Friday, June 29, 2012

Obama & Roberts Give Health Care, Now Our Duty Begins

Well folks, there is a whole lot of excitement now about the Supreme Court decision on President Obama's health care program.  Some pundits say Roberts was an idiot, others say he is a Machiavellian who has successfully motivated the far right base to run Obama out of office in November.  Of course, many feel just as strongly this is a great victory for the President which will motivate his base to reelect him in November, and it appears they were right.

What not many people are talking about is our share of responsibility in making this program a success.  There is certainly much potential for lowering health care costs if everyone takes more personal responsibility for their own health care.  Whether it is improving our life style choices to maintain our good health, learning more about our individual health problems so we can do things that will improve them, or going for routine regular check-ups to keep problems from appearing and getting out of hand, we have a lot of power.

For example, here is the experience of one family that decided to eliminate all sugar from their diet for one year and the benefits experienced.  In 2016, a study has reported the potential for saving $63billion in smoking health care costs if 10% of smokers quit, and others would reduce their amount of smoking by 10%.

[12/27/16]  Republicans continue to declare their intentions of defunding Planned Parenthood and shutting down "Obamacare" (Affordable Health Care) as soon as possible.  This 2015 article shows how one Republican Congresswoman perpetuated lies and misinformation on behalf of her candidacy.  Many comments tear Rep. Cathy McMorris Rodgers viewpoint to shreds.
     People at this site, which described Trump voters' distress at the idea of defunding Planned Parenthood, also had a lot to say. One commented "It's Obamacare because Pres. Obama DOES care, it will be called the Trump DOESN'T care plan when he and the GOP get done!"  I like  "TrumpNoCare" plan, or "TrumpCareless" plan, or "TrumpLessCare"plan for a label.
     Unfortunately, many people do NOT realize the well liked Affordable Care Act is "Obamacare". Mostly poorer states refused to expand their Medicaid services (fully funded by the Federal government) leaving many of their citizens underinsured.  If Trump succeeds in destroying "Obamacare" as promised, all the lower income people who voted for him in states with expanded benefits will loose them.  [States expanding Medicaid – AZ, AR, CA, CO, DE, DC, HI, IL, IA, IN, KY, MD, MA, MN, MA, NH, NV, NJ, UT, NM, NY, ND, OH, OR, PA, RI, VT, WA, WV]  If you live in one of these states and voted Trump you voted against your own interest.  This long, detailed article with maps and listing of who has benefited from this program and by how much will answer your question.

[11/19/16]  One casualty of reduced spending on preventive health care and education has been the increase in the rate of sexually transmitted diseases (STD's) since the major recession began in 2008.  Let us hope that Republicans in Congress are not penny wise and dollar foolish with their cutting of Obamacare, Planned Parenthood, and other programs that help prevent or reduce STD rates.  Health care costs for increasing rates of STD are far higher than prevention.

Of course, sometimes danger are not apparent until some years have passed.  Black lung disease has plagued miners, and asbestos lung cancer has made $millions for mesothelioma law firms, also known as asbestos lawyers.  Unfortunately, such lawsuits have been so expensive that doctors are forced to carry  extremely costly liability insurance.  This is one contributor to current high medical costs.  Something has to be done in the way of tort reform, that is lowering the amount that can be collected in lawsuits.  Trial lawyers will fight this tooth and nail.  Some balance has to be found between the extremely high legal settlements that excessively benefit lawyers and very low recompense that is unfair to injured parties.

Doctors can do a lot to fix serious problems, just as a mechanic can fix your car when it breaks down.  However, if we change the oil regularly, inflate the tires, keep other fluid levels up, and drive carefully, we have the ultimate power to preserve our autos.  It is the same with our health.  If you are reading this blog, then you know how to use a computer.  You can always Google to find information about different health needs, problems and symptoms.  You can also order useful books on line.  Of course the medical profession has been slow to get on board with this approach as it tends to reduce their business.  Concern has now been expressed that we do not have enough General Practitioners to care for the millions of new people with health insurance.  This will be less of a problem when we take fuller responsibility for our own health.

