraud and should resign
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  Because there are TONS of them to make money with. it is like shooting wild ducks the more you shoot the more ducks you get for profit.
- Modavations
  
  Mr.Obama,in his push to Socialize the world,is banning the charitable deduction.Boston Globe ran the piece yeasterday
  - Anonymous
    
    Actually, the president can’t “ban” the charitable deduction. He has proposed a cut in the deduction wealthy people can take. Proposed.
    According to the report in WaPo: “Under Obama’s proposal, the tax deduction for those with incomes over $250,000 — which is now 35 cents for each dollar donated — would be limited to 28 percent. That would return the rate to where it was during President Ronald Reagan’s administration.
    Obama said the change would help equalize the tax break for those donating to charity.”
    http://www.washingtonpost.com/wp-dyn/content/article/2009/03/25/AR2009032503103.html
    - Modavations
      
      Join the olympics,you’re acrobatics are impressive.You know I’m right.
- Brett
  
  In both this post and your earlier one I found myself nodding in complete agreement. I have worked in the mental health field for a long time and my experiences with non-profit vs. for-profit agencies are very much the same as yours, leading me to the same conclusions (for both group homes and nursing homes). I have only worked for non-profit agencies but have coordinated services with for-profit agencies. I have seen a lot of what would be considered bordering on negligence in for-profit facilities, from cutting corners to save money on food (often at the expense of a healthful diet for the patients) to over-medicating patients because that is easier and cheaper than providing a therapeutic environment implemented and maintained by highly trained staff.�
Modavations

Ms Sibelius(?) is leaving because she does not want to be involved in the coming scandal.Good move,in my opinion
Modavations

In Ma,.OBAMA-Romney Care has caused my Blue Cross Premiums ,to rise 47% in 3 years(42% in two years alone).It was supposed to drop prices.The Boston Globe wrote Emergency Ward treatment didn’t drop at all.
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  The plan was not to reduce premiums but to make HMOs pay more on health insurance CLAIMS to minimize denials and rejections of claims. That was the intended plan not to lower the cost. I am sorry the public was misinformed.
  - Modavations
    
    And it’s failed abysmally.Note the Boston Globe stories claiming usage of Em.Ward treatment ,hasn’t dropped an iota.Open the market to competition.We have 4 carriers,but need 400.
- Anonymous
  
  The costs of healthcare have been skyrocketing without any changes from the state or federal governments. Massachusetts and the federal plans are not perfect to be sure, but they are at least an attempt to slow the cost increases.
  The real reason for the increasing costs are that we are suffering with delusions that the “market” is the best way to provide healthcare. It isn’t.
  Every other developed country in the world has figured this out, and they are paying *no more* than HALF of what we are paying — and *everybody* is covered in their systems.
  Neil
  - http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
    
    We told our government but they never listen they are more with the HMOs than the American people. The main reason is money.
  - Modavations
    
    In Ma.we have 4 carriers who collude.We have to cover Chiropactors and sex changes and envitro,and…..We need “Tort Reform” and policies with an a la carte menu.How ’bout “Catastrophic Only Policies”, for young,able body types.
    - Anonymous
      
      Tort reform can only change things a *tiny little* bit. We already have very high deductible policies. If only sick people buy healthcare policies, then there is no profit.
      Preventative measures are by far the least expensive, and so if people wait until they are sick, then they won’t be able to buy a policy — and who can predict what specific coverage they will need?
      Universal coverage by a non-profit payer is the only way this can be made to work.
      Neil
      - Modavations
        
        Go to the Dr. and measure your BMI.Adjust for age.The closer you are to your BMI, the less your insurance costs per month.If you’re fat,you pay up the absolute Wazoo.As you get in shape and move toward optimal BMI,you pay less and less.If you are fat and refuse to get in shape ,because of sloth,you get no coverage.I’ll bet in one years time,we’d have a nation of Friggin Jack Lalanes.
      - Modavations
        
        I meant Optimal BMI
      - Anonymous
        
        Have you had any health issues? They can take you by surprise. You see, things like chemical pollutants that can give you cancer; of the brain, of the lungs, of the liver, of the kidney, etc.
        Also, we have so much prepared foods, so much fried foods, so much factory farmed meat that is loaded with antibiotics and hormones — that eating a healthy diet is very hard to do.
        Lots of people do not have access to a doctor, or they cannot afford a doctor.
        Why is it okay for some people to profit off of the need for healthcare of other people; when we all should have access to healthcare? Why is it okay to let someone’s health condition go untreated just because it is not on the allowed list? Why is dental health separated from the healthcare of the rest of our bodies? What are we going to do when we have a majority of people who are older? Why should someone suffer just because the company they worked at moved overseas?
        Neil
      - Modavations
        
        Neil,I’m not a youngster and wouldn’t go one second without an ins.policy.I work out 5 times a week.The average life span in the USA is 80(78 men-82 women).We were only designed to live to 50ish.Cancer is an old person disease,compromised immune systems.Imagine how much we’d save if everyone was at proper BMI.We’d pay off the national debt in 10 years.
      - Modavations
        
        Drs are retiring in droves because they can’t make a sufficient profit to run their practices.It’s illegal to be denied health care and we have Medicaid as a back up
- Anonymous
  
  Your premiums went up because your insurance company decided to raise them. They were going up at this rate before the Mass health care law came into effect. The new national health care law has not even taken effect yet. Wait, I’m debating a mindless man/child.
  - Modavations
    
    That fool, Deval Patrick,tried to litigate “wage and price controls and the 4 remaining insurers said,we’ll leave.My old insurer,USAA,did leave
    - Jasoturner
      
      Yes, Massachusetts is little more than a smoking pile of rubble since Romneycare was enacted.
      - nj
        
        I have no idea what Moda-troll is babbling about, but the solution to “healtcare” is not holding a gun to people’s heads and forcing them to buy crappy insurance policies.
      - Dave in CT
        
        “not holding a gun to people’s heads and forcing them to buy crappy insurance policies.”
        Unless its a government one!
        You almost sounded like a libertarian!
Modavations

The shovel ready jobs weren’t so shovel ready and Affordable Care isn’t so affordable.
- Gregg
  
  The change isn’t all that hopey.
  - CORY
    
    Can’t even call this profound using all the sarcasm I can muster.
  - Modavations
    
    General,What up dude.Find me an Emerald
- CORY
  
  Profound.
sailon_52

Advocates for changes in health care that will truly help people who need it, should be making contact with the Republicans and the Tea Party. They are the people standing in the way of constructive change. Let them have to publicly answer to the desperate straights that millions of sick people find themselves. Let’s see what the “pro life” party really stands for.
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

HMO premiums will never go down as long the prices of prescriptions drugs, medical supplies,gas etc etc goes up premiums goes up.
That is why we need Universal Healthcare and 9 9 9 tax plan.
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

I pay a lot for health insurance every week but I never use my Tufts plan for almost 10 years now. I am one of those people who are saving a lot for the HMOs so other people with terminal illness can be reimburse.
Anonymous

I believe it’s more useful to talk about the system than to throw blame around. That approach just divides us; we need to work together.
Bilbo

ltc ins problem is basically a middle class problem. The rich like the Kenndeys have enough money to proivde care and or buy insurance. Example Rose Kennedy was taken care at home. The lower income or poor do not have enough assets and qualify for medicaid. that leaves the middle class. The middle class deal with the issue in three ways. One the family provides home care. two they do medicare planning and get assets transfer out to be to able to qualify for medicare( give assets to relative and let the govt pay) and third is to buy LTC ins. Ltc care ins policies all have a provision for auto inflation protection but this is an optional provision and makes the policy more expensive. LTC like disability have a 90 to 100 day waiting period becasue they are meant to cover long term problems not short term problems. If some on medicare goes into the hospital for three days they can qualify for 100 days of nursing home care. The major problem for health care is COST. Also we are the only nation in the world that spends 15 to 20% of our national budget on defense. This is in part because we are protecting all of the other nations that are spending their monies on social programs and in part to protect us. Look at what happen in Libiya with Nato and what Gates said
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  im sorry it is An American problem.
Jean Smith

In this era of part-time jobs with no benefits where the housing bubble was about milking home values to maintain living standards while cost outraced wages. I don’t see where this $200/month is coming from the median income.
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

Remember the Topic are Caregivers and the elderlies not health insurances.
- Steve__T
  
  How can you have an honest discussion of care givers and elderly w/o talking about insurance company’s and their policies?
http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68

I forgot to mention that the Pharmaceutical companies are contributing to the health problems of the American people.
hint: you take it and you get side effects.
- Modavations
  
