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When its children who suffer the most? As a healthcare professional, I was reading an interesting blog. As a peds nurse I see many children who can't this or that done because there is no funding or they get rejected by insurance companies,meanwhile an elderly person who is 98 and on a ventilator ,and non responsive(brain dead) is getting her 5th. Hip surgery? Isn't that hip surgery unessesary at this point,meanwhile a child of 5 who is alert and has muscular dystrophy gets denied a wheelchair (and medicaid insurance) when they have a better prognosis than the elderly client? Or an elderly client who gets social security on top of getting a 3000 dollar pension and free medicare but we deny medicaid to the child who has cancer because the parents make 2000 a month? Tell me your opinions please
Medicare isn't free.
The elderly client getting Social Security paid into that system for years, and my guess is the government was more than happy to take his money.
I guess because I see it from another end. For example,the 90 year old who falls because she has dementia and keeps breaking her hips and needs surgey like 5 times a year? Or the 100 year old who is on a vent and has end stage cancer who is getting knee surgery,and whose family doesn't want a dnr on her and wants her life saved at all costs?(a full code)
How are you seeing this if you're a pediatric nurse. I have never heard of 5 hip replacements in a year, or Knee surgery on patients on ventilators. I work in peds now, but I have also done home health.
It is the mark of a civilized society which takes care of the frail, elderly and very young, as this nation does. The extra burden comes when socialism rears its ugly head and requires the healthy who can work and pay their own way, and those who don't belong here, to also get on the government dole.
I was just tired of seeing posts about "obamacare was going to decide who lives and who dies and then they would talk about death panels for elderly. I see elderly who we should just let die in peace instead of doing all this expensive treatments.
The reason health care costs are higher at the end of life is because people are sicker at the end of their lives. We would all like to just drop dead some day (well, most of us anyway), but that's not how it usually happens. Go to work in geriatrics instead of reading nursing blogs, and see what's really going on out there.
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Originally Posted by GregW
I would bet there is more short term profit in treating the very elderly than in treating a child with a serious disease. This is an example of short term thinking on the part of the medical industry. By spending the money on a very elderly dying patient the cash flow is extended for a limited amount of time. If they spent the money on a child that would survive into middle age this patient would provide far more total profit to the industry over a much longer time. The problem is the long term patient does not yield as much short term profit that determines the current administrator’s bonus.
In reality we could provide for all of the sick if we just eliminated the profits and the huge executive salaries, along with the shysters doctors that “At 20 grand a pop and four boob jobs a day of course I have a boat†that are, pardon the expression, milking the system. We could afford to pay doctors and other staff generous salaries if we did not have to pay multimillion dollar executives in the medical delivery and supply system. This is why a socialized system is less expensive than a corrupted private system. It is also why we need a government sponsored Universal Health Care system outside of the private sector.
I seriously doubt that, and it is an example of what the health care (not medical) "industry" (yeah, the assembly line, you know), is up against. We supposedly treat when we shouldn't 'to make money'; we supposedly withold proven treatments to keep people sick 'to make money', and so on. There are a lot of problems in health care, but that's not one of them.
When I mentioned my son who has cerebral palsy & couldn't get a wheelchair due to Medicaid cuts, the response I got here was "Why should WE have to pay for YOUR child?" - - And always from conservative "Christians", no less. (No offense to REAL Christians, who actually follow Jesus' actual words as opposed to the "other" kind. )
Personally, it is my opinion that for a country who calls itself "The Greatest country on earth", we treat our own pretty crappy.
I will gladly have my tax payer dollars go towards health care of my fellow citizens, young and old, before paying for any wars of choice.
We need national single payer health insurance, joining the rest of the civilized world
It's something that's rather tricky to discuss. Especially because many of today's elderly (say roughly those who are 85+) are members of the greatest generation. To openly say that we should cut benefits for the elderly is frequently seen as blasphemous. Do we just strip them of their benefits and leave them to fend for themselves? I don't know.
In a "free market" that hates any form of socialism, that would be the approach. Somehow, we like socialism. But we don't like paying for them, or those who need care, when we're healthy, because we're overconsumed with ourselves... until we're in their position. This keeps pushing the costs higher. And part of the reason why, while I hate the insurance mandate, I see its point.
As a society, we better decide if we all want to contribute or just think for ourselves and be done with it (and leave everything, including the treatment for elderly and the children on "charity").
Quote:
Originally Posted by lilypad
It is the mark of a civilized society which takes care of the frail, elderly and very young, as this nation does. The extra burden comes when socialism rears its ugly head and requires the healthy who can work and pay their own way, and those who don't belong here, to also get on the government dole.
