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May 24, 2013
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 A Calamity in the MakingPosted on Feb 22, 2010
A major reason for enacting health reform is the fate of elderly and disabled patients—especially the indigent—in nursing homes and assisted-care facilities. Except for the visits of relatives and thoughtful friends, they’re out of sight, out of mind, all but ignored by politicians and media tuning up for President Barack Obama’s health care summit Feb. 25. But nobody is affected more by the confluence of the health care stalemate and the recession than these patients. Care for roughly two-thirds of the almost 2 million in these facilities is paid for by Medicaid, the federal and state government aid program for those with low or no income. The stalemated health reform bill would extend Medicaid to cover more people. Another provision would create a federal long-term health insurance for the disabled, with benefits of $50 to $100 a day. Meanwhile, many states, their revenues reduced by the recession, are cutting Medicaid, ripping into services provided by nursing homes and assisted-care facilities. The New York Times reported that Nevada’s Republican Gov. Jim Gibbons has proposed ending Medicaid coverage for adult day care, eyeglasses, hearing aids and dentures and limiting the number of diapers provided monthly to incontinent adults to 186, down from the present 300. My attention turned to these people because of my friend Gary Guthman, who works with Sal Rosselli, the charismatic president of the National Union of Healthcare Workers. Rosselli and his allies formed the union after he was removed from his California leadership post in the Service Employees International Union, the big union headed by the dynamic Andy Stern, a major power in the Democratic Party and national politics. Advertisement Guthman had urged me to write about the dispute between Rosselli and Stern. My first response was that it was a union beef of interest only to members and management. Guthman persisted, and I finally decided to interview Rosselli. We met in a union office building located amid the crowded apartment houses of the dense Latino neighborhood west of downtown Los Angeles. How would this fight over which union represents the health care workers affect a patient in a nursing home? I asked. Why should patients “care whether you or Andy Stern win?” Rosselli, who had helped build the SEIU’s largest health care local in California before breaking with Stern, said that “with the corporatization of health care in the mid-’90s, the priorities of our members changed from the traditional wages and benefits to having a real voice in how care is given. … [They saw] huge cutbacks in staffing. In nursing homes, where a nurse’s aide does the primary care, feeding, bathing, getting people up, on a day shift where it was normal to have six patients and on the p.m. shift 12 patients, they changed the day shift to having 10 or 12, on the night shift 30 patients.” The aides are paid $10 to $12 an hour. “We see unionized health care workers are the last line of defense against employers making decisions based on profit as opposed to adequate care because unionized health care workers have a union to stand behind them when they blow the whistle on an employer,” Rosselli said. Stern’s SEIU can’t be trusted with the workers’ welfare, he said. The SEIU has made sweetheart deals with national health care chains, getting their permission to launch organizing campaigns in some hospitals in return for agreeing not to strike and or advocate for patients. I asked Steve Trossman, the SEIU’s California spokesman, about what Rosselli had said. “If you tell a series of lies enough, people will start to believe,” Trossman said. He said that in facilities organized by the SEIU, staff members and management meet to discuss how to improve quality of care, staffing, supplies and “other issues that have an impact on patient care” and “members are encouraged to report any threat to patients.” No matter which side wins, the drive to unionize the health care workers deserves our full support. Care workers should be well paid. Enough nurse’s aides should be working the floors. But this is just part of the process of assuring adequate care for their patients. Washington’s help is badly needed. The number of aged is growing. A high percentage of the elderly and the disabled is likely to wind up in nursing homes or assisted-living facilities or become recipients of home care. It’s a calamity in the making. As Howard Gleckman wrote in the Kaiser Health News website last October, “we are desperately unprepared for the costly medical and long-term care we are likely to need in old age.” He said that “[t]he annual cost of a nursing home stay is nearly $80,000 and can easily be more. The average cost of a home health aide is nearly $20 an hour. … About 20 per cent are expected to require care for five years or more.” This is the cruel future that faces our parents, relatives, friends—and us. Such a fate is a powerful argument for President Obama and a recalcitrant Congress to hurry up and act on health reform.  TAGS:
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By anaman51, February 27, 2010 at 12:49 pm Link to this comment
I see a lot of wordy, complicated explanations for this situation. The simple truth is that most Americans don’t give a damn about other people, especially when their own lives continue to be unaffected. The aged, the disabled, the poor; these people simply do not matter to the general population. It’s as if they think they’ll live forever in a state of perfect health. They believe becoming old or disabled can’t happen to them.
Report thisBy chuckie2u, February 24, 2010 at 10:33 am Link to this comment
(Unregistered commenter)
Bottom line rules Government and Capitalistic Services and not the care of the elderly. Keeping alive individuals means a monthly paycheck for the institution as opposed to replacing one who has died. Passing the care around to fewer caregivers means less service at a lower wage and at a bigger profit.
Report thisThe Medical Caregiver Industry could be a large pool for employment if created as a non-profit organization with a desire to allow the AGING to Live longer. With the proposed MEDICARE cuts in HEALTCARE for those over the majic age of 65 and more of a push for the Young and Healthy will create the natural deaths desired by the government to cut their bottom line Healthcare costs and a cut back in Nursing Home and Assisted Living Industry.
By C.Curtis.Dillon, February 24, 2010 at 6:49 am Link to this comment
A lot of issues here for commenting:
1) I don’t believe in smart vs. dumb as an identifying trait for wealth accumulation. In many cases, it is more being “clever” and corrupt. He who wins is usually the one who is more willing to cross those invisible lines of morality and decency that the vast majority adheres to throughout life. When one watches all the sharks climbing the career ladder within a corporation, it is usually the one who is most willing to undermine his competitors and do the dirty work of a superior that elevates up the chain. Just an observation from 40+ years in the trenches.
2) The rich accumulate wealth on the backs of those who labor below them ... they are not usually so gifted that they can generate that type of cash flow alone. They then gather that money to themselves like the greedy they are and proclaim that they alone made this money and therefore they should not be forced to share it with anyone. They complain about all the taxes and yet, on the whole, they are the most voracious users of government services and largess in the country. A corporate merger costs us, the taxpayers, millions of dollars through the SEC, DOJ and agencies that need to make sure the marriage is legal and/or non-monopolistic. Of course, the wealthy would argue that the merger should not be evaluated at all ... it is, after all, a “free market” which protects them from any scrutiny.
3) Those who argue that medicine and other health care services should be subject to the same free market forces as other sectors forget one very important thing ... health care is not a voluntary choice. We don’t decide when our health fails or we need to see a doctor. Health care is one of those things we all have to do or we are dead. Thus, we all fall victim to the greed of those supplying the service. They know we will come knocking at some time in the future and we will be vulnerable and an easy mark. Would any of us argue cost with an emergency room doctor while a family member lies dying? Probably not. So, this simple fact argues, convincingly I believe, that health care needs to be taken out of the “for profit” column and needs to be tightly regulated and controlled by an entity which has no vested interest in extracting the most money from our suffering. Sorry ... that is not the free enterprise, for profit insurance companies. Only a non-profit entity can do this.
4) Yes, our life style choices impact health care costs. But I don’t think that is anywhere near 90% of all illness. Our 17% cost figure does not compare well with the 7-8% values found throughout Europe. And Europeans have just a lousy a lifestyle as we do. Germans drink far more than we do (ever seen a German drink beer ... it is a frightening experience) and consume extremely fatty foods as well. They are probably no more active than we are. And yet their health care costs are far lower than ours and they have the same expensive procedures. But they have eliminated the profit motive from insurance ... a quick 30% reduction in costs with no decrease in quality or quantity.
Report thisBy hark, February 23, 2010 at 8:58 pm Link to this comment
(Unregistered commenter)
Every problem in this country seems to boil down to the same thing: we’ve allowed the rich to acquire all the wealth and income, and there’s nothing left for the bottom 99% of us.
Until we recognize that, and recover the wealth that these greedy few have arrogated unto themselves, there will be no stopping our decline as a nation or as a people.
Report thisBy TAO Walker, February 23, 2010 at 6:53 pm Link to this comment
The “calamity” Bill Boyarsky here warns-about much too late, far from being merely “in the making,” is a done-deal. It is in the very mass-warehousing itself of millions of mostly elderly “individuals.” Institutions are never anything but “cheap-imitation-plastic-(and ever-more-costly)-substitutes” for the natural organic forms they supplant. Without exception they reach a point in their “development” where they are cripplingly unaffordable for those who’ve in-turn come to be CONvinced they’re virtually helpless (i.e. crippled) without them. It’s the old “....rock and a hard place” phenomenon….with a vengeance.
“Visits from relatives and thoughtful friends” may make slightly less degrading (for all-concerned) the ‘solution’ this ‘modern’ society has opted-for, to the ‘problem’ of those with no other eCONomic “worth” than what can be wrung-out of the system to pay for their “care.” This is just one more among many CONsequences of the “civilization” CONtraption becoming totally cannibalistic, here in the terminal phase of its operations. For-profit and government ‘providers’ both are already well beyond the ‘tipping-point’ at where the automatic institutionalization of various ‘segments’ of the captive population becomes eCONomically unsustainable even behind massive efforts to cook both public and private ‘books.’ Biologically it has never been anything but a DEAD END. The ‘school’ system is likewise bankrupt in every conceivable way, for just one more major example.
Isolated from our natural Organic Form, with its given Organic Function, our tame Sisters and Brothers are CONdemned to perish “individual”-ly in ever-worsening CONditions. There is no Medicine for them in “money” or “power” or make-believe of any kind.
There IS, though, in The Tiyoshpaye Way.
HokaHey!
Report thisBy balkas, February 23, 2010 at 4:44 pm Link to this comment
ellis,
those who control symbols control u,said i wise P., and no amount of revolution or evolution, will change that.
Who controls symbolic value of the symbols “talent”. “intelligence”, “domocracy”, “hero”,
“laws”, “god”, “flag”, star, etc?
But, of course, those who rule us: priests, ‘educators’, pols, collumnists, starry ‘stars’, ceos, judges, generals, et al.
Isn’t a woman who raises well-behaved children as talented [or valuable] as a very good singer, teacher?
Isn’t a good listener as talented as a mathematician?
In any case, who knows? But apodicticly [of necessary truth] we err, if it be so and we cannot ever know that, in favor of majority of people.
Survival of specie depends on majority and not minority of people.
Survival being the only proof of succces, talent, intelligence, etc., at least to me!
Btw, what does namecalling teach: he’s dumb, the other guy is talented? Such behavior actually misteaches.
Precisely why it is used!!
What’s symbolic value of US flag? Obedience to the ruling class! Natch, the ruling class teaches children that it means love for one’s country.
What’s right to life mean? Well, if u die because u’r getting killed in iraq or afgh’n, u have lost that right.
And if u’r sick and die because u cldn’t afford treatment, once again u were deprived of right to life
And what is law? Had we ever had any in recorded history? Obvioulsy not! We have despotism and not ever most important laws. I am using the word “laws” in its folk-sense which has an entirely different symbolic value than the one to the ruling class.
Is the ruling class aware of all i said? I don’t know but think it does know! More cld be said! tnx
Report thisBy NYCartist, February 23, 2010 at 3:16 pm Link to this comment
I write this comment as a person who is both severely disabled since middle age (ME/CFS), a wheelchair user (due to ME/CFS) and going to be 7 0 - 17 1/2 leap year birthdays at the end of this weekend (no leap year this):
See http://www.notdeadyet.org on this topic (where I comment
often)
and the new good website:
http://betteroffalive.org
Sanda
Report thisBy balkas, February 23, 2010 at 2:02 pm Link to this comment
ellis, with respect,
neither god nor nature,i affirm,make dumb or smart people.
These categories were probably created by hell-on-earth people.
To nature or god, each of the zillions and zillions of tiny wigglers swimming/wiggling to reach an ovary, is equally valuable.
So, we all are equal on that level. On this level, it may take trnsXtrns of the wigglers to obtain a single genius. All progress we’ve had is due to our geniuses; thus,all of us shld have an equal share of benefits that accrue from their brain-work.
It is also our brain-work!
However, ancient and modern ‘nobility’ have usurped our rights to equality on living level; basing, this on animalistic theories which proclaim that the stronger [read please, more vicious]have greater wealth-rights-power.
This is the root cause of all evils on interpersonal level that had befallen us over the last ?15k yrs.
To change things for better, we also need to become devious and vitiating to their causes wherever we safely can.
Report thisOnly thus: give them back the same medicine! tnx
By Samson, February 23, 2010 at 1:50 pm Link to this comment
Strange article. He bounces through topics so fast its hard to keep up.
He starts talking about Obama’s Health Corp Enrichment Act of 2010. Then he’s suddenly talking about state Medicaid budget cuts. Then he magically ends up trying to talk about some local union fight over who controls a union local.
I’m not a fan of the SEIU’s taking over and de-powering of locals. I’m a believer in grassroots democracy, especially in a union. But, of the three topics in this piece, it seems that Mr. Boyarsky has landed on what has to be the least important.
Report thisBy RdV, February 23, 2010 at 1:43 pm Link to this comment
Granted these inside-the beltway hacks obviously have their marching orders to deliver talking points, but what they don’t seem to realize is their versions of cutting waste are impacting directly on these “entitlements” they are shedding a tear over. Do your damn research—Obama is setting us to hack Social security, Medicare, Medicaid eith his stacked deficit commission—claiming we can’t afford these entitlements—and I have to question the mindset of the individual who refers to them as “entitlements” while handing blank checks to the military, to Wall Street Gangsters, to nuclear power.
Report thisMakes me want to retch.