  While your average NPR type, loathes Big Pharma,I thank you for the “Wonder Drugs”
Elder Law Atty in MA

What is in the future is the government continuing to pay for long-term care through the Medicaid program as it already is rather than receiving contributions towards costs by the purchase of LTC insurance through the CLASS program.
Private LTC insurance is unavailable (because of health or family history) or unaffordable to most people. And the benefits do not cover the cost of care. (I see many people with LTC insurance who still require Medicaid to cover the rest of their costs!) And at an average of $8,000 to $10,000 LTC cost per month, even folks who have savings soon spend them. Everyone ends up on Medicaid eventually. Even on Medicaid, you contribute all of your income except for an allowance of less than $100 per month, towards the cost of your care. And after your death, they recover the benefits they’ve paid by taking your home. At the same time massive lobbying efforts to eliminate the “burdensome” estate tax for people owning more than $5 mil ($10 mil for spouses!) continues.
The need for LTC has little to nothing to do with lifestyle choices or personal responsibility. And personal responsibility can only take us so far. With mortgages, saving for our own retirements (since pensions no longer exist), increased living expenses, paying huge health insurance premiums, paying for child care and expenses, paying our debt load, paying off our own college loans still while paying for the college education of our children, it is next to impossible for anyone in the middle class to save for LTC or pay for a private policy. These days, if you have the ability to meet all of those other obligations you’re an amazing success story.
Aside and apart from all of these financial considerations is the question of the quality of institutional LTC; while there are many dedicated providers, neglect and even abuse is rampant. Theft, surprisingly, is a huge issue in nursing facilities. Jewelry, clothing, supplies, even durable medical equipment disappear from residents with shocking regularity, while nursing home administrators generally disavow responsibility.
The treatment of our elderly in this country is appalling and in massive need of reform. The elimination of CLASS policies is a sad step backwards.
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  What is LTC. I never heard of it and I work for a Hospital
  - http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
    
    oh sorry I got the meaning. We call it Preventive Care.
  - Elder Law Atty in MA
    
    LTC is long-term care. I am curious what country you’re in if you work in a hospital and haven’t heard this term; in the U.S. this is standard nomenclature.
    - http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
      
      I live in Boston and I am Medicare Reimbursement Specialist. (If your claim get denied by the government I am the one who calls them so your claim will get paid)
      Long Term Care is not long term because insurance companies can deny any claim that are not covered. We call it Preventive Care. You can go any time any day and see your doctor for an office visit just to check on you, if you have any new health issues that’s preventive care.
      - Elder Law Atty in MA
        
        I’m sorry; long-term care is not preventive care. Long-term care refers to the fact that the need is long-term and the patient is not showing improvement, but rather is stable. In the Medicare realm, when a patient in a skilled nursing facility transitions from rehabilitative care (where the patient improves) to custodial care (where the patient merely maintains) the patient is then considered to require long-term care, which is not covered by Medicare or other health insurance policies, and payment terminates. If your experience originates from a billing office in a hospital then perhaps you have not run across this term, but it does surprise me.
- Modavations
  
  Medicare-Medicaid cost 600billionish ,per annum.We are now paying 457billion interest on the debt.When you open the S.Sec.”lock box”moths fly out.We have big problems.
Modavations

In England,they have the Death Panels,Unfortuneatly,they start denying care when you’re in your 60′s.You should read the horror stories in the papres.Ask Lord Moncton what they did to his mum.
- Anonymous
  
  You’re just making this stuff up! What *is* a “death panel”?
  Lord Monckton has zero credibility, because he makes stuff up.
  Neil
  - Anonymous
    
    Don’t feed the troll. I know it’s hard to do, I just responded to one of his inane comments. This guy is very offensive and when he’s called out he’s then starts in with the nasty name calling. He’s not worth it.
    - Modavations
      
      Don’t say that,don’t think that,as the Thought Policeman went for his “Ball Peen”
      - Anonymous
        
        If the “Thought Policeman” is only going after thoughts, you’re safe.
  - Modavations
    
    lORD Moncton said his mum died in filth.He said elderly were left unattended in feces and urine.Just because he is a Tory, does not mean he was lying about his mum.You can now buy private ins.in England.
Modavations

In Europe ,if you are a “ward of the state,” they either give you a “hot shot”,or a pillow over your face.I’ve often thought of this method for my “pop”
- Jasoturner
  
  In Asia I think they turn you into soup and sell it to the orphanages. Either that or they blast you into space on a nuclear-fired rocket. I can never remember.
  - Modavations
    
    Ever see that flic sOYLENT gREEN
    - Jasoturner
      
      Nyet. But I have a hunch about it…
      - Modavations
        
        The mother tongue of the average NPR listener
http://www.coryatkins.com Cory Atkins

As our population ages, this is a very important issue to consider. Many of my constituents have recently experienced outrageous long-term care insurance premium increases, leading me to believe that the product itself is unsustainable. -MA State Representative Cory Atkins
Modavations

We live too long.If not for Medical Intervention,we’d be dead by 50.
- Steve__T
  
  NO we don’t, you have!
Modavations

Speaking of health issues, what’s more dangerous…..Walking in the woods in Ohio(?)with loose lions and Tigers,walking around Madison with “R”taped to your back when the Union thugs were running amok,walking around a Dem.US Ghetto,or walking around Bagdad?
- Jasoturner
  
  I think tigers are more dangerous…
Modavations

The Premier of Newfoundland was so enamored with socialized medicine,that he flew to Florida ,for his heart operation.
- http://pulse.yahoo.com/_C2STBLZJK4VKQBV27DVQX3I6CU FAX68
  
  Take it easy with comments it destroys the fabric of the arguement
- Anonymous
  
  Prove it, please.
  Neil
  - Modavations
    
    I also have a pal in Halifax who says ,what the Socialists have done to the Canadian System,breaks his heart
    - Anonymous
      
      Sarah Palin has gone over into Canada to get healthcare.
      Neil
- nj
  
  Moda-troll feigns having some kind of relevant point.
  Williams’ surgery choice obviously means that the American, profit-based system is in every way superior to a single-payer system. It couldn’t possibly be that the rich and well off will always have choices that people of more moderate means don’t.
PZ

I’m outraged by “public servants” (politicians) who don’t think our gov’t should help its citizens. My husband & I are 60+ but under retirement age, our careers were cut short, our hard-earned savings evaporate, we struggle daily to stay afloat & help care for my Mom, all while financiers who committed fraud and got rich(er) thereby go unpunished & funnel big bucks to the same “public servants” who can thus keep their “jobs” indefinitely. Whatever happened to “gov’t of the people, by the people, AND FOR THE PEOPLE??”
Modavations

The hospital M.Moore uses in “sicko” was exclusively, for upper echelon members of Casto’s Communist Party.For the proleteriate(if you can get care at all),you are treated in friggin “Charnel House”
- TrollPolice
  
  Where’s your ‘ArnoldWalker’, today?
  By the way where’s ‘GretchenMo’ or ‘notafeminista’ lately?
  Trolling elsewhere or just temporarily off the payroll.
  Go ‘Zing’ yourself as you are so apt to do.
  Your asinine behavior and repetitive comments are pathetic.
  - Modavations
    
    Dude,I haven’t got the slightest idea what you’re taling about.I have never impersonated anyone.When a leftist can’t make an intellectual rispost,he turns to name calling,then the Khmer Rouge,s favorite,the ball peen hammer
    - YourOwnHammer
      
      The CIA supported Pol Pot. Look it up.
      - Modavations
        
        I know,I know.And Stalin,Hitler,Mao,Ceacuscu(?),Tito,Fidel,Honeker,Hoxha,Hugo, were really Right Wingers.They were fooling, us by calling themselves Socialists.
- Anonymous
  
  Medical Benefits: The Cuban government maintains a public healthcare system; private hospitals and doctor’s offices are prohibited. Citizens capable of paying for prescription drugs, dental, and medical equipment, such as wheelchairs, do so. Low income patients are provided with these services by the government. Cuban medicine’s focus is on preventative treatment rather than treatment of the sick. According to the U.S. Department of State, the U.S. trade embargo on Cuba has, however, made it difficult for the country to provide prescription drugs of an equally high quality to its citizens.
  Maternity Benefits: The Medical Education Cooperation with Cuba (MEDICC) states that, “Women are entitled to 18 weeks fully-paid leave (six weeks before birth and 12 after), plus an additional 40 weeks at 60 percent pay, assured of returning to their same job.” Both father and mother have the option to take paid leave at 60 percent of their salaries to care for their infants from the age of 12 weeks up to one year of age. Fathers may take this leave regardless of whether the couple is married or not.
  http://www.everydayhealth.com/features/healthcare/comparison-sidebar.aspx
  I dunno, but it looks awfully good to this American. I also like the Cuban effort to provide medical care in countries that can’t afford it.
  - Modavations
    
