why do we pay for so much healthcare for the elderly? (compared, top 10)

[GuyNTexas]

Originally Posted by Who?Me?!

However, ...who the hell are you or anyone else to determine when a human "should" die????

The answer is quite simple ... when the money runs out, so too does the value of life leave the body.

[Mircea]

Originally Posted by SoCalCroozer

Since when does medicare pay for Viagra?

Since physicians started prescribing it.

Originally Posted by SoCalCroozer

Your money you've put into medicare is not being frittered away on viagra and elective medicine.

Yes, it is. Bush's disastrous Prescription Drug program is way out of control.

Originally Posted by SoCalCroozer

It's being frittered away on elderly patients and the families of elderly patients who refuse to realize it just might be their time to go or worse are noncompliant with their lifestyles or unrealistic about their own health.

That too.

Medicare does stupid stuff like pay for a hip replacement for someone who has been bed-ridden for several years and will remain bed-ridden the rest of their life. Does that make any sense?

Originally Posted by SoCalCroozer

I see it day in and day out. You know how many patients come into my unit because they had a fall at home and hit their head??????????????? You know how many patients come into my unit after having a massive stroke and the family, usually the daughter, would rather see her mother **** and defecate all over herself instead of sending her home on hospice or making her a DNR?

I know. My mother is a neuro-psychologist (in Florida). She evaluates people with head injuries, brain trauma, stroke, aneurysms etc to see the extent to which they might be rehabilitated.

Some people, after 6, 9, 12 or even more months of physical therapy or speech therapy might be able to walk with the use of a cane, or be able to speak again, but many never will. Some patients were already bed-ridden at the time they had their stroke or aneurysm, and yet Medicare will pay for months and months of physical therapy for someone who wasn't even able to walk before their affliction.

Does that make sense? No, but that's what Medicare does, and it's a waste of money.

Originally Posted by SoCalCroozer

You know how many elderly patients come into the hospital with C-Difficile and use up copious amounts of vancomycin and other powerful but increasingly resistant antibiotics??????? No sweetie your medicare dollars are being frittered away for much bigger reasons than some 65 year old wanting to have an erection.

Yes, I know, I was just being facetious.

Originally Posted by ray1945

My mother died at 93 after living 3 years in assisted living (paid by her own funds + nominal assistance from the state). She was able to live a full life until around age 87, when she began her mental decline. She had no desire to live a life of no meaning and so executed a Living Will. When she entered the hospital for the last time, the ER staff had already intubated her, even though the AFL had a copy of her LW. I insisted that they follow my mother's wishes and they removed the tube. She died two days later without ever regaining consciousness.

Most enlightened Americans recognize that quality of life trumps quantity and have end of life directives. Education regarding EOL directives is desperately needed. Everyone should have a living will - no matter their age.

Good for you and your mother. That she had 87 wonderful years is fantastic.

Originally Posted by 20yrsinBranson

Second of all, the senior citizens of this country are responsible not only for creating the extraordinary quality of life that we enjoy because they are the ones who built the bridges, and the highways, and the dams *and* fought most of the wars that keep you and I safe and free.

And left us with $TRILLIONS in debt.

Originally Posted by 20yrsinBranson

Senior Citizens have worked their butts off building businesses, growing food, raising children (you and me, actually), that has made this country greater than any other country on earth. We owe them nothing but the greatest respect and an unbelievable debt of gratitude.

Yes, and they left us with $TRILLIONS in debt.

Originally Posted by 20yrsinBranson

The elderly do not have this option.

No, but they do have their entire lives to plan for their retirement and health care needs, and that includes purchasing their own "health insurance" at their expense.

Originally Posted by 20yrsinBranson

Even with Medicare, often all medical expenses cannot be met and older people end up losing their homes and life savings to pay for medical expenses.

Not everyone is meant to live to age 150.

They paid into Medicare, and the certainly deserve a fair return for that, but that doesn't include extraordinary means or preserving life beyond the normal life span.

Originally Posted by thenewtexan

You haven't seen anything yet. As the baby boomers age, it'll only get worse. As a Gen X menber, I am totally convinced the Baby Boomers will suck us dry, and they'll being nothing left for those of us born after 1965. Hopefully, the government will be smart enough to limit it by then.

They will? They already did. There is no Social Security for those born after 1960 (and that includes me). That goes belly up in 2028 unless major changes are made. At that time, the Trust Fund (or OASI) will be totally exhausted and the revenues will not be able to pay existing or future Social Security benefit recipients.

As far as Medicare, I can't say with any certainty because I haven't looked at the numbers in any great detail. It is insolvent, I just can't tell you when that will happen.

You don't need to make cuts to Medicare, you just need to reform the system to use the money more judiciously. Call them "death panels" if you want, but if you're going to continue to spend $30,000 on heart-bypass surgery for someone with pancreatic cancer that will be dead in 4-6 months anyway, then the system is going to go bankrupt very quickly.

[Minethatbird]

Originally Posted by jerseygal4u

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

Your examples seem rather exaggerated.

Muscular dystrophy is incurable.

The elderly client has presumably worked all their life to get that pension, as well as paid into Social Security.