How do you propose taking care of the frail, elderly and very young without involving any form of socialism? Rely on charity?
You must not be in the healthcare field,because they would understand what I'm saying.
How is what I wrote unrealistic. What do you want me to write"the end stage cancer, demented 103 yo pt who can't talk and walk anymore and needs total care and on a vent whose fam family wants us to save her life at all costs and want these expensive tests and surgeries done when clearly she only has a few months,if not weeks,to live?
It depends on the setting. I'm specifically talking about in a ltac facility. Why can't we just let them die in peace instead of constantly subjected them to these things?(and save money) As I said,what sense does it make to keep operating on someone who is probably going to die in a few months? Fyi,most people on vents are alert and are not on any sedation,unless you are talking about. The Er.)
Now see, I am indeed in healthcare, which is precisely why I can see all the holes in your made-up scenarios.
Mental status of a post-op vent patient is typically, but not always, quite different from a post-cardiopulmonary arrest vent patient. One is simply transitioning from the effects of surgery...the other has most likely suffered anoxic insult.
In a decade I have NEVER seen a patient on a vent awaiting THA (Total Hip Arthroplasty) and going through with the surgery. Why do I know that's true?
Simple. They'd never pass the presurgical consult.
If YOU were in healthcare, you'd know that. To claim that any patient, geriatric or not, is actually cleared for surgery (outside of maybe a PEG for feeding) WHILE BEING ON A VENT AND UNRESPONSIVE...sorry, I just can't fathom that line of thinking.
On a vent POST-op? Why yes, of course that happens...at any age.
It's extremely rare to see THA or TKA in any patient over the age of about 80 anyway. And they simply do not come in for 5 replacements in a year. Absolutely ludicrous statement.
The single biggest reason I see patients of extreme frailty--of ANY age--being subjected to futile interventions is by the directive of their FAMILIES.
Not the medical staff.
I've seen many cases where Medical Ethics meetings have been held at the medical staff's request, and with Risk Management in attendance, to establish cause for going over a family's head in extreme cases....cases where the family's insistence on intervention can clearly be seen as abuse of the patient.
With Oncology out of the mix, the two most costly inpatient types that I see regularly are Neonatal and Geriatric....and usually Neonatal care for extreme prematurity wins hands down on cost.
We may have the technology to make them breathe months before they should, but we still are lightyears away from ensuring intact neurological status for most of them.
Outrageous cost of care (often qualifying the families for Medicaid), atrocious outcomes.
Last edited by rayneinspain; 04-20-2010 at 09:48 AM..
Just like calling a baby a "fetus", we can now start with a hip operation for a brain dead 90 year old to open the door and ease ourselves into offering a shot to Grandma, rather than giving her any healthcare by saying "This is only for the children".
Actually, it IS a fetus from about 8 weeks until delivery. That's a FACT.
And NO physician or hospital will ever--EVER--conduct any type of surgery on a brain dead patient. (thus the term 'brain death')
That is, until after clinical death has been pronounced and organ harvestation has commenced.
The elderly client getting Social Security paid into that system for years, and my guess is the government was more than happy to take his money.
In socialism, people pay for a safety net, usually in the form of taxes. And when it comes to health care, the older population (always high risk) has to be supported by the healthy to help compensate for the costs. And with the health care costs where they're right now, do you seriously believe everybody that is a part of medicare has paid enough so that they've paid for their care for the rest of the life? Nope. We all contribute to ensure they get covered and I'm glad we can. "Free market" would eat these very same elders alive.
What I have difficulty to understand is the following scenario:
Dude X is working at a job that pays him 40K. No benefits. He can't afford healthcare. Works his tail off for 35 years. Gets a heart attack at the age of 55 as he skipped many early warnings and does not get preventive care and poor folk dies. For his 30 years of working, he contributed to medicare via SS taxes. Can't enjoy any of it as he died before reaching 65.
Dude Y is a college graduate who works a desk job making a 100K. Excellent benefits. Goes to check up every 6 months. Does everything right in terms of preventive care as he has the means to do so. Retires at 65 and obviously gets medicare. He lives to 95, stays on medicare for almost 30 years, gets the best care, millions spent on him over his retirement through medicare
Somebody please explain me how is this right? Why does the poor folk have to finance the well-off guy who lives longer because he had an easier life? How is this fair? Why is not anyone outraged because the poor folk has to spread his "wealth" to the better-off?
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