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She is 89 years old, and if you saw her now, you'd never give her hopes to go another month let alone another year.  Her husband died thirteen years ago and for a few years, she was able to make it on her own, with her husbands meager retirement, a small sum she was getting from his social security and healthcare through Medicare/Medicaid.

She had suffered from heart disease since she was in her forties, now it progressed to congestive heart failure.  In the past few years, signs of  dementia had started showing itself.  Her family had a history of Alzheimer's, she had lost a sister and a brother to it.  The doctor's performed extensive tests and ruled it out, however, the dementia was still progressing.  

Once living by herself, she eventually moved in with her daughter, who helped provide care, until she reached a point where she was a risk to herself.  She spends her days in a nursing home now, her health and declining mental faculties made it necessary for her to have round the clock care.  Her moments of dementia are more often and longer then her moments of lucidity.

Except for when my mother and uncle were little, my grandmother had worked most of her life.  The jobs she held were low paying, sometimes dirty, often times thankless.  My grandfather worked in a glass factory, long hours on the line, cutting glass.  Between the two of them, they made ends meet for four kids.  Now she relies on the Medicare/Medicaid  (MCR/MCD) program to survive.  Luckily, the nursing home that she is in, is well managed, clean and she is well cared for, despite, being a MCR/MCD patient.  Many of the elderly on MCR/MCD aren't so lucky.

Over the years, we've heard the horror stories of wretched care of the elderly and bedridden.  In the past six years, cutbacks to MCR and MCD, has threaten the health and well-being of the individuals who have built this country up to what it is.  As doctors and facilities receive less in payments for these patients, more are either refusing to take them, or have limited the numbers of patients with MCR/MCD to their practice.

In an attempt to cut back costs and reform the programs, the Republican congress and President, over the past years, have converted Medicare  and Medicaid plans to either health maintenance organizations or preferred provider organizations.  Although most look good on paper, often times, doctors and patients are left jumping through hoops, trying to get needed tests, under these plans.  

The enrollment process for these plans are often confusing to even the youngest of Medicare and/or Medicaid patients.  They're deluged with information, that, unless you're an insurance specialist, or in the healthcare field, is often difficult to understand.

We can lay the blame on the doctors and facilities for wanting more money, but let's not.  I work for a company that provides information systems to healthcare providers.  The payments providers receive from MCR/MCD for services are often less then what it cost to perform the services that are approved.  Should the insurance companies deny the claim, then practices who I work with usually end up writing off the cost of these services and continue to treat these patients.  These are physicians who take their hippocratic oath seriously.

Rather then laying blame, our elected officials must continue to work at providing a healthcare package for those individuals who are in need our governments assistance.  As the 2008 elections approach, our Presidential candidates on both sides of the aisle are jockeying for support to get them past the primary.  While the candidates on the right discuss terrorism, abortion and family values, it's the Democratic candidates, or some of them, that are discussing healthcare reform and comprehensive healthcare packages.  

It is imperative, that as our parents or even ourselves reach our twilight years, to elect an individual who is truly interested in ensuring that the elderly, especially the poorest of them, receives the quality of healthcare necessary to allow those years to be golden.

Originally posted to mpwife on Fri Jun 15, 2007 at 06:34 PM PDT.

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Comment Preferences

  •  tips, suggestions and demands from our reps n/t (20+ / 0-)

    "A feminist is a woman who does not allow anyone to think in her place." Michelle Le Doeuff

    by mpwife on Fri Jun 15, 2007 at 06:32:54 PM PDT

  •  This is an important issue (6+ / 0-)

    And an excellent diary. I hope this gets some attention, from the Kos community and from the politicians.

    My mother-in-law is 91 and in a nursing home in another state. I wish the best for your grandmother.

    "They Call Him "W" So He Can Spell It"

    by Ekaterin on Fri Jun 15, 2007 at 09:15:58 PM PDT

  •  My mother-in-law lived frugally..... (4+ / 0-)

    ....for her entire life, saving money so she would be secure in case there was an emergency. She has paid for her own care for these past few years in the nursing home, but now that her own money is running out, she will be going on Medicaid.

    That process is so demeaning to the dignity of the elderly. She's not allowed to have more than $40 a month, and if we pay for something like her TV service, Medicaid counts it as income and takes it out of HER $40 a month.