[Had2SaySumthin]

Originally Posted by Minethatbird

Your examples seem rather exaggerated.

Muscular dystrophy is incurable.

The elderly client has presumably worked all their life to get that pension, as well as paid into Social Security.

You didn't earn medicare. You can't "earn" medicare.

Social Security and the Medicare Program

It's a government run insurance program. The problem is, we don't charge enough for it.

[Nite Ryder]

Originally Posted by jerseygal4u

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

Hitler would have loved the way you think. Who should make these decisions? I say the person who can afford to pay for their health insurance should also have available health care. Don't forget, that elderly person who is on social security and medicare have already paid their fair share by paying into social security. They are entitled to a pension plan if they have worked for a company who provides it. If all nurses thought like you do, our nation could become communistic and no one would care...

[jerseygal4u]

Originally Posted by Minethatbird

Your examples seem rather exaggerated.

Muscular dystrophy is incurable.

The elderly client has presumably worked all their life to get that pension, as well as paid into Social Security.

Yes,I know that.
However,this is where the discrepancy comes in.

Little John,who is 7 and suffering from muscular dystrophy,gets denied Medicaid because his parents make $40,000 a year.

Meanwhile, Mary,who is 90 and has dementia, has her 3rd hip replacement because she constantly gets up,even when staff at the nursing home told her to call for help.
Its against the law to restrain a resident both chemically and physically,plus there isn't enough staff for her to have one on one care. She will also receive physical and occupational therapy,even though its highly unlikely she will walk again.

What's the difference when both can't be cured? Why deny one and not the other?

[jerseygal4u]

For starters,I don't know why some are saying death panels. I never,ever said anything about a death panel.
I said FUTILE treatments. I'm talking about putting an 99 year old end stage cancer pt on a vent, NGT,?that's going to prolong their life by 6 months. You guys are saying who am I deciding when someone dies,but we are also deciding who lives and how long.


I also was saying what's the difference between a sick child with an incurable disease and a sick elderly person with an incurable disease? Why go "all out" for one and not the other?

[jerseygal4u]

Originally Posted by Nite Ryder

Hitler would have loved the way you think. Who should make these decisions? I say the person who can afford to pay for their health insurance should also have available health care. Don't forget, that elderly person who is on social security and medicare have already paid their fair share by paying into social security. They are entitled to a pension plan if they have worked for a company who provides it. If all nurses thought like you do, our nation could become communistic and no one would care...

So by your logic,since sick children who have poor parents that can't afford health care,they should just die? Yes,Hitler would have loved that way of thinking.

[NHartphotog]

Another thought on the topic: medical science is much more geared to "fixing" the problems of the elderly, and medical problems that are "fixable" (especially with one-time surgery) are overall much less expensive than chronic diseases or medical problems.

Many of the problems of the elderly are broken bones, arthritis, and other structural degeneration problems. These are relatively easily fixed through surgery and replacement of joints--such surgeons are often compared to carpenters. Once the surgery is over, the patient is fine. Similarly we have very common problems of the elderly like atherosclerosis and the specific case of carotid artery disease, where the main artery to the brain is restricted with plaque. It is relatively easy to "clean out" these arteries and prevent an almost inevitable stroke or heart attack. Furthermore, there are many problems with aging that can be addressed with medication--look at the rise of statin drugs to prevent or slow "clogging of the arteries." Multiply many prescriptions by a large number of problems of the elderly, by a large number of elderly, and the "cost of the elderly" looks out of proportion.

However, this says very little about whether we are "wasting money" on the elderly, since the money that would be freed if everyone abandoned such efforts would NOT end up going to a needy child somewhere.

Now look at children's diseases and problems. Cancers, genetic birth defects (20-30% of all infant deaths are due to genetic disorders; 30-50% of post-neonatal deaths are due to congenital malformations), cystic fibrosis (1/2500 Caucasian Americans), sickle cell disease (1/500 of African American births), hemophilia - Factor VIII Deficiency (48/100,000 male births), duchenne muscular dystrophy (200/million male births), hemochromatosis (1/450 individuals). Prevalence of Genetic Conditions / Birth Defects

These cannot be fixed with a simple operation, and in many cases cannot be "fixed" at all--merely treated. Consequently, these problems will start hitting barriers like maximum insurance coverages in certain time frames, accumulation of co-pays and patients "responsibility," and insurance companies looking to stem the flow of money attributable to a very few number of patients.

So it seems our "system," patchwork as it is, will have many cases of systemic misallocation of resources, and many case of simply spending money where it has the most "bang for the buck." And with the elderly still a large voting block, I don't expect things to change much in the future, as they try to protect the system that maximizes their share of the health care pie.

[NHartphotog]

Originally Posted by jerseygal4u

I don't understand why people don't think it cruel to do a code on a frail 98 year old end stage cancer client over and over again. So we do a code,breaking her ribs in the process causing pain, after saving her,sending her to a hospital,she comes back to the nursing home but this time with mrsa infected bed sores, and still in pain

That's beyond cruel. It's horrendous.

To prevent this, every one of us needs to have an advance directive on file with the local hospital, all your doctors, a lawyer, several trusted family members, and certainly any involved nursing home.