The whole short-funding of nursing homes is due to their having been bought up by the @#$#@#@!!! hedgefund scum, when the government made them 100% paid by MediCare. And then, like they do with anything else they buy, they hollowed them out to provide more money to the pinstriped pimps.
venture capital-another phrase substituting for robber barrons. When human services like caregiving is the commodity that is having "efficiencies" squeezed out of it, the "juice" is contact hours, compassion, standards of care, workforce morale and esprit-de-corps. There are simply too many fleas on the back of the dog.
I keep hearing about the primacy of "efficiency" and certainly efficiency can be a good thing; but efficiency for what? Most of the economic "efficiencies" I have seen since Reagan have had to do with finding legal ways for companies to give less product or service for ever higher prices, exporting jobs out of the country while making domestic employment less safe, less rewarding, and less secure. Offloading costs, risks and responsibilities off onto the public, while hoovering up every business in sight, anti-trust be damned. A kitchen knife can be useful tool or a murder weapon. So can efficiency.
Time to do it differently? More people seem to be thinking so.
I have a great nephew who works for a private hedge fund that buys up single family homes across the nation. We talked and I began paying attention. This is another example of capital exercising power that is detrimental to the general population, freezing many out of home ownership. These hedge funds need to be regulated.
Richard, so well described. Regulation "of the people, by the people and for the people" is the essential counterbalance to the ravages of a rapacious capitalism which provides the money energy and creativity which drives so much of our economy. Regulations and laws provide a healthier balance between the two major forces in our democracy which keep it the most productive and successful economy on earth. The only countries with happier citizens are those of the Scandinavian countries with an even higher tilt toward socialistic laws and regulations.
You are correct about the Scandinavian countries, John. They have in place what I believe Joseph Stiglitz calls pragmatic capitalism. Regarding terms, Bernie Sanders, who is a capitalist, would gather much more support if he deemed himself to be a "pragmatic capitalist" rather than a "democratic socialist." Americans in general won't "buy" that label. Words matter.
I prefer to refer to myself as a "democratic capitalist."
Democracy must guide a healthy capitalism in order for there to be a healthy economy. I'm referring to moral and physical health.
Until capitalism has healthy guidelines, we'll have an unhealthy society, both morally and physically unhealthy. Sickly, to be precise. In fact, we will be literally killing ourselves due to our cancerous economic system. The body politic hosts far too many infections, and symptoms abound ...
Democratic capitalism - where democracy guides a healthy capitalism.
Agreed, Richard. Our nephew's wife is from Norway. I was talking to her mother who noted the high taxes, but all the services these countries have in return. She is comfortably rich as well.
Richard, well said! Words do indeed matter if, and when, people can agree on their meaning (or look them up), however, part of the orange guy's appeal is his profligate use of words without reference to actual meanings which have been written down but are used as part of his emotional appeals, usually to our baser instincts. While I don't advocate for government ownership of the means for production (except for things like healthcare and law enforcement) as in pure "socialism," I don't see why we should be afraid of a more socialist bent for government if one takes "socialist democracies" like the Scandinavian countries as our target for the improvement of the welfare of our citizens rather than corporate interests.
I'm not as big on labels as I am on policies and practice, but point well taken. At least until young 'uns get the education to know what these terms mean. I admire Bernie for sticking to his guns. He says he's a socialist, always has, and although his career in the Senate is notable, he hasn't gotten a lotta bills through. So we toddle along moving toward a working economy for all brick by bleeding brick.
Our ex-banker neighbor noted this and that we have many rentals, not well-cared for, in the neighborhood. He despises hedge funds and I value his insights into the money industry. On the other hand, our long time neighbors just sold their house for 750k and we are now hoping that we get decent neighbors who take care of it and don't make huge amounts of noise like the guy with the shop across the street from us. His newest project is a hot rod which backfires a lot. I also have a friend whose son flips houses, another thing that bothers me to a degree. Now he wants to use the park in central Salem, which has Willamette U's football field as a place for some kind of sports league. It is surrounded for the most part, by a nice neighborhood and I hope that the neighbors can prevent this from happening.
We live on a Lake and every new home being built is a mansion and Air B&B/VRBO/ No longer do we have consisitant neighbors. This has gotten worse over the years. Housing Crisis yes! Gone are moderate homes anyone can affort to live in full-tme. Capitalism at it's best. Party, Party, every night.
This sounds horrible. AirB&B has caused problems in housing in Portland with apartments as well as houses being rented out. I mentioned on an earlier blog about people not being able to afford a roof let alone a modest home while running back who has now in the portal from Oregon State whined that his NIL promised him a house. The house flipper I mentioned in another post today lived in Eugene, a college town, where the need for housing is great.
It is a tough issue, how to regulate this. Clearly, though, it does virtually nothing to improve the quality of life for the vast majority of Americans.
So well stated. Two-edged sword indeed. I love efficiency, but when laced with greed, it is just another scam. A deliberate one, all prettied up, with a nice bow like an empty gift box.
Jeri, that is such an elegantly simple truth, I had to copy it so as not to forget it. Thanks. This whole thread has been fascinating to read, but your comment is icing on the cake for me.
Thank you. Repub lawmakers are just empty suits; magats are just empty humanoids. I have more respect for the lowest animals. The alpha male guerilla may be greedy, but even he cannot compare to chump and his cohort of greedy bastards.
I used to think that lack of conscience (evil in my book) was rare. Even after knowing more than a few narcissists. I had no idea that so many repubs signed on to the evil agenda, with absolutely no reservations. Maybe extreme greed negates any self-reflection
But, haven't you heard or read? Business owners need that capital (revenue) in order to reinvest in their businesses including paying employees a saving wage. I mean if one asks them, they will say so, won't they? Gee, maybe they're getting a bum rap, here. "Amen?" Anyone? Amen?
You nailed it. And that is the sick and cruel premise of our entire health care system. While I applaud the new rules for nursing homes and home care, unless there are rules that require good pay for those required workers, the rule will be toothless. The companies that employ these workers complain endlessly about how hard it is to find good help. Perhaps if they paid people well, they would find more applicants? Duh?
Profits for caring for people is immoral and not effective at delivering care. Most advanced democracies and "developed" countries know that.
The next step for our government: Have Medicare and Medicaid to assume direct control of these employees. If you have ever dealt with a nursing home or a home care company, you will know why I suggest this.
Medicare is extremely well run with administrative costs of about 4% - not 20%!
My father lived his last years and died in a nursing home to the tune of 8K + per month, they threw away his hearing aids when he took them out as well as his dentures, the Cartier watch I gave him disappeared, they housed him in a tiny space that would make a holiday inn look like a luxury resort. He passed during the plague, the people that cared for him were caring and gentle with him, but the administrators ala carted every single interaction any staff member had with him. My sister bless her heart, dealt with the administrators who may have been working for a hedge fund for all I know, I would guess that they were. When I go I want to go at home not in some warehouse for the elderly run by a hedge fund. These facilities are very expensive to set up which is probably why they attract hedge fund money, which in turn demand a quick return on their investment, they are not in the business of providing a service, they are in business for a quick return on their investment.
I "liked" your story and hitting the button felt weird. Please consider "like" to mean support and agreement. So sorry for what your dad and your family experienced. Unfortunately, it is all too common.
A story that hits home for our friends is that of the Holyoke Soldiers Home.
Dick, the thought of this happening to your Dad makes me want to cry. Multiply this by millions and it becomes a current standard. And at 8K a month. This is a sin and a crime! Noone deserves to be treated this way.
There is a fine line between amoral and immoral. The concept of insurance is based on a well accepted principle of pooling risk, an amoral concept. The practice of stratifying risk pools to the nth degree is bordering on immoral when submitting a claim for an "act of God" event driven by the weather results in the insurance company tossing you into a risk pool that makes your insurance unaffordable. Social services, health care, human services and financial arbitrage simply make poor bedfellows, resulting in some truly immoral outcomes. Arbitrage on world-wide fluctuations in the price of gold and silver is closer to amoral than immoral.
I’d also like to chime in that many of the workers in nursing homes are immigrants. At my mom’s private home, fewer of the nurses were immigrants but almost all of the aides were. Turnover was high; it’s not an easy job.
"Profits for caring for people is immoral and not effective at delivering care. Most advanced democracies and "developed" countries know that." Thanks for this Bill. If only the greedy ones at the top realized this! Greed has taken over our country and it makes me sick.
Something over a decade ago I knew a licensed mental heath councilor who was working in a privately owned facility for patients nobody else wanted. He tried to form a union there by failed. Apart from lack of support, he was riled when management cut employees pay by $2/hr, while simultaneously boosting executive compensation. I'm not sure if that was before or after the $13/hr he mentioned being payed. He quit and joined a private practice at $75/hr. I hear and red many stories about privatized services ripping off their clients, employees, and the public, with little if any accountability.
But let's have nationalized health insurance (like France) instead of a single-payer system (like the U.K. and Ireland). I have experienced both and found that treatment is too often delayed in countries with single-payer healthcare. I've learned this from friends in the U.K. and firsthand In Ireland. One of my students experienced a grand mal seizure on the day that my study abroad group arrived in Ireland. The hospital in Galway didn't have the equipment to do a brain scan to map seizure activity, and their "men's ward" was one large room with cloth curtains separating the patients, and there was barely enough room to put a chair in between the bed and the curtain. The man in the bed closest to my student needed to have his urine bag changed, but instead it tended to leak under the curtain and puddle next to my students' bed. I couldn't send my student home to the U.S. for treatment because it was likely the flight that had provoked his seizure (this was information that his parents got from a neurologist in the U.S.). I strong-armed the doctor at the hospital into prescribing anti-seizure medication for my student even though they couldn't do a brain scan to show that he'd had a grand mal seizure. It turned out that the young man had already experienced one a couple of months earlier, but he was alone and thought that he must have stood up under a wall-mounted bookshelf and hit his head hard, based on the fact that he had a big lump and a laceration on the back of his head and a large bump/bruise on his forehead. When he told me that, I asked him whether he had bitten the sides of his tongue, and he told me that his tongue had been very sore and that he'd shown it to the nurse practitioner on campus and she'd said, "Oh. You bit your tongue!" but didn't suggest that he see a physician or a neurologist.
Once again, it's a matter of what the aim of "efficiency" is. Nazis sought efficient ways to murder people. Medicare is efficient at converting it's revenue into care. And even human services run at modest profit can be useful when the welfare of the pubic is put first, although I think it should be obvious that some services are too vital and/or too dangerous to be entrusted to private control.
But prioritizing profit over people is evil; even the Bible says so.
Jeri, not unlike the oligarch-buddies of Putin who lapped up the major industries and resources when the Soviet Union dissolved back into Russia! ...and then they discovered they didn't have the military might they thought they had, much of which had become inoperable because so much had been siphoned off by the moneyed class.
Ross Perot was wrong. That sucking sound we heard was the oligarchs hoovering up all our available resources. Like Mnuchin buying Sears and destroying the company and many lives along with it.
My understanding is that the East Germans got screwed by the "money men" in reunification. Getting rid of the Soviet yoke was great, but plutocrats showed up along side liberation.
I think in many cases that's true. I especially notice recently reformulated processed food products that have changed, sometimes quite visibly, for the worse.
The last 8 years of my nursing career I worked in a federal program evaluating the care of residents of nursing homes in a multi-county rural area. During that time I watched many excellent care facilities, built with local funds and run by caring staff, rapidly deteriorate once they were bought out by conglomerates. It wasn't just the cutting of staff and the increase in workload, but the whole evisceration of the homes' caring cultures. You could feel the angst and the exhaustion when you walked in the agency door, at the nursing desk, at the resident's bedside. The best staff left. The residents couldn't.
I lived through and experienced first hand, the devastation wrought upon the nursing home industry as it was, pre, during, and after the buyouts. It was the saddest story yet untold. My personal involvement began in 2011 as I recall, perhaps a bit earlier as a prime consideration.
What hasn't been mentioned in all of this morning's comments is how our own culture has sadly lost its care and commitment to our elders. The US is really the odd one out as from the Mediterranean and Africa to most all of the Eastern cultures (Korea, China, VietNam), Scandinavia, elders are respected and have valued places in Society. It's mostly here where greed and personal interests have led to the system we have today where elders are sent to "group homes" where they live largely in isolation save for the occasional visit from family and friends.
It's this cultural issue we have that opened the door for corporations to move in and exploit it. And, exploit it they have.
Yes, and Buettner nailed it in Blue Zones. But the nursing home I wrote about here was in a village that could be classified as a blue zone. A farmer donated some of his acerage located not far from the center of town for the home. Then the local folks pulled together to get it built and staffed. Many of the nurses and aides were from the village or farms nearby, and had known the facility's residents as their teacher or minister or car service guy. Often when I sat at the
nursing station desk, reviewing a chart, a visitor would come up and the nurse would hug her and walk to the relative's room with them (and, of course, the visitor had brought vegetables from the garden or homemade cookies). This home felt like HOME. Corporate buy out then blackened the blue zone.
The Biden Administration is doing a great job at making Americans live, safer, healthier, and more prosperous. They are doing hundreds of little things that many people hardly notice and some will take but not acknowledge. It’s up to us to get the word out. Do you want a country run for the people or by a cruel exploitive mafia?
I agree with you: we all must get the word out. The accomplishments of the Biden Administration are remarkable but receive far too little recognition. Today's Newsletter points out the ongoing progress the President makes on behalf of everyone. So yes, get the word out!
A spot on evaluation of "efficiency". When has efficiency ever had a place in a moral, thoughtful, conscientious, driven society. We cannot, and remain humane, be efficient when it comes to the stewardship of our resources and responsibilities.
Energy efficiency, doing more with less, is a good thing, and there are efficiencies "wired in" to the ecosphere. But the seeming inefficiencies of squabbly democratic governance vs dictatorship, or competing smaller business vs giant conglomerates, is where much of the vitality and balance of life comes from. Diversity is the essence of freedom, but dictators want to harness everyone to the same project. We need to establish rights that are never broken and lines that should not be crossed, but our collected pursuits of happiness take us SO many places we would not have time and resources to go without the aid of other citizens. That too may be a kind of efficiency, exploration and mastery of a broadened array of options by hearing different drums. E Pluribus Unum.
Sadly, as you and I have said many times in this space, "Follow the Money." Another thing I've said, and hated it each time is, "Empires require slaves."
Today a job arises but not , in our aged and sizeable group, is there a young man capable of ‘the dig’ physically nor others known trust worthy or again physically capable. Of the 5 nurses in our own family also near 50 ,the ones ‘friends’ in our group , are near retirement -actively planning- and the others solidly employed. The work force is dwindling , progress has soften the roughened hand,the hard laborer/farm hand/strapping teenager…oh wait maybe we know some Mexicans, immigrants, or an able bodied Guatemalan who will work for $15 -$18 an hour? Ah….hmmmm
A lot of people are (or need to be ) waking up ( thank you) , things are changing , we have , are faced, with reality -have some immediate changing to do .
Some of the factors will require minds to adapt, be mandated, and cross thresholds of long held denial…mind you-cost a lot more due to time wasted, codes not adhered to, or people looking the other way from persuasive ‘incentive’.
Thank you President Biden for steadfast sure stride caring for US. Thanks to those that stood, wrote, supported that and continue .
Nicely put, J L. Efficiency here is just another word for everything left to lose. I see many large corporations, venture (remember vulture capitalists),hedge funds, etc. as giant vacuum cleaners sucking up money with no concern for anything else: pure unadulterated greed.
An understaffed nursing home is NOT efficient. It is basically a warehouse for the infirm elderly. I am speaking from personal experience. How can one caregiver look after 15 residents, many of whom are not mobile?
I completely disagree Virginia. Both my mom and dad ended up in facilities -- a total of 3 -- and I have nothing but kind words to say about each of them. I won't speak about ownership, but the staffs were all supremely dedicated, kind and hard-working.
I'm not suggesting you're being critical of staff, but I refuse to say that animals are treated better. We have no complaints about the care my parents each received.
Perhaps. Of course I never saw what went on when nobody was around, but I can't fault any of the facilities in terms of communicating with me (I was the primary contact and health care proxy for both parents.) I received calls when even a minor fall occurred, or if my dad developed pneumonia and needed to be transported to the hospital for care on a few occasions (and my dad ended up in a facility due to a fall that happened at home.)
Caring for seniors nearing the end point of their lives takes a special person -- they're certainly not doing it for the money. And many suffer verbal abuse from residents with dementia. It's a thankless job, and we should be grateful that there are people willing to do it.
Jenn, here's some love sent out to nursing home staff. My wife and I cared for my mother for 7 years when dementia started rotting her brain. When it became too much ended up in a small not-for-profit home of 32 beds. Then Covid hit the home (they had managed to stay Covid-free for an unbelievable 18 months) and staffing issues forced the home to shift her to a larger, for-profit facility, where she eventually died of Alzheimers.
All along the way we found the staff, from the admin down to the housekeeping folks, to be focused on the patient. It takes a special kind of person to care for others, and thank goodness they exist.
I do however agree with your thankfulness and for nearly the same experience Doug. Mom developed a form of early onset. Of course, as many do, they hid this the best they could. Dad, ever the soldier / Marine, retired early to care for her. As it all grew as it does, Dad reached out to my baby sister - disabled herself to help him with Mom's care. The household income went from scarcely tolerable to worse, then worse imaginable, to ruin. Mom's employer of 30 something years had stolen her retirement funds (got away with it too). Dad's pension was sparse, Mom's - non existent. The greater of their two SS available was Dad's. Mom and her extremely costly medications for dementia fell into the dreaded 'doughnut hole', uncovered. Ruin followed shortly, including Dad having a massive, hemorrhagic stroke - bleeder rather than blockage. Then the entire bag was tossed into my hands. I can't tell you in mere words, how very deeply this wounds me in retelling. Tears, deep pain and trauma now demand that I stop here for now
D4N, damn, this was hard to “like”…a hard memory to carry let alone live through/witness, especially if you don’t have the wherewithal to “fix” any part of it. It is our country’s failing to have better systems/supports in place that means situations like yours are playing out nationwide. 💔
D4N, I'm sorry to read of your troubles. Our experience was much less traumatic -- if I can even call it that. My wife is a gem and provided the care (mostly) without complaint until she just couldn't any longer. We did it for 7 years. And looking back, there's little we would have done differently.
