ST. PETERSBURG, Fla. — Since a stroke four years ago, 66-year-old Bud Lee can't lift himself out of bed or take himself to the bathroom. He would like to regain a bit of his old independence.
John Boyd, 50, has been paralyzed since 14. He would like an apartment of his own and a job, like when he answered customer service phones for Red Lobster a few years back.
Instead, both men live in nursing homes, a frequent situation when Florida Medicaid pays the bills.
That may change.
Lee, Boyd and five other nursing home residents backed by the AARP Foundation have filed a class-action lawsuit against the state of Florida under the Americans with Disabilities Act, citing a 1999 court ruling that helped spring mentally ill people from big, impersonal hospitals.
After serving a tour in Vietnam, Murphy has a new enemy these days…the American Health Care System, especially when it comes to long-term care for disabled American veterans.
Murphy says, “I guess I didn’t think we would have to fight this hard for adequate budgets…especially for health care in the 38 years since I returned.”
From heads of state to politicians, even Presidents both present and former, Murphy has been a strong voice in Washington on behalf of disabled vets and says the toughest fight of all seems to be securing benefits that were promised to them by their government.
Murphy says, “And I’ve heard different administrators say I don’t know if we can afford it right now. And I said wait a minute, you had all kinds of money when we sent these young sons and daughters to wars, so we should have all kinds of money now.”
Amen to that Mr Murphy!
Growing trendThe legislation affects people under age 64. In 2006, the latest year for which figures are available, 256,000 people purchased their own health insurance in Michigan and another 66,000 had so-called group conversion policies that extend workplace coverage they once had, according to the insurance bureau.The individual market, now 6 percent of all insurance sold in the state, will grow to 25 percent of all insurance policies in the next five to seven years, according to Blue Cross estimates. Using those projections, the individual market could affect as many as 2.5 million Michigan residents, said Sen. Tom George, R-Portage, chairman of the Senate committee.The bills quickly passed the House in October by overwhelming margins.
The Medicare Payment Advisory Committee is proposing changes to Medicare reimbursement to skilled nursing facilities that could lower payments to those facilities performing a high-volume of therapy related services.
The report recommends lower payments made by medicare based upon the efficiencies of scale that the Council has stated that any high volume provide should have achieved by technology and standardization processes. Is the council recommending punishing quality providers by reducing their payments? This could be a big blow to long term care for those who need to use these facilities.
The report criticizes that the current medicare system does not provide the best delivery and the use of private sector physicians and facilities is necessary to cope with the growing needs of the system. The council should recognize that private physicians are not government employees or programs and have every right to run their business as they see fit from an operational and financial perspective. The good news for those in private practice is that the proposal could be years from enactment and is contradictory to previous statements that it believes that highly efficient facilities are better for the long-term health of the medicare program (yeah, but if you cut their margins….). Additionally, Congress has routinely ignored the suggestions of this PAC.
One Minnesota baby boomer seemed to have an ideal combination of resources to care for her aging mother — 10 siblings as caretakers; a doctor, a lawyer and a geriatric social worker in the family; and multiple housing options from which to choose.Even with these resources and a carefully considered plan, this was not enough. Her mother experienced three broken hips (including two in one week), staffing issues that added to medical problems, continual shifts in housing to address changing care needs, medication complications, and sudden memory problems. The greatest frustrations and struggles though, have resulted from the bureaucracy of the elder care system, which culminated in a letter sent from the government telling the family members their mother was dead (she wasn't).Julie Groshens wondered how families get through the maze of elder care options without a social-worker sibling to guide them. Nearly every day, she heard similar stories from colleagues, friends and family. So Groshens decided to form Elder Care Expos, LLC, a Minnesota-based company that produces elder-care resource events for the public.