    Not only are the Proleteriate relagated to Charnel Houses,the gringos in the flic, were guys who’d been denied coverage in the US.They were the Medical Tourists of Bangkok and Dehli
Dave in CT

I fear we are reaching the jar of bacteria that divide into 2 every hour, and the jar is half full moment.
Erey

America’s health care future! HMO-Healthy Members Only!
Brightideas4gardens

I didn’t get to hear the whole broadcast because I arrived at my destination before it was over. However, I heard enough to form an opinion of Congressman Burgess: insufferable! My husband and I are in our mid sixties and only recently (a couple of years ago) learned about long term care insurance. The cost for us was exhorbitant; much more than we could conceivably afford. A conundrum for us is whether to forgo paying for life insurance and sign up for long term care insurance instead. Anyone have a comment on this?
Astarap

I am so tired of all of the people in Washington thinking that the American people just have to plan better with their health insurance. What they don’t seem to understand is if we could afford ANY kind of health insurance, we would have it. There is a vast majority of Americans who simply can not afford any insurance at all. If I have to choose between groceries, house payments, utilities, and gas, the insurance will lose. This is the problem. And it seems that no one in Washington gets it.
Mattyster

Republicans are always saying “you can’t trust the government”, but for-profit insurance companies are By Definition more concerned with making money than the welfare of their customers. The government is there to represent “we the people”. I realize that for-profit corporations have bought and paid for way too many of our representatives because of our broken campaign finance system, but there are still dedicated public servants in our government and I’m still more likely to believe that they, not for-profit insurance companies, have our best interest at heart. I’m not against corporations, but their mandate is to make money. They’ll do the right thing if it helps their bottom line or if the government makes them do it.
Jan

It’s been a long time since I’ve seen ivory towers so solidly built as those in which Gleckman and Burgess live. Their refrains of “people just need to take care of this themselves” are testimony to the fact that they don’t understand that the average American CANNOT AFFORD to buy LTC insurance even if the DO qualify. T
hey were repeatedly asked what they expect will happen in the absence of a LTC program of some kind, and each fell back to rhetoric about how important it is for people to get their own insurance. Intentionally dodging the question, or just so cossetted in their status as wealthy Americans that they simply cannot process the idea that most people aren’t so lucky?
DeathByMedicine

Prescription Drugs are one of the leading causes of death in the United States:
http://www.alternativehealth.com/hmc/prescription-drugs-can-kill.htm
The leading cause of death and injury is the American medical system:
http://www.whale.to/a/null9.html
Bruce

In general the health care market perhaps more than any other sector of the economy demonstrates the perverse incentives and gross inefficiencies as well as inequities inherent in a strictly free-market approach. Without govt. intervention and social investment, the laissez-faire position leaves young people without cash or proof of insurance bleeding to death untreated outside the hospital emergency room (see earlier Republican debate when a similar scenario evoked applause) and older folks without long-term care insurance, shopping in the private market when it’s too late or too expensive or at the mercy of unscrupulous hucksters.
- Dave in CT
  
  “young people without cash or proof of insurance bleeding to death untreated outside the hospital emergency room (see earlier Republican debate when a similar scenario evoked applause)”
  The example was actually a young person with the financial resources to buy insurance, CHOOSING not too.
  Choices? Consequences?
  We can’t have that now can we. I mean…..banks might…. Fail!
  Who needs accountability when we have……bailouts!
  - Bruce
    
    I did said “similar scenario” in my post.
    The example you cite from the debate dealt with the problem of “free-riders” who know they are not going to be denied emergency care when they present at the emergency room. Wasn’t the libertarian position to withhold life-saving treatment if that person could have afforded insurance, but chose not to buy it (applause from audience)? Is that who we are as a country or who we should aspire to be?
    The liberal/humane response (based on among other things the widely held view that health care is a human right) is to provide the life-saving care, but not thru cost shifting (highly inefficient) onto everyone else who did plan for and acquire the insurance to meet their needs.
    One solution is the individual mandate which would require individual responsibility. Oh, I forgot, that was what the Heritage Foundation and other hard-core conservatives were advocating a decade ago until now. Since Obama compromised and adopted the idea, all of sudden it’s unacceptable or unconstitutional.
    Sounds like another example of obfuscation and obstructionism from the Right, in order to ensure Obama is a one-term President. I think/hope their tactic might actually backfire and turn out to be the Republicans’ “Waterloo.”
    - Dave in CT
      
      I understand the liberal/humane response. But that logic can go on ad infinitum, kind of like our debt.
      Hard core conservatives are not libertarians, they are authoritarians, so issues of Mandate Constitutionality are not an issue for them. They, like the Dems, would love to force the public to buy something, and get the kickbacks from the industry they have just propped up.
      We really have to re-examine our understanding of our humane ideals, and our government/market/individual means of achieving them.
      If we bankrupt ourselves chasing every good intention (and they ARE GOOD, and are TRULY GOOD AND DESIRABLE THINGS), we will end up not being able to do ANYTHING, like defense and infrastructure.
      This thing of hiding behind good intentions to demonize people who don’t like an authoritarian, or centrally-managed approach to things as heartless and evil, while sadly effective, is quite shameless.
      Everybody has their core list of “Very Good Important Things the government should provide for us as necessary Right”. When that logic of passion is accepted, the list very quickly overwhelms our budget reality. Be it military adventurism, or cutting edge MRIs for all guaranteed.
      If we want to debt-spend our way to humane-nirvanna, their will be debt-collectors happy to take our perpetual servitude, and be at the front of the line, in front of U.S. Citizens, to get payback when Default comes, leaving the rest of us with such severe austerity, that we would shudder at the levels of comfort and entitlement we had demand just a few years earlier.
      - Bruce
        
        Thanks for the thoughtful reply. Having some affinity with Herman Daly and steady-state economics, I agree that we need to live within our means and avoid over-consumption as well as nonrenewable resource depletion, environmental degradation and excessive debt whether to finance consumption or speculation.
        When it comes to the gross inefficiencies and inequities of the health care market, however, meaningful reform (i.e. substantial social investment and state intervention) is absolutely necessary if we are maintain a sustainable economy (health care costs as a % of GDP are huge and out of control). 40 million Americans without insurance is not only morally unacceptable, but also fiscally unsustainable.
        How is it that nearly every advanced Western democracy has figured out a way to contain health care costs as well achieve universal access and maintain quality? While I would prefer single-payer or some variation of single-payer to Obama’s hybrid reform, his plan is nonetheless a significant step forward.
        These are not liberal “wish lists” or “goodies” we can’t afford; rather, we cannot afford not to do these things in order to preserve our civil society and remain competitive in the global economy.
        How is it that the neo-liberal Clinton managed to balance the budget and uphold our social contract and collective obligations?
        How is it that among OECD countries we rank near the bottom (lowest) in terms of tax burden and public spending as a % of GDP? And what we have to show for this self-restraint over the past decades is a debt to GDP ratio worse than 20 of the 30 countries comprising the OECD.
        This stat alone suggests to me that as a nation we could have been supporting a much higher level of social investment than we actually did. We chose not to because of a failure of imagination and political will as well as an ideology promoting growth for its own sake at any cost, wealth concentration and the virtue of selfishness.
      - Bruce
        
        Just to self-disclose a bit. I’m not an academic, nor particularly active in any political party at the moment. I take exception to the characterization of “hiding behind good intentions to demonize people…”
        With respect, the people you refer to do a great job demonizing themselves when they applaud a governor for his record number of executions, or when they applaud a person without health ins. being denied life-saving treatment, or when they boo a gay military serviceman.
      - Bruce
        
        Maybe I am having difficulty seeing the difference between the authoritarian and libertarian conservative; to me they seem to inhabit the same space. I promise to work on trying to discern the difference…but cannot guarantee I’ll find any difference that is substantive.
AmericanNightmare

You provide for yourself and your family for your whole life.
You save, you budget, you invest, you do all the right things financially.
Then you, or someone in your family, gets sick or needs long-term care.
�
All of sudden, all of your hard work and effort is being slowly drained away by ‘health care’ expenses.
Insurance doesn’t cover it all. You file for bankruptcy.
You eventually become destitute and rely on the government for care.
You just lived the American nightmare.
MedicalBankruptcy