A very important influence is the quality of our nutrition.  We can choose foods that will build up our health or break it down.  If you do the latter, then you are betraying the President's efforts to provide affordable care for all.  If you have developed health problems through age, neglect or stress you may also need to learn about vitamin, mineral, and herbal supplements for restoring health in addition to good foods and exercise.  It is very easy to Google the name or description of the health problem and then add "nutritional treatment for".  Sometimes foods will be recommended and sometimes supplements of one sort or another.  These "neutriceuticals" can do many wonderful things.  They are not as quick as drugs, but they are much better at creating permanent cures or improvements, and rarely have side effects.

Good books are available in health food stores and on line that will help you learn more about the great variety of things you can do through nutrition.  It is well worth your while reading some and learning how to take care of yourself and your family.  You will save your own money, and that of your country.  Paying attention to exercise and emotional health and equilibrium are also valuable and you should learn about those aspects of health as well.  Unfortunately in 2016 there are increases in "Obamacare" costs in many states as shown on a this map.

In a broader vein, we must take a more intelligent approach to serious illness, and death and dying.  Today I heard someone report it is known that 10% of the sick run up around 90% of the health care costs.  It is also the case that often half of the lifetime medical costs for an individual are spent in the last 6 months of their life.  Almost 40 years ago, I and some friends formed something call The Health Action Committee.  I testified before Congress when attempts were being made to reduce the availability of nutritional supplements.  Thank goodness we won, and I know I owe much of my generally good health now to our success then.

We also approached a well known health insurance company.  They allowed us to examine their records for our area.  We determined that indeed it was10% of their policy holders who were causing 90% of their costs.  We then proposed an experiment where this 10% and/or their spouse/caregiver would be given focused information on how to improve their health with an emphasis on diet and neutriceuticals.  We explained to the insurance company that if this training resulted in lower costs, then they would make money, because lowering fees always falls behind lower costs.  Unfortunately, we were 40 years too early.  Now, however, would be a perfect time for insurance companies, businesses and labor unions to take another look at this approach to lowering health care costs.

When first proposed, the far right made a big fuss about the idea of people being able to discuss decisions around dying and death with their physicians.  This was even mislabeled as "death panels".  Every one of us is going to die, and it is wise to make plans about it while one is still healthy and communicative.  Our culture has also made dying a fearful and technical process.  It has been taken out of the hands of families and turned over to the "experts".  My late mother, who died of congestive heart failure at 89, and my late husband who died of Alzheimers at 75, both begged me not to let them die in some impersonal hospital.  They also made a point of getting legal help with wills and advanced directives while they were still mobile and mentally active.

I had to confront my own feelings about death, and also learn how to give them the care they needed.  Fortunately, they were not in a lot of pain or it might have been a lot harder to care for them.  I had gotten my whole family interested in therapeutic nutrition some years earlier.  When caring for them I made sure they got the nutritional inputs that would help them the most.  The result is that they were mobile and active until the last few months, which greatly reduced the need for costly medical inputs.  When the time came that they could no longer eat much or take their supplements, the end came quickly.  I also was able to get home hospice services to come to my home on a daily basis in the last week or two.  They explained and helped me do what would be most helpful, and also gave some emotional support.

One very important help was through the Medicare program.  There was, and probably still is, a provision that up to 20 days of free Medicare treatment in a Rehabilitation Nursing Facility can be used if one has been hospitalized for 3 days or more.  This is not nursing care.  There must be a real goal for some sort of rehabilitation.  In my husband's case the goal was for him to be able to walk the stairs to our second floor bedroom after he was hospitalized for 4 days.  This service has to be used within 30 days of the hospitalization.  I found out about it after my mother had been out of the hospital for 25 days.  We frantically  found a facility for her.  I don't remember what our rehabilitation goal was, but it did enable us to drive to her home state, close down her room in the boarding home where she had been living, put her possessions in storage, and bring back her winter clothes and other items she wanted with her.  She stayed there for 5 days, and lived with us for another 4 months without further hospitalization.  Here is more on this service from a legal information site.

AARP has pointed out that some hospitals are holding patients for several days without legally/formally admitting them.  The family is then shocked to discover that the 3 qualifying days for free Medicare rehabilitation care have not actually occurred and they are stuck with a large Rehabilitation Nursing Facility bill.  Be sure you or your relative is actually admitted to the hospital and yell like hexx if they are not.

Thus, by learning skills and being able to care for my mother and husband, we saved both ourselves and the medical/insurance system many, many treatment and hospitalization dollars.  We can all help the Obama health care program be a success if we learn how to take maximum responsibility for our own health and that of the ones we love.

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