Wednesday, January 17, 2007

Health Care: www.dividedwefail.org

The SEIU (union), AARP, and Business Roundtable are launching a partnership to reform health care. SEIU's President Stern will stand with Bill Novelli, CEO of AARP, and John Castellani, President of the Business Roundtable, at the National Press Club in Washington, D.C. to announce the formation of the Divided We Fail partnership today. The groups represent more than 50 million and are joining forces to influence the political debate on health care reform and long-term financial security for working people.

Webcast of the event slated for 2 pm today.

Los Angeles Times has coverage of the partnership in today's edition. Full-page ads announcing the launch are in major national newspapers this week.

More about the campaign, www.dividedwefail.org.

5 comments:

George Link said...

Both my wife and I suffer with WEP and this year, because of an aberration in 2005,we are each also paying an additional $12.30 for Medicare B. Our 2006 IRS return has our joint income well below the trigger threshold and we fully expect 2007 to be the same. We believe the $12.30 IRMMA increase to be wrong because it is a FULL penalty while WEP gives us only partial SS payments AND the year we are paying the additional Part B amount we will not have the additional income to make things fair.

Richard P. Phelan said...

Read the article, "Divided we fail" in the March issue of the AARP Bulletin. Inasmuch as I have been the victim of reclining health care coverage as a GM retiree, I totally support your efforts in health care reform. In fact, as a frequent contributor to The Tampa Tribune, I just submitted an article bringing attention to your article. Hopefully it will be instrumental in creating greater support for you.

Diana C. said...

I am 56 and have diabetes. 2years ago I went to a seminar about long-term health insurance to find out that I couldnt get this type of insurance at all. My diabetes is controlled and managed by me everyday. I dont think this is fair...and should be a situation that is under consideration for change.

Anonymous said...

Re: article "Divided we fail" I live in small rural town in North Texas. Currently, I'm assisting with health care and financial infor for an 82 y. o. woman who insists living in her home, which was her family home on a few acres. She is in rehab now from a fall in her home which hurt her back.

Her Social Security income is $800 per month and has a more than $2,000 in her bank acct and one small CD. She has children/ but they are unable to help her due to other health and family issues.

This woman is bright, well educated with a degree. The upkeep on her house is difficult due to her limited resources. She has had her roof replaced twice, and may need to be replaced another time from the recent hail damage.

She wants to stay in her home and has neighbors go to grocery store, etc.
She can drive short distances, but unable to walk from the car into the place where she is going.

Do not know who to call re: medicaid info eligibilty criteria. She thinks she is not qualified; I saw on the on the internet the possibility of Asset Protection, so that she can qualify for Medicaid.

I NEED TO KNOW HOW TO OBTAIN THIS INFORMATION FOR HER. It seems there are private companies providing this info by buying their $200. CD and booklet to tell one how to do this; and then there are lawyers who can help.

Question: Are the Area Agencies on Aging knowledgeable about this?

I've contacted several resource; it seems they need to come out and evaluate her financial/ living situtaion before they release any info.

Due to the length of time in obtaining all the information and red tape, it is mind boggeling to try and help her in a more simplified manner.

Question: is there a list on the internet with some agency about the eligibilty criteria? And, should she be a little over the line -- think there needs to be exceptions to these rules and/or change them legislatively.

These elderly widows have been self reliant all their lives, and now that THEY need help, it seems as though they have to pay for several insurance policies to cover expenses, which are quite expensive, and leave them little money to cover regular living expenses.

Please consider this issue which are shared by many elderly, and FIX the problem.

Thank you very Much

Pat Zink

martha m said...