“A study done at Harvard University indicates that this is the biggest cause of bankruptcy, representing 62% of all personal bankruptcies. One of the interesting caveats of this study shows that 78% of filers had some form of health insurance, thus bucking the myth that medical bills affect only the uninsured.”
http://finance.yahoo.com/banking-budgeting/article/109143/top-5-reasons-why-people-go-bankrupt?mod=bb-checking_savings
Dsmith

The caller’s story about his parents not understanding that they had to pay all expenses for the first 100 days isa great example why this kind of benefit should not be left to the market. Too many people end up buying a pig in a poke and families and it does not serve the family’s interest or the publics.
ItReignsItPours

The Republicrats should love the current administration.
They have continued practically all of the previous administration’s corruptions and anti-democratic principles.
In many circumstances, they have even ‘kicked-it-up-a-notch’.
Open your eyes people, its reigning fascism and soon it will be pouring.
AC

so much bashing going on. From personal experience; 6 times now i’ve been hrs from death, literally, and was saved by the American medical system - so I’m afraid to say – I don’t believe the naysayers here.
& on top of that, 100s of thousand of dollars of cost (1 time in hospital 4 mos straight!) I paid out of pocket ~a few hundred. I’ve paid into the system since my first ‘mall job’ at 16 and have never had problems. Why are people so negative? What DOES worry me is the cost of meds. One of the meds I pay $10 for a 5 day supply costs $750 w/o insurance (found out once while system was down). What do people w/o insurance do? I’m worried about them….
- Anonymous
  
  You know just because you have been lucky, and you have been very lucky, does not mean the system is a failure. I hate to say this but you sound willfully ignorant to what is going on in this country in regards to health care. I do not mean disrespect, but something does not sound quite right here. Either you have one of the best Cadillac insurance policies or you are not really dealing with reality. What about the fact that over 60% of bankruptcies in this country are due to medical bills. Are you really this unaware of the world around you? Are you living in Lake Wobegon?
  My father had both private health insurance and Medicare and our family still had thousands of dollars in bills to contend with.
  My cousin died of ovarian cancer and she had to fight for years for what her insurance covered and what it did not.
  You say you don’t believe the naysayers? That’s a bit rich, no pun intended. Our system is broken and it’s failing. By the way you post the cost differential of meds and few hospital stays and right there is the crux of the problem.
  You sound like that (expletive) Herman Cain who blames the unemployed for their plight.
  - AC
    
    i’m not ‘willfully’ ignorant, just ignorant in the only 1st hand experience is my own. & i appreciate hearing another experience as opposed to just ‘American Medical system kills’ or some post to that affect.
    I do know, as I posted earlier that I do feel I got lucky because my condition is rare & i’m in Boston, near some of the best medical schools and I know I’ve been used in case studies so maybe that’s helped. But I’m not lying, I still have weekly blood tests at $123.00 that I don’t even pay for!! I really can’t complain about my medical care or my insurance coverage w/o being a hypocrite. I don’t think I’m not ‘being real’ for what I have to contribute to the subject. The only other experience or opinion I can give is that an old neighbor was a nurse who complained ‘waste’ in hospitals was awful (personally, i’m ok w/them not using the same gloves twice) and my husband’s grandparents lived in a horrible but $$expensive nursing home which I’ve sworn to avoid at all costs!!
    My worry, that a caller alerted me too is that there may be a ‘cut off’ date on my care. I wasn’t aware of this and I don’t like it. I thought that was illegal?
    I’m not sure that I am going to come back with experience/opinions anymore. I can’t even speak from experience w/o someone calling me ‘ditzy’ or jumping down my throat, comparing me to an idiot sound bite of a politician. Maybe I need to take a critical writing course, I really don’t see how any of what I wrote warrants the need to defend myself or feel sad, but here I am doing it….
    - Modavations
      
      Don’t pay this guy any attention.As you’ve noticed these guys have chips on their shoulders.I enjoy your posts.
      - Steve__T
        
        Don’t pay this guy any attention.As you’ve noticed this guy has nothing on his shoulders.
    - Anonymous
      
      As someone who has a pre-existing condition and has managed to stay insured despite being self employed I understand. It takes a lot of planning though, and a lot of people don’t take health insurance into account when making a life plan.
    - Brett
      
      AC, I saw your earlier comment as in the category of “personal experience comment,” and there’s nothing wrong with those kinds of posts; they do add to an array of perspectives. I enjoy most of your posts because they ask questions and seem as though they are trying to get at the essence of something in a fresh way. I don’t know how old you are (my sense is mid-twenties), which is important on one level in that the more diverse the commentators, the more perspectives we can consider. I think your participation on this forum is valuable.
      Without prying, it sounds as though you have some chronic medical conditions and feel fairly satisfied with your insurance coverage and medical treatment. [My Perspective] I have a couple of chronic conditions I have had my whole life, and when I had great insurance coming from my employer (excellent, comprehensive insurance that covered most things; a PPO, which acts similarly to both an HMO AND indemnity-type insurance together), I, too, didn’t have much of a problem with that model. Since I’ve been self-employed–and having two chronic conditions in addition to being 56 years old–I have had difficulty procuring insurance. Due to those aforementioned conditions in my life (including my age) most insurance companies won’t insure me, and the ones that are willing offer substandard insurance at exorbitant rates. My only solution right now is to have a separate savings account for my medical expenses. This works for my day-to-day needs, but it won’t begin to cover any extended hospital stay, for example.
      So, while I did think how lucky you are (in reading your earlier post) and how your experiences may indeed be very different than others, I understood that you were just trying to relate your perspective from your own personal experiences. Like you, I don’t want to paint the evils lurking within modern medicine using a broad brush. I have Type 1 diabetes and lifelong asthma, I have also had cataracts and secondary cataracts. If I had lived a hundred years ago, I’d be dead by now. Just having cataracts a hundred years ago, or so, would have meant blindness…Essentially, what I’m saying is I understand your view, and may you never suffer lapses in coverage when you really need them.
      Anyway, please keep contributing; as you can determine, this forum needs as many reasonable voices as possible, albeit sometimes those voices are in disagreement.
      - AC
        
        is that seperate account tax-free? Are there any medicare/caid help you can get? I really don’t know how that works.
        When did they cut you off? When you turned 50? It makes me think of a comedian I recently saw that says no one cares after you’re 40 because they know it just gets worse…I laughed at the skit but now I am feeling bewildered….
      - Brett
        
        Tax deferred? Yes. Did they “cut me off”? I’m not sure who “they” are or what you mean, but I’ll assume you mean the insurance companies and how did I lose my health insurance? I began working for myself. I COBRA’d my insurance from work for…18 months, the maximum if I remember correctly. After that, I was on my own.
        I don’t live in Mass., so I don’t know what your laws and insurance industry are like there or what “paying into the system” means in your case. The impression I get from various comments here, and from other forums, is that they differ from state to state.
        I make way too much money to qualify for Medicaid, and I am too young for Medicare (which would need to be supplemented with private insurance). I work hard to stay healthy, and I am very careful in my savings and planning. Planning is key. If I stay on course with few health problems and “pass away peacefully in my sleep” at age 76, according to my calculations, I’ll be fine.
    - Anonymous
      
      You wrote this, not me. “I don’t believe the naysayers here.”
      How am I to take a comment like this. Cain used language in a similar manner when describing people who are unemployed. You say you have a preexisting condition, and you know what you are lucky you live in Massachusetts. This is all fine and good, but if you lived in Ohio you would be without insurance or your premiums and deductible would be so high that it might be unaffordable. The bottom line is ones own personal experience is not a way to judge the absurd for profit fee based system we have.
      Am I jumping down your throat, well yeah I was and I do apologize. However, I’ve had family who have had horrid experiences with insurance companies in this state and in others. Try arguing with your insurance company while you are dieing from cancer and then tell me we have a great system. This is no joke, we have the worst health care system when compared with other nations. When people say we have the best health care they mean we have the best money can buy. They do not mean we get good results or that we have a decent cost relationship to care system. We don’t. You are lucky, very lucky.
      - AC
        
        i’m sorry your family has had bad care…
      - Anonymous
        
        My cousin died from ovarian cancer at age 51 and her experience was pretty disgusting. Her doctors were great as was her partner.
        If she did not have these people advocating for her she would have died on hold with these SOB’s who run the insurance industry.
      - AC
        
        maybe if they had direct ‘people’ at the hospital, they would have been more motivated to help. I wonder who the person on the other end of the phone was and how they could be so cruel? Or was it a horrendous voice recorded ‘press here’ type of system? In any case, maybe it should be a law that insurance companies keep customer service reps ‘face-to-face’ accessible….
    - SorrytoSay
      
