Hi guys - I am a little confused about some of the information stated in the video. They say that "last year Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients' lives... that's more than the budget for the dept. of homeland security or the dept. of education." What confuses me is that in 2012 the U.S. federal government spent between $1.030 - $1.415 trillion (w/ interest incurred) on the total annual defense budget from tax money in order to fund the military. My question is... Is there a difference between dept. of homeland security and defense budget? Or is it basically the same thing? I understand that this is a national threat, and that this money is being spent on octogenarians or terminal patients who don't really have an optimal quality of life. But what about the money used for defense in the U.S.? Is that really necessary? I don't dispute the fact that Americans need to be protected against terrorism and external threats, but what about some other internal threats (health care and poverty among others)?
My wife is an internist and she some times discuss (Of course only high-level details complying to HIPPA) with me how the near and dear would like to have all possible procedures to be performed instead of the deteriorating conditions to their loved ones. Such choices from the family would simply skyrocket the cost for every else in the insurance pool or for the medicare/medicaid. It is not simply true that every hospital is trying to rip off the patients by keeping them in ICU etc, most of the times it is originating from the patient and their families right to opt for procedures. Not knowing all the fine details and being a outsider from the medical field I was thinking in the below lines. If one hospital strongly suggests to go for hospice care, First, the patient should be able to get a 2nd independent opinion. If the 2nd independent opinion also clearly indicates to go for hospice care, they should go to a ethics committee (Fed or State regulated) to obtain the final opinion. If the ethics committee also concludes that hospice is the better option, the patient still can opt to go against it, however it has to be mandated that the patient or patient family or living will executioner, should be incurring 25%-50% of the hospitalization costs. I know it sounds hard, however such measures would really make the patient and their families think a bit of hard to make the right decision. I understand that one day I will be facing the same issue, but would be opting hospice instead of wasting lots of money for future generations instead of living a dying life. Hope I have not hurt any ones feeling(s), I suggest we all should make the right decisions to provide better life to our kids and future generation(s).
They could do like Group Health did to my poor mother. She needed a hip replacement surgery, but they knew she had been diagnosed with breast cancer in the past. She was treated with surgery and considered cancer free, yet Group Health would not perform the hip surgery. Several years later she was discovered to have a metastasis in her liver while participating in one of their cancer free drug studies. To make a long story short, she went for five years with excruciating pain in her hip and could barely walk the last few years of her life because Group Health was banking on a recurrence of the cancer and her eventual death. She lived for 9 more years after her breast cancer diagnosis.
If healthcare costs are not contained, this country will not be able to sustain it. I see patients that are 95 on BIPAP and struggle with every breath, but the family refuses to let go. Are they holding on for the patient or for themselves? I have been in the position of honoring the wishes of family and letting them die with dignity rather than dragging out their suffering. A 90 y/o who is fragile and immobile, should not have heart surgery to prolong a life for quantity and not quality.
We should all have advance directive and not leave these decisions up to our families it is too much to ask of anyone to make these decisions for us. We should investigate the options that are available to us for DNR's and certainly for hospice care they are not all cut and dry and the same. A DNR does not have to be withholding of all medical services just heroic ones. Hospice care does not have to be legalized murder either with Terminal Sedation as the means. You can if you know what to look for avoid these hospices and have a better death for yourself or those close to you but only if you talk about it first. Unfortunately for my family I found all of this out after the fact.
It would be great if people had advanced directives. It is also important that your family members are on board with what you decide because they can come in, even if you have advanced directives, and go against them.
Way to leave out of the story that Obama tried to address this issue in the healthcare reform bill and the Republicans called, "death panels". The corporate media fails again. We can't get anything productive done in this country with the radical right wing holding us hostage.
Let's just concentrate on the 41% of the US population who had Advance Directives as of 2007 and find them. Then, set up a system where that information is on their person to make it easy for hospital personel to find, like a notation on a drivers license. We, in Hawaii have now started to discuss this in an on-going legislation. But we are only .4% of the population. If the rest of the country did this, we will have significantly reduced the cost of healthcare. Some, please, take this ball and run with it.
