She was determined to fulfill her father’s dearest wish, the wish so common among frail, elderly people: to die at home. But it seemed as if all the forces of the health care system were against her — hospitals, nursing homes, home health agencies, insurance companies, and the shifting crosscurrents of public health care spending. The NYT reports in depth on a single case, a snapshot of the typical end-of-life care situation in the United States. A worthwhile but disturbing long read, potentially very upsetting if you've lost a loved one in a similar managed care setting. [more inside]
Rising Demand for Long-Term Services and Supports for Elderly People (pdf, 574 kb) - "By 2050, one-fifth of the total U.S. population will be elderly (that is, 65 or older), up from 12 percent in 2000 and 8 percent in 1950. The number of people age 85 or older will grow the fastest over the next few decades, constituting 4 percent of the population by 2050, or 10 times its share in 1950. That growth in the elderly population will bring a corresponding surge in the number of elderly people with functional and cognitive limitations."
As part of the Affordable Care Act, The Centers for Medicare and Medicaid Services has released data that show significant variation across the country and within communities in what hospitals charge for common inpatient services. (via) [more inside]
Jonathan Cohn compares the effects on Medicare from the Affordable Care Act with the proposals being promoted by Mitt Romney and Paul Ryan.
Paul Ryan. Seven-term congressman for Wisconsin's 1st District. Chairman of the powerful House Budget Committee. Architect of the controversial Ryan Budget -- a "Path to Prosperity" [PDF - video - CBO] that would slash trillions from the federal budget, sharply curtail taxes on the wealthy, and transform Medicare into a private voucher system. Proponent (vid) -- and renouncer -- of Ayn Rand 's Objectivism. Social Security beneficiary. Hunter. Weinermobile driver. And as of this morning, the 2012 Republican candidate for Vice President of the United States of America. [more inside]
The Boston Globe reports that nursing homes in the United States continue to administer antipsychotic medications to patients who do not fit criteria for these drugs, in many cases to manage behavior considered disruptive by staff. For example, "in 21 percent of US nursing homes in 2010, at least one-quarter of the residents without illnesses recommended for antipsychotic use received the medications." Overuse of antipsychotic medications appears to correlate with nursing homes that have higher staff:patient ratios and to homes that house more people covered by Medicaid/Medicare. [more inside]
"We’re not going to say, 'Give it to me and let my grandchildren suffer.' I think they underestimate seniors when they think that way." But 71-year-old Barbara Sullivan cannot imagine asking people to pay higher taxes. And as she considered making do with less, she started to cry." (slnyt) [more inside]
A simple question shows how complex the issue is. Chris at "Cynical C" asks his fellow citizens where they get thier health care (insurance) from and the incredible diversity of the current options and situations is immediately apparent. Quite spontaneously (but surely not unexpectedly), the question of "How much does it cost you?" becomes an essential part of the answers. Outsiders opine and tell stories and commiserate. [more inside]
Is the U.S. Bankrupt? [332Kb PDF] Laurence Kotlikoff, writing in this month's Federal Reserve Bank of St. Louis Review, says "yes" - to the tune of $66 trillion! [more inside]