When my mom finally died a year ago in March, I smiled rather than grieved -- she lived to reach 90 years and I knew we did the absolute best for her. My siblings helped in their own ways as well-- that's important to note. But I was proud we were able to see both my dad and mom through to the end of their lives, and making sure they were well cared for.
It takes a special nursing home to be willing and able to invest in good hiring, adequate staff:patient ratios, staff training, supervision and pay-with-benefits. A nursing home that has been bought by corporate raiders is very unlikely to do any of this.
Yes, but if they receive federal funds, they have to maintain and report resident:staff ratios. I can't speak to the pay, but as there is a dearth of health care workers to begin with, then it behooves a facility to attract more workers with better pay and benefits.
Believe me, I'm no supporter of for-profit health and senior care, and I have a healthy distrust of their purported objective to provide high level care.
The staff of my mother's facility were kind and caring. They were overworked and underpaid. Any deficiencies were the result of corporate decisions that the staff didn't control.
Been there done that. After 8 weeks switched jobs. I had taken classes in care and understanding of Alzheimer’s. The nurse not only didn’t speak very good understandable English but were clueless. I ended up telling them I would handle it. Ended up doing private homecare and now on my 70+ work at a nursery.
No to term limits and lobby bans; lobby reins yes. When we get good representatives, we should have no restriction on returning them. Term limits only invites dominance by bureaucracy.
This is why it people whose financial crisis tips them into homelessness are so often trapped. If you lost your housing because you lost your job and were $400 short on the rent, how can you save up the $3-4,000 needed for application fees, security deposit, first (and sometimes last) month’s rent, plus utility hookup fees?
Which, ML is all about, again lining their filthy pockets with our rights to be human. As we have said time and again and again and again…… healthcare and housing are not yours…. They are ours! People also forget that the Chamber of Commerce is simply a club house for hoarders of citizens rights. Jesus , sorry to wake you, but many of our major problems are simply ignored .
I know , let’s make the penis a commodity. Let’s buy and sell on the blue chip commodity market. No one gets to own it… just trade it to make a profit for those who can’t get it up unless they have all the power! Is that vulgar enough? Aughghghghghghghg!!!!!!!
Robber barons buy up single houses to rent out forcing the rents to cause tenants to pay half their income for rent when historically they paid a third of their income.
The lowest income strata pay up to 80% of their income on rent, leaving practically nothing to save in preparation for the next crisis. I worked for decades in the homelessness system and believe me, this is true.
I had to rescue my dad from a "skilled nursing facility" called Bryn Mawr Extended Care Facility. I think they've actually had to change the name (again) due to reviews of the horrific conditions. My dad ended up in the ER after Two unreported falls within 4 days of admission, because No One Answered His Bell.
Dead rodents in rooms for days. Patients routinely left to sit in their own feces after pressing "the red button" for help. Forced to sit in the hallway for hours and hours if marked as a "fall risk" meaning anyone who dared to try to get themselves to a bathroom when their calls went unanswered.
Lies about major falls, for days. Threats to Throw my father Out if I didn't sign paperwork saying he was incontinent and suffering from Dementia (so they could just ignore him].)
SO many violations. Run by Saber Health, the corporation that has been Successfully sued for wrongful death and still exists. https://www.saberhealth.com/
Don't let anyone you know go anywhere near them. If you have elders make Sure you know which SNFs and Elder Care Homes are Highly rated and establish contact with them and ask about their admissions. Your loved one is at the mercy of Who Has A Bed at the time they need help. It is yet another disgusting, inhumane result of our profit uber alles "health care" industry. We must spend Hours and Hours preparing for the worst.
In the case of elder care, you must. It is Very Very Scary out there.
Patrice, i believe my father died from the poor service he received at the “transitional care” nursing home. He was there after surgery for a broken hip, supposedly for physical therapy and monitoring. I lived in a different state and did my homework, selecting a care center with good State compliance reports. I know quite a bit about NH standards and every time I visited him (about every three weeks - my brother lived nearby and saw him daily) I witnessed many violations. He got 30 minutes of PT three times/week and they kept his walker on the opposite wall, so he could never work on his mobility. They dropped a tray off by his bed at mealtimes and took it away ten minutes later, even though he had barely taken a bite - but the chart on his door would indicate he ate 1/3 or 1/2 of the meal. They did not answer his call light for trips to the bathroom, so he tried to walk by himself and fell, so they alarmed his bed so he stopped trying. I never saw staff wash their hands when they came in his room, despite the fact that there were multiple cases of C diff in the unit. Of course he caught that, too. And yet the nursing home had a banner in their lobby bragging about their “deficiency-free survey” by the State. Believe me, I tried sweet talk, demands, etc but nothing changed.
I hope Biden and Harris do something to enforce care standards. Clearly, the lack of oversight is resulting in patient falls, infections and deaths.
I'm so so sorry to hear that. It was our greatest fear. We had No one living near our dad by then. He never wanted to move to SoCal where all his kids had moved. That's why I said I had to rescue him. We truly feared for his life. We did complain to the "ombudsman" but she seemed to have given up on the hopes of anything changing and I'm sure she filed a report, but PA Dept of Who Knows never got back in touch with us.
I feel awful that for the people that remained there, or have been abused there since. There was only one person there that seemed to care, but she was so beaten down.
We need Profit taken OUT of health care. Pay providers well, from the dietician staff and the aids to the specialists, but not for the monsters who make a profit at the expense of human health and dignity.
I know it's hard, but it's up to us to enforce standards, too. I saved a few drafts of letters to the State of Pa, and my father's representatives, and even to the Philadeliphia papers, but then we were so exhausted by the process of moving him and his Medicare and Medicaid to CA, and finding him a better place to live, in the goddamn lottery of who has a bed open when you need one, that I just burned out.
The tragedy of your family's loss has spurred me on to send what I wrote, and more.
I am 63, and after what I went through with him truly makes me fear for my future.
I wish you well.
Thank you for sharing your story, and galvanizing me.
Patrice, it would seem you have or acquired an eponymous name for the need for a movement toward better healthcare you so effectively describe.
One wonders if some method could be crafted for those who really do care about the care their relatives receive could be paid for providing that very care thereby bypassing for some the need for a nursing home?
Elder care in this country is a horror show. Went through it with our Dad who had means to pay, but a decent care facility having a room available at any given time was a crap shoot. And now we're going through it with life-long friends who don't have the means to pay. All of this happening in Northern Virginia that has excellent hospitals, but not enough decent interim care after discharge. And zero oversight of these places.
When I was working for the State of Minnesota nearly 50 years ago I read a study of “board and care” facilities. The conclusion was that they were unregulated and provided highly substandard care. Things have not improved in nearly half a century! That is why I would rather end my life than move into a care institution. Biden/Harris are taking one step (which will likely be fought by the nursing home industry and delayed until after I die) but so much more is needed.
Quit putting our elders away like dirty linen. Start giving HUGE and monitored tax breakers to families who comply to the rules who also make room for their own family member who needs them more than the kids need a cell phone! Get a heart America. It will show one day.
The average time a person is in an extended care facility is about 6 months because the people pass away. The majority of the facilities are depressing and have woefully inadequate care. There should not be for profit healthcare at any point. It's too ripe for abuse. In NC, some of the best facilities are operated in association with churches. They do not accept Medicaid and are expensive. Those facilities reflect the true cost of care. Decent wages, trained staff, clean and well maintained facilities. The staff is responsive to the residents in such facilities because there's enough staff. My brother and/or I went every day when our mother was in the best facility in our county.
My parents thrived after moving to a retirement/care facility. It's good to know there examples that point the way forward, as well as those that demonstrate the wrong way.
Thank you. It took a village. Three daughters and a son. He is now living in the "Treasure Island" of SNFs in Santa Barbara, just by chance. I was in the process of taking $10k out of my meager IRA to put a deposit down on a tiny SNF in a strip mall in Torrance, that was the only one we found that didn't have flies or the stink of urine, and the long shot home of our dreams in Santa Barbara called and said they had an empty bed. That's how it works. I know that life is a lottery in a lot of ways, but this particular one is cruel.
Yes, my dad had children and one of us might have been able to provide 24/7 care for him in our homes, but for so many reasons we could not.
So we were lucky. The luck of the Irish. We looked long and hard from SB to Long Beach, and spent money we didn't have to make it happen. We are privileged to be able to do so.
I absolutely agree, TC. Next we need protection for Seniors who moved to independent facilities, currently there are no rules protecting us from mistreatment or reduction in services with no reduction in rent.
'Millions Cancel Subscriptions to National Enquirer After Learning Its Stories May Not be True'
'APR 24'
'NEW YORK (The Borowitz Report, Satire))—In a development that has rocked the news industry, The National Enquirer has lost millions of subscribers amid revelations that some of its stories might not be factual.'
'After Donald J. Trump’s hush money trial exposed the Enquirer’s inner workings, the newspaper’s reputation for unimpeachable journalism suffered a severe blow, media insiders say.'
'Harland Dorrinson, an Enquirer subscriber for over thirty years, said discovering that the weekly periodical was not a dependable information source was' “a gut punch.”
“In a complex and confusing world, I always felt that there was one news outlet that could make sense of it all,” he said. “That’s been stolen from me.”
'If the Enquirer distorted its coverage to support Trump’s election in 2016, Dorrinson wondered,' “Does that mean Hillary Clinton wasn’t really dying? Or that she didn’t delete emails from her multiple lesbian lovers? Or that Bill Clinton didn’t have a sex romp in a pickup truck that was caught on video? Now I don’t know what to believe.”
'The longtime subscriber said that the Enquirer’s sudden loss of credibility would force him to seek reliable reporting elsewhere, adding,' “I guess I’ll give Fox a shot.” (Borowitzsubstack) See link below.
I was living in KY in 2016 when I saw copies of the National Enquirer at the check out in a grocery store. It had HRC on the cover with the gross headline that she was dying. I grabbed all the copies from each checkout and buried them behind products in random aisles. Made me furious that trash was being sold to unsuspecting people.
Ever since I read a spoof in MAD magazine (when I was about 13) where it was called "The National Perspirer" that is how I have referred to it. I used to work in a small, rural grocery store; we carried ALL the tabloids. There were people who came in every freaking week and bought one copy of each.
Ally, the one and only time, decades ago, I bought one to take on a hiking trip in the Marble mountains area (inland far northern CA)…was back when it was (mostly) safe to have a small campfire & we sat & read it aloud and laughed our asses off!!
I've ridden my motorcycle through there (from Weaverville north, through Yreka, up to Taklima and over to Crescent City). Amazing country! We call it the "State of Jefferson Highway" here.
Ah, Heather, exactly my thoughts. Laughter is a must! Restoring trust in the crush of disinformation and greed as the lethal games of evil seek control with the help sick fools, Trump twisting in the courtroom and, hopefully, coming face to face with the rule of law is one important positive factor, and there are more.
FERN MCBRIDE. Valuable research & Link as always, thank You.
I strongly recommend , Chris Jansing Reports on-air interview yesterday of STU' ZAKIM, a former 2004-2006 AMI Executive & spokesperson. ZAKIM says AMI owned many "titles" & even owned a newsstand distribution company. Thus, AMI controlled the entire "rack space". "It was like a moving Billboard". "It's all about the headlines", left to right. ZAKIM concludes "it resonates in you know matter what you think".
Sorry, I found it on YouTube last night under something like "MSNBC Shows" under the Jansing segment title: "Could charm anybody. Ex-colleague says it's perverse ...".
Ah, Bryan Sean McKown, you have been such a fine subscriber friend. It is time for me explore new social-political terrain but not without a note of appreciation to you. To our work on behalf of democracy and one another.
I have a lot of respect for you TCinLA but they are NOT100% paid by MediCare!!! Some patients are covered by Medicaid and others, like my mother and millions more like her were not and she had to cover the expenses.
Medicare and Medicaid are two different programs. Medicare is paid through the federal government and covers doctors, hospitals, tests etc. it will cover up to 60 days in a care facility for rehab only. Medicaid is covered by the states with some federal money and each state has their own rules. It covers care facility stays for anyone else.
One has to be able to afford a team of Philly lawyers to make sense of this system. It begs simplification and uniformity. The 'devil' is in the rule differences from state to state, and we all know - at least we in red states like myself and KR in Ohio, that gerrymandering, like money - want or demand of it, are two of the roots of evil.
One has to be able to afford a team of Philly lawyers to make sense of this system. It begs simplification and uniformity. The 'devil' is in the rule differences from state to state, and we all know - at least we in red states like myself and KR in Ohio, that gerrymandering, like money - want or demand of it, are two of the roots of evil.
D4N, agree! Back in the early 2000’s I handled all of my mom’s affairs & it was like having a 2nd job. One day the Chief of my town’s volunteer fire dept knocked on my door to ask if they could borrow my dog Sadie (a Dalmatian & dog of my heart) to ride on the fire truck in the parade (she did this almost every year for most of her life)—-well, he looked in at the large table I had set up in the living room w/ piles of papers & asked if I had a home business…no, I said, it’s just my mom’s financial/medical/etc affairs!
There are exceptions, like Hospice with a prescription for "skilled care."
People on Medicaid can get coverage based on low income. Many of us outlive our assets and fall into that category. There are ways to create "special needs trusts" to try to protect some assets. The predecessor of CMS used to sue to recoup "preferential transfers" of assets to turn grandma into a pauper.
Yes! True! People must exhaust their financial resources to become eligible for 100% Medicaid. Medicare will pay only for the first three months of transitional nursing home care. Then you pay until you are poor enough to qualify for Medicaid.
Daniel, here's an interesting story. My wife and I cared for my mom (diagnosed with dementia, died with Alzheimers) for 7 years. Along the way I met with a local nursing home which had a memory care unit. I met with both the admin of the SNF as well as the memory care unit (MCU). I was told (in 2019) that my mom had to have assets of $250k to get into the MCU; after that money was expended she would then qualify for Medicaid and could likely stay there.
When I explained she didn't have $250K, the admin handed me a business card of a "Medicaid Consultant", and suggested I give her a call. So I did -- and that was a complete eye-opener. The consultant, for a fee of about $1500, was *invaluable*, and got all the paperwork submitted and approved for us. She had formerly worked for the state in the Medicaid section and knew the ins and outs. Without her, I would have had a more difficult time getting additional care for my mom which was very helpful, and proved instrumental in getting her into an assisted living facility *3 weeks* before Covid shut them all down. If not for that, my wife and I would have been at our wits end, as my mom was becoming increasingly difficult to care for and it stressed our relationship (my mom always referred to my wife as her "daughter-in-love", so it was emotionally challenging for her to provide personal hygiene.)
She even let me know about the "Child Caregiver Exemption", which was extremely helpful -- I had no idea of its existence.
"HospiceI"is no longer the "last 2 weeks" of Life: Services are provided over many months now -- over 6 months to a family member with Home Delivery of Prescriptions Meds & daily nurse visits who diaries meds & may other tasks.
YES! My wife heartily agrees. She was an RN and worked her way up to become manager of the case management dept for Blue Cross (then a non-profit.) and they even helped put her through an MBA program. But HMOs were becoming the norm, and she had no HMO experience. So 3 months after she got her degree, she was laid off. She then went to work for another non-profit, which happened to be an HMO, and in a similar position in case management.
Well, BC/BS bought the HMO so they'd have that component, and was laid off again (twice within 11 months) due to "staffing redundancies". BC/BS then became for-profit.
Yes, she remains angry that she was treated that way, but she is more angry that BCBS put profits ahead of care.
As a capitalist, I strongly believe that healthcare in its many forms should not be motivated by profit. Capitalism only works when it is regulated and wealth is redistributed. Facts that conservatives are ignorant of or refuse to recognize.
Biden/Harris admin is trying to address some of this (and probably not going as far as they’d like to), but is getting intense push-back from all the “cronies” that reject the solutions.
Agreed. The commodification of nursing home care, and healthcare in general, has proved disastrous to patients and workers alike. The real nursing shortage is the shortage of good nursing jobs. This is largely because healthcare policy at many institutions is set by MBAs, not healthcare professionals.
There IS a lack of nurses. Many left the profession after the horrors of COVID. Many just got fed up with being expected to work rotating shifts (this means working a combination of 1st, 2nd, and/or 3rd shift hours in any given week). The bottle neck in the system is the lack of qualified, well supported nursing instructors training the next generation of nurses. I looked into becoming a nursing instructor and discovered I could be liable for the mistakes of my students (that's why they're students - they're SUPPOSED to make mistakes, it's how we learn). Most schools will cover you for MOST things, but not everything. Also, becoming an instructor would have come with a pretty hefty reduction in pay. It seems nursing education has become commodified as well.
Steve, you have hit the nail on the head! Commodification of healthcare in general as a for-profit undertaking doesn't serve it well. It mostly serves the entrepreneur types who see a way to squeeze a few more bucks out of federal and state governments, squeeze more out of OUR taxes. This happened in spades with commodification of mental healthcare to such a point that few if any providers will accept all the intrusions into treatment by the for-profit intermediaries who have to pay their executives and advertising and administrative fees out of the basic amount provided by the feds. As a result we have ended up with the mental "healthcare crisis" we currently face.