I live in Grand Junction, Colorado. Grand Junction experiences the lowest Medicare costs in the country according to the Dartmouth Atlas. Our hospitalization rate is 16% compared to some areas of the country reporting 75%. 80 some percent of our Medicare beneficiaries die with hospice care and 100% report they would recommend to others. I appreciate the last statement in the program that related the irony that the best solution for lowering cost and increasing patient satisfaction has been targeted for cuts rather than promotion in our current health policy environment. It seems to me there is a significant story to be told. Check out www.hospicewco.com for more information.
Please contact me. I have a news worthy program that will minimize healthcare costs. I have already written once and explained the Intensivist program, however I have not herd back. This program saves lives and decreases costs to those who have multi co-morbidities, it is important to offer a solution to our countries hospitals. Again I extend my knowledge and program to 60 minutes, this is a solution to some of our economics struggles in America.
I am an active duty Army ICU nurse whose mother is on hospice. She has lived for over 5 years in an assisted living retirement community at our expense from the money from my father's death. Due to increased weaknesses and previous falls, we have now hired a sitter for her at the cost of $17 an hour for 12 hours. She is very lucid and happy there where she can have her own apartment, her cat, her friends, and provided meals. Moving her to a nursing home and taking away all that she knows would just be devasting for her since she has been there for so long and she probably doesnt have much longer. Every day I get to go to work and provide costly end of life care to others -- about $10,000 a day. The money I earn in my job is now going to pay for the sitter for my mom at the monthly personal cost over 6,000 a month. Hospice and medicare do not cover cost of ADLs (Activities of Daily Living) since hospice and medicare assumes that relatives don't work and can stay home and provide the ADLs to the hospice patients. The sad irony is that the taxes for the money I earn goes to pay for the $10,000 ICU beds for the patients I provide end of life care to. Essentially, I get the double whammy of health care costs and I get to see it occuring right under my nose. Even more sadly ironic is that if my mother chose to die in a hospital and endure that loss of dignity so common with ICU end of life care, we wouldn't have to pay a dime for it. I am beyond pissed off and aggravated and there is nothing I can do about it. I'm not against health care reform, but did they really have to cut hospice funding and why can't medicare and health care reform make it so that people can die on hospice without it being more expensive? No wonder people chose to die in ICUs, it's obviously cheaper.
I totally agree... As a new nurse myself watching this was eye opening!! Many times already I have questioned judgment of the doctors as well as the families in end-of life care. In hearing how much you are having to pay out of pocket I feel somewhat on the fence about what to advocate to my patients. Its sad that we have to choose care by the amount of cost. I know this is years later.. But, I hope all has worked out with you. P.S. I am interested in joining the service myself.. If you ever get this I would love a little insight or words of direction if possible.. Thanks soo much and God Bless!
Well the trend has now gone in the opposite direction as things often do in this country. Hospice care now practices TERMINAL SEDATION which in my book is legalized murder sure they make you comfortable by making you unconscious and then of course you can't eat or drink and you die rather quickly of dehydration because these " hospice services" will not hang a bag of fluids, that might extend you life a few hours or days .
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If one hospital strongly suggests to go for hospice care, First, the patient should be able to get a 2nd independent opinion. If the 2nd independent opinion also clearly indicates to go for hospice care, they should go to a ethics committee (Fed or State regulated) to obtain the final opinion. If the ethics committee also concludes that hospice is the better option, the patient still can opt to go against it, however it has to be mandated that the patient or patient family or living will executioner, should be incurring 25%-50% of the hospitalization costs. I know it sounds hard, however such measures would really make the patient and their families think a bit of hard to make the right decision.
I understand that one day I will be facing the same issue, but would be opting hospice instead of wasting lots of money for future generations instead of living a dying life. Hope I have not hurt any ones feeling(s), I suggest we all should make the right decisions to provide better life to our kids and future generation(s).
Stupid usually stands out like a sore thumb.