Wednesday, June 20, 2007

If you want my vote, fix the health care problem

Pollster John Zogby thinks the Iraq war will be the top issue in the 2008 presidential campaign and he's probably right, but my vote will go to the candidate with the best plan to fix health care. Next to the war, it is also the one issue I find my baby boomer friends and I discussing when we get together. We're caught in the middle between our adult children and parents. We worry about our children who don't have employee provided health insurance and the ones who have it and struggle to pay increasingly expensive deductibles and co-pays, not to mention our children who simply don't have insurance at all.

On the other side, we have our elderly parents who find it difficult to pay for prescriptions, home health care or - God forbid - long-term care. One serious medical emergency can wipe out a lifetime of savings and leave our parents destitute. The fortunate ones will have children they can turn to for help. The others will be at the mercy of the overburdened and underfunded Medicaid system they'll be forced to turn to when they become penniless.

I'm speaking from experience here. Several months ago,
I told you about my mother who was then in a skilled-care nursing home covered by Medicare and her supplemental insurance plan. She regained her health and was discharged to go back home to live with my sister and brother-in-law. Mom is almost 90-years-old and has had Alzheimer's for nearly a decade, but she moved in with my sister years ago simply because she outlived her money and couldn't afford to live on her own. Her only source of income is social security, and mom was too proud to live in a rent subsidized senior apartment.

Moving in with my sister turned out to be a godsend. We noticed the early symptoms of Alzheimer's sooner than we might have and got mom the help she needed, which included the extremely expensive medication Aricept (one month's supply was more than $350). Over time, however, the disease progressed and it became clear that mom needed someone with her 24 hours a day, so my brother-in-law retired a few years earlier than planned and stayed home to care for my mom.

Out of respect for my mother's modesty, we hired an aide to come in to help her bathe, wash her hair, etc., and that worked out well until my mother became totally incontinent and we needed the aide 5 days a week. My sister and I were splitting the cost of the aide and mom's medications and the expenses were becoming a burden. We eventually turned to Medicaid for help and mom was instantly approved. She is now considered dual-enrolled since she has Medicare and Medicaid, in addition to the prescription program.

How does all of this relate to what I said at the top about voting for the candidate with the best plan to fix health care? Simple, I think Medicare and Medicaid have provided my mother with a level of care that all people should have access to - regardless of age.

That being said, Medicare and Medicaid don't do enough to help families caring for loved ones in their homes. Medicare only covers a home health aide for a short period of time after hospitalization or transition from a rehab facility. Medicaid provides home care assistance, but there's a long waiting list in our area (my mom's been on the list for 18 months). Respite care isn't available either, unless the person is terminal and a doctor certifies the patient has less than 6 months to live.

The government is penny wise and pound foolish when it comes to helping loved ones care for family at home, as we found out firsthand. Overwhelmed by the level of care my mother has needed for years, and the out-of-pocket expense of having to hire aides to deal with her daily hygiene, my sister and I decided last week it was time to put mom in a long-term care facility. It was the hardest thing we ever had to do. We cried and we prayed. We wanted to honor mom's wishes to die at home someday, but we just don't have the strength or the financial means to do so anymore. Instead, mom will soon be going to live in a nursing home that accepts Medicaid.

This is where the government is being foolish. They limit the funds available to provide home health care support, but they'll spend thousands of dollars a year to keep someone in a nursing home. In my mother's case, my sister saved the government thousands of dollars over the years by caring for my mother at home, and we waited for years after my mom exhausted all her resources to apply for that just wasn't enough and didn't come in time. How many other people can't manage to hold on as long as we did?

So, my vote, my sister's vote, my husband's vote, and I'm sure the votes of millions of others will go to the candidate that has a plan to insure all Americans and expand the level of home care available to families taking care of loved ones.

Iraq may be the top issue, but among my friends there's a lot of anger about health care in this country. Our thinking goes something like this: If there are tax dollars available to keep an American presence in Iraq for up to 50 years, then there darn well better be tax dollars to take care of people here at home.

(I've started researching where the candidates stand on this issue and I'll be posting something on it real soon. In the meantime, here's a link that gives more information on
Michigan's Medicaid Program.)


Lew Scannon said...

I think that the Iraq war and health care are intertwined in the fact that the billions we are sending to the defense contractors could be (and should be) better spent providing coverage for al Americans.