I have a chronic, complex disease. I was able to find specialist who actually understood and treated such patients. But both are private pay, and do not accept insurance. Why? Insurance is the godlike overseer of healthcare - specifying the amount of time for an office visit (usually 15 minutes), the lab tests doctors can order and the medications that are covered. Both of these brilliant doctors (who literally saved my life) spend 1-2 hours with me, order lab tests that insurance-paid physicians have never heard of, and prescribe both special diets and a “cocktail “ of meds and supplements. One charges $350/hour and the other gives me his lowest rate ($650/hour). How many people with complicated, undiagnosed conditions can afford the best? And why does insurance set intolerable conditions for paying for high quality medical care? (Well, of course I know the answer: It’s The Profits, Stupid!)
I've been around awhile and have had jobs that did direct business with the government. Long before hedge fund sum, scammers were always setting up companies to enter into contracts with the government so they could rip it off. And of course most of the owners I met were future MAGA types that hated the government.
I refer to them as the "rape and pillage" crowd. I worked on air in radio for over 20 years back when there were Mom & Pop companies that owned groups of local radio stations. Then the venture capitalist came to town.
They saw them as easy pickens and a quick way to make some cash. They would buy the stations, go into them, reduce staff to the bare minimum to get by and then remove from the properties anything they could sell. That's how all the radio stations got consolidated under just a couple of companies. Everything was managed from a central location and the "local" was stripped out of all the local stations. And they homogenized what we heard and promoted the likes of Rush and company across the country.
What a great name for them. That has sure happened in my neck of the woods.
I see all of my friends (I'm 66, these friends are roughly my age) posting things like "do you remember waiting for THAT SONG to come on the radio, and recording it on a cassette?" One of the things we have lost with our advances in audio music options is all of us listening to mostly the same music; it has depleted one of our "common bonds".
I saw it all happen in real time. It used to be the local program director “programmed” the music. It kinda matched what was being played elsewhere but driven by local buying of “records”. That changed when they could literally “program” what you hear because it could be driven by internet connections into each “local” station. They didn’t need the local personalities because the same guy doing a show in a bigger market could be piped into the smaller markets. They make more money, employ fewer people with more control over what people hear.
Sigh. I loved being the wiseass woman who didn’t let the guy I worked with get away with giving voice to things that were stupid. We were live and people heard it in real time what was going on. I was venture capitalized off the air, (people wanted to listen to male voices I was told (don’t get me started)). Twenty five years later I’m better off, better paid, have more benefits and have money in the bank for my retirement. Loved being the wiseass though….
Ally, I now have my truck radio tuned to the NPR radio station out of Ashland—Jefferson radio. KHSU used to be my go-to until the Univ admin gutted the very popular station (wonderful, quirky programming & personalities) a number of years ago…it’s now mostly a canned program-feed out of Chico State. Don’t know of anyone who listens to it anymore; was a real loss to the community.
At least insofar as they substantially harm individuals and the common good. That's one of the main things a public centered (of, by, for) government is there for, no?
In the middle of this nightmare now the for profit ‘assisted’ living facility has consumed my mothers considerable savings, the inadequately staffed facility requires my family to be there daily. At $10k a month for 3 years. My mother now requires more care and only for profit more advanced (nursing) care will serve her needs. Only for profit nursing homes exist in her area. Requiring more staff without raising medicaid funding only makes this more impossible.
Here in NH, we have County run nursing homes in addition to for-profit facilities. I worked as an RN/Supervisor in a county nursing home for 35 years. What had been a a job choice turned out to have a hidden benefiit-being a county run facility, I have a real and truly state sponsored Pension! In addition, the county offers a retirement enrollment for the equivalent of a "Medicare "Advantage" plan. Basically, nearly all my medical expenses are covered and the only things I need to pay for is my medication co-pays. We also are a very good nursing home. When I had my second knee replacement, I chose my own nursing home for my rehab stay. Today it's crazy-hip replacements are done as day surgery and access to rehab stay access is very limited-only if you're single and have no back up to help w/care. That was my situation in December when I had my hip replaced, so I was able to have 2 weeks of in facility rehab care.
Hedge funds also created the rental crisis by purchasing single family homes en mass and colluding to keep rents high. Their actions also jacked up home prices and took away first time buyer homes reducing home ownership.
Richard, you have directed us to a most useful if somewhat complicated and necessarily detailed history of our founding documents and beliefs from Mother Jones and how those beliefs from the 18th century have become amplified in the 21st century. You have done us a great service. One wonders what HCR's take on this history would be?
I think that HCR would concur, that the problem has been there all along, a cancer, growing as state by state was brought into the union with hardly any populations at all. HCR is a better student of American history than I am by far, yet this state of affairs, particularly the disparity in representation in the U.S. Senate along with the filibuster, have had me full of concern for decades.
Hedge fund investors poison everything they touch. They’ve decimated the housing market in Florida, outbidding homebuyers, driving up housing prices, then raising rents. They do little maintenance and quickly evict anyone who is late paying rent or complains about needed repairs. Renters put up with it because there is so little inventory to choose from.
Yes, TC they need to be outlawed. The trickle down/supply side economic theory is greed disguised as policy.
During my late wife's last 15 months here, we were able to take advantage of home hospice services. She was able to stay at home and the hospice sent an RN once a week to check on her, and three different LVNs/home care workers to bathe her and change her, and to take care of her other needs. That hospice was well-run and the care was excellent. We were able to get it when a county social worker (sicced on us by her worthless damn sisters) saw I was in overwhelm and recommended the place to us since she knew the operation. All paid by her MediCare. But there are certainly places (Yelp is real good on pointing out the bad ones) where the money is obviously being sucked up by the hedgefundscum who are looting the system.
In early summer, 2020 an aide at the Deer Isle, Maine nursing home returned from visiting friends. For whatever reason, she infected many of the forty some patients with Covid-19 and 12 of them died. The nursing home closed their doors in September, 2020 and never reopened.
Five towns provided support to this nursing home before the pandemicic to insure a minimum number of beds would be available for their residents. In spite of multiple efforts to reopen the facility they have never been able to reopen.
This story is not unique to Deer Isle or Maine. It has happened all over the country and is still happening as HCR points out.
DJT and the Republicans ask us time and again if life was better 4 years ago than now. Maybe for Warren Buffett, Bill Gates, Elon Musk, Jeff Bezos and the other uber rich, but with 22 million unemployed, the price of oil going negative, the unemployment rate at 14% and people dying of Covid-19 by the dozens every day. Yeah what a great time we were all having then.
Many of you are caregivers for one or more people. Most of you are not paid for your hard work and care you provide. You cannot hold another job because being a caregiver is 24/7/365 in many cases. Here are some statistics regarding caregivers-
Caregivers: A Snapshot
58% of caregivers are women.
Almost one-third of caregivers provide care at least 20 hours a week.
Caregivers typically learn as they go and aren’t formally trained.
79% of caregivers care for adults aged 50 or older, and 76% of care recipients are aged 65 years and older.
One in 6 non-caregivers expects to become a caregiver within two years.
Increasing Demand for Caregivers
The need for caregivers is growing along with the aging of the US population. The number of caregivers increased from 43.5 million in 2015 to about 53 million in 2020, or more than 1 in 5 Americans.3 By 2030, an estimated 73 million people in the United States will be 65 years or older.4 Many will require daily assistance from at least one caregiver to maintain quality of life, independence, and physical and social well-being. More than two-thirds of the US population will likely need help with tasks at some point in their lifetime.
Gary, a (nearly) similar thing happened to a small (32 bed) not-forprofit facility that my late mom was in from Feb '20 to Mar '22 -- in other words, spanning the worst of Covid. They managed to keep Covid out for about 18 months, but the inevitable happened. It affected staff, as absences and people quitting severely strained the facility. The exec admin, the exec director and the head nurse all left within a year or so, not to mention aides, etc. There were rumors the facility would close. Fortunately the head nurse, before she left, made it her mission to get my mom transferred to a larger facility, even jumping the lengthy wait list (and my mom was Medicaid.)
I believe the facility is still open, though.
As to your last point, another aspect of caregivers is that they are frequently recent immigrants, a population that MAGA would as soon deport or not allow in. It makes no sense.
Immigrants do so many jobs across the spectrum and usually for wages that most Americans would never consider.
I hadn't considered the caregiver aspect. My Doctor in FL was an immigrant from Columbia. She saved my life one morning when I had blood clots throughout my lungs.
She was one of the few bi-lingual doctors in Jacksonville even though there is a large Spanish population there.
At times I felt guilty for taking a slot that a Spanish speaking person could have filled. But, I just couldn't quit her.
I'm glad you were able to connect to good services, but I know that can be a challenge when you have other pressing needs. I remember the Biden campaign floating these policies back in 2020 and thinking what a good idea it was, because I am of an age where friends are in need of nursing care and I and my partner could be as well. I had to drop long term care insurance when I lost my job since it was prohibitive.
Only if the States monitor and enforce care standards. The horrendous care my father received despite the facility’s bragging about their deficiency-free state survey certainly proves that!
I'm sure the doctor at @#$#@!! Kaiser (if that place is America's #1 private health care, we're in trouble; every time I had to deal with them, I walked out and said "thank god I have the VA!") would have signed anything to get her off their records since she dragged their "success rate" down. Mostly due to things not done for her by them.
OMG, so true. My sister worked for Kaiser fora few years as a case manager. They encouraged her to move onto other “opportunities” because she approved too many claims. And this was over a decade ago.
In the late 90s, when my sister and I were searching for a nursing home for my dad, we chose the first one that did not smell like urine when we walked in (it was the 7th or 8th one we visited). It worked out very well.
My mother ended up in a care facility the last 8 months of her long life. At the beginning of her stay, there was enough staff. Then management changed and staffing cuts were made. Towards the end, she couldn’t get staff to move her to the bathroom- multiple calls for help. And, she contracted a cold which turned into pneumonia which she died from. All at 10,000.00 per month. I still am awestruck by the cost and lack of care in the last 60 days of her life.
I am so sorry. My Mom died in a nursing home because her doctor would not put her on hospice. She had emphysema from a lifetime of smoking, and had contracted pneumonia, cracking her sacrum from coughing. She was in hospital for about a week before discharge. That conversation with my sister, me, and my wife present went like this: I asked about hospice care. Doc said "If she works hard, she can get back to where she was before pneumonia.". After this conversation with the doc, we went to the coffee shop to discuss it. My sister (she, her son, and my mom were all living together in a rental house) said "How am I going to do that? I work 40 hours a week, and I can't be there all the time." My wife and I told her that we would support her, and that we were pretty sure we could get her into a nursing home until she "got her strength back" which was code for "regained some semblance of consciousness and coherence." We ended up placing her in a Medicare home just down the street from where my sister lived. She spent about a month there before she died; I think during that time she was "herself" for about 3 days.
On our way home from Medford, I said something to the effect of: Lets see, if she works hard she can get back to: waking up, getting up, and going to the bathroom. It will take 10 minutes unless she loses bladder control, then it will take 20. She can go into the breakfast nook (the only room they could keep warm enough for her, in their cinder block house in February) and read the paper using a magnifying glass with a halogen bulb to illuminate the page. My wife said "I've known your Mom for 20 years. I have never seen her work "hard" at anything."
The care she got was good, and the staff was very attentive. The nurse on duty the night she died came in for her swing shift, checked on Mom and told me "She's real close. Have your sister come in." My sister got the time off from work, and we were there together most of the day. At about 7:30 she left to go get something to eat, and told me there was a show she wanted to watch at 8. At about 8:20, Mom started agonal breathing, and at 8:30 I called my sister. Mom died at 8:42, and my sister got there at about 8:55. Two things about this paragraph: My wife and I saw the nurse at an Indigo Girls concert that summer, and she remembered us and asked how we were doing. My sister, to this day, regrets that the TV show was more important. The show?" "The Apprentice".
I am so sorry to hear of your wife’s challenges and passing. I speak from a similar experience, so I know the multiple responsibilities of caring for someone so dear, navigating a care system, all the while of facing the daily grieving of someone in hospice (and the worthless sibling thing, too). Our society should step up in a bigger way to support our fellow humans who require extraordinary. Yet, as you note, there is profound greed in our society that needs to be called out and addressed. I’m not a big fan of shame, but a heap of it should be shoveled it on those who hoard money and power in an attempt to fill their empty souls.
TC, I'm glad you found your way to home hospice, even if it was a rotten reason. I've had experience with that kind of care for my mother-in-law and another dear friend and I can't say enough about the kind of care they provide. Makes the terrible situation so much better for everyone. I'm sorry for the loss of your wife.
Big, projectile sigh of relief..! Aid to Ukraine has passed both houses and is receiving the President's signature, finally. Nothing, but nothing, was gained by 6 months of delay. Correction, nothing for Americans, less than nothing for Ukraine. Perhaps, just maybe, a little more proactive engagement by NATO allies was achieved in separately pledging support and war materials to Ukraine to partly fill the gap created by the abdication of international obligations by the Repuglican caucus in the House. That is poor compensation for thousands of lost lives, widespread dispair and demoralization of a war-fatigued Ukrainian military and volunteer civilian corps supporting the war. I'm relieved, but also ashamed for my country. We can and should do better.
This is how we bring back the Middle Class. Now let’s make sure the voters know. The media as a whole are not helping so it is up to people like Heather Cox Richardson to do their job for them.
Yes, I agree, the media barelly mentions all of what Biden/Harris are doing to benefit our country, often filling theirr shows with tfg's antics or other fluff or showcasing polls favoring tfg. So its not a suprise that so few realize what Biden has done for the environment, or so many other things. I hope they will finally start showcasing his accomplishments more, so the public will be better able to make iinformed votes for Biden in November!
I just hope people are paying attention. The direct attack on fascist minority state governments' ability to demand women's health information to support their draconian anti-choice legislation is very welcome, and a sign I hope that the Biden administration will vigorously fight Red States overstepping their authority.
Women's health care has always been second fiddle to men's. There was a story on BBC radio this morning about the difference between heart disease and their diagnosis and treatment between men and women.
If a women is having heart attack symptoms it takes up to 7 1/2 hours to be treated for the heart attack and less than half as long for men. There are many reasons for this including the difference between plaque build-up in men and women, but the point remains. Women's health care is still secondary to men's in the US.
In the past, all the research that defines "normal" was done on men. Studies of medications, illnesses, treatment plans, etc. are based on men. Seatbelt positioning in vehicles is designed for male bodies.
Ally, some months ago amidst a rainstorm, I attended a pro-choice rally in front of the courthouse in Eureka (sparsely attended due to the rain…most were women from before the Roe v Wade times). There was a counter-protest including a priest carrying a large cross—we talked about our opposing views & he made a comment that prompted me to inform him of just what you say. He was very surprised & had no idea….I told him “dude, you need to get out more & expand your horizons of knowledge”.
I thought I would include this link to clarify just a bit as far as the privacy move the administration is going to put in place or try to. No doubt it will be challenged.
Great the number of positives that Heather sees and champions here today.
The largest batch begins the piece -- the Biden administration's effort to improve health and nursing home care, where insufficient workers and other poor conditions prevail.
The next batch isn't any batch of positives, but of areas where Americans are too unaware of practical steps being taken by government to aid Americans. This of course could find redress in the coming season of campaigns if Dems would align their appearances with each other to enunciate and celebrate their good programs.
Penultimate batch of positives is Biden's stop in Florida, where he's underlining America's need to reverse the theocrat medievalists eager to kill the rights of U.S. women.
The last batch concerns, finally, passage of aid to Ukraine, and other places the U.S. can shore up democracy and its incurred costs.
Heather's on a roll here, and midway in she interrupts herself, or digresses from the positives to note how the orange demagogue feels frustrated by his lack of fans parading in the streets for him. Suck it up, Donald.
Surely doesn't resemble Churchill. I think I have heard that expression before. My Mom knew several that have stuck with me. One being - you're so hard headed, you have to learn everything the hard way. Think she knew me well.
Check this map for the deadly cost of Republican ignoring COVID experts. See how many people died from COVID in your community (thanks to data from the John Hopkins Medical Center).
Gotta love that overlay of Fatal Incompetence. Although New York was not featured in the first piece, I watched day after day as refrigerated mobile morgues lined up for a trip to Mt. Sinai Morningside and returned to await another trip. I never got to say good-bye to my friend Betty, and neither could her family.
Amazing, progwoman, how those with the billions so hate everyone else.
But they don't see "others" as human -- just more numbers (it starts, by design, in K-12). And the numbers threaten them with needs, potential funding for humane programs -- the billionaires (see, lately, management at Boeing) in the U.S. would be happy were "the people" to be treated worse than serfs in Tsarist Russia, or oligarch Russia.
I guess that's about as polite a spin as one can put on it, progwoman.
One needs to have gone to a school which by plan, program, and intention dehumanizes one. Starts with the standardized testing racket which created some billionaire families gutting all of U.S. K-12 -- eliminating all humanities in order to reduce all life to numbers.
Continues with today's version of higher ed, where all disappear into neutered siloes, along with placement in group identity zones -- where corporate HR assigns trigger warnings, lest any in any in any orthodox-approved label ever feel personally challenged by anything.
To live in, support, serve, and be blind to what the billionaires are doing requires total desensitivization, progwoman. Total anesthetization.
That you still hold some human feelings (of revolt? disgust? shame?) at a society ruled this way puts you in the position of that one person who escaped that one small town in northern California in "Invasion of the Body Snatchers."
One of the biggest Trump Covid-19 fuck-ups was to not restrict international flights as soon as they knew of the dangers of the pandemic, which would have been around 1/1/2020. Instead, JFK allowed international flights from Italy without testing where the pandemic was raging, until the hospitals in NYC were overrun.
