Real progressive Healthcare Reform

from The Gray Area:

I found this recent article in “Atlantic” on the future of health care to be both timely and thought stimulating.

What I found most fascinating about these thoughts is how backward our existing system truly is.

From a human standpoint, wouldn’t it be wonderful to age in place at home with a team of professionals at your disposal as your needs for care increase. Why can’t it be this way?

Simply put, “ It cannot be this way for most people because the system of payments for such care is virtually non-existent”.

We have Medicare, supplemental insurance and Long-term health care coverage. Intuitively, you would think the majority of costs for “at home care” would be covered. But it would not be?

Supplemental insurance only pays after Medicare pays. If Medicare does not pay then supplemental insurance does not pay either. Then, to make matters even worse, long-term care in our country is normally provided today inside institutional settings.

So, if your personal desire is to die at home “your way”—you have to have the money to pay for most of that care out of your estate ( liquid cash, savings and investments). That estate you wanted to leave to your descendants would go to your end of life care because all forms of insurance failed you even though you paid premiums for all of them regularly.

Existing Medicare is rules based and has no sympathy or understanding of the need for the human soul to find its own way home.

A fundamental change in the way healthcare benefits are provided is required.

Right now, you go to a hospital, may or may not be admitted, must stay past three midnights after admittance to have Medicare cover the costs, must get a doctor’s order to go to rehab (stroke related) and then, and only then can you have part-time at home care coverage paid for through the system we now have.

My three wishes would be these:

1. Allow each individual to die at home with dignity and avoid the real threats that exist inside today’s hospital settings. Hospitals are truly dangerous places!

2. Reverse the system of payments that now exists inside Medicare. Stimulate at home care by providing incentives to be treated there.

3. Reserve hospitalization for only those whose lives are immediately threatened. Let a team of “home care professionals” guide the journey home with dignity for all the rest of us.

My two comparisons are these:

1. I can now die in a hospital, rehabilitation center or nursing home surrounded by strangers and have virtually all of my bills paid for by my existing insurances.

2. Or, I can pre-plan my journey with an identified team of professionals who will serve my needs as I age here at my own home, near my own bed, watching my own TV while sitting in my own recliner.

Number two is my choice and unfortunately— for that to come true, under today’s system, I will have to pay for most of it myself. So be it! I intend to do it my way and I hope you do too.

by Jonathan Rauch,

Medical treatment for aging, chronically ill patients is costly and often ineffective. Can they get better care at home?

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