Praguetwin said...

Penny-wise and pound-foolish. That pretty much sums up the U.S. healthcare system, doesn't it?

It is going to be a long, hard slog to reform. I'll be looking forward to your posts.

Larry said...

It is a shame that in the wealthiest nation in the world, we have at least 47 million people without healthcare, 1/3 of those making $40.000 per year.

These figures do not reflect the severly underinsured in America which are in the millions.

Good post.

abi said...

You make some great points, Kathy. Good comments, too. But don't go praising Medicare too loudly - Bush might want to privatize it. ;-)

Kathy said...

Lew, absolutely, and that one fact has many of us ticked off. We don't want our tax dollars being spent in the Middle East, we want them spent here at home on our fellow Americans.

Praguetwin, you're right about a long, hard slog, but if we don't fight to take it, no one's going to hand it to us.

Larry, thanks for stopping by. You're right about those severely uninsured. I know some of them personally. They have insurance, but they can't afford to pay the high deductibles if they use it. What good is that?

Abi, too late, the Bush administration is already trying to do that!

enigma4ever said...

First off I was so touched reading this...and moved that you , all of you , a Loving family have had to juggle this precarious situation.....You have been resourceful and brave....

Aricept should not be costing so much- I would love to know if it costs so much in Canada....

All kinds of families are being ruined by this....and the bankruptcy rates in this counttry have skyrocketed over the past 5 years due to this Mess...

Now about candiates- Edwards and Obama are the only ones that I think have been putting forth adequate proactive plans vs. lip service...and I will be honest Hillary has been less than forceful on this issue....My son ( 6-6- my teenage son) says that Bill Richardson is worth a neighbor says Ron Paul is working on Healthcare issues...
My other neighbor says there you have the round up from my little street in Ohio...

Your blog really is doing a wonderful job on this...

Kathy said...

Enigma, I'm not sure what Canada charges for Aricept now, but at one time it was about $200 per month, still a lot of money.

I like the Edwards and Kucinich plans the best so far. I haven't had a chance to research Richardson yet, but plan to.

Regarding my mom, thanks for caring about all of us. Mom is moved into the nursing home now and so far she seems to be adjusting. As you know, Alzheimer's patients don't take well to disruptions in their lives so we were concerned, but so far so good. We think the nursing home has a great staff too. My mom is on Medicaid and I know that shouldn't affect the quality of her care, but I know better - sadly - so that was a concern too.

Tameshia said...

Hi Kathy,
Thank you for sharing your story about your mother and the importance of having good health care coverage.

My name is Tameshia, and I work in Michigan on the Health Care for Health Care Workers Campaign. I'm happy to hear that health care is such a pressing issue for yourself and your other "boomer" friends. Another side to the sad state of health care in our country is that many direct-care workers, like the aide you hired for your mother when she was still at home and those caring for her in the nursing home, do not have health insurance. As many as 2 in 5 direct-care workers are uninsured! It is sad and ironic that so many women who are working in the health care industry lack coverage for themselves. The HCHCW Campaign is working in Michigan to secure coverage for these necessary workers. If you are interested in finding out more about our work in Michigan, go to . We have a petition that we would love for you and others to sign and information on how you can get involved in our work in Michigan. If you would like to talk with me directly, my contact info is on the website.

We recognize that there are many in this country that do not have health insurance coverage. But, the lack of coverage for these valuable workers is appaling and without health insurance it will be difficult to continue attracting committed caregivers to provide care and support when we need it the most.

Kathy said...

Tameshia, thanks for the information. I agree with you that direct care workers should have health insurance, and it's just one more reason I lean toward a universal plan, but until that happens workers need something now.

It just doesn't make sense to have direct care aides wait until a nagging cough turns into something serious, but that's exactly what happens when a person doesn't have insurance and puts off seeing a doctor. They jeopardize the health of their patient and they also disrupt that patient's life. In my mom's case, whenever an aide left or took time off, it confused her and left her anxious since she couldn't understand what happened.

I also agree that's it's difficult to hold onto valuable employees when health insurance isn't part of the package. I don't blame them for leaving and taking another job that does, and that's also another reason I favor universal health care. It would help resolve the problems of high turnover and retention that many industries face.

Good luck in your efforts to bring about reform. I'll definitely click over and sign your petition.