Of course, this was just one of their huge mistakes but thousands of people died because of this including hospital personnel.
Yes, but her early death—before rapid tests and readily available masks and ppe— was a warning to her many friends that Covid was something to be taken seriously.
Thanks, Deepak. This really shows who controls things at nursing homes and it’s all about screwing the elderly and the government. Lots of elder abuse!
Thank you Dr Richardson for writing about the Biden-Harris new rules for healthcare services, Medicare accountability, overtime pay, HIPPA and climate change. I watch MSNBC and did not know of these B/H wins for the middle class. This is a shout out to the Democratic establishment to promulgate these achievements in plain English for all to see and hear and recognize !
Here is a letter to an editor who refuses to publish it.
Don't Slit Your Own Throat
As of 2020, 3,273 Lawrence County residents received SSI. I’m sure more do now. When I was calling for Biden in 2020 I found that some people didn't know they were eligible. The Republicans have tried to kill it. It's ironic that some on SSI slit their own throats.
About 20% of the general population needs a hand-up. I'm so old I remember when there was little hope -- before SSI came to the rescue in 1973. SSI gives people a chance to survive. Before age 65, it's limited to families who qualify economically and usually due to "disability" as that term is defined in the Social Security Act. The money comes from the general funds of the US, not from the two Social Security trust funds. Anyone over the age of 65 now qualifies if they are destitute and can show that have some kind of legal status.
Every dime an SSI beneficiary gets proves that John Maynard Keynes was right -- they must spend it -- causing a positive ripple effect. “Demand creates its own supply.” Those benefits go into the hands of practically every business in the county.
Sadly, SSI is not enough for disabled folks to stay housed. There is not one county in the US where a single adult can rent a one-bedroom apartment and pay no more than 30% of that income. The average SSI payment is $698/month. And the average rent for a one bedroom apartment in my city (St Paul, Minnesota) is $951/month. Only one low-income person in four who is eligible for a rent subsidy will ever get one.
They can get HUD chits for housing. Under HUD rules their rent can be subsidized and the most they can be charged is 25% of income.
Depends on location, location, location for many recipients. SSI is portable within the US. No SSI in Puerto Rico, so millions of PRs live in the states.
In my home town, many SSI recipients pay less than $100 per month in rent out of pocket. The landlords get the subsidy. The grocers are paid in food stamps.
IMHO entire red states are subsidized in this way. They vote against their own interests.
Only one person in four who qualifies (by income, etc) for a HUD rent subsidy will ever receive one. Waiting lists are years long or closed due to the number of people on those lists. Neither Party seems to have the balls to propose full funding for HUD subsidies but that is really the only solution for many people to achieve stable housing.
A quick scan of this morning’s NY Times on-line headlines revealed a story on the new FTC non-compete rules, and no mention of the other new healthcare rules cited by HCR
Biden and the Democrats indeed have some PR work to do.
We have a conundrum, how to care for our elderly in the declining years of their life, and staff care facilities sufficiently well that patients and clients are well care for, and that the caretakers earn a living wage while doing so. Increasingly, the cost of long-term care is outstripping the ability of working people to save enough, and to invest enough, to be able to afford the care that they need as they get older. People are living longer, there are no economies of scale, and we are relying increasingly on recent immigrants to undertake the tasks of becoming care givers.
I am 81 and am hoping more elderly people come to terms with approaching death by choosing the time and manner of their passing in order to do so with dignity and avoid the pain, humiliation, and expense of hanging on for...what??? In future I am hoping this strategy will become legal for anyone who cares to take that route.
The father of my children was dying of a terribly invasive cancer in 2022, and even though CA has a "compassionate death with dignity" type of law, by the time he was able to complete the exams and find another physician to co-sign and then sign the many, many docs himself (with a few cups of coffee administered through his Gtube to overcome the morphine dose his hospice nurser of the day had pumped him with without asking), and then the 3 day wait to pick up the med packet for the cocktail, it was too late. He was no longer capable of administering the "cocktail" himself. So we had to watch as he was "humanely" starved for a few days, with a controlled morphine pump. Horrible. My sons, 17 and 20, had to endure that. Let's do better.
Thank you for sharing the details so we all can be realistic about the potential snafus. Looking up the forms for medical directives in your state helps prepare for the decisions that can guide what happens later on. They go by acronyms like MOLST, POLST, COLST. All these can help our thinking but uncertainties lie ahead for most of us.
In the states that allow medical aid in dying (I haven't researched each) it might be standard that two medical doctors need to sign off that the person has a disease prognosis of living for six months and that they are mentally capable. The patient needs to be able to swallow and self-administer the cocktail. It's helpful to become acquainted with natural decline when people voluntarily decide to stop eating and drinking (VSED). This entire post is difficult to face because we don't have good solutions to graceful aging and for the most part, we don't value the contributions of elders -- all related to housing generally. Business interests aren't doing the innovative models that are possible when multi-generational communities are designed for all to thrive.
Oregon has a "Death With Dignity" law. I only know a few people who have taken that path. What it does not cover is dementia patients the way Sweden does. I had a dear friend that I played music with who, when she got dementia, was able to travel to Sweden with her wife and their lifelong friend, and leave on her own terms. I have another musician friend that I know from my college days whose father chose his own death. A third friend's mother, who was a local activist, chose VSED to depart. That element of control in one's own death is, I think, crucial.
Thanks for the pointer--I'll look into Sweden's way of dealing with dementia. Compassion and Choices has an advanced directive that includes dementia but I haven't thought about it. I was privileged to be with a close cousin at Calvary Hospice in the Bronx NY -- historically a leader with end-of-life care and it was so well managed and patients were so caringly tended. No assistance in the form of cocktails was allowed there and food was brought at every meal but if patients didn't touch it there was no encouragement.
A friend of mine died recently in a care facility. She was on the locked memory care unit - which was staffed 100% by African immigrants. They provided the most conscientious, attentive, loving care I have ever seen in any nursing home. They really valued their elderly patients. We should all be so lucky - and need more of these saintly caregivers.
We are one of the few countries (or maybe the only one) that does not value and respect their elderly. And as someone mentioned “care givers” barely make a living wage and usually work two jobs. Tell me this…how does one find the compassion, empathy and respect to care for the elderly when the care giver is struggling to find the energy to give to others. Each of us only gets a spoonful of energy each day and we have to spread that spoonful throughout the day. When the spoon is empty—-it is empty.
We can substantially contain costs by regulating private equity so that it doesn’t hollow out services to enrich investors. And we can do even better by enacting Medicare for All. BTW, the recent immigrants who become care givers show how a sound immigration policy helps our economy, contrary to MAGA claims that immigration is ruining our country.
You're conflating apples with oranges. We tax private equity to raise money to pay for social services, among other things. That's a question of tax fairness. How the money is spent is a different question, involving issues of affordability and the overall fairness of the way a particular industry operates. It's more than simply Medicaid.
Great news Dr. Richardson, It's been a long time coming but the sun is shining on America once again, Now trump could do everyone a huge favor and have a massive, fatal heart attack.
My husband has said that he doesn’t wish Trumpf death he wishes him a stroke which leaves him voiceless in a inadequately poorly ventilated nursing home for 4 years as was his dear grandmothers fate.
That wouldn't help us now. There could just be another younger, slick repug with more charisma and intelligence who could beat our chances of winning across the board in 2024, yet have the same bad intentions.
"we stand resolutely for democracy and freedom, and against tyranny and oppression.”
This rings hollow for me. I, like Biden, have blindly supported Israel all my life. This was due to the holocaust, and my age. Israel was only 12 years old when I was born.
But my unquestioning support of a Jewish homeland, at last, was also because I was raised in an Irish and Italian Catholic town, run by White Protestants, but I somehow surrounded ended up with only Jewish friends. (There was one black friend, for a moment, before the locals somehow ran her family off my street.)
One best friend was from the south side of the tracks (a little nicer) and the other 2 live on the cul de sac where All the other Jews lived. Cindy, Michelle and Pam were my do or dies. I was invited for Passover and for seder, and political discussions around the table, and my favorite snacks (dingdongs and TandyCakes) were kept in their bread drawers for me. I was also introduced to the wonderful, bohemian artist and inventor life, and freedom of thought.
Since my own parents were ex-Catholics who sent us to catechism just to inoculate us against the Power of the Church, this makes sense. I was a free thinker. Don't ever underestimate the intellectual life of a child.
Mea culpa.
I never applied the same skepticism to the theocratic concept of Zionism. I celebrated Israel as a manifestation of justice vs persecution. In 8 million ways, it is. My friends were Reform, if they practiced religion at all. I knew this. I was drawn to their freedom to Question the Torah.
My sister and I had both been thrown out of catechism just for asking "awkward" questions like "why can't priests get married" and "why do babies who never heard of the holy spirit have to suffer in purgatory?"
When my friend Michelle invited me to her reform synagogue I actually believed, in spite of my inoculation, that I might be struck by lightning. I am not exaggerating. This was 1969. Michelle wasn't nervous about being struck down. She was just shy and didn't want anyone to notice. We were both exploring. We were gently poking at the boundaries.
Today, I am afraid to poke at all. I have written and deleted so many emails to journalists, comments on ig. But I am afraid to actually hit send. Not because the MAGAns might come after me, and my family, and my business. Because yes, I have swallowed the frog since 2016 because of that fear.
No, sadly, now I am afraid of the "ironclad supporters" of Israel.
I am crying as I write this.
I demonstrated "in the quad" for divestment from South Africa. I am with the kids on the lawn. I am with the Jewish Voices For Peace students.
Bibi is the Trump of Israel. I am so sad that Israel's "democracy" has not risen against him.
Yet look at us? US. Bibi knows we're up against the rails.
We Must support Biden against Project 2025 (aka Fascism)
at any cost?
Truly I am crying as I write this. And I communicate that to him, and Dr. Jill, and VP, and many, many Democrats every day.
I am With those students in the quads. I remain #uncommitted
I understand your pain. I learned about the Holocaust at age 11 (or 12?) and have been fiercely pro-Israel every since. But Netanyahu is no more the voice of Jews than Trump is the voice of America. I cry, too, about what is being done in Israel’s name. And as someone who has volunteered to resettle war refugees who lost their lands, their country and their friends/family due to religious persecution, I can hardly bear to watch what is happening to innocent civilians.
So many parallels to my life as a young Protestant on his way to agnosticism - as a kid who was stunned by the stories Catholic girls told me - as one who grew up around Jews and admired their intelligence and success - horrified beyond words by their eons of persecution.
And now...Bibi betrays his people with his brutal "solution". Yet, it is so very complicated. As a commenter said yesterday: "Why aren't they protesting October 7th?".
I do think we must support Biden against Project 2025 - as a concept so horrific as to be the core issue of November 5, 2024. That and the theft of reproductive rights...how can we not vote Blue from the top of the ticket all the way down?
I sympathize with your disillusionment. But we can only do so much with regards to Israel and Gaza. Biden does not have direct control over Netanyahu. And if we stopped providing support for Israel, Iran and its proxies - Hamas, Hezbollah and the Houthis will have the upper hand in the effort to completely eliminate Jews from their lands. THAT, as you know, is their only platform, their only goal. And they are willing to sacrifice their own families in the process.
Biden might not be hard enough on Netanyahu, but there is no reason to believe any other Democratic President would do better; there's only so much a President can do to alter long standing U.S. policy. On the other hand, a Republican President, especially Trump, would actively support Netanyahu. People should definitely make their displeasure known, but we can't lose sight of the fact that if Biden doesn't win it will get worse on not just the Israel issue but pretty much any issue you could name.
Sister Alfreda told our class of second graders that we would be struck down dead if we had a mortal sin on our soul when we recieved communion. I remember being terrified of committing adultery, whatever that was.
David Pecker did not testify for the prosecution. He was called to testify by the prosecution. Legally speaking, there is no such thing as a prosecution or defense witness. They are simply witnesses. Oftentimes, they are reluctant witnesses or they feign reluctance.
yes. because all most people (esp the young) remember is Willow and at LOT of offshore drilling leases.
Oh, and record breaking US oil production.
But I agree. The DEMS Suck at getting the message out. It's as if their entire marketing and PR team has been infiltrated by the Putin bots.
But it's also because the only real journalism left standing after Google's takeover of the Ad market is being out-clicked. By the nature of social media and dopamine, and the kleptocracy.
It's also that what Biden and the democrats are doing is governing, which is not sexy and attention grabbing. Trump and his cohorts saying outrageous lies is attention getting.
The whole short-funding of nursing homes is due to their having been bought up by the @#$#@#@!!! hedgefund scum, when the government made them 100% paid by MediCare. And then, like they do with anything else they buy, they hollowed them out to provide more money to the pinstriped pimps.
Hedgefunds have to be declared illegal.
venture capital-another phrase substituting for robber barrons. When human services like caregiving is the commodity that is having "efficiencies" squeezed out of it, the "juice" is contact hours, compassion, standards of care, workforce morale and esprit-de-corps. There are simply too many fleas on the back of the dog.
I keep hearing about the primacy of "efficiency" and certainly efficiency can be a good thing; but efficiency for what? Most of the economic "efficiencies" I have seen since Reagan have had to do with finding legal ways for companies to give less product or service for ever higher prices, exporting jobs out of the country while making domestic employment less safe, less rewarding, and less secure. Offloading costs, risks and responsibilities off onto the public, while hoovering up every business in sight, anti-trust be damned. A kitchen knife can be useful tool or a murder weapon. So can efficiency.
Time to do it differently? More people seem to be thinking so.
I have a great nephew who works for a private hedge fund that buys up single family homes across the nation. We talked and I began paying attention. This is another example of capital exercising power that is detrimental to the general population, freezing many out of home ownership. These hedge funds need to be regulated.
Richard, so well described. Regulation "of the people, by the people and for the people" is the essential counterbalance to the ravages of a rapacious capitalism which provides the money energy and creativity which drives so much of our economy. Regulations and laws provide a healthier balance between the two major forces in our democracy which keep it the most productive and successful economy on earth. The only countries with happier citizens are those of the Scandinavian countries with an even higher tilt toward socialistic laws and regulations.
You are correct about the Scandinavian countries, John. They have in place what I believe Joseph Stiglitz calls pragmatic capitalism. Regarding terms, Bernie Sanders, who is a capitalist, would gather much more support if he deemed himself to be a "pragmatic capitalist" rather than a "democratic socialist." Americans in general won't "buy" that label. Words matter.
I prefer to refer to myself as a "democratic capitalist."
Democracy must guide a healthy capitalism in order for there to be a healthy economy. I'm referring to moral and physical health.
Until capitalism has healthy guidelines, we'll have an unhealthy society, both morally and physically unhealthy. Sickly, to be precise. In fact, we will be literally killing ourselves due to our cancerous economic system. The body politic hosts far too many infections, and symptoms abound ...
Democratic capitalism - where democracy guides a healthy capitalism.
imho
Even "social democrat" is better than democratic socialist.
Agreed, Richard. Our nephew's wife is from Norway. I was talking to her mother who noted the high taxes, but all the services these countries have in return. She is comfortably rich as well.
Richard, well said! Words do indeed matter if, and when, people can agree on their meaning (or look them up), however, part of the orange guy's appeal is his profligate use of words without reference to actual meanings which have been written down but are used as part of his emotional appeals, usually to our baser instincts. While I don't advocate for government ownership of the means for production (except for things like healthcare and law enforcement) as in pure "socialism," I don't see why we should be afraid of a more socialist bent for government if one takes "socialist democracies" like the Scandinavian countries as our target for the improvement of the welfare of our citizens rather than corporate interests.
Pragmatic Capitalist! Yes!!
I'm not as big on labels as I am on policies and practice, but point well taken. At least until young 'uns get the education to know what these terms mean. I admire Bernie for sticking to his guns. He says he's a socialist, always has, and although his career in the Senate is notable, he hasn't gotten a lotta bills through. So we toddle along moving toward a working economy for all brick by bleeding brick.
Here's an explanation of the the terms "Democratic Socialism" and "Social Democracy" https://jacobin.com/2018/08/democratic-socialism-social-democracy-nordic-countries#:~:text=The%20Nordic%20countries%20%E2%80%94%20Finland%2C%20Norway%2C%20and%20Sweden,state%2C%20and%20some%20state%20ownership%20of%20the%20economy.Source Le Jacobin (rated as Left-leaning by "All Sides Media" and "Media Bias Fact Check," while AdFontes Media rates it as "Hyper-Partisan Left "). I'm also "hyper-partisan left".
Our ex-banker neighbor noted this and that we have many rentals, not well-cared for, in the neighborhood. He despises hedge funds and I value his insights into the money industry. On the other hand, our long time neighbors just sold their house for 750k and we are now hoping that we get decent neighbors who take care of it and don't make huge amounts of noise like the guy with the shop across the street from us. His newest project is a hot rod which backfires a lot. I also have a friend whose son flips houses, another thing that bothers me to a degree. Now he wants to use the park in central Salem, which has Willamette U's football field as a place for some kind of sports league. It is surrounded for the most part, by a nice neighborhood and I hope that the neighbors can prevent this from happening.
We live on a Lake and every new home being built is a mansion and Air B&B/VRBO/ No longer do we have consisitant neighbors. This has gotten worse over the years. Housing Crisis yes! Gone are moderate homes anyone can affort to live in full-tme. Capitalism at it's best. Party, Party, every night.
This sounds horrible. AirB&B has caused problems in housing in Portland with apartments as well as houses being rented out. I mentioned on an earlier blog about people not being able to afford a roof let alone a modest home while running back who has now in the portal from Oregon State whined that his NIL promised him a house. The house flipper I mentioned in another post today lived in Eugene, a college town, where the need for housing is great.
