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Currently she resides in a privately owned facility and they have made it perfectly clear that they do not accept Medicaid. After 4 years all her money is nearly gone! As her guardian, will I be responsible to pay if I haven't found her a place? I can hardly stay afloat myself living paycheck to paycheck!

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You are responsible to pay only her own money, if you have POA for her finances. If she is completely out of money she will, sadly, have to go onto medicaid. The reason of course is cost. But you are not responsible for the debts of others unless you sign that you will be responsible for them. You need to make it clear to the facility that her funds are running out and you need to see what the process is. She may need to be hospitalized just to find Social Worker care to help with placement as you can spend months looking for what they can find on their list in no time at all. So sorry. We are all outliving whatever we managed to save and it is hard to imagine where all this goes. Perhaps see an Elder Care Attorney to see what minimal amounts can get protected, how to start applications for medicaid.
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Genita Jul 2019
Who would have my mother hospitalized? The facility she lives