      Ignoring the information and statistics that the American medical system is one of the leading causes of death does make you willfully ignorant.
      - AC
        
        my father was a statitician, i have much experience with them, i think you just want to call me names. i can hardly stop this….
      - Anonymous
        
        OK then why not look up the stats. I think the number of people without insurance is now in the range of 50 million and rising as people lose their jobs. Premiums have been rising at rates that far out pace inflation. I could go on, but I hope you get my drift.
        I mean it’s pretty obvious that we have a crisis in this country in terms of health care costs and how a huge chunk of this is in the profit margins of the insurance companies and the pharmaceuticals.
        We should also add that hospitals are out of control in costs as well.
        Doctors are caught in the middle somewhat, but the whole system is falling apart. Not one politician or anyone in this sector is doing anything about it. We wont until the whole thing collapses in on it self.
      - AC
        
        i don’t understand – did i not say i was worried about people WITHOUT insurance? at the cost? My main questions have been how do they do it without insurance and when is it legal for an insurance company to ‘cut you off’? & w/direct awareness to the show, how older people get treated.
        But every post seemed to completely malign the health care system – I love my Doctors, 1 more than the rest and she is like a friend to me now. I’m not completely aware of what goes on behind the scenes w/insurance and maybe she is taking on a bigger fight for me than I’m aware of, but there ARE good humans left that are doing their best to battle for us, I don’t want to see them trashed.�
        I have to try & stop myself from responding anymore, I can’t be objective because I’m so upset at how everything I says ends up being exactly the wrong thing.
        I can look up stats that will support any argument from any side, I have a healthy fascination and suspicion of stats (thanks Dad)- i try to stay away from those too. It is not ‘willful ignorance’, it is an understanding of a form of information that is open to manipulation. This is why I became an engineer, I like my black and white math, it won’t lie to me….
      - Anonymous
        
        Your doctor is most likely advocating for you and you are unaware of it. I am sorry you feel like you are being misunderstood. I do apologize for making you feel as if I’m being heavy with you.
        However, you seem to say one thing then go on to say stats can be used to skew anything. I’m sure the 50 million plus who do not have health insurance would love to hear that. Also are you aware that for a family of 4 who does not have work related heath insurance that it can cost upwards of $14,000 a year plus a high deductible. If the average income of a family of 4 is about 60 to 70K a year that’s a pretty huge chunk of their income. I’m just suggesting that you to do a little research on the subject, it kind of helps when you want to make comments on forums.
      - AC
        
        no, this i AGREE with. I live in fear of not having insurance (i don’t know the actual costs, but i feel as if they would be outrageous based on what i’ve seen from bills). Nor do I really know or understand how hospital billing works since I don’t know anyone in that industry. Hence why I am so selfishly motivated for someone to PLEASE tell me it is illegal for your insurance company to ‘cut you off’ at a certain age, or, other insurance companies won’t take you on at a certain age due to pre-existing conditions?
        Someone mentioned that it is possible but you pay more – but is that fair?
      - Pudyson
        
        Clearly AC is grateful for doctors saving her life. This means that no amount of quantifying stats and figures about how horrible our health care system is ( a cerebral activity) appeals to her emotional self – of being a survivor in spite of the odds.�
        This compartmentalizing of one’s views, though seemingly contradictory, is common. For example, most polls/surveys show that the US Congress is regarded minimally as ineffectual and maximally as corrupt. Yet most people like their own US Representatives & Senators…and think they do a good job. Same with education. Many knock the system, the power of the teachers’ unions, but “love” their own kid’s teachers. Go figure!
      - Modavations
        
        You guys are Frigging too much.I may join you AC
      - Terry Tree Tree
        
        Really???
    - Terry Tree Tree
      
      That makes it a discussion, NOT a monologue!! There are name-callers on several sides of this forum. If someone calls you a name you do not deserve, ignore them, or show them that they are wrong! Read my first post, and the replies, then my answer.
      If someone calls you a name that you do not like, but fits, CHANGE!
    - Gregg
      
      So often around here commenters get personal when they disagree. They are sure they know best and if you don’t see it that way then you are stupid. They are very close minded… and mean. Try not to take it personally, it awards them too much power.
      I hope you stick around, I enjoy your comments and these are particularly enlightening.
  - Modavations
    
    Shame!!!!!!!!!!!
    - Anonymous
      
      You do not offer anything but BS pal. It’s getting real old.
  - Anonymous
    
    The 60% of bankruptcies stat is a bit misleading. The average was $5000 in health care debt in those bankruptcies — they also owed money on everything else. You could probably say 60% of those people went bankrupt over car loans by the same logic.
    I have sympathy with AC. I’ve gone through a lot of trouble and expense to see that my family and I have always been insured. �
    I was listening to some guy complaining on Talk of the Nation that he couldn’t get health insurance one time. There was noise in the background and he confessed he was going skydiving. SKYDIVING. That’s about $159.00 a jump in Illinois, which is exactly what you’d pay/month on HIPAA here for a High Deductible Plan with no pre-existing condition exclusions.
    Some people complain about the “high cost of care” but really just don’t want to give up on other things.
    - Anonymous
      
      That’s the most absurd reasoning I’ve read in a long time.
      As if this guy’s skydiving has anything to do with the subject of the huge cost increases in health care premiums.
      http://articles.cnn.com/2009-06-05/health/bankruptcy.medical.bills_1_medical-bills-bankruptcies-health-insurance?_s=PM:HEALTH
      http://www.insurancequotes.org/news/more-seniors-filing-for-bankruptcy-due-to-medical-expenses/
      - Anonymous
        
        http://www.realclearmarkets.com/articles/2009/07/30/the_medical_bankruptcy_myth_97335.html
        > As if this guy’s skydiving has anything to do with the subject of the huge cost increases in health care premiums. �
        Um, I think an uninsured guy SKYDIVING probably does raise premiums. It’s a dangerous activity and if he gets hurt all of us with insurance pay for it in the end.
      - Anonymous
        
        So is driving. In fact more people die in car accidents than from skydiving or scuba diving for that matter. All this talk about what people do is beside the point.
      - Anonymous
        
        That’s a silly comparison. More people drive than scuba diving or skydiving put together.
      - Anonymous
        
        The link in my other post describes the problems with their study.
    - Markus
      
      I remember hearing Elizabeth Warren quote this stat with the conclusion that health care was the major cause of bankruptcies. She can conclude what she wants, but leaving out the important facts of the study that refuted her conclusion was, well, typical of a politician or a cable TV talking head. I now wonder every time she says something how she’s manipulating the numbers to support an agenda. Too bad, I liked her work in banking.
      In any event, thanks for the post. Impossible to find the time to look into these kinds of claims, so I’m glad when people in this forum do it.
      - Modavations
        
        Wonder why “Big College” costs so much.It’s because the E.Warren’s of the world, make 365,000 per annum.
      - Terry Tree Tree
        
        And the gem dealers make?
      - Modavations
        
        My wage is strictly dependent on my sales.I have taken a 50% paycut for the last two years.Being a college kid, I was taught about the business cycle.I had 15 solid years and banked a bunch.
      - Pudyson
        
        Elizabeth Warren is at Harvard,,,, the top US higher educational place and she is a public figure working in DC., but most “Big College” costs go into administration salaries and prominent profs who are in science and finance/business fields. These never teach undergrads. Meanwhile, the grunt educational work is done by Ph.D’s on one year contracts and graduate assistants. Incidentally, “Big College” costs so much because the graduates then have an entre`into the secret chambers of the big power brokers in whatever field of specialization they major leads them.
      - Modavations
        
        That apllies only to Harvard,Yale,MIT,,Stanford.All the others,have no cachet at all.That cachet makes those institutions worth the 50,000 per annum tuition.The others are vastly overpriced.In my opinion Pres.Obama is an affirmative action kid and he threw Ms.Warren to the wolves.
- Modavations
  
  Why do you think everyone in the world ,comes for treatment to the good old USA.I’ll say a little ptayer for you
  - AC
    
    well, there have been experimental cures in Japan that won’t get passed here. I’ve considered sneaking over, but I am afraid of losing my insurance if i try something outside the box….
  - Alan in NH
    
    Actually, they also go to Germany, Czech Republic, India and Cuba as well.
    - Modavations
      