They need to be outlawed.
It is a tough issue, how to regulate this. Clearly, though, it does virtually nothing to improve the quality of life for the vast majority of Americans.
So well stated. Two-edged sword indeed. I love efficiency, but when laced with greed, it is just another scam. A deliberate one, all prettied up, with a nice bow like an empty gift box.
Jeri, that is such an elegantly simple truth, I had to copy it so as not to forget it. Thanks. This whole thread has been fascinating to read, but your comment is icing on the cake for me.
Thank you. Repub lawmakers are just empty suits; magats are just empty humanoids. I have more respect for the lowest animals. The alpha male guerilla may be greedy, but even he cannot compare to chump and his cohort of greedy bastards.
And apparently, most times not even slightly prettied up Jeri. Lack of conscience and greed seem to go hand in hand.
I used to think that lack of conscience (evil in my book) was rare. Even after knowing more than a few narcissists. I had no idea that so many repubs signed on to the evil agenda, with absolutely no reservations. Maybe extreme greed negates any self-reflection
But, haven't you heard or read? Business owners need that capital (revenue) in order to reinvest in their businesses including paying employees a saving wage. I mean if one asks them, they will say so, won't they? Gee, maybe they're getting a bum rap, here. "Amen?" Anyone? Amen?
Amen, ad nauseam. Stockholders should never have a license to steal from the rest of us, workers, and customers
Exactly so, Jeri. "all prettied up".
A mirage.
Agree. Effective versus efficient. Prioritize efficiency over the purpose of effectiveness and you have profit over people.
You nailed it. And that is the sick and cruel premise of our entire health care system. While I applaud the new rules for nursing homes and home care, unless there are rules that require good pay for those required workers, the rule will be toothless. The companies that employ these workers complain endlessly about how hard it is to find good help. Perhaps if they paid people well, they would find more applicants? Duh?
Profits for caring for people is immoral and not effective at delivering care. Most advanced democracies and "developed" countries know that.
The next step for our government: Have Medicare and Medicaid to assume direct control of these employees. If you have ever dealt with a nursing home or a home care company, you will know why I suggest this.
Medicare is extremely well run with administrative costs of about 4% - not 20%!
My father lived his last years and died in a nursing home to the tune of 8K + per month, they threw away his hearing aids when he took them out as well as his dentures, the Cartier watch I gave him disappeared, they housed him in a tiny space that would make a holiday inn look like a luxury resort. He passed during the plague, the people that cared for him were caring and gentle with him, but the administrators ala carted every single interaction any staff member had with him. My sister bless her heart, dealt with the administrators who may have been working for a hedge fund for all I know, I would guess that they were. When I go I want to go at home not in some warehouse for the elderly run by a hedge fund. These facilities are very expensive to set up which is probably why they attract hedge fund money, which in turn demand a quick return on their investment, they are not in the business of providing a service, they are in business for a quick return on their investment.
I "liked" your story and hitting the button felt weird. Please consider "like" to mean support and agreement. So sorry for what your dad and your family experienced. Unfortunately, it is all too common.
A story that hits home for our friends is that of the Holyoke Soldiers Home.
https://www.nbcboston.com/news/local/holyoke-soldiers-home-employees-allege-criminally-catastrophic-decisions-in-covid-outbreak/2999036/
Dick, the thought of this happening to your Dad makes me want to cry. Multiply this by millions and it becomes a current standard. And at 8K a month. This is a sin and a crime! Noone deserves to be treated this way.
Healthcare: my son just received a bill from a hospital in IL:
‘Date of service, 7/29/22, hospital services, charges $31,667.50,
Adjustments/Ins payments -$30,150.29, out due, $1,517.21.
I, as POA will be writing to request an itemized account.
I keep wondering just what was done in a one day stay that cost,
$31,667.50.
There is a fine line between amoral and immoral. The concept of insurance is based on a well accepted principle of pooling risk, an amoral concept. The practice of stratifying risk pools to the nth degree is bordering on immoral when submitting a claim for an "act of God" event driven by the weather results in the insurance company tossing you into a risk pool that makes your insurance unaffordable. Social services, health care, human services and financial arbitrage simply make poor bedfellows, resulting in some truly immoral outcomes. Arbitrage on world-wide fluctuations in the price of gold and silver is closer to amoral than immoral.
💔
I’d also like to chime in that many of the workers in nursing homes are immigrants. At my mom’s private home, fewer of the nurses were immigrants but almost all of the aides were. Turnover was high; it’s not an easy job.
"Profits for caring for people is immoral and not effective at delivering care. Most advanced democracies and "developed" countries know that." Thanks for this Bill. If only the greedy ones at the top realized this! Greed has taken over our country and it makes me sick.
Something over a decade ago I knew a licensed mental heath councilor who was working in a privately owned facility for patients nobody else wanted. He tried to form a union there by failed. Apart from lack of support, he was riled when management cut employees pay by $2/hr, while simultaneously boosting executive compensation. I'm not sure if that was before or after the $13/hr he mentioned being payed. He quit and joined a private practice at $75/hr. I hear and red many stories about privatized services ripping off their clients, employees, and the public, with little if any accountability.
But let's have nationalized health insurance (like France) instead of a single-payer system (like the U.K. and Ireland). I have experienced both and found that treatment is too often delayed in countries with single-payer healthcare. I've learned this from friends in the U.K. and firsthand In Ireland. One of my students experienced a grand mal seizure on the day that my study abroad group arrived in Ireland. The hospital in Galway didn't have the equipment to do a brain scan to map seizure activity, and their "men's ward" was one large room with cloth curtains separating the patients, and there was barely enough room to put a chair in between the bed and the curtain. The man in the bed closest to my student needed to have his urine bag changed, but instead it tended to leak under the curtain and puddle next to my students' bed. I couldn't send my student home to the U.S. for treatment because it was likely the flight that had provoked his seizure (this was information that his parents got from a neurologist in the U.S.). I strong-armed the doctor at the hospital into prescribing anti-seizure medication for my student even though they couldn't do a brain scan to show that he'd had a grand mal seizure. It turned out that the young man had already experienced one a couple of months earlier, but he was alone and thought that he must have stood up under a wall-mounted bookshelf and hit his head hard, based on the fact that he had a big lump and a laceration on the back of his head and a large bump/bruise on his forehead. When he told me that, I asked him whether he had bitten the sides of his tongue, and he told me that his tongue had been very sore and that he'd shown it to the nurse practitioner on campus and she'd said, "Oh. You bit your tongue!" but didn't suggest that he see a physician or a neurologist.
Once again, it's a matter of what the aim of "efficiency" is. Nazis sought efficient ways to murder people. Medicare is efficient at converting it's revenue into care. And even human services run at modest profit can be useful when the welfare of the pubic is put first, although I think it should be obvious that some services are too vital and/or too dangerous to be entrusted to private control.
But prioritizing profit over people is evil; even the Bible says so.
Maybe it shouldn’t be called efficiency, but money lapping up any available resources before the public even has an inkling…
Jeri, not unlike the oligarch-buddies of Putin who lapped up the major industries and resources when the Soviet Union dissolved back into Russia! ...and then they discovered they didn't have the military might they thought they had, much of which had become inoperable because so much had been siphoned off by the moneyed class.
Ross Perot was wrong. That sucking sound we heard was the oligarchs hoovering up all our available resources. Like Mnuchin buying Sears and destroying the company and many lives along with it.
My understanding is that the East Germans got screwed by the "money men" in reunification. Getting rid of the Soviet yoke was great, but plutocrats showed up along side liberation.
I mean efficeny in the term of being a good steward with money avoiding waste.
Totally different. I like your definition. The cretins really like to redefine and use “opposites.” Taught well by the likes of Frank Luntz.
Very well said, JL! And don’t forget, they do it with less oversight. Not just less product/service but also poorer quality.
I think in many cases that's true. I especially notice recently reformulated processed food products that have changed, sometimes quite visibly, for the worse.
The last 8 years of my nursing career I worked in a federal program evaluating the care of residents of nursing homes in a multi-county rural area. During that time I watched many excellent care facilities, built with local funds and run by caring staff, rapidly deteriorate once they were bought out by conglomerates. It wasn't just the cutting of staff and the increase in workload, but the whole evisceration of the homes' caring cultures. You could feel the angst and the exhaustion when you walked in the agency door, at the nursing desk, at the resident's bedside. The best staff left. The residents couldn't.
I lived through and experienced first hand, the devastation wrought upon the nursing home industry as it was, pre, during, and after the buyouts. It was the saddest story yet untold. My personal involvement began in 2011 as I recall, perhaps a bit earlier as a prime consideration.
What hasn't been mentioned in all of this morning's comments is how our own culture has sadly lost its care and commitment to our elders. The US is really the odd one out as from the Mediterranean and Africa to most all of the Eastern cultures (Korea, China, VietNam), Scandinavia, elders are respected and have valued places in Society. It's mostly here where greed and personal interests have led to the system we have today where elders are sent to "group homes" where they live largely in isolation save for the occasional visit from family and friends.
It's this cultural issue we have that opened the door for corporations to move in and exploit it. And, exploit it they have.
https://www.linkedin.com/pulse/cultures-where-elders-revered-pam-moorhouse/
Yes, and Buettner nailed it in Blue Zones. But the nursing home I wrote about here was in a village that could be classified as a blue zone. A farmer donated some of his acerage located not far from the center of town for the home. Then the local folks pulled together to get it built and staffed. Many of the nurses and aides were from the village or farms nearby, and had known the facility's residents as their teacher or minister or car service guy. Often when I sat at the
nursing station desk, reviewing a chart, a visitor would come up and the nurse would hug her and walk to the relative's room with them (and, of course, the visitor had brought vegetables from the garden or homemade cookies). This home felt like HOME. Corporate buy out then blackened the blue zone.
That is a very sad reality.
The Biden Administration is doing a great job at making Americans live, safer, healthier, and more prosperous. They are doing hundreds of little things that many people hardly notice and some will take but not acknowledge. It’s up to us to get the word out. Do you want a country run for the people or by a cruel exploitive mafia?
I agree with you: we all must get the word out. The accomplishments of the Biden Administration are remarkable but receive far too little recognition. Today's Newsletter points out the ongoing progress the President makes on behalf of everyone. So yes, get the word out!
Leeches are "efficient" at removing blood. Nuclear bombs are "efficient" at killing.
Yes, efficiency to make money. Has nothing to do with people.
A spot on evaluation of "efficiency". When has efficiency ever had a place in a moral, thoughtful, conscientious, driven society. We cannot, and remain humane, be efficient when it comes to the stewardship of our resources and responsibilities.
Energy efficiency, doing more with less, is a good thing, and there are efficiencies "wired in" to the ecosphere. But the seeming inefficiencies of squabbly democratic governance vs dictatorship, or competing smaller business vs giant conglomerates, is where much of the vitality and balance of life comes from. Diversity is the essence of freedom, but dictators want to harness everyone to the same project. We need to establish rights that are never broken and lines that should not be crossed, but our collected pursuits of happiness take us SO many places we would not have time and resources to go without the aid of other citizens. That too may be a kind of efficiency, exploration and mastery of a broadened array of options by hearing different drums. E Pluribus Unum.
Sadly, as you and I have said many times in this space, "Follow the Money." Another thing I've said, and hated it each time is, "Empires require slaves."
Today a job arises but not , in our aged and sizeable group, is there a young man capable of ‘the dig’ physically nor others known trust worthy or again physically capable. Of the 5 nurses in our own family also near 50 ,the ones ‘friends’ in our group , are near retirement -actively planning- and the others solidly employed. The work force is dwindling , progress has soften the roughened hand,the hard laborer/farm hand/strapping teenager…oh wait maybe we know some Mexicans, immigrants, or an able bodied Guatemalan who will work for $15 -$18 an hour? Ah….hmmmm
A lot of people are (or need to be ) waking up ( thank you) , things are changing , we have , are faced, with reality -have some immediate changing to do .
Some of the factors will require minds to adapt, be mandated, and cross thresholds of long held denial…mind you-cost a lot more due to time wasted, codes not adhered to, or people looking the other way from persuasive ‘incentive’.
Thank you President Biden for steadfast sure stride caring for US. Thanks to those that stood, wrote, supported that and continue .
Thanks Heather …👏🫶
Nicely put, J L. Efficiency here is just another word for everything left to lose. I see many large corporations, venture (remember vulture capitalists),hedge funds, etc. as giant vacuum cleaners sucking up money with no concern for anything else: pure unadulterated greed.
Wouldn't efficiency AND decent pay be a glorious thing? I dread the day when I won't be able to take care of myself.
I think Biden described this as buying a bag of chips: higher prices and fewer chips.
An understaffed nursing home is NOT efficient. It is basically a warehouse for the infirm elderly. I am speaking from personal experience. How can one caregiver look after 15 residents, many of whom are not mobile?
Animal Hospitals give better care.
I completely disagree Virginia. Both my mom and dad ended up in facilities -- a total of 3 -- and I have nothing but kind words to say about each of them. I won't speak about ownership, but the staffs were all supremely dedicated, kind and hard-working.
I'm not suggesting you're being critical of staff, but I refuse to say that animals are treated better. We have no complaints about the care my parents each received.
Doug, they were some of the lucky ones.
Perhaps. Of course I never saw what went on when nobody was around, but I can't fault any of the facilities in terms of communicating with me (I was the primary contact and health care proxy for both parents.) I received calls when even a minor fall occurred, or if my dad developed pneumonia and needed to be transported to the hospital for care on a few occasions (and my dad ended up in a facility due to a fall that happened at home.)
Caring for seniors nearing the end point of their lives takes a special person -- they're certainly not doing it for the money. And many suffer verbal abuse from residents with dementia. It's a thankless job, and we should be grateful that there are people willing to do it.
Agree Jeanne; I've live the experience you speak of.
You're lucky!
Jenn, here's some love sent out to nursing home staff. My wife and I cared for my mother for 7 years when dementia started rotting her brain. When it became too much ended up in a small not-for-profit home of 32 beds. Then Covid hit the home (they had managed to stay Covid-free for an unbelievable 18 months) and staffing issues forced the home to shift her to a larger, for-profit facility, where she eventually died of Alzheimers.
All along the way we found the staff, from the admin down to the housekeeping folks, to be focused on the patient. It takes a special kind of person to care for others, and thank goodness they exist.
I do however agree with your thankfulness and for nearly the same experience Doug. Mom developed a form of early onset. Of course, as many do, they hid this the best they could. Dad, ever the soldier / Marine, retired early to care for her. As it all grew as it does, Dad reached out to my baby sister - disabled herself to help him with Mom's care. The household income went from scarcely tolerable to worse, then worse imaginable, to ruin. Mom's employer of 30 something years had stolen her retirement funds (got away with it too). Dad's pension was sparse, Mom's - non existent. The greater of their two SS available was Dad's. Mom and her extremely costly medications for dementia fell into the dreaded 'doughnut hole', uncovered. Ruin followed shortly, including Dad having a massive, hemorrhagic stroke - bleeder rather than blockage. Then the entire bag was tossed into my hands. I can't tell you in mere words, how very deeply this wounds me in retelling. Tears, deep pain and trauma now demand that I stop here for now
D4N, damn, this was hard to “like”…a hard memory to carry let alone live through/witness, especially if you don’t have the wherewithal to “fix” any part of it. It is our country’s failing to have better systems/supports in place that means situations like yours are playing out nationwide. 💔
D4N, I'm sorry to read of your troubles. Our experience was much less traumatic -- if I can even call it that. My wife is a gem and provided the care (mostly) without complaint until she just couldn't any longer. We did it for 7 years. And looking back, there's little we would have done differently.
When my mom finally died a year ago in March, I smiled rather than grieved -- she lived to reach 90 years and I knew we did the absolute best for her. My siblings helped in their own ways as well-- that's important to note. But I was proud we were able to see both my dad and mom through to the end of their lives, and making sure they were well cared for.
It takes a special nursing home to be willing and able to invest in good hiring, adequate staff:patient ratios, staff training, supervision and pay-with-benefits. A nursing home that has been bought by corporate raiders is very unlikely to do any of this.
Yes, but if they receive federal funds, they have to maintain and report resident:staff ratios. I can't speak to the pay, but as there is a dearth of health care workers to begin with, then it behooves a facility to attract more workers with better pay and benefits.
Believe me, I'm no supporter of for-profit health and senior care, and I have a healthy distrust of their purported objective to provide high level care.
As a fledgling nurse, many years ago, I was giving medication to 60 patients.
The staff of my mother's facility were kind and caring. They were overworked and underpaid. Any deficiencies were the result of corporate decisions that the staff didn't control.
Been there done that. After 8 weeks switched jobs. I had taken classes in care and understanding of Alzheimer’s. The nurse not only didn’t speak very good understandable English but were clueless. I ended up telling them I would handle it. Ended up doing private homecare and now on my 70+ work at a nursery.
And finance “moguls” are buying homes and renting them. Talk about absentee landlords.
Making housing ownership and rental prices higher and higher. There is an extreme housing shortage and we allow these leeches to make it worse.
We need term limits and a ban on lobbyists.
No to term limits and lobby bans; lobby reins yes. When we get good representatives, we should have no restriction on returning them. Term limits only invites dominance by bureaucracy.
There are good lobbyists, too. A ban will not solve the problem.
Nor will term limits. When we get good ones, we should have no restriction on returning them. Term limits only invites dominance by bureaucracy.
And the rent is way above the means of most people looking for a home to rent. And requiring a deposit and 1st and last month’s rent is astronomical!
This is why it people whose financial crisis tips them into homelessness are so often trapped. If you lost your housing because you lost your job and were $400 short on the rent, how can you save up the $3-4,000 needed for application fees, security deposit, first (and sometimes last) month’s rent, plus utility hookup fees?
