Getting Care As You Age

How to Get the Care You Need in Old Age.
Very useful guest post by Harry Cline.

Most Americans over the age of 65 will need long-term care at some point as they age. That could mean residing at a nursing home or seeking home care, both of which are among the wide variety of solutions available to meet the needs of the elderly. The problem is the costs, which can be frightening.

A private room in that aforementioned nursing home? That runs an average of over $8,000 a month, while a home health aide would set you back over $4,000. In some extreme cases, the total price of such support and services grows into the millions. Wow.

So, what’s a financially-responsible person to do in the face of such financial challenges? Plan. Here’s a breakdown on how to assess your basic needs and pay for care.

Do Your Research

The first step is learning what services are available. The most basic level is visits from friends and family or custodial care at home. There’s also adult day care, assisted living facilities and nursing homes. What you need depends on your level of health along with whether you suffer from a chronic condition and its severity.

Assess Your Health Risks

It’s tantamount to looking into the future. However, the likelihood of certain diseases can be gauged based on your lifestyle, current overall health and family history. If you have a parent, brother or sister with Alzheimer’s, for example, you are more likely to develop this form of dementia, and the same goes for some cardiovascular conditions.

Make Lifestyle Changes

The risk of falling ill can be reduced through exercise and a better diet. There’s no simple recommendation as far as what to eat, though Elders’ Helpers recommends nutrient-rich foods such as fruits, vegetables, legumes, beans and whole grains. As far as getting your body in motion, choose something you enjoy, whether it’s swimming, cycling or long walks on the beach.

Modify Your Home

This not only prevents injury, but allows you to stay there for longer and save money on costly assisted living and nursing homes. Some adjustments include installing railings on both sides of the stairs as well as automatic lighting to avoid nasty falls when you wake up in the middle of the night. You should also remove loose rugs and carpeting to enhance mobility and safety.

Now, we’ll move on to how to pay for all that. Bear in mind that the earlier you start, the better, and some options aren’t even available after retirement or a diagnosis with a severe medical condition.

Get the Right Insurance

Specifically, long-term care insurance. As implied by the name, it covers the cost of home care, assisted living and nursing homes, though the premiums can be high, averaging $2,700 a year, according to information cited by the AARP. That could be a worthwhile investment, though, if there’s a history of serious health conditions in your family.

Use Your Living Benefit

That means the living benefit rider in your life insurance, if you have one. If not, your insurer may be able to add one to your policy, in which case you would be able to draw from your death benefit to pay for medical expenses. Again, this could be a great option to have if you’re at high risk of chronic illness.

Put Money In Savings

Take this step before retirement with a health savings account. Both you and your employer make contributions, but the money stays with you when you’ve finished working. It’s tax-free when used for medical expenses, making it an attractive option along with high-deductible health plans.

Tap Into Your Property

You can do that via a home equity line of credit. This financial instrument allows you to withdraw money with your property serving as collateral, and offers a simpler alternative to a reverse mortgage, with lower associated costs. Both are common means of securing cash for long-term care, and which one’s right for you depends on your circumstances.

Planning for your care is not always easy, but you’ll breathe a sigh of relief when you’re done knowing that your future medical care is assured. Get started as soon as possible.

Image via Pixabay.

FINCA + YOU

Dear Gabriel and Colleagues,

When you think of FINCA, what comes to mind – microcredit, entrepreneurship, sustainability? When you think of FINCA +, what do you envision? We see FINCA + You, working together to change the world.

FINCA + You = Microcredit and other financial services for the world’s lowest-income entrepreneurs, so they can work their way out of poverty, create jobs for others, and improve their families’ standard of living.

FINCA + You = Microenergy, a pilot project we’re running in Uganda and seek to expand elsewhere in Africa and eventually throughout the 21-country FINCA network, helping deliver clean, affordable energy technologies to FINCA clients and their families.

FINCA + You = the possibility for improving the health of our clients. Healthcare emergencies are one of the leading reasons families that climbed out of poverty fall back into it. So FINCA is exploring ways to help our over one million clients create “rainy day” saving funds and access insurance services to protect themselves in the event of serious illness or other calamity.

Join us as we create hope and opportunity to help change lives in 21 countries around the world.

Sincerely,
Soledad Gompf
Vice President, FINCA

PS: Don’t forget, FINCA is part of a $1 million challenge grant to fight hunger around the world. Donate today, and your support will be partially matched!

California OneCare Call

Dear Gabriel,

We join The Coalition for A Healthy California and PNHP-CA to seek your help starting Friday, February 15th.

Please take a moment to make brief, polite phone calls to encourage an Assemblymember to author and introduce single payer legislation in the Assembly by next Friday, February 22nd.

If the bill is not introduced in time, there will be no single payer legislation this session, which lasts two years.