      Fidel ran to Spain for treatment.The Spanish didn’t have anyone up to the task and called in Engliah experts.I had a pal in Jaipur who went in to have Gall Stones removed and woke up with his “joint”attached to his forehead.I’ll take my treatment right here in the Good Ole USA
      - Alan in NH
        
        You can always find horror stories if you look for them, here as well. I know of some myself. I have a brother-in-law who almost died because of a misdiagnosis at a Boston hospital. Does that prove U.S. care is bad? My point was good health care is available elsewhere in the world as well as here and often at better prices. I think it may be a kind of self-delusion that we have a monopoly on quality health care.
      - Modavations
        
        Fair nuff
      - Pudyson
        
        All the good doctors in Jaipur are practicing in the U.S. where they make lots of money.
      - Modavations
        
        I have much experience in Jaipur and there are plenty of good doctors.French Drs. want to come to the US ,becauuse the Socialized system, puts caps on their wages.
  - CORY
    
    Because we are absolutely the best at catering to the wealthy.
  - Terry Tree Tree
    
    Quite a bit of ‘health-care-tourism going OUT of this country! So ‘everyone in the world’, ISN”T!
    - http://reinventing-america.blogspot.com/ ulTRAX
      
      Don’t confuse Moda with facts. Nothing but propaganda, lies, and distortions from the political right even register with him.
- Modavations
  
  Medicaid
- Anonymous
  
  What “system” that you paid into are you talking about? Private health insurance? Some public program?
  - AC
    
    HMO. Harvard Pilgrim…
- Elder Law Atty in MA
  
  AC, this story is about long-term care (nursing home care), not general health care. The medical insurance you have, as well as Medicare, is likely to cover a maximum of 100 days of nursing home care. And when I say maximum, I will say that most of the time insurance starts attempting to terminate coverage at around 20 days, deeming the care “custodial” rather than “rehabilitative.” Once this stops, the alternative is private pay at $8,000 to $10,000 per month (hopefully having a LTC policy to help pay for this), or to apply for Medicaid. That’s why it’s such a difficult situation for anyone to plan for; even with planning it is unlikely that you can save enough to pay privately or insure for even one year of a nursing home stay. This is not similar to your situation at all.
  The bottom line is that, if you live long enough in a nursing home, you will lose everything you own. I don’t think that’s a very fair way to treat the elderly and disabled, and neither is it a sustainable financial model.
  - AC
    
    i do agree with this completely, but it’s not just the health care/insurance system – some of it is culture. In other countries I’ve seen people care more about the older peeople in their communities, not just the direct family. Here, it’s like they’re stuffed away & hidden. I hated how the nursing home treated my husband’s grandparents & i couldn’t believe they charged an arm & leg for that ‘care’. One older man wasn’t even allowed to go out and watch the sunset, it depressed me like crazy but my own mother-in-law, who is a sweet woman, said they had to force him inside because of liability issues.�
    That’s not right. If i want to watch the sunset on a nice night when I’m 90, I’m going to!
    - Elder Law Atty in MA
      
      I see a lot of people with this plan; I call it “The Revolver” because the plan is usually to have a relative “take them out to the woods and shoot them” rather than place them in a nursing home. � I’ve yet to see anyone follow through with this.
      But I do hope you are allowed to watch the sun set whenever you want.
      It’s a complicated problem: costs are high, quality is low, noone wants it in the first place but they don’t have any choice, family members have to work so much there’s noone home to provide care. No simple solution but someone needs to start working on it, and soon.
      On the positive side, here’s an article I enjoyed recently about a nursing home with a terrific approach to caring for its patients:
      http://www.nytimes.com/2011/01/01/health/01care.html?pagewanted=all
RottenToTheCore

The American medical system is like the American banking system:
Corrupt to the core. And everyone in DC knows it and is on the take.
I’d say it’s time to vote ALL of the incumbents out of office – no matter what their party affiliation or their past record – until ALL of our ‘elected officials’ listen to us.
Drew You Too

So long as profitabily remains the motivation it will also be the obstacle.
- Jasoturner
  
  I don’t think the congress people receiving political contributions from the health care industry see any obstacles with the current way we do business.
  - Guest
    
    Especially since congress is fully insured and we are paying for it.
Dave in CT

Accused of Deception, Citi Agrees to Pay $285 Million
By EDWARD WYATT
37 minutes ago
“Citigroup was accused of misleading investors in a $1 billion derivatives deal, then betting against them as the housing market showed signs of distress.”
http://www.nytimes.com/2011/10/20/business/citigroup-to-pay-285-million-to-settle-sec-charges.html
Wow. What a paper cut. Hope and Change.
- Dave in CT
  
  Time for OSEC
  Occupy the SEC.
- Guest
  
  Wrong show and comment thread.
  - Dave in CT
    
    Was hot off the press, and IMO everything is connected, or needs to be looked at holistically, these days when it comes to role of government issues.
  - Modavations
    
    Cosmically speaking ,all thread lead to Rome
- Modavations
  
  Isn’t that the home of Herr Rubin?
AndGettingWorse

Medical ‘horror stories’ are more the rule than the exception.
Statistics prove the American medical system is horrendous.
In fact, our ‘health care’ system is one of the leading causes of death in the US. (See “DeathByMedicine” post below.)
Or, just do a internet search yourself.
Why America would prefer to be delusional about the most deadly,
inefficient and costly medical system in the world is beyond me.
Carletonford

I would like to echo the sentiments of listeners who have observed the long term care policies of their parents shrink in value: higher premiums and a shrinking daily benefit that is nowhere near sufficient to cover the cost of care.
For people who can afford the premium in the first place, it appears they are still in great jeopardy of spending down whatever assets they may have accumulated when it comes time to pay for care.
Even with private policies, we are stacking the burden on the younger generations.
Maggie Ribb

Mike in Acton, you are so right!! I am sick and tired of the “there but for the grace of God go I” attitude expressed by those who have no financial worries. Responsible?? You can only be financially “responsible” to the degree that you can afford to be. A vast majority of Americans are becoming less and less so through no fault of their own.
ajparrillo

Again, conservatives keep moralizing about what people “should” do. Just like any normative model, it does breaks down in reality. So what are the societal plans for the model not working. Other countries have gotten health care right, not for profit, universal insurance, but conservatives continue to block actual working models. Shame on this congressman. You do the “responsible” thing and actually serve the public in its best interest.
- Zing
  
  Ask those who elected him what kind of service he’s provided and then report back here…
Bob of newton

On August 9, 2011, Burgess met with a local Tea Party group to discuss his recent vote to raise the debt ceiling. When a constituent asked if the House of Representatives was considering impeaching President Barack Obama, Burgess replied “It needs to happen, and I agree with you it would tie things up,” Burgess said. “No question about that.”
- Modavations
  
  I’m sorry,but I believe he was elected to his post
Eyssurvey2

Sorry, here we go again. All these people calling in to say that, surprise! their policy had a 100 day exclusion, or that coverage wasn’t indexed to inflation. It’s all a matter of money. You can get all of these things, it justs costs more and most people don’t want to pay for it. Yes, it’s expensive, yes, we need to fix this growing problem, but there are calculators all over the web that you can use to figure out your payment, depending on the details of your prospective policy. Why are people so surprised when they buy a policy and then have to live by its terms? If you don’t understand what you are buying, for heaven’s sake, ask someone -a friend, a relative, or read up on this stuff before you sign up for something as expensive as this.
If you bought LTC insurance, you had at least some disposable income and you probably had access to an hour of a financial advisor/accountant’s time.
Same thing with anything you sign. Loan docs, other insurance policies, etc. Stop signing things that you don’t understand.
- Zing
  
  You mean I should have done research before I signed a mortgage I couldn’t afford?
  - Anonymous
    
    You mean the entity holding itself out as an expert financial adviser to me doesn’t have to tell me the truth about what they advising me to do and can actually lie about it to my detriment and their profit?
  - http://reinventing-america.blogspot.com/ ulTRAX
    
    At risk of going off topic for this forum….
    In the world of the Orwellian Right, none of these predatory lenders who were getting massive commissions for subprime loans and then selling them off to third parties so they never dealt with the consequences… these lenders like Countrywide, NEVER deceived anyone seeking a mortgage? They never pushed people into interest-only or exploding rate mortgages telling them get what they could afford now and not to worry, they could re-fi later? They all in good conscience believed every applicant was qualified for the loan they were granting?
    Ya, you probably do!
    - Modavations
      