Which is why you're suddenly seeing stories about baby boomers hogging up houses.
Wall Street knows we're an easy demographic to blame and they're looking forward to churning houses.
Yep, suddenly we are the scapegoats. For everything.
MLM another area local if not national regulation could be used to level the playing field for individual citizens needing a home.
Which, ML is all about, again lining their filthy pockets with our rights to be human. As we have said time and again and again and again…… healthcare and housing are not yours…. They are ours! People also forget that the Chamber of Commerce is simply a club house for hoarders of citizens rights. Jesus , sorry to wake you, but many of our major problems are simply ignored .
I know , let’s make the penis a commodity. Let’s buy and sell on the blue chip commodity market. No one gets to own it… just trade it to make a profit for those who can’t get it up unless they have all the power! Is that vulgar enough? Aughghghghghghghg!!!!!!!
Robber barons buy up single houses to rent out forcing the rents to cause tenants to pay half their income for rent when historically they paid a third of their income.
The lowest income strata pay up to 80% of their income on rent, leaving practically nothing to save in preparation for the next crisis. I worked for decades in the homelessness system and believe me, this is true.
I had to rescue my dad from a "skilled nursing facility" called Bryn Mawr Extended Care Facility. I think they've actually had to change the name (again) due to reviews of the horrific conditions. My dad ended up in the ER after Two unreported falls within 4 days of admission, because No One Answered His Bell.
Dead rodents in rooms for days. Patients routinely left to sit in their own feces after pressing "the red button" for help. Forced to sit in the hallway for hours and hours if marked as a "fall risk" meaning anyone who dared to try to get themselves to a bathroom when their calls went unanswered.
Lies about major falls, for days. Threats to Throw my father Out if I didn't sign paperwork saying he was incontinent and suffering from Dementia (so they could just ignore him].)
SO many violations. Run by Saber Health, the corporation that has been Successfully sued for wrongful death and still exists. https://www.saberhealth.com/
Don't let anyone you know go anywhere near them. If you have elders make Sure you know which SNFs and Elder Care Homes are Highly rated and establish contact with them and ask about their admissions. Your loved one is at the mercy of Who Has A Bed at the time they need help. It is yet another disgusting, inhumane result of our profit uber alles "health care" industry. We must spend Hours and Hours preparing for the worst.
In the case of elder care, you must. It is Very Very Scary out there.
Patrice, i believe my father died from the poor service he received at the “transitional care” nursing home. He was there after surgery for a broken hip, supposedly for physical therapy and monitoring. I lived in a different state and did my homework, selecting a care center with good State compliance reports. I know quite a bit about NH standards and every time I visited him (about every three weeks - my brother lived nearby and saw him daily) I witnessed many violations. He got 30 minutes of PT three times/week and they kept his walker on the opposite wall, so he could never work on his mobility. They dropped a tray off by his bed at mealtimes and took it away ten minutes later, even though he had barely taken a bite - but the chart on his door would indicate he ate 1/3 or 1/2 of the meal. They did not answer his call light for trips to the bathroom, so he tried to walk by himself and fell, so they alarmed his bed so he stopped trying. I never saw staff wash their hands when they came in his room, despite the fact that there were multiple cases of C diff in the unit. Of course he caught that, too. And yet the nursing home had a banner in their lobby bragging about their “deficiency-free survey” by the State. Believe me, I tried sweet talk, demands, etc but nothing changed.
I hope Biden and Harris do something to enforce care standards. Clearly, the lack of oversight is resulting in patient falls, infections and deaths.
I'm so so sorry to hear that. It was our greatest fear. We had No one living near our dad by then. He never wanted to move to SoCal where all his kids had moved. That's why I said I had to rescue him. We truly feared for his life. We did complain to the "ombudsman" but she seemed to have given up on the hopes of anything changing and I'm sure she filed a report, but PA Dept of Who Knows never got back in touch with us.
I feel awful that for the people that remained there, or have been abused there since. There was only one person there that seemed to care, but she was so beaten down.
We need Profit taken OUT of health care. Pay providers well, from the dietician staff and the aids to the specialists, but not for the monsters who make a profit at the expense of human health and dignity.
I know it's hard, but it's up to us to enforce standards, too. I saved a few drafts of letters to the State of Pa, and my father's representatives, and even to the Philadeliphia papers, but then we were so exhausted by the process of moving him and his Medicare and Medicaid to CA, and finding him a better place to live, in the goddamn lottery of who has a bed open when you need one, that I just burned out.
The tragedy of your family's loss has spurred me on to send what I wrote, and more.
I am 63, and after what I went through with him truly makes me fear for my future.
I wish you well.
Thank you for sharing your story, and galvanizing me.
Patrice
Patrice, it would seem you have or acquired an eponymous name for the need for a movement toward better healthcare you so effectively describe.
One wonders if some method could be crafted for those who really do care about the care their relatives receive could be paid for providing that very care thereby bypassing for some the need for a nursing home?
There is a system for doing that. I got paid over my wife's last 9 months here in California.
I believe this is the case in NJ, but only for people on Medicaid
❤️❤️❤️
Elder care in this country is a horror show. Went through it with our Dad who had means to pay, but a decent care facility having a room available at any given time was a crap shoot. And now we're going through it with life-long friends who don't have the means to pay. All of this happening in Northern Virginia that has excellent hospitals, but not enough decent interim care after discharge. And zero oversight of these places.
When I was working for the State of Minnesota nearly 50 years ago I read a study of “board and care” facilities. The conclusion was that they were unregulated and provided highly substandard care. Things have not improved in nearly half a century! That is why I would rather end my life than move into a care institution. Biden/Harris are taking one step (which will likely be fought by the nursing home industry and delayed until after I die) but so much more is needed.
Oh no I'm so sorry.
I'm so sorry for what you and your Dad had to experience at the hands of uncaring "professionals".
Thank you, Jeanne. I’ve had nightmares for 17 years, a bit of PTSD for not being able to secure better care for him.
Ditto Marge
All these stories need to see light.
Any ideas about how to do that? Seriously.
Quit putting our elders away like dirty linen. Start giving HUGE and monitored tax breakers to families who comply to the rules who also make room for their own family member who needs them more than the kids need a cell phone! Get a heart America. It will show one day.
Sometimes they are falsely highly rated and in reality are horrible.
The average time a person is in an extended care facility is about 6 months because the people pass away. The majority of the facilities are depressing and have woefully inadequate care. There should not be for profit healthcare at any point. It's too ripe for abuse. In NC, some of the best facilities are operated in association with churches. They do not accept Medicaid and are expensive. Those facilities reflect the true cost of care. Decent wages, trained staff, clean and well maintained facilities. The staff is responsive to the residents in such facilities because there's enough staff. My brother and/or I went every day when our mother was in the best facility in our county.
My husband and I have been in assisted living almost two years. Some here are older and some younger than us. We are 74.
Knowing that something may not be around long is of course no excuse for poor care.
Correct re. falsely rated. It got worse over time as I watched in horror.
My parents thrived after moving to a retirement/care facility. It's good to know there examples that point the way forward, as well as those that demonstrate the wrong way.
I'm so sorry to hear about your dad. Thank god he had you.
Thank you. It took a village. Three daughters and a son. He is now living in the "Treasure Island" of SNFs in Santa Barbara, just by chance. I was in the process of taking $10k out of my meager IRA to put a deposit down on a tiny SNF in a strip mall in Torrance, that was the only one we found that didn't have flies or the stink of urine, and the long shot home of our dreams in Santa Barbara called and said they had an empty bed. That's how it works. I know that life is a lottery in a lot of ways, but this particular one is cruel.
Yes, my dad had children and one of us might have been able to provide 24/7 care for him in our homes, but for so many reasons we could not.
So we were lucky. The luck of the Irish. We looked long and hard from SB to Long Beach, and spent money we didn't have to make it happen. We are privileged to be able to do so.
Bryn Mawr sounds really familiar. Where are they located? I think I might remember hearing about this.
Patrice, thank God you were able to save your Dad from that horrid place. It paints a very scary picture of what seems to be too often the norm.
I absolutely agree, TC. Next we need protection for Seniors who moved to independent facilities, currently there are no rules protecting us from mistreatment or reduction in services with no reduction in rent.
'Millions Cancel Subscriptions to National Enquirer After Learning Its Stories May Not be True'
'APR 24'
'NEW YORK (The Borowitz Report, Satire))—In a development that has rocked the news industry, The National Enquirer has lost millions of subscribers amid revelations that some of its stories might not be factual.'
'After Donald J. Trump’s hush money trial exposed the Enquirer’s inner workings, the newspaper’s reputation for unimpeachable journalism suffered a severe blow, media insiders say.'
'Harland Dorrinson, an Enquirer subscriber for over thirty years, said discovering that the weekly periodical was not a dependable information source was' “a gut punch.”
“In a complex and confusing world, I always felt that there was one news outlet that could make sense of it all,” he said. “That’s been stolen from me.”
'If the Enquirer distorted its coverage to support Trump’s election in 2016, Dorrinson wondered,' “Does that mean Hillary Clinton wasn’t really dying? Or that she didn’t delete emails from her multiple lesbian lovers? Or that Bill Clinton didn’t have a sex romp in a pickup truck that was caught on video? Now I don’t know what to believe.”
'The longtime subscriber said that the Enquirer’s sudden loss of credibility would force him to seek reliable reporting elsewhere, adding,' “I guess I’ll give Fox a shot.” (Borowitzsubstack) See link below.
https://www.borowitzreport.com/
I was living in KY in 2016 when I saw copies of the National Enquirer at the check out in a grocery store. It had HRC on the cover with the gross headline that she was dying. I grabbed all the copies from each checkout and buried them behind products in random aisles. Made me furious that trash was being sold to unsuspecting people.
Ever since I read a spoof in MAD magazine (when I was about 13) where it was called "The National Perspirer" that is how I have referred to it. I used to work in a small, rural grocery store; we carried ALL the tabloids. There were people who came in every freaking week and bought one copy of each.
It’s astonishing that people not only read this trash but believe what they read in these trash publications🤬
It’s the believing part that stuns me.
Right ? *And,, then traffic the pablum as though they read it written on a tablet handed down from on high.
Ally, the one and only time, decades ago, I bought one to take on a hiking trip in the Marble mountains area (inland far northern CA)…was back when it was (mostly) safe to have a small campfire & we sat & read it aloud and laughed our asses off!!
I've ridden my motorcycle through there (from Weaverville north, through Yreka, up to Taklima and over to Crescent City). Amazing country! We call it the "State of Jefferson Highway" here.
Thank you, Fern. You made my day! I"m shocked to learn that the Enquirer was not a fact based news source!
Enjoy your day!
Ah, Heather, exactly my thoughts. Laughter is a must! Restoring trust in the crush of disinformation and greed as the lethal games of evil seek control with the help sick fools, Trump twisting in the courtroom and, hopefully, coming face to face with the rule of law is one important positive factor, and there are more.
Enjoy the day, dear compatriot Heather!
Lol Fern.
FERN MCBRIDE. Valuable research & Link as always, thank You.
I strongly recommend , Chris Jansing Reports on-air interview yesterday of STU' ZAKIM, a former 2004-2006 AMI Executive & spokesperson. ZAKIM says AMI owned many "titles" & even owned a newsstand distribution company. Thus, AMI controlled the entire "rack space". "It was like a moving Billboard". "It's all about the headlines", left to right. ZAKIM concludes "it resonates in you know matter what you think".
Sorry, I found it on YouTube last night under something like "MSNBC Shows" under the Jansing segment title: "Could charm anybody. Ex-colleague says it's perverse ...".
No question, Bryan Sean, there are times, more than ever in the last 8 years, for Borowitz to tickle our spirits.
Biden signing the funding for Ukraine is a major reason to cheer today!
Ah, Bryan Sean McKown, you have been such a fine subscriber friend. It is time for me explore new social-political terrain but not without a note of appreciation to you. To our work on behalf of democracy and one another.
Big HUG, brother!
Thanks, Fern!!
!!, yourself!
I sobappreciate yoir morning laughs!!
I have a lot of respect for you TCinLA but they are NOT100% paid by MediCare!!! Some patients are covered by Medicaid and others, like my mother and millions more like her were not and she had to cover the expenses.
Medicare only kicks in after the resident has depleted ALL their assets, and not all retirement homes take Medicare patients.
Medicare and Medicaid are two different programs. Medicare is paid through the federal government and covers doctors, hospitals, tests etc. it will cover up to 60 days in a care facility for rehab only. Medicaid is covered by the states with some federal money and each state has their own rules. It covers care facility stays for anyone else.
You’re right, sorry!
One has to be able to afford a team of Philly lawyers to make sense of this system. It begs simplification and uniformity. The 'devil' is in the rule differences from state to state, and we all know - at least we in red states like myself and KR in Ohio, that gerrymandering, like money - want or demand of it, are two of the roots of evil.
One has to be able to afford a team of Philly lawyers to make sense of this system. It begs simplification and uniformity. The 'devil' is in the rule differences from state to state, and we all know - at least we in red states like myself and KR in Ohio, that gerrymandering, like money - want or demand of it, are two of the roots of evil.
D4N, agree! Back in the early 2000’s I handled all of my mom’s affairs & it was like having a 2nd job. One day the Chief of my town’s volunteer fire dept knocked on my door to ask if they could borrow my dog Sadie (a Dalmatian & dog of my heart) to ride on the fire truck in the parade (she did this almost every year for most of her life)—-well, he looked in at the large table I had set up in the living room w/ piles of papers & asked if I had a home business…no, I said, it’s just my mom’s financial/medical/etc affairs!
There are exceptions, like Hospice with a prescription for "skilled care."
People on Medicaid can get coverage based on low income. Many of us outlive our assets and fall into that category. There are ways to create "special needs trusts" to try to protect some assets. The predecessor of CMS used to sue to recoup "preferential transfers" of assets to turn grandma into a pauper.
Yes! True! People must exhaust their financial resources to become eligible for 100% Medicaid. Medicare will pay only for the first three months of transitional nursing home care. Then you pay until you are poor enough to qualify for Medicaid.
Daniel, here's an interesting story. My wife and I cared for my mom (diagnosed with dementia, died with Alzheimers) for 7 years. Along the way I met with a local nursing home which had a memory care unit. I met with both the admin of the SNF as well as the memory care unit (MCU). I was told (in 2019) that my mom had to have assets of $250k to get into the MCU; after that money was expended she would then qualify for Medicaid and could likely stay there.
When I explained she didn't have $250K, the admin handed me a business card of a "Medicaid Consultant", and suggested I give her a call. So I did -- and that was a complete eye-opener. The consultant, for a fee of about $1500, was *invaluable*, and got all the paperwork submitted and approved for us. She had formerly worked for the state in the Medicaid section and knew the ins and outs. Without her, I would have had a more difficult time getting additional care for my mom which was very helpful, and proved instrumental in getting her into an assisted living facility *3 weeks* before Covid shut them all down. If not for that, my wife and I would have been at our wits end, as my mom was becoming increasingly difficult to care for and it stressed our relationship (my mom always referred to my wife as her "daughter-in-love", so it was emotionally challenging for her to provide personal hygiene.)
She even let me know about the "Child Caregiver Exemption", which was extremely helpful -- I had no idea of its existence.
It was money well-spent.
We should compare notes Doug.
I'm not talking about retirement homes. I'm talking about hospice care. It is covered 100%.
"HospiceI"is no longer the "last 2 weeks" of Life: Services are provided over many months now -- over 6 months to a family member with Home Delivery of Prescriptions Meds & daily nurse visits who diaries meds & may other tasks.
Up to 2 years.
Longer than that in our case.
Healthcare should be a non-profit industry, with good wages, strong organizational principles, and nurturing of a caring work culture for all.
YES! My wife heartily agrees. She was an RN and worked her way up to become manager of the case management dept for Blue Cross (then a non-profit.) and they even helped put her through an MBA program. But HMOs were becoming the norm, and she had no HMO experience. So 3 months after she got her degree, she was laid off. She then went to work for another non-profit, which happened to be an HMO, and in a similar position in case management.
Well, BC/BS bought the HMO so they'd have that component, and was laid off again (twice within 11 months) due to "staffing redundancies". BC/BS then became for-profit.
Yes, she remains angry that she was treated that way, but she is more angry that BCBS put profits ahead of care.
And regular, independent monitoring if compliance with standards.
As a capitalist, I strongly believe that healthcare in its many forms should not be motivated by profit. Capitalism only works when it is regulated and wealth is redistributed. Facts that conservatives are ignorant of or refuse to recognize.
They prefer "crony capitalism" Harvey. Solutions have abounded; will however, not so much.
Biden/Harris admin is trying to address some of this (and probably not going as far as they’d like to), but is getting intense push-back from all the “cronies” that reject the solutions.
Agreed. The commodification of nursing home care, and healthcare in general, has proved disastrous to patients and workers alike. The real nursing shortage is the shortage of good nursing jobs. This is largely because healthcare policy at many institutions is set by MBAs, not healthcare professionals.
There IS a lack of nurses. Many left the profession after the horrors of COVID. Many just got fed up with being expected to work rotating shifts (this means working a combination of 1st, 2nd, and/or 3rd shift hours in any given week). The bottle neck in the system is the lack of qualified, well supported nursing instructors training the next generation of nurses. I looked into becoming a nursing instructor and discovered I could be liable for the mistakes of my students (that's why they're students - they're SUPPOSED to make mistakes, it's how we learn). Most schools will cover you for MOST things, but not everything. Also, becoming an instructor would have come with a pretty hefty reduction in pay. It seems nursing education has become commodified as well.