DIARY OF A DIABETIC STROKE PATIENT

6/1/2007 5:15pm JRG/patient falls while dressing to go out to dinner with friends
5:25pm I, his wife, return home from grocery shopping and find husband (JRG) on the floor with slurred speech and unable to get up. Call manager of the retirement home where we are independent residents. He immediately comes and calls the local EMT.
6:15pm EMT arrives and has JRG loaded in the ambulance for Barnesville Hospital, Barnesville, OH, where they assess he has possibly had a stroke. He was on coumadin and they administer heparin. They want a neurologist to see him. Local neurologist is not available. Try to get him transported to Wheeling Hospital or Ohio Valley Medical Center in Wheeling WV, or Eastern Ohio Regional Hospital, in Martins Ferry, OH, within 30 miles of Barnesville. Either a neurologist is not available or the secondary insurance company will not approve the facility. Decision is made to transport to UPMC, Pittsburgh, PA, 92 miles from Barnesville, where JRG received a kidney transplant in 1992.
6/2/2007 1:00am Facility and transport approved by insurance company and JRG is transported to UPMC.
2:30am JRG arrived at UPMC ER. Requested the Kidney Transplant coordinator be informed that JRG was in UPMC.
10:30am JRG transferred from UPMC ER to PACU. Confirmed that JRG had a bleeding stroke. Orders for coumadin and heparin stopped. Patient experiencing very high blood glucose readings. Not allowed to use insulin pump for boluses to control blood glucose levels. Maintain basal rate of insulin received through pump. Hospital policy to take BGs every four hours, call doctor for allowed insulin injection coverage. Type of insulin changed. Patient experiencing weakness and inattentiveness to his left side. In the night patient became confused and was placed in “Posey” jacket. Family member told that it would have been helpful to have a family member sit with him to minimize confusion.
6/3/2007 10:00am JRG transferred from UPMC PACU to G-5 floor. Transplant coordinator has not been contacted. Was told by neurologist that there was no need to contact transplant team, as there was no correlation between stroke occurrence and diabetes/kidney function; that area of brain affected was not an important factor for the family to be concerned about. Patient still experiencing very high blood glucose levels. Allowed to eat first soft foods - not diabetic diet. Patient less confused.
6/4/2007 am JRG informed he was being discharged to an acute rehabilitation facility. Social coordinator having difficulty finding facility within “network” of insurance company. When meds were given to JRG it was observed the wrong dosage of prograf was being given. Upon asking, was informed that this was the first time he was given prograf, meaning he had been two days in UPMC without his anti-rejection drug. Family scolded by nurse for trying to monitor blood glucose levels with personal blood glucose meter. Hospital policy monitors every 4 hours with doctor giving orders for insulin coverage of high readings. Patient experiencing very high blood glucose levels.
6/6/2007 about 4am JRG became disoriented and fell out of bed, skinning his knee. Wife was asked to leave room evening before and nurse in charge knew she was in waiting room on same floor through the night. Made no contact to inform of patient’s confusion. Found him in a “Posey” jacket again this morning. The now discharged patient (6/4) was visited by very well trained diabetes specialist and some adjustments of basal rate on insulin pump were made. Visited by nutrition staff and requested diabetic, low-glycemic diet but no changes were evident on subsequent food tray.
7 pm JRG transported from UPMC to Peterson Rehabilitation Hospital, Wheeling, WV (Drivers of transport from Washington, PA got lost and patient gave them directions to get to Peterson Rehab Hospital!). Endocrinologist of over 15 years does not have “privileges” at Peterson, thus cannot assess or prescribe insulin (but was consulted) and is going on vacation. No one on staff is versed in use of insulin pump so the decision is made to remove insulin pump. Again changed type of insulin, monitoring only before meals and at bedtime. Blood glucose levels become very elevated. Meals do not follow a diabetic, low glycemic diet.
6/8/2007 5:00pm JRG transported from Peterson Rehab to Ohio Valley Medical Center ER. ER doctor had many interruptions. Patient not transferred from ER to bed on floor 5 of OVMC until after 11pm. Floor nurse and doctor were not finished with questions until after 12 am. Diet for the next three days is not diabetic. Request low glycemic and diabetic foods with poor response. Supply whole wheat breads and non-fat plain yogurt to be served. Patient must ask for them or they are not served from refrigerator on floor. Blood glucose readings indicate slightly more control
6/12/2007 10:30am JRG discharged to return to Peterson. Informed after 5:00 pm that insurance will not approve wheelchair transport. Pay $37.75 for local hospital wheelchair transport. Again supply whole wheat breads and non-fat plain yogurt but patient must ask for them when in dining room.
6/13-15/2007 JRG receives three days of acute rehab at Peterson.
6/16/2007 9:30am JRG transported from Peterson Rehab to Wheeling Hospital ER. Elevated blood glucose readings and slight temperature with some evidence of confusion.
1:00pm JRG transferred from ER to bed on floor 4 of WH. Blood glucose levels remain elevated, at first monitored every 4 hours and on last day, monitored every hour. Supply whole wheat breads and low-fat, plain yogurt but again, patient must remember to ask for them to be brought from the floor refrigerator. Takes two days to get diabetic diet then begin ordering each meal by phone with some improvement. Excellent communications with neurologist.
6/19/2007 8:30am JRG to be transferred from floor 4 to floor 3 - ICU of Wheeling Hospital at which time I said, “Because of his blood glucose readings, he is not receiving acute physical therapy. I can control his blood glucose levels at home with his insulin pump and he will get more therapy there than here in these hospitals! I am taking him home!” Did not move patient to ICU. Began monitoring BG every hour and correction shot of insulin every two hours.
6/20/2007 3:00pm JRG leaves WH. Is in hospital bed in home by 4:30pm; he is reconnected with his insulin pump; now receiving home health care, physical, occupational and speech therapy from Barnesville Hospital. Blood glucose readings are in 80 - 220 mg/dl range.

Summary:
20 days
5 hospitals
estimated 20 to 30 hours waiting and answering questions in ER and hospital admissions
14 patient transfers to-bed or to-transport, not counting being taken for x-rays, CT scans and MRI tests
Maximum estimate - 12 total hours of acute physical, occupational and/or speech therapy for stroke.
Wait time between receiving a high blood glucose reading, calling the doctor, receiving the return call, to giving an insulin shot to bring readings down was very unacceptable, one time being 4 hours, usually 1 hour or more, and no retesting of blood glucose to see if the shot was still the right correction.

Conclusions:
Hospitals’ staffs are overworked and poorly supervised
Hospitals are understaffed and possibly underpaid
Hospitals differ greatly in housekeeping; in one hospital two bloody drainage containers sat on shelf above the bathroom sink for three days until I asked that they be removed
Hospitals have wasted a lot of money to put boards in place and not have them used. In the 5 hospitals, 3 nurses, some on more than one shift, took the initiative to write the date and their names on boards provided to help their patients be oriented in time and surroundings
Policies of monitoring diabetes and blood glucose levels are “prehistoric.” Patient’s management of own diabetes was not considered - hospital policies overrode patient’s with very poor control resulting
Hospitals need staff well trained in the use of insulin pumps for the increasing number of patients with insulin pumps and for better control of blood glucose levels
Communications between admissions and food services of hospitals is generally very poor
Hospital food service/dieticians need more training in relationships of foods and blood sugars.
Hospital policies of “privileged” physicians is sometimes detrimental to care of patients
Insurance companies grossly increase the costs of hospitalization
Insurance “network” policies are detrimental to facilitating timely treatment of stroke patients thus increasing time required for, and overall costs of recovery