      For the 53rd time Orwell was a reformed communist.He wrote Animal Farm,to heap scorn on you Politboro types.You know ,”all animals are equal,but some more so,then others.Orwell is my Doppleganger and we’ll fight you guys till the bitter end.
      - http://reinventing-america.blogspot.com/ ulTRAX
        
        For the 54th time I’ve explained to you the term Orwellian is NOT associated with his politics but OF THE NOVELS HE WROTE.
        “Orwellian” describes the situation, idea, or societal condition that George Orwell identified as being destructive to the welfare of a free society. It connotes an attitude and a policy of control by propaganda, surveillance, misinformation, denial of truth, and manipulation of the past, including the “unperson” — a person whose past existence is expunged from the public record and memory, practiced by modern repressive governments. Often, this includes the circumstances depicted in his novels, particularly Nineteen Eighty-Four.
        Getting this yet Einstein? Didn’t think so.
        source: http://en.wikipedia.org/wiki/Orwellian
      - Modavations
        
        For the 53 time.Orwell is a Rightie and you are a Leftie.While you say you are a Progressive,me and Orwell would say, there ain’t nothing Progressive about Fascisti.I taught Einstein physics,by the way.I can not believe you’re a shrink.You’re a bully.You probably caused half your clientel to jump off the roof.As for 1984,that’s a hoot.You are the torturer, in that tome.You can’t think that,you can’t say that.Send him to the reeduaction camp.Idealogues can’t see the truth, 2 inches from their noses.Barney Frank is your hero.How pathetic
      - http://reinventing-america.blogspot.com/ ulTRAX
        
        Thanks for AGAIN proving you’re incapable of reasoning. The word in question is not ORWELL…. it’s ORWELLIAN. My usage is correct and you’re just making an ass of yourself AGAIN. Maybe it’s time you did get some ” reeduaction” (sic).
- Sfdworks
  
  you are blaming the victim
- Mabaumgartner
  
  Yes, exactly, thank you for the good explanation Eyssurvey 2.
- Terry Tree Tree
  
  Tell everyone you know that they need to schedule 10 hours for each transaction that they enter into, to read, research, and try to understand the legalese, and do the checking on ALL the affiliates referred to, and NOT listed in the contract for each service or purchase!
Dusty

Long-term care from private insurance companies is not the answer. All they care about is profit and will do anything to achieve it.
Mary Anne Bingham

I am 77 years old. A registered nurse and going back to work. I am insulted by Congressman Michael Burgess implying that you are not responsible if you do not have long term insurance. I feel our Congress is not responsible for not supporting and implementing national medical care as my sister enjoys in Canada. It is especially insulting, for this man who is supposed to be representing us, when so much of our nation is having trouble putting food on the table. Shame on him!!
Mary Anne Bingham
- Sfdworks
  
  If I could like this a thousand times I would, he is extremely insulting!
- Anonymous
  
  And in addition to being just another complete fool on the real world implications of the issue he’s in charge of solving the problem! God help us.
Aileen_merrick

I know this is taboo, but…. I’m not really interested in living until I’m 90 just to be a burden on others. If I am so incapacitated I would consider assisted suicide. Why isn’t anyone working to legalize that?
- Gregg
  
  As I understand it, suicide is illegal. To me, that’s the place to start. Assisted suicide is a bit creepy.
- Zing
  
  Why aren’t you?
  - http://reinventing-america.blogspot.com/ ulTRAX
    
    I think as long as you plague these forums with nothing intelligent to say, I bet many of us wish you’d look into this option.
Ann

I am so annoyed by Rep. Burgess’ self-righteous, judgmental tone, I could spit! I’m so glad for him that long-term care was part of his “life-planning” but as a 67 y o woman, not only did my planning years pre-date the existance of long-term care but I grew up at a time that financial planning was never discussed: it was something men handled. I’m not advocating a return to that state of ignorance, but Rep Burgess ought to thank his lucky (Texas) stars that he’s a male who grew up at the time he did. As for me, I did not anticipate a divorce in my 40s, or being childless, or developing a health condition in my 60s that would prevent me from practicing my profession. I want back in my 50s to earn a Ph.D. but have been unable to work and am now paying off school loans while collecting social security. What savings I have squirreled away took substantial hits in 2008, etc. Afford l-t care? You’ve got to be kidding. I can’t even afford TV! Ann from Boston
- Sfdworks
  
  AMEN!
Sfdworks

Tom, your guests are out of touch with reality.
Don A.

I have long term care in New York. We have what’s called Long Term Care Partnership. Under this, if we buy 3 yrs of coverage, after 3 yrs we will get Medicare without using up all our assets. (I guess the State figures that’s better than having people try to hide assets.) We also get a credit of 20% of the premiums on our state income tax i.e. the State pays 20% of our insurance.
Let’s face it long term care is expensive. If the government is going to pay for it, it still is going to be expensive. (Insurance companies are not what make it expensive; it just is.) The only way an individual is going to save is if someone else is paying for it (in higher taxes). Therefore, don’t begrudge having all your assets taken before you begin receiving Medicaid. Pay me now or pay me later and don’t expect someone else to pay for you.
- nj
  
  What are you talking about?: [[ If the government is going to pay for it, it still is going to be expensive. (Insurance companies are not what make it expensive; it just is.) ]]
  Take away insurance company profits and make health care a publicly managed function, and it becomes a lot less expensive.
  - Don A.
    
    Not a lot less expensive, maybe 5%-10%, and that doesn’t account for the inherent inefficiencies of government (lack of incentive, lack of competition, cronyism, nepotism, graft, etc; without profit motive there is little incentive to perform efficiently.)
    - nj
      
      Again, i say, what are you talking about?
      Per capita U.S. health expenditure is about 2.5 times the OECD average, with generally poorer health outcomes.
      Compare and contrast:
      http://www.infoplease.com/ipa/A0934556.html
      - Don A.
        
        And what are the salaries of doctors in those countries, how many MRI machines do they have, how many hip replacements, how many pacemakers, how many doctors, how many people have to suffer without treatment, etc, etc?
      - WhoCollects
        
        The amount of money a doctor makes is not relational to the quality of care they give.
        MRI machines have more to do with generating profit for their owners than a successful rate or prognosis or cure.
        Healthy environments and countries with healthier people don’t require hip replacements and pacemakers.
        Almost half of America is suffering from not being able to afford health care.
      - Mabaumgartner
        
        I actually agree with much of what is said, but the fact remains that somehow medical care has to be paid for. I lived in Europe and have experienced health care in the UK, France, and Switzerland. All have different systems but they work pretty well. And the one main difference between those systems and the US is that these countries (as well as many more) have decided that it is in the best interest for the country to have everyone (or as close to everyone) in their countries covered by some sort of universal health care. It is ridiculous that we in the USA have not seen the sense of doing the same. Our first priority should really not be long term care, but ensuring that ALL Americans have access to good quality health care, for all ages. Long term care is just the icing on the cake, but we don’t even have the cake — yet!
      - http://reinventing-america.blogspot.com/ ulTRAX
        
        Read it an weep….
        http://assets.opencrs.com/rpts/RL34175_20070917.pdf
        America does NOT get a good bang for its buck.
    - WhoCollects
      
      What study did you get your ’5-10%’ savings information from?
      Who funded it and what benchmarks were they using?
      Inherent inefficiencies of government?
      There wouldn’t be any corruption if you took the profit motive out for all of the private corporations and contractors who are thriving off of taxpayer’s money.
      Just look at the ‘defense’ (war) industry and ‘education’ (dumbing-down) industry – the ‘health care’ (stay sick) industry works the same way – it rewards inadequate outcomes, poor performance and economic inefficiencies.
      Because, that’s were the profit is.
    - http://reinventing-america.blogspot.com/ ulTRAX
      
      You’re confusing bad management with something innate in the public sector. We have a double standard. Private sector failures are praised as the wisdom of the market. Public sector mistakes live on forever. Assuming equally good management, the public sector should come in cheaper since it doesn’t have all that wasteful overhead like high CEO pay, non-standard procedures and billing, profits to stockholders, advertising etc. We saw this in how private Medicare Advantage plans were getting about 14% more than traditional Medicare.
- Don A.
  