Steve, you have hit the nail on the head! Commodification of healthcare in general as a for-profit undertaking doesn't serve it well. It mostly serves the entrepreneur types who see a way to squeeze a few more bucks out of federal and state governments, squeeze more out of OUR taxes. This happened in spades with commodification of mental healthcare to such a point that few if any providers will accept all the intrusions into treatment by the for-profit intermediaries who have to pay their executives and advertising and administrative fees out of the basic amount provided by the feds. As a result we have ended up with the mental "healthcare crisis" we currently face.
I have a chronic, complex disease. I was able to find specialist who actually understood and treated such patients. But both are private pay, and do not accept insurance. Why? Insurance is the godlike overseer of healthcare - specifying the amount of time for an office visit (usually 15 minutes), the lab tests doctors can order and the medications that are covered. Both of these brilliant doctors (who literally saved my life) spend 1-2 hours with me, order lab tests that insurance-paid physicians have never heard of, and prescribe both special diets and a “cocktail “ of meds and supplements. One charges $350/hour and the other gives me his lowest rate ($650/hour). How many people with complicated, undiagnosed conditions can afford the best? And why does insurance set intolerable conditions for paying for high quality medical care? (Well, of course I know the answer: It’s The Profits, Stupid!)
I've been around awhile and have had jobs that did direct business with the government. Long before hedge fund sum, scammers were always setting up companies to enter into contracts with the government so they could rip it off. And of course most of the owners I met were future MAGA types that hated the government.
I refer to them as the "rape and pillage" crowd. I worked on air in radio for over 20 years back when there were Mom & Pop companies that owned groups of local radio stations. Then the venture capitalist came to town.
They saw them as easy pickens and a quick way to make some cash. They would buy the stations, go into them, reduce staff to the bare minimum to get by and then remove from the properties anything they could sell. That's how all the radio stations got consolidated under just a couple of companies. Everything was managed from a central location and the "local" was stripped out of all the local stations. And they homogenized what we heard and promoted the likes of Rush and company across the country.
What a great name for them. That has sure happened in my neck of the woods.
I see all of my friends (I'm 66, these friends are roughly my age) posting things like "do you remember waiting for THAT SONG to come on the radio, and recording it on a cassette?" One of the things we have lost with our advances in audio music options is all of us listening to mostly the same music; it has depleted one of our "common bonds".
I saw it all happen in real time. It used to be the local program director “programmed” the music. It kinda matched what was being played elsewhere but driven by local buying of “records”. That changed when they could literally “program” what you hear because it could be driven by internet connections into each “local” station. They didn’t need the local personalities because the same guy doing a show in a bigger market could be piped into the smaller markets. They make more money, employ fewer people with more control over what people hear.
Sigh. I loved being the wiseass woman who didn’t let the guy I worked with get away with giving voice to things that were stupid. We were live and people heard it in real time what was going on. I was venture capitalized off the air, (people wanted to listen to male voices I was told (don’t get me started)). Twenty five years later I’m better off, better paid, have more benefits and have money in the bank for my retirement. Loved being the wiseass though….
Donna, I’m fast approaching 75 and I love be an “old wiseass”!
I will join you in that decade in July. Where the hell did all those years go?
Ally, I now have my truck radio tuned to the NPR radio station out of Ashland—Jefferson radio. KHSU used to be my go-to until the Univ admin gutted the very popular station (wonderful, quirky programming & personalities) a number of years ago…it’s now mostly a canned program-feed out of Chico State. Don’t know of anyone who listens to it anymore; was a real loss to the community.
I listen to JPR when I’m in the Rogue Vally. KSOR was the college radio station (at then SOSC).
And that’s exactly what those vultures are doing to healthcare!
At least insofar as they substantially harm individuals and the common good. That's one of the main things a public centered (of, by, for) government is there for, no?
In the middle of this nightmare now the for profit ‘assisted’ living facility has consumed my mothers considerable savings, the inadequately staffed facility requires my family to be there daily. At $10k a month for 3 years. My mother now requires more care and only for profit more advanced (nursing) care will serve her needs. Only for profit nursing homes exist in her area. Requiring more staff without raising medicaid funding only makes this more impossible.
Here in NH, we have County run nursing homes in addition to for-profit facilities. I worked as an RN/Supervisor in a county nursing home for 35 years. What had been a a job choice turned out to have a hidden benefiit-being a county run facility, I have a real and truly state sponsored Pension! In addition, the county offers a retirement enrollment for the equivalent of a "Medicare "Advantage" plan. Basically, nearly all my medical expenses are covered and the only things I need to pay for is my medication co-pays. We also are a very good nursing home. When I had my second knee replacement, I chose my own nursing home for my rehab stay. Today it's crazy-hip replacements are done as day surgery and access to rehab stay access is very limited-only if you're single and have no back up to help w/care. That was my situation in December when I had my hip replaced, so I was able to have 2 weeks of in facility rehab care.
Hedge funds also created the rental crisis by purchasing single family homes en mass and colluding to keep rents high. Their actions also jacked up home prices and took away first time buyer homes reducing home ownership.
One more thing, a must read from Mother Jones on how the minority is winning the war on who government benefits: https://www.motherjones.com/politics/2024/04/minority-rule-is-threatening-american-democracy-like-never-before/
Richard, you have directed us to a most useful if somewhat complicated and necessarily detailed history of our founding documents and beliefs from Mother Jones and how those beliefs from the 18th century have become amplified in the 21st century. You have done us a great service. One wonders what HCR's take on this history would be?
I think that HCR would concur, that the problem has been there all along, a cancer, growing as state by state was brought into the union with hardly any populations at all. HCR is a better student of American history than I am by far, yet this state of affairs, particularly the disparity in representation in the U.S. Senate along with the filibuster, have had me full of concern for decades.
Thanks for the link. It is exceptionally jarring and adds much to the weight of this year’s election.
Hedge fund investors poison everything they touch. They’ve decimated the housing market in Florida, outbidding homebuyers, driving up housing prices, then raising rents. They do little maintenance and quickly evict anyone who is late paying rent or complains about needed repairs. Renters put up with it because there is so little inventory to choose from.
Yes, TC they need to be outlawed. The trickle down/supply side economic theory is greed disguised as policy.
Diane, I’ve long thought the whole “trickle down” economic theory was really a “piss on ‘em” one instead!
Once again, nail on head.
Thank you sir, I love my new subscribers! :-)
During my late wife's last 15 months here, we were able to take advantage of home hospice services. She was able to stay at home and the hospice sent an RN once a week to check on her, and three different LVNs/home care workers to bathe her and change her, and to take care of her other needs. That hospice was well-run and the care was excellent. We were able to get it when a county social worker (sicced on us by her worthless damn sisters) saw I was in overwhelm and recommended the place to us since she knew the operation. All paid by her MediCare. But there are certainly places (Yelp is real good on pointing out the bad ones) where the money is obviously being sucked up by the hedgefundscum who are looting the system.
In early summer, 2020 an aide at the Deer Isle, Maine nursing home returned from visiting friends. For whatever reason, she infected many of the forty some patients with Covid-19 and 12 of them died. The nursing home closed their doors in September, 2020 and never reopened.
Five towns provided support to this nursing home before the pandemicic to insure a minimum number of beds would be available for their residents. In spite of multiple efforts to reopen the facility they have never been able to reopen.
This story is not unique to Deer Isle or Maine. It has happened all over the country and is still happening as HCR points out.
DJT and the Republicans ask us time and again if life was better 4 years ago than now. Maybe for Warren Buffett, Bill Gates, Elon Musk, Jeff Bezos and the other uber rich, but with 22 million unemployed, the price of oil going negative, the unemployment rate at 14% and people dying of Covid-19 by the dozens every day. Yeah what a great time we were all having then.
Many of you are caregivers for one or more people. Most of you are not paid for your hard work and care you provide. You cannot hold another job because being a caregiver is 24/7/365 in many cases. Here are some statistics regarding caregivers-
Caregivers: A Snapshot
58% of caregivers are women.
Almost one-third of caregivers provide care at least 20 hours a week.
Caregivers typically learn as they go and aren’t formally trained.
79% of caregivers care for adults aged 50 or older, and 76% of care recipients are aged 65 years and older.
One in 6 non-caregivers expects to become a caregiver within two years.
Increasing Demand for Caregivers
The need for caregivers is growing along with the aging of the US population. The number of caregivers increased from 43.5 million in 2015 to about 53 million in 2020, or more than 1 in 5 Americans.3 By 2030, an estimated 73 million people in the United States will be 65 years or older.4 Many will require daily assistance from at least one caregiver to maintain quality of life, independence, and physical and social well-being. More than two-thirds of the US population will likely need help with tasks at some point in their lifetime.
https://www.cdc.gov/aging/publications/features/supporting-caregivers.htm
Does anyone think that Don Snoreleone or most Republicans gives a rip about any of these caregivers or their patients?
I don't think Republicans care about anything but making the rich richer.
Susan, They also care about imposing their interpretation of the Bible on everyone else.
I feel the same way.
Gary, a (nearly) similar thing happened to a small (32 bed) not-forprofit facility that my late mom was in from Feb '20 to Mar '22 -- in other words, spanning the worst of Covid. They managed to keep Covid out for about 18 months, but the inevitable happened. It affected staff, as absences and people quitting severely strained the facility. The exec admin, the exec director and the head nurse all left within a year or so, not to mention aides, etc. There were rumors the facility would close. Fortunately the head nurse, before she left, made it her mission to get my mom transferred to a larger facility, even jumping the lengthy wait list (and my mom was Medicaid.)
I believe the facility is still open, though.
As to your last point, another aspect of caregivers is that they are frequently recent immigrants, a population that MAGA would as soon deport or not allow in. It makes no sense.
Immigrants do so many jobs across the spectrum and usually for wages that most Americans would never consider.
I hadn't considered the caregiver aspect. My Doctor in FL was an immigrant from Columbia. She saved my life one morning when I had blood clots throughout my lungs.
She was one of the few bi-lingual doctors in Jacksonville even though there is a large Spanish population there.
At times I felt guilty for taking a slot that a Spanish speaking person could have filled. But, I just couldn't quit her.
I'm glad you were able to connect to good services, but I know that can be a challenge when you have other pressing needs. I remember the Biden campaign floating these policies back in 2020 and thinking what a good idea it was, because I am of an age where friends are in need of nursing care and I and my partner could be as well. I had to drop long term care insurance when I lost my job since it was prohibitive.
Well, with these rules from the Biden Administration, you should be able to feel good about going to a full-Medicare facility if the time comes.
Only if the States monitor and enforce care standards. The horrendous care my father received despite the facility’s bragging about their deficiency-free state survey certainly proves that!
TCinLA -- The only reason your wife was covered was probably that her medical provider prescribed "skilled nursing care" under Part A. https://www.medicare.gov/what-medicare-covers/what-part-a-covers
Most people in nursing homes do not get that kind of care.
I'm sure the doctor at @#$#@!! Kaiser (if that place is America's #1 private health care, we're in trouble; every time I had to deal with them, I walked out and said "thank god I have the VA!") would have signed anything to get her off their records since she dragged their "success rate" down. Mostly due to things not done for her by them.
OMG, so true. My sister worked for Kaiser fora few years as a case manager. They encouraged her to move onto other “opportunities” because she approved too many claims. And this was over a decade ago.
In the late 90s, when my sister and I were searching for a nursing home for my dad, we chose the first one that did not smell like urine when we walked in (it was the 7th or 8th one we visited). It worked out very well.
In our county of over 50,000 full time residents there aren't 7 or 8 choices of nursing home.
That is a good initial indicator of quality.
I did the same for my parents, and you’re right, it took many visits to find one.
My mother ended up in a care facility the last 8 months of her long life. At the beginning of her stay, there was enough staff. Then management changed and staffing cuts were made. Towards the end, she couldn’t get staff to move her to the bathroom- multiple calls for help. And, she contracted a cold which turned into pneumonia which she died from. All at 10,000.00 per month. I still am awestruck by the cost and lack of care in the last 60 days of her life.
I am so sorry. My Mom died in a nursing home because her doctor would not put her on hospice. She had emphysema from a lifetime of smoking, and had contracted pneumonia, cracking her sacrum from coughing. She was in hospital for about a week before discharge. That conversation with my sister, me, and my wife present went like this: I asked about hospice care. Doc said "If she works hard, she can get back to where she was before pneumonia.". After this conversation with the doc, we went to the coffee shop to discuss it. My sister (she, her son, and my mom were all living together in a rental house) said "How am I going to do that? I work 40 hours a week, and I can't be there all the time." My wife and I told her that we would support her, and that we were pretty sure we could get her into a nursing home until she "got her strength back" which was code for "regained some semblance of consciousness and coherence." We ended up placing her in a Medicare home just down the street from where my sister lived. She spent about a month there before she died; I think during that time she was "herself" for about 3 days.
On our way home from Medford, I said something to the effect of: Lets see, if she works hard she can get back to: waking up, getting up, and going to the bathroom. It will take 10 minutes unless she loses bladder control, then it will take 20. She can go into the breakfast nook (the only room they could keep warm enough for her, in their cinder block house in February) and read the paper using a magnifying glass with a halogen bulb to illuminate the page. My wife said "I've known your Mom for 20 years. I have never seen her work "hard" at anything."
The care she got was good, and the staff was very attentive. The nurse on duty the night she died came in for her swing shift, checked on Mom and told me "She's real close. Have your sister come in." My sister got the time off from work, and we were there together most of the day. At about 7:30 she left to go get something to eat, and told me there was a show she wanted to watch at 8. At about 8:20, Mom started agonal breathing, and at 8:30 I called my sister. Mom died at 8:42, and my sister got there at about 8:55. Two things about this paragraph: My wife and I saw the nurse at an Indigo Girls concert that summer, and she remembered us and asked how we were doing. My sister, to this day, regrets that the TV show was more important. The show?" "The Apprentice".
Oh Ally, what a story. Ironically, how telling.
Salud, friend.
🗽💜
Thank you.
Oh, Ally, my heart breaks at this story.
😢💔
I am so sorry to hear of your wife’s challenges and passing. I speak from a similar experience, so I know the multiple responsibilities of caring for someone so dear, navigating a care system, all the while of facing the daily grieving of someone in hospice (and the worthless sibling thing, too). Our society should step up in a bigger way to support our fellow humans who require extraordinary. Yet, as you note, there is profound greed in our society that needs to be called out and addressed. I’m not a big fan of shame, but a heap of it should be shoveled it on those who hoard money and power in an attempt to fill their empty souls.
TC, I'm glad you found your way to home hospice, even if it was a rotten reason. I've had experience with that kind of care for my mother-in-law and another dear friend and I can't say enough about the kind of care they provide. Makes the terrible situation so much better for everyone. I'm sorry for the loss of your wife.
My Dad, my Mother-in-Law, and her brother, my Uncle Chuck all died on hospice. It is a godsend.
Thank you for sharing.
Big, projectile sigh of relief..! Aid to Ukraine has passed both houses and is receiving the President's signature, finally. Nothing, but nothing, was gained by 6 months of delay. Correction, nothing for Americans, less than nothing for Ukraine. Perhaps, just maybe, a little more proactive engagement by NATO allies was achieved in separately pledging support and war materials to Ukraine to partly fill the gap created by the abdication of international obligations by the Repuglican caucus in the House. That is poor compensation for thousands of lost lives, widespread dispair and demoralization of a war-fatigued Ukrainian military and volunteer civilian corps supporting the war. I'm relieved, but also ashamed for my country. We can and should do better.
Well said, JS. I so agree with you.
Morning, Lynell, and I agree with JS too.
Morning, Ally! It's up to us to make sure we do better. I'm onboard with that.
Just Sayin', that is profound. We can and should do better.
This is how we bring back the Middle Class. Now let’s make sure the voters know. The media as a whole are not helping so it is up to people like Heather Cox Richardson to do their job for them.
The voters need to know what's happened to the middle class in Reaanomics' wake. And why.
JL, I have been jousting with my MNJ friends about this. To date, none of them "believe" my statistics etc. and only keep posting ridiculous memes.
Yes, I agree, the media barelly mentions all of what Biden/Harris are doing to benefit our country, often filling theirr shows with tfg's antics or other fluff or showcasing polls favoring tfg. So its not a suprise that so few realize what Biden has done for the environment, or so many other things. I hope they will finally start showcasing his accomplishments more, so the public will be better able to make iinformed votes for Biden in November!
The voters must be informed somehow. But when the MSM is obsessed with Trump 24/7, what are we to do?
Turn yourself into a media outlet. The DNC has a program, "Social Ambassador" https://democrats.org/share/
Likewise FT6 has Social Storm: Spread messages to help register Democrats, protect voting rights and more using social media!
https://share.fieldteam6.org/campaign/F6DDBE84-04F4-4C96-A5FA-7E22A07FEDDB
I just hope people are paying attention. The direct attack on fascist minority state governments' ability to demand women's health information to support their draconian anti-choice legislation is very welcome, and a sign I hope that the Biden administration will vigorously fight Red States overstepping their authority.
Women's health care has always been second fiddle to men's. There was a story on BBC radio this morning about the difference between heart disease and their diagnosis and treatment between men and women.
If a women is having heart attack symptoms it takes up to 7 1/2 hours to be treated for the heart attack and less than half as long for men. There are many reasons for this including the difference between plaque build-up in men and women, but the point remains. Women's health care is still secondary to men's in the US.
In the past, all the research that defines "normal" was done on men. Studies of medications, illnesses, treatment plans, etc. are based on men. Seatbelt positioning in vehicles is designed for male bodies.
Ally, some months ago amidst a rainstorm, I attended a pro-choice rally in front of the courthouse in Eureka (sparsely attended due to the rain…most were women from before the Roe v Wade times). There was a counter-protest including a priest carrying a large cross—we talked about our opposing views & he made a comment that prompted me to inform him of just what you say. He was very surprised & had no idea….I told him “dude, you need to get out more & expand your horizons of knowledge”.
