Rebate checks began going out the first week of May. They seem to be having some effect on spending, but expect it to be limited. For those trying to survive off a limited income such as social security and low wage work (remember older Americans are likely to work in low wage jobs such as retail) the checks can only provide some temporary debt relief. What is unfortunate is that so many Americans are suffering from real economic distress because economic policies that have shifted wealth from the middle and lower tier to the top one percent of the population.
June 28, 2008
June 26, 2008
Congress favors medical equipment makers over the taxpaying public
A typical Wal-Mart walker can be had for $59.92. Medicare pays close to $110 for the same or a similar walker. This is going to change on July 1st, or at least that’s what’s supposed to happen. Traditionally the price for walkers and various medical equipment is set by Congress. This price is well above market value and according to the New York Times has the effect of “handing out a few hundred million dollars of corporate welfare to the equipment makers.” As of July 1st companies will have to submit competitive bids if they want to continue selling products to Medicare.
But enter the lobbyists. Lobbyists have stepped up their contributions to Congress, while making absurd claims that competitive bidding will deprive patients of needed oxygen equipment, and will cause job loss. Congress, of course is caving. After all its allegiance is to medical equipment makers, and not to the taxpaying public. A bill supported by Pete Stark and John Dingell, two Democratic committee chairmen, and John Boehner, the House Republican leader and overwhelmingly passed by the House aims to throw out competitive billing. According to the New York Times
A small number of companies, including Invacare, Pride, Praxair and the Scooter Store, want to keep the billion-dollar subsidy that they’re receiving every year. Or at least they want to keep as much of it as possible — which explains their strong support for the current House bill, even though it includes a 10 percent fee reduction. They recognize that the alternative — competition — would be worse for them
A similiar bill will soon be taken up by the Senate.
June 17, 2008
Money to be made in some caregiving professions
I read in the New York Times the other day about the rising opportunities for those working as geriatric care managers. Some working in this field specialize in dementia or aging related issues like depression or relocation.
There seems to be opportunities to make good money. The article reports that it’s possible to work solo and for social services agencies or small practices, making from $50,000 to $80,000 at an agency or small practice, $250,000 to $500,000 as an owner, or up to a $100,000, working solo.
Requirements are related to licensing and experience. Technically, anyone can call themselves a geriatric care manager. But the association requires new members to hold one of four certifications. Among them is care manager certified, issued by the National Academy of Certified Care Managers. It requires several years of supervised experience and a four-hour exam.
Another possibility is working as a certified case manager. Certified Case Manager Certification requires a degree in a caregiving field such as nursing and social work, as well as experience and an exam.
Anyone working in the profession need to be familiar with the physical, emotional and social issues of aging, as well as with local resources. More colleges are offering programs in geriatric care management. Information on training and requirements can be acquired at the care managers association www.caremanager.org.
Of course there are some drawbacks. According to the article, some of them may have to do with mediating bitter family conflicts, being on call round the clock. Because geriatric care management is rarely covered by insurance, most clients pay out of pocket. Those starting practices may earn nothing or very little the first year, as they build networks.
June 11, 2008
Should heath care be privatized?
I am reprinting this posting on the argument against privatizing health care. The title is Should our health care be further privatized?
Is the primary purpose of my life to make those already rich, even richer? Health care is a general good just like education, military and police. Is government’s reason for being to ensure or to promote the general good? Do the rights of a small group of individuals to make money off my health triumph my right to this general good? I ask these questions as I reflect on John McCain’s free market approach to health care.
If we believe that government’s reason for being is to promote the common good, a free market approach to health care can be disastrous. Already our privatized health care system is ranked a low 37 by the World Health Organization. To put this in perspective, when it comes to health care, countries like Costa Rica and Columbia rank higher than the US.
John McCain’s proposed health care plan would shift the responsibility for health care from employers or the government onto individuals. He plans to do this by shifting the tax benefits that now go to employers onto individuals. Under his plan individuals would receive a $2500 credit, families a $5000 credit. The fear is that change would cause some businesses to drop coverage. The result would be a large number of workers flooding the system as they try to obtain individually based plans.
The problem with individually based plans is that individuals have to qualify. For the young and healthy that might not be a problem. But the elderly and those suffering from chronic health problems might be unable to purchase health care plans. A second problem is that the administrative costs of individual polices are at least triple of those of employer based policies.
McCain also wants to deregulate the insurance industry; a step he believes would promote competition. A possible downside of deregulation is that it could lead to looser standards and higher costs and diminished coverage. As it stands now each state sets minimum standards under which plans can be sold. McCain’s plan could override state regulations. Companies would be able to sell in every state any policy that was approved in any state. That means that if an insurer’s policy was approved in a state with looser standards, a state with higher standards could not impose those standards on the insurer. For example if one state require insurers to pay for specific procedures such as mammograms, a state that does not set this standard is the one whose rules ensurers must follow. Or if one state sets a minimum deductible, a state that sets a higher deductible is the one that prevails.
Hospital downsizing
Centinela Hospital Center in Inglewood is where residents of the City of Inglewood go for healhcare. Since acquiring the hospital, its new owners, Victorville-based Prime Healthcare Services Inc. has closed many of the hospital’s departments and has laid off 13% of the 1700 who work there. It has also cancelled most private insurance contracts.
This is very much how Prime Healthcare does business and may be the blueprint that other healthcare providers follow. Prime Healthcare already owns nine area hospitals, eight of which were bought in the last four years. When it takes over a hospital it cancels private insurance contracts. This forces patients to enter into its emergency system which is open to everyone. Emergency services pay more and because its hospitals are not bound by insurance contracts it is able to collect higher reimbursements. It also suspends services that provide relatively little income, including chemotherapy treatments, mental health care and birthing centers. This helps to provide them with a profit margin of as much as 15% per hospital, way beyond the industry average. It has already closed seven of Centinela’s operating rooms.
The changes at Centinela adds to an already difficult healthcare situation in Southern California. Within the region, the general hospital Martin Luther King Jr-Harbor Hospital has shut down. Brotman Medical Center in Culver City filed for bankruptcy protection. In April, Prime Healthcare bought the majority of Brotman Medical Center’s loans. Downey Regional Medical Center does not know how much longer it can remain open. For more information on the healthcare crisis in Los Angeles County, go to the L.A. Times website.
June 2, 2008
Exec who presided over bilking of elderly fired
Perhaps there is some accountability after all. Bloomberg reported this morning that G. Kennedy Thompson, the head of Wachovia has been fired. Under his tenure Wachovia was accused of abetting a telemarketing scam that defrauded thousands of mostly elderly people out of their money. To settle the investigation Wachovia paid a government imposed fine of as much as $144 million. The N.Y. Times which broke the story had obtained documents that showed high ranking officials at Wachovia knew about the scheme but continued to process the telemarketers’ fraudulent claims. Their incentive to allow the fraud to go forward was the large fees they received as a result of the fraud.
Of course I’m not naive enough to think that this episode played more than a small role in the board’s decision. The truth is that his fall was precipited by banking losses, and I’m sure Thompson will leave Wachovia with millions in his pocket. Still it’s something.