  Correction: After 3 yrs we get Medicaid.
  - WhoCollects
    
    Medicaid: A taxpayer funded entitlement.
    A health care trust set up between a people and their government.
    Why are private corporations profiting on that trust?
- WhoCollects
  
  “The only way an individual is going to save is if someone else is paying for it.”
  “If the government is going to pay for it, it still is going to be expensive.”
  Your own statements are proof of a private system being subsidized by the state of New York and everyone living there.
  We are all “paying for it” already.
  Why is private enterprise making the profit off of the system and us?
  You have just proved opposite of your contention.
  Your assests should not be taken for health care and given to the state or private enterprise.
  We all pay for it already. Who collects?
- Mabaumgartner
  
  Well said Don A. Long term care is expensive. We bought a long-term care (LTC) insurance policy for my mother 11 years ago and we Currently pay ~$6,000 for the policy. She is now 95 and in a nursing home in Massachusetts and that LTC policy is paying for part of her care there. Massachusetts has a program which is similar, but not as good as New York;s, regarding people who buy long-term care policies. So my mother’s care is being paid with her LTC policy, part with her own assets and the remainder with Mass Health/Medicaid. I am a firm believer and advocate for people buying long-term care insurance, if they possibly can afford it, which means buying it when you are younger and the premiums are lower. My husband (who is 49) and I (53) bought long-term care insurance policies for both of us a couple of years ago. We do not have children and want to try to plan ahead for our health care when we are older. We pay $925.00 a year for both policies for the TWO of us, which is amazing. I am actually going to contact our “senior advisor” who sold us the policy and see if we can up our coverages or buy another policy. We are not rich (my academician husband was out of work for 2.5 years). But after having seen the benefit to my mother, I would not be without LTC insurance, not in this health care climate. I wish all the states could implement something along New York’s lines. As Don says, health care is expensive and we all have to pay for it, one way or the other, either privately, or through our taxes. I don’t have a problem with that.
Amittsg

Now look at this congressman; he is living in a different world. Why is he representing people in washington!!!!
dblP

Rep. Burgess made me sick to my stomach this morning as I listened to his unbelievably clueless diatribe about how we all ought to be buying long-term care insurance (and what if we have a hard enough time paying the electric bill because we’re a single mother with two children whose former spouse left us and is not paying his child support?). It is disgraceful that people like him, who are so out of touch with the reality of the MAJORITY of the populace, are making policy decisions. I found him disgusting. I was actually embarrassed to hear him on the air of a radio station that I imagine spends a lot of time vetting its guests. He didn’t sound like he represented “the other side of the issue,” he sounded like a delusional crackpot.
As a side note: the audio quality of Rep. Burgess’ phone-in was very poor.
ReadItAndWeep

Re-post:
Prescription Drugs are one of the leading causes of death in the United States:
“The overall incidence of hospitalizations related to adverse drug reactions was 6.7%, and the associated death rate, 0.32%. This translates into 2.2 million serious drug reactions, and 106,000 deaths every year in America, at an estimated cost of as much as $4 billion per year.”
http://www.alternativehealth.com/hmc/prescription-drugs-can-kill.htm
The leading cause of death and injury is the American medical system:
“The total number of iatrogenic deaths
shown in the following table is 783,936. It is evident that the
American medical system is the leading cause of death and injury
in the United States.”
http://www.whale.to/a/null9.html
- Terry Tree Tree
  
  First, Do NO harm! ???
Kb2345

According to http://burgess.house.gov/About/, “…He was raised in Denton, and attended The Selwyn School, graduating in 1968 as valedictorian…”. If he was 18 at the time he graduated (presumably a High School), he would be roughly 61 today.
I say we all fast forward 10-15 years. Imagine Dr Burgess retired and no longer w/the political benefits of being a member of Congress. He’sin the ER with a stroke. That cell phone call from his LTC insurer saying that they are unable to continue insuring him because he never disclo that he had been treated for acne when he was 16.
Too bad that by then, it will be too late for him to do the right thing. Some things just DO NOT belong in the private sector. Period.
Dave in CT

How did you guys like Zbigniew Brzezinski’s comments about creating a list of all the “rich” people? Never mind us going to a frightening autocratic China 2.0 model, he wants to go straight for the Maoist mainline….
http://newsbusters.org/blogs/noel-sheppard/2011/10/17/carter-national-security-advisor-lists-rich-people-should-be-publishe#ixzz1b3gCM42h
- Guest
  
  Second time: wrong show and comment thread.
- TwiceToday
  
  You should start your own blog or curtail your comments to a
  specific thread. Nothing personal, just ‘rule of law’ etiquette.
Dennis

I was pleased to see so many comments to this program. I
have never written to On Point before but I have to say this particular was
infuriating. As an American Indian, White Earth Ojibwe to be specific and a
Vietnam Veteran, listening to someone like Rep. Burgess reminds me how far we
have slid backward as a nation. I had a very difficult time listening to
Congressman Michael Burgess talk down to the American public in his smug shroud
of privilege.

He is a Republican and a Tea Party “Patriot” whatever that term
means to that group. I don’t particularly like it when NPR brings such hard
core conservatives on their programs, however, it does serve to shine a light on
the Michael Burgesses in our government. And I don’t mean this as a criticism of
Republicans and Tea Party people in general. President Eisenhower taxed the most wealthy at 90% to build our highway system. However, people in power like Rep. Burgess
only protect a very narrow view point of what they perceive as what is right
and moral and really care very little about helping people who do not fit
within their view point.

Throughout our history people like Burgess have harmed not
only people but our democracy itself. I suggest people interested take a look
at his voting record especially on health and education. For example, although
he’s a medical doctor yet voted no in support of giving mental health full
equity with physical health in March 2008. Our returning veterans are going to
need access to affordable mental health as much as physical health in the years
to come.
- Terry Tree Tree
  
  Welcome aboard! Great examples, and comment! I hope you will join us more often, now that you took the first step.
  Foreign ‘Super-citizens have MORE vote-getting money than us, but we Veterans, (not the AWOL DRUNK DESERTER!) can still voice our opinions, and exercise a lot of power to expose the lies!
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http://reinventing-america.blogspot.com/ ulTRAX

There are some agencies that provide 24/7 at home care. One of my friends signed up with them for one of their parents. The cost for the worker per week is now about $1025 a week. The price did NOT include room and board. But the agency fees were outrageous… almost $1000 a month atop what was spent for the actual home health aid. Few seniors can even afford that $1025 a week but if my math is correct this parasitic agency is extracting a whopping 22% OVERHEAD… and this was the most reasonably priced agency.
I know many believe the private sector is the answer to everything. It’s not. This is an area where the government could step in and provide this service at a MUCH lower overhead. This agency could provide scheduling and oversight, and the home health aids would remain private contractors.

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Mark Baron

I am a specialist in Long Term Care Insurance planning and I was disappointed that certain comments that were made during the broadcast weren’t properly addressed to give a complete view. There were 2 specific comments and 1 overall coversation that needs clarification to better help understand the issues. First, if someone bought a plan years ago that only had $100 per day in benefits, they should have taken inflation options with the plan. If they weren’t advised to do that, shame on the insurance agent, not the industry. If they didn’t want to pay for that option, its not the insurance industry’s mistake, but rather a shortsighted choice made by either an advisor or the client. Inflation is probably the most important option to add for anyone under age 70. Next, regarding the comment about the 100 day elimination period; this is “Long Term Care” insurance, not short term care insurance. If that caller’s family member needed care for 5 years, they wouldn’t have an issue with the elimination period. I agree that its frustrating to go through the elimination period, but if you can save 25% in premiums by taking a 90 day versus 30 day period, almost everyone chooses the 90 day. Common sense dictates that the big risk is multiple years of care at hundreds of thousands of dollars. The elimination period is a choice. Last comment: The discussion surrounding the main reason for the failure of the CLASS Act failed to mention a key reason for its demise and key reason why it couldn’t fund itself. The pricing that was likely to be set for this was going to be much higher than what it would cost for a healthy person to buy it privately. Therefore, if all healthy people would find it too expensive and buy elsewhere, the only buyers would be uninsurable people, which would bankrupt any insurance program.

http://www.copperreflections.com/ handmadejewelry

Health care should be accessible to everyone and be free to those who need it and cannot afford the high price of health insurance. The government should be responsible for all the people who cannot provide for themselves.

http://profile.yahoo.com/CT6FVIV7SNB2LM2HG75SOPCEE4 yahoo-CT6FVIV7SNB2LM2HG75SOPCEE4

Back in 1983 I saw you driving by with moussed up hair and your “Baby On Board” decal. You were in a rush to buy a new espresso machine. They called you a Yuppie. There was a TV show about you called “Thirty Something.” Time to pay the piper!

The Ramblings of AGIII

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Tuesday, April 30, 2013

ELDERCARE TALK: Decisions

FUTURE OF ELDER CARE (text)

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