I thought I would include this link to clarify just a bit as far as the privacy move the administration is going to put in place or try to. No doubt it will be challenged.
https://youtu.be/-kM5PVxHCEM?si=17MivygjARsegYQX
Great the number of positives that Heather sees and champions here today.
The largest batch begins the piece -- the Biden administration's effort to improve health and nursing home care, where insufficient workers and other poor conditions prevail.
The next batch isn't any batch of positives, but of areas where Americans are too unaware of practical steps being taken by government to aid Americans. This of course could find redress in the coming season of campaigns if Dems would align their appearances with each other to enunciate and celebrate their good programs.
Penultimate batch of positives is Biden's stop in Florida, where he's underlining America's need to reverse the theocrat medievalists eager to kill the rights of U.S. women.
The last batch concerns, finally, passage of aid to Ukraine, and other places the U.S. can shore up democracy and its incurred costs.
Heather's on a roll here, and midway in she interrupts herself, or digresses from the positives to note how the orange demagogue feels frustrated by his lack of fans parading in the streets for him. Suck it up, Donald.
Quite a split screen. Biden-Harris achievements as Trump is forced to just sit there.
Sit there and scowl
Looking presidential.
He thinks he looks like Churchill when he does that. Boy, is he deluded.
My mom used to say “keep making that face & it will get stuck like that!”. Not sure what “look” he is going for, but whatever it is, it’s not working.
Surely doesn't resemble Churchill. I think I have heard that expression before. My Mom knew several that have stuck with me. One being - you're so hard headed, you have to learn everything the hard way. Think she knew me well.
Check this map for the deadly cost of Republican ignoring COVID experts. See how many people died from COVID in your community (thanks to data from the John Hopkins Medical Center).
https://arcg.is/1fWqPb
Why is grandma treated like dirt at the nursing home? Follow the money with this interactive chart.
https://thedemlabs.org/2023/12/26/private-equity-lenders-exploit-seniors-and-nursing-homes/
Gotta love that overlay of Fatal Incompetence. Although New York was not featured in the first piece, I watched day after day as refrigerated mobile morgues lined up for a trip to Mt. Sinai Morningside and returned to await another trip. I never got to say good-bye to my friend Betty, and neither could her family.
Amazing, progwoman, how those with the billions so hate everyone else.
But they don't see "others" as human -- just more numbers (it starts, by design, in K-12). And the numbers threaten them with needs, potential funding for humane programs -- the billionaires (see, lately, management at Boeing) in the U.S. would be happy were "the people" to be treated worse than serfs in Tsarist Russia, or oligarch Russia.
Following the news about the many unhoused people in our country gives me the chills.
I guess that's about as polite a spin as one can put on it, progwoman.
One needs to have gone to a school which by plan, program, and intention dehumanizes one. Starts with the standardized testing racket which created some billionaire families gutting all of U.S. K-12 -- eliminating all humanities in order to reduce all life to numbers.
Continues with today's version of higher ed, where all disappear into neutered siloes, along with placement in group identity zones -- where corporate HR assigns trigger warnings, lest any in any in any orthodox-approved label ever feel personally challenged by anything.
To live in, support, serve, and be blind to what the billionaires are doing requires total desensitivization, progwoman. Total anesthetization.
That you still hold some human feelings (of revolt? disgust? shame?) at a society ruled this way puts you in the position of that one person who escaped that one small town in northern California in "Invasion of the Body Snatchers."
One of the biggest Trump Covid-19 fuck-ups was to not restrict international flights as soon as they knew of the dangers of the pandemic, which would have been around 1/1/2020. Instead, JFK allowed international flights from Italy without testing where the pandemic was raging, until the hospitals in NYC were overrun.
Of course, this was just one of their huge mistakes but thousands of people died because of this including hospital personnel.
So sorry, progwoman. That’s a hurt that lingers. ❤️
Yes, but her early death—before rapid tests and readily available masks and ppe— was a warning to her many friends that Covid was something to be taken seriously.
Thanks, Deepak. This really shows who controls things at nursing homes and it’s all about screwing the elderly and the government. Lots of elder abuse!
Great point Deepak. It's easy to lose sight of how our own communities were affected when the numbers roll into overall US deaths from Covid-19.
And thanks for the link to the interactive chart.
Thank you Dr Richardson for writing about the Biden-Harris new rules for healthcare services, Medicare accountability, overtime pay, HIPPA and climate change. I watch MSNBC and did not know of these B/H wins for the middle class. This is a shout out to the Democratic establishment to promulgate these achievements in plain English for all to see and hear and recognize !
Here is a letter to an editor who refuses to publish it.
Don't Slit Your Own Throat
As of 2020, 3,273 Lawrence County residents received SSI. I’m sure more do now. When I was calling for Biden in 2020 I found that some people didn't know they were eligible. The Republicans have tried to kill it. It's ironic that some on SSI slit their own throats.
About 20% of the general population needs a hand-up. I'm so old I remember when there was little hope -- before SSI came to the rescue in 1973. SSI gives people a chance to survive. Before age 65, it's limited to families who qualify economically and usually due to "disability" as that term is defined in the Social Security Act. The money comes from the general funds of the US, not from the two Social Security trust funds. Anyone over the age of 65 now qualifies if they are destitute and can show that have some kind of legal status.
Every dime an SSI beneficiary gets proves that John Maynard Keynes was right -- they must spend it -- causing a positive ripple effect. “Demand creates its own supply.” Those benefits go into the hands of practically every business in the county.
Dan Solomon
Sadly, SSI is not enough for disabled folks to stay housed. There is not one county in the US where a single adult can rent a one-bedroom apartment and pay no more than 30% of that income. The average SSI payment is $698/month. And the average rent for a one bedroom apartment in my city (St Paul, Minnesota) is $951/month. Only one low-income person in four who is eligible for a rent subsidy will ever get one.
To someone who has nothing, it is a godsend. I guess you miss the irony. In my hometown these recipients voted for Trump X 2.
And to the landlord, the grocer, etc, it's their income source.
It’s better than nothing. But not good enough for the recipients who are increasingly numbered among those experiencing homelessness.
They can get HUD chits for housing. Under HUD rules their rent can be subsidized and the most they can be charged is 25% of income.
Depends on location, location, location for many recipients. SSI is portable within the US. No SSI in Puerto Rico, so millions of PRs live in the states.
In my home town, many SSI recipients pay less than $100 per month in rent out of pocket. The landlords get the subsidy. The grocers are paid in food stamps.
IMHO entire red states are subsidized in this way. They vote against their own interests.
Only one person in four who qualifies (by income, etc) for a HUD rent subsidy will ever receive one. Waiting lists are years long or closed due to the number of people on those lists. Neither Party seems to have the balls to propose full funding for HUD subsidies but that is really the only solution for many people to achieve stable housing.
The waiting list for HUD rentals is prohibitively long in many, many cities.
Wins for the poorest Americans as well.
A quick scan of this morning’s NY Times on-line headlines revealed a story on the new FTC non-compete rules, and no mention of the other new healthcare rules cited by HCR
Biden and the Democrats indeed have some PR work to do.
What’s up with the NYT? Such abbreviated coverage!
We have a conundrum, how to care for our elderly in the declining years of their life, and staff care facilities sufficiently well that patients and clients are well care for, and that the caretakers earn a living wage while doing so. Increasingly, the cost of long-term care is outstripping the ability of working people to save enough, and to invest enough, to be able to afford the care that they need as they get older. People are living longer, there are no economies of scale, and we are relying increasingly on recent immigrants to undertake the tasks of becoming care givers.
I am 81 and am hoping more elderly people come to terms with approaching death by choosing the time and manner of their passing in order to do so with dignity and avoid the pain, humiliation, and expense of hanging on for...what??? In future I am hoping this strategy will become legal for anyone who cares to take that route.
The father of my children was dying of a terribly invasive cancer in 2022, and even though CA has a "compassionate death with dignity" type of law, by the time he was able to complete the exams and find another physician to co-sign and then sign the many, many docs himself (with a few cups of coffee administered through his Gtube to overcome the morphine dose his hospice nurser of the day had pumped him with without asking), and then the 3 day wait to pick up the med packet for the cocktail, it was too late. He was no longer capable of administering the "cocktail" himself. So we had to watch as he was "humanely" starved for a few days, with a controlled morphine pump. Horrible. My sons, 17 and 20, had to endure that. Let's do better.
Thank you for sharing the details so we all can be realistic about the potential snafus. Looking up the forms for medical directives in your state helps prepare for the decisions that can guide what happens later on. They go by acronyms like MOLST, POLST, COLST. All these can help our thinking but uncertainties lie ahead for most of us.
A heartbreaking story. One that likely still haunts you. I’m sorry for him - and for you.
Compassion and Choices advocates for humane end-of-life care, and I know of someone who recently moved to Vermont to take advantage of that.
In the states that allow medical aid in dying (I haven't researched each) it might be standard that two medical doctors need to sign off that the person has a disease prognosis of living for six months and that they are mentally capable. The patient needs to be able to swallow and self-administer the cocktail. It's helpful to become acquainted with natural decline when people voluntarily decide to stop eating and drinking (VSED). This entire post is difficult to face because we don't have good solutions to graceful aging and for the most part, we don't value the contributions of elders -- all related to housing generally. Business interests aren't doing the innovative models that are possible when multi-generational communities are designed for all to thrive.
Oregon has a "Death With Dignity" law. I only know a few people who have taken that path. What it does not cover is dementia patients the way Sweden does. I had a dear friend that I played music with who, when she got dementia, was able to travel to Sweden with her wife and their lifelong friend, and leave on her own terms. I have another musician friend that I know from my college days whose father chose his own death. A third friend's mother, who was a local activist, chose VSED to depart. That element of control in one's own death is, I think, crucial.
Thanks for the pointer--I'll look into Sweden's way of dealing with dementia. Compassion and Choices has an advanced directive that includes dementia but I haven't thought about it. I was privileged to be with a close cousin at Calvary Hospice in the Bronx NY -- historically a leader with end-of-life care and it was so well managed and patients were so caringly tended. No assistance in the form of cocktails was allowed there and food was brought at every meal but if patients didn't touch it there was no encouragement.
I misspoke on the country. Belgium, Luxembourg, and The Netherlands all have that option.
A friend of mine died recently in a care facility. She was on the locked memory care unit - which was staffed 100% by African immigrants. They provided the most conscientious, attentive, loving care I have ever seen in any nursing home. They really valued their elderly patients. We should all be so lucky - and need more of these saintly caregivers.
We are one of the few countries (or maybe the only one) that does not value and respect their elderly. And as someone mentioned “care givers” barely make a living wage and usually work two jobs. Tell me this…how does one find the compassion, empathy and respect to care for the elderly when the care giver is struggling to find the energy to give to others. Each of us only gets a spoonful of energy each day and we have to spread that spoonful throughout the day. When the spoon is empty—-it is empty.
The
Same with my husband. But most worked two jobs
We can substantially contain costs by regulating private equity so that it doesn’t hollow out services to enrich investors. And we can do even better by enacting Medicare for All. BTW, the recent immigrants who become care givers show how a sound immigration policy helps our economy, contrary to MAGA claims that immigration is ruining our country.
You're conflating apples with oranges. We tax private equity to raise money to pay for social services, among other things. That's a question of tax fairness. How the money is spent is a different question, involving issues of affordability and the overall fairness of the way a particular industry operates. It's more than simply Medicaid.
Great news Dr. Richardson, It's been a long time coming but the sun is shining on America once again, Now trump could do everyone a huge favor and have a massive, fatal heart attack.
Don't forget Alito and Thomas in your wishful thinking.
They've done enough damage during their time on the court.
My husband has said that he doesn’t wish Trumpf death he wishes him a stroke which leaves him voiceless in a inadequately poorly ventilated nursing home for 4 years as was his dear grandmothers fate.
Heart breaker.
I’m going to frame the award you get for best comment of the day. Would you like 14 caret gold trim around the framing surround?
Thank you LOL!!!
That wouldn't help us now. There could just be another younger, slick repug with more charisma and intelligence who could beat our chances of winning across the board in 2024, yet have the same bad intentions.
One of the best gifts to myself was to get a subscription to the writings of Dr. Heather Cox Richardson on Substack.
Thank you, Dr. Richardson, for all that you write.
"we stand resolutely for democracy and freedom, and against tyranny and oppression.”
This rings hollow for me. I, like Biden, have blindly supported Israel all my life. This was due to the holocaust, and my age. Israel was only 12 years old when I was born.
But my unquestioning support of a Jewish homeland, at last, was also because I was raised in an Irish and Italian Catholic town, run by White Protestants, but I somehow surrounded ended up with only Jewish friends. (There was one black friend, for a moment, before the locals somehow ran her family off my street.)
One best friend was from the south side of the tracks (a little nicer) and the other 2 live on the cul de sac where All the other Jews lived. Cindy, Michelle and Pam were my do or dies. I was invited for Passover and for seder, and political discussions around the table, and my favorite snacks (dingdongs and TandyCakes) were kept in their bread drawers for me. I was also introduced to the wonderful, bohemian artist and inventor life, and freedom of thought.
Since my own parents were ex-Catholics who sent us to catechism just to inoculate us against the Power of the Church, this makes sense. I was a free thinker. Don't ever underestimate the intellectual life of a child.
Mea culpa.
I never applied the same skepticism to the theocratic concept of Zionism. I celebrated Israel as a manifestation of justice vs persecution. In 8 million ways, it is. My friends were Reform, if they practiced religion at all. I knew this. I was drawn to their freedom to Question the Torah.
My sister and I had both been thrown out of catechism just for asking "awkward" questions like "why can't priests get married" and "why do babies who never heard of the holy spirit have to suffer in purgatory?"
When my friend Michelle invited me to her reform synagogue I actually believed, in spite of my inoculation, that I might be struck by lightning. I am not exaggerating. This was 1969. Michelle wasn't nervous about being struck down. She was just shy and didn't want anyone to notice. We were both exploring. We were gently poking at the boundaries.
Today, I am afraid to poke at all. I have written and deleted so many emails to journalists, comments on ig. But I am afraid to actually hit send. Not because the MAGAns might come after me, and my family, and my business. Because yes, I have swallowed the frog since 2016 because of that fear.
No, sadly, now I am afraid of the "ironclad supporters" of Israel.
I am crying as I write this.
I demonstrated "in the quad" for divestment from South Africa. I am with the kids on the lawn. I am with the Jewish Voices For Peace students.
Bibi is the Trump of Israel. I am so sad that Israel's "democracy" has not risen against him.
Yet look at us? US. Bibi knows we're up against the rails.
We Must support Biden against Project 2025 (aka Fascism)
at any cost?
Truly I am crying as I write this. And I communicate that to him, and Dr. Jill, and VP, and many, many Democrats every day.
I am With those students in the quads. I remain #uncommitted
I understand your pain. I learned about the Holocaust at age 11 (or 12?) and have been fiercely pro-Israel every since. But Netanyahu is no more the voice of Jews than Trump is the voice of America. I cry, too, about what is being done in Israel’s name. And as someone who has volunteered to resettle war refugees who lost their lands, their country and their friends/family due to religious persecution, I can hardly bear to watch what is happening to innocent civilians.
So many parallels to my life as a young Protestant on his way to agnosticism - as a kid who was stunned by the stories Catholic girls told me - as one who grew up around Jews and admired their intelligence and success - horrified beyond words by their eons of persecution.
And now...Bibi betrays his people with his brutal "solution". Yet, it is so very complicated. As a commenter said yesterday: "Why aren't they protesting October 7th?".
I do think we must support Biden against Project 2025 - as a concept so horrific as to be the core issue of November 5, 2024. That and the theft of reproductive rights...how can we not vote Blue from the top of the ticket all the way down?
I sympathize with your disillusionment. But we can only do so much with regards to Israel and Gaza. Biden does not have direct control over Netanyahu. And if we stopped providing support for Israel, Iran and its proxies - Hamas, Hezbollah and the Houthis will have the upper hand in the effort to completely eliminate Jews from their lands. THAT, as you know, is their only platform, their only goal. And they are willing to sacrifice their own families in the process.
Biden might not be hard enough on Netanyahu, but there is no reason to believe any other Democratic President would do better; there's only so much a President can do to alter long standing U.S. policy. On the other hand, a Republican President, especially Trump, would actively support Netanyahu. People should definitely make their displeasure known, but we can't lose sight of the fact that if Biden doesn't win it will get worse on not just the Israel issue but pretty much any issue you could name.
Bibi is the chump of Israel, says it all. I will never be uncommitted.
Sister Alfreda told our class of second graders that we would be struck down dead if we had a mortal sin on our soul when we recieved communion. I remember being terrified of committing adultery, whatever that was.
David Pecker did not testify for the prosecution. He was called to testify by the prosecution. Legally speaking, there is no such thing as a prosecution or defense witness. They are simply witnesses. Oftentimes, they are reluctant witnesses or they feign reluctance.
I want to underscore the need for Biden to get out the message about his accomplishments and goals in the climate change arena
yes. because all most people (esp the young) remember is Willow and at LOT of offshore drilling leases.
Oh, and record breaking US oil production.
But I agree. The DEMS Suck at getting the message out. It's as if their entire marketing and PR team has been infiltrated by the Putin bots.
But it's also because the only real journalism left standing after Google's takeover of the Ad market is being out-clicked. By the nature of social media and dopamine, and the kleptocracy.
Patrice,
It's also that what Biden and the democrats are doing is governing, which is not sexy and attention grabbing. Trump and his cohorts saying outrageous lies is attention getting.