    On a few occasions, the nursing home has tried to fraudulently bill us for amounts like $37,000, when the law clearly states that Medicaid, not us, must pick up her charges. In other states, I understand that family members CAN be held liable for charges, which can certainly be disastrous to most families.

    I just wish there were a way to handle this process with more dignity for the elderly person. The system does need reform. And I pity the elderly who do not have family members who are able to continually monitor the nursing care the patient is receiving.

    "They Call Him "W" So He Can Spell It"

    by Ekaterin on Fri Jun 15, 2007 at 10:58:01 PM PDT

    •  Fixed income (2+ / 0-)

      Yes, there's alot within the system that needs to be reformed, cutbacks on medical care isn't the answer.  Fraud is less rampant with these programs.  Alot of times what may seem to be fraud is either a computer error (trust me those occur...lol) or unqualified billers who aren't aware of billing procedures.  Regardless it can still be frustrating to the patients and their families.

      My mother has found a way around the income issue, but then she lives close enough to visit often, and bring items that my grandmother may want or need without giving her actual cash.

      "A feminist is a woman who does not allow anyone to think in her place." Michelle Le Doeuff

      by mpwife on Sat Jun 16, 2007 at 05:48:01 AM PDT

      [ Parent ]

  •  I see so many older women (4+ / 0-)

    at the Jewel checkout counter - struggling to bag.  Can't retire, I guess - and I see people alone struggling for dignity.  Which of us knows what will happen to us?  Which of us?  

    I have no patience with people who grow old at 60 just because they are entitled to a bus pass. Mary Wesley, British novelist

    by xanthe on Sat Jun 16, 2007 at 05:33:25 AM PDT

    •  It's unfortunate (3+ / 0-)

      Women have been known to live longer then men.  My mother is 66.  My stepfather passed away about 5 years ago.  She's a certified medical biller/transcriptionist, but due to her age, she can't find a job in her field, so she works at Walmart.  

      Luckily she owns her home, has some retirement money of her own stored away, as well as my stepfathers 401 and life insurance money.  So hopefully she won't struggle when she's in her 70's.  However, her medicare premiums are 300.00 a month and then there's her prescriptions.

      "A feminist is a woman who does not allow anyone to think in her place." Michelle Le Doeuff

      by mpwife on Sat Jun 16, 2007 at 05:52:16 AM PDT

      [ Parent ]

  •  My nightmare (3+ / 0-)
    Recommended by:
    gogol, Blue Waters Run Deep, mpwife

    This diary hits upon a secret fear of mine. That, decades from now, when I'm in my 80s or 90s, I won't be able to care for myself, but our health care system will have deteriorated to the point where I just "fall through the cracks."

    Some of what is happening already is a tragedy. The wealthiest country in the world should be able to care for its elders.

    •  I think that's alot of our fear (2+ / 0-)
      Recommended by:
      3goldens, WayneNight

      There are already elderly slipping through the cracks now.  We've seen where pension funds were robbed and where companies quit offering retirement plans.  Alot of people live paycheck to paycheck and aren't able to put away money on their own for IRAs or 401Ks.  

      That's why it is important for the government to keep their hands in maintaining the major programs for the elderly like MCR/MCD and Social Security.  
      Unfortunately, it doesn't do us any good to have a president who borrows from the social security fund, agrees to privatize a healthcare program and give the contracts to his buds.  Too easily for someone to defraud those funds.  

      "A feminist is a woman who does not allow anyone to think in her place." Michelle Le Doeuff

      by mpwife on Sun Jun 17, 2007 at 01:52:29 AM PDT

      [ Parent ]

  •  Ironically, the elderly are the luck ones. (1+ / 0-)
    Recommended by:
    mpwife

    At least everyone 65 and older has Medicare; for all its flaws, it's a reasonably efficient and comprehensive form of health insurance. All the "managed care" variants are frauds and shell games, but the underlying system remains a good basis for a national health insurance scheme.

    •  Agreed, however (0+ / 0-)

      The HMO and PPO plans do make it more difficult to get certain tests and services that may not be covered or more difficult to obtain due to the attempt to "privatize" the system.  

      "A feminist is a woman who does not allow anyone to think in her place." Michelle Le Doeuff

      by mpwife on Mon Jun 18, 2007 at 09:33:12 AM PDT

      [ Parent ]

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