Background:


Senator Mark Leno authored the single payer legislation, SB 810 in the past two sessions (four years) and the bill failed last year by only two votes. At the end of last session, Senator Leno declined to author the bill again and suggested we seek an author in the Assembly. Despite concerted efforts, we have not been successful in finding an Assemblymember to introduce the bill. We are told that the legislature is focused on implementing the private health insurance exchange mandated by the Affordable Care Act (ACA). Single payer bills SB-810 and SB-840, which passed twice, had over 40 Co-Authors in the legislature previous years!

Tell our Assemblymembers they can chew gum and walk at the same time! A single payer system cannot be implemented until 2017 – the date the Affordable Care Act allows states to go beyond the ACA and set up their own healthcare systems. We can both implement the health exchange this year and get California ready for single payer in 2017.

HOW TO HELP

Please call the following legislators starting Friday and request that they carry the single payer legislation. Ask for the legislative aide listed below. If they are not available, please ask for their voicemail and leave a brief message. If voicemail is unavailable, simply leave your message with the person who answers the phone. Be sure to mention if you happen to live in the district.

Here are the legislators to call, with the name of their aide:

1. Paul Fong (28, Sunnyvale): Andrew Medina (916-319-2028)


2. Bonnie Lowenthal (70, Long Beach): MJ Gascon Flores (916-319-2070)


3. Rob Bonta (18, Oakland): An-Chi Tsou (916-319-2018)


4. Richard Gordon (24, Los Altos): Angela Pontes (916-319-2024)


5. Mariko Yamada (4, Vacaville): Robert McLaughlin (916-319-2004)


6. Mark Stone (29, Monterey, Santa Cruz): Arianna Smith (916-319-2029)


7. Shirley Weber (79, San Diego): Crystal Quezada (916-319-2079)

PLEASE CALL!

We need and appreciate your ACTION NOW. We also appreciate your generous DONATIONS. With your help, WE WILL WIN!

Sincerely,

Andrew McGuire, Executive Director, California OneCare Campaign & California OneCare Education Fund

(Our thanks to our friends at PNHP California (Physicians for a National Health Program – California) for this Alert)

U.S. Healthcare Near the Bottom

U.S. Healthcare Worse Than Almost All Other Industrialized Countries
by Carey L. Brown
Inter Press Service/Nation of Change
11 January 2013

U.S. citizens suffer from poorer health than nearly all other industrialized countries, according to the first comprehensive government analysis on the subject, released Wednesday.

Of 17 high-income countries looked at by a committee of experts sponsored by the National Institutes of Health, the United States is at or near the bottom in at least nine indicators.

These include infant mortality, heart and lung disease, sexually transmitted infections, and adolescent pregnancies, as well as more systemic issues such as injuries, homicides, and rates of disability.

Together, such issues place U.S. males at the very bottom of the list, among those countries, for life expectancy; on average, a U.S. male can be expected to live almost four fewer years than those in the top-ranked country, Switzerland. U.S. females fare little better, ranked 16th out of the 17 high-income countries under review.

“We were stunned by the propensity of findings all on the negative side – the scope of the disadvantage covers all ages, from babies to seniors, both sexes, all classes of society,” Steven H. Woolf, a professor of family medicine at Virginia Commonwealth University and chair of the panel that wrote the report, told IPS.

“It’s unclear whether some of these patterns will be experienced by other countries in the years to come, but developing countries will undoubtedly begin facing some of these issues as they take on more habits similar to the United States. Currently, however, even countries in the developing world are outpacing the U.S. in certain outcomes.”

Although the new findings offer a uniquely comprehensive view of the problem, the fact is that U.S. citizens have for decades been dying at younger ages than those in nearly all other industrialized countries. The committee looked at data going back to the 1970s to note that such a trend has been worsening at least since then, with women particularly affected.

“A particular concern with these findings was about adolescents, about whom we document very serious issues that, again, stand out starkly from other counties,” Woolf says.

Beyond insurance

The unusually high levels of population who lack health insurance in the U.S. would certainly seem to be one factor at work here. In 2010, some 50 million people, around 16 percent of the population, were uninsured – a massive proportion compared with the rest of the world’s high-income countries.

Of course, after a rancorous debate and more than a decade of political infighting, in 2010 President Barack Obama did succeed in putting in place broad legislation that will bring the number of uninsured in the United States down significantly.

Further, Obama’s winning of a second term in office, coupled with a recent decision by the Supreme Court, will now undercut most attempts by critics to roll back Obama’s new health-care provisions.

And yet, according to the new findings, the insurance issue has relatively little impact on the overall state of poor health in the United States. (In fact, those 75 years old or more can expect to live longer than those in other countries, a clear indication of the tremendous money and effort that has gone into end-of-life care.)

“Even advantaged Americans – those who are white, insured, college-educated, or upper income – are in worse health than similar individuals in other countries,” the report states. Likewise, “Americans who do not smoke or are not overweight also appear to have higher rates of disease than similar groups in peer countries.”

Indeed, some of the few categories in which U.S. citizens are found to do better than their peers in other countries include smoking less tobacco and drinking less alcohol. They also appear to have gained greater control over their cholesterol levels and blood pressure.

At the same time, people in the United States have begun to suffer inordinately from a host of other problems that can contribute to a spectrum of additional health concerns.

Sky-high obesity rates, for instance, are undergirded by findings that people in the U.S. on average consume more calories per person than in other countries, as well as analysis that suggest that the U.S. physical environment in recent decades has been built around the automobile rather than the pedestrian.

Health disadvantage

Confusingly, people in the United States not only record far lower health indicators on average when compared to other high-income countries, but also score far lower on seemingly unrelated issues related to environmental safety – for instance, experiencing inordinate numbers of homicide and car accidents.

The committee clearly had trouble putting together these seemingly disparate datasets.

“No single factor can fully explain the U.S. health disadvantage,” the report states. “More likely, the U.S. health disadvantage has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions.”

According to Samuel Preston, a demographer and fellow committee member, “The bottom line is that we are not preventing damaging health behaviors. You can blame that on public health officials or on the health care system … but put it all together and it is creating a very negative portrait.”

Read entire article and other stories at Nation of Change.

Lives On The Line

Dear Gabriel,

Our military women put their lives on the line for our country and they deserve the same care and benefits as other women.

But I was shocked to learn that if servicewoman is raped and become pregnant, our government forces the servicewoman to pay out of her own pocket. This law is unfair, indefensible and must be changed.

Military women, wives and daughters should have the same insurance coverage as federal employees, when facing a pregnancy caused by rape, so that they too can make the decision that is best for them and their families.

This kind of injustice cannot stand. Urge Congress to change this unfair policy and ensure no servicewoman is denied the health care she needs!

Thank you for taking action,

Ellen B.
Care2 and ThePetitionSite Team

California Single Payer Saves

California’s Historic Fight for Single Payer Continues BIG TIME

Dear Gabriel,

On Wednesday, the New York Times reported that a man was denied health care insurance because years before he had donated one of his kidneys to save his daughter’s life. It didn’t matter that kidney donors live as long as people with two kidneys. To Blue Cross and Blue Shield, it’s always and only about the bottom line. As long as private, profiteering insurance companies are in charge, this will never change.

That’s why the California OneCare campaign will continue to fight for universal, single payer, improved Medicare-for-All regardless of the imminent decision from the U. S. Supreme Court. The Court’s ruling on the constitutionality of the Patient Protection and Affordable Care Act (PPACA) will come this month, perhaps even this Monday.

If the justices uphold the Act, the health care system will still be broken

More than 3 million Californians will remain without health insurance and millions of middle-income families will be required by law to buy second-rate health plans that will consume up to 9.5% of their income. Insurers will continue to tell us which doctors we may use, and medical co-pays will go on wiping out the life savings of families who thought they were covered.

If the law is struck down, we will be left as we are now

Seven million Californians will remain without health coverage, medical bankruptcies will escalate and medical costs will continue to spiral out of control.

Whatever the Supreme Court decision, the fight continues: a 19-City Bus Tour starts Tuesday in San Diego, then a Summer Conference on July 7-8

Last year, we joined the new statewide coalition of single payer activist groups called the Campaign for a Healthy California (CHC). CHC will help kick off a first-ever 19-city bus tour on June 19 and then stage a two day Summer Conference on the UCLA campus. To learn more about the coalition and how you can help, you’re invited to attend the CHC Summer Conference on July 7th & 8th.

Full Care, for All for Less!

With your continued help and support, the fight for single payer will not stop until ALL Californians are covered by California OneCare. We WILL Win.

Andrew McGuire, Executive Director
California OneCare

History of US Healthcare

Healthcare history: How the patchwork coverage came to be.
by Bob Rosenblatt
Los Angeles Times
February 27, 2012

Workers swarmed through Henry J. Kaiser’s Richmond, Calif., shipyard in World War II, building 747 ships for the Navy. The war “had siphoned off the most hardy specimens,” a newspaper reported, so Kaiser was left with many workers too young, old or infirm to be drafted.

The workers needed to be in good health to be effective on the job, and Kaiser offered them care from doctors in company clinics and at company hospitals. The workers paid 50 cents a week for the benefit.

It was something new in industrial America — a bonus offered to attract scarce labor while wages were frozen during the war.

The war ended, the workers quit the shipyards, leaving behind hospitals and doctors but no patients. So the company decided to open the system to the public — and that’s how generations of Californians who never heard of Kaiser shipyards have since gotten medical care.

It is just one example of the way America’s health insurance system has grown into the strange patchwork program it is today.

Most of us get health insurance through our jobs, a system puzzling to the rest of the industrial world, where the government levies taxes and offers health coverage to all as a basic right of modern society. But for many Americans, their way feels alien — the heavy hand of government reaching into our business as some bureaucrat tells doctors and patients what to do.

We always seem to fight over the role of government in our healthcare. In 1918, California voters defeated a proposed constitutional amendment that would have organized a state-run healthcare program. Doctors fought it with a publication declaring that “compulsory social health insurance” was “a dangerous device invented in Germany, announced by the German Emperor from the throne in the same year he started plotting and preparing to conquer the world.”

The amendment was defeated by a huge margin.

This year’s presidential and congressional election campaigns will feature intense argument over the Affordable Care Act signed by President Obama in 2010, the most ambitious effort yet to bring health insurance to all Americans. Everyone is required to have health insurance, and all but the poorest citizens face a tax penalty if they don’t comply.

For liberals, the act is a culmination of the dream to complete the work of President Franklin D. Roosevelt’s New Deal. For conservatives, many of whom scornfully refer to the law as Obamacare, it is big government run amok. The first battleground will be in the U.S. Supreme Court next month, when the justices hear arguments on whether it is constitutional for the federal government to make citizens buy health insurance.

The long-standing tension between public and private healthcare in America has produced a unique and confusing way to provide protection against the cost of ill health.

It was Teddy Roosevelt’s Bull Moose party that first suggested, in the 1912 presidential campaign, that Americans would need help paying their medical bills.

Medicine was becoming safe and even effective. Doctors could treat typhoid and diphtheria. Hospitals were becoming places that could help you get better rather than serving as dumping grounds for the insane or warehouses for paupers.

Being able to treat sickness meant that healthcare started to cost more.

When FDR became president in 1933, the committees that developed the concept of Social Security for him also considered national health insurance. Roosevelt flirted with the idea but never threw political muscle behind it.

After Harry S. Truman became president in 1945, he called on Congress to provide national health insurance but could never bring it to a vote. Opponents included the American Medical Assn., which in 1948 asked each of its members to kick in $25 to fund a campaign warning that Truman’s “socialized medicine” plan could lead to socialism throughout American life.

Health insurance, when it did emerge on a mass basis, came from the business world, as exemplified by the Kaiser shipyard story. World War II-era employers faced government-mandated wage freezes to prevent them from competing with dollars for scarce workers, which would drive up prices and cause inflation. But the IRS allowed companies to offer benefits up to 5% of the value of wages without counting them as taxable income.

The ruling became permanent in 1954, creating the foundation for the insurance system we have today.

After the war ended, the powerful labor union movement focused on expanding health coverage as well as boosting wages. Health insurance became a standard feature in labor contracts. Elsewhere in the economy, nonunion employers too decided it was a good tool to attract workers.

And then, in 1965, after years of hearings and campaigns, the federal government dived into healthcare in a big way.

For years, there had been talk of the needs of the elderly, who couldn’t afford the hospital bills that came with the ravages of old age. Old people were a sympathetic and deserving group for politicians. President Lyndon B. Johnson, armed with the power and prestige of a landslide victory in 1964 and the support of big Democratic majorities in both houses of Congress, pushed through a legislative three-layer cake.

For people ages 65 and older, there would be Medicare Part A. It would pay their hospital bills with taxes collected from workers, just as the government collects taxes from workers to pay for Social Security retirement checks.

The second layer on the cake was Medicare Part B, set up in a fashion to win over doctors: They would receive their usual and customary fees for each thing they did for patients.

The third layer on the cake was Medicaid, a federal-state program of care for the poor.

Even after Medicare became law, there were great fears it might be too controversial to work. Would doctors refuse to see Medicare patients? Would Southern hospitals agree to dismantle their segregated wards and have patients of different races sharing the same rooms?

The doctors didn’t strike. And the hospitals were immediately integrated without protest.

Today, Medicare seems like the birthright of every American who reaches age 65. John Breaux, a former U.S. senator from Louisiana, likes to tell the story of an elderly woman who accosted him at an airport, declaring, “Don’t let the government mess with my Medicare.”

Seniors had their national health insurance, and the Democrats thought they had a winning issue. Bill Clinton entered his presidency in 1993 with an ambitious plan to extend national health insurance to everyone.

Hundreds of experts spent hours behind closed doors drawing up intricate plans. But Congress felt excluded and insulted, and the plan never came to a floor vote in the House or Senate. Its fate was sealed when the GOP made big gains in 1994, giving Clinton a Republican House to deal with for the rest of his presidency.

The big plan had failed.

When President Obama approached the health insurance dilemma, he avoided the Clinton tactic of creating a detailed blueprint without input from Congress.

Instead, he relied on the congressional process. It was filled with deals.

Read entire article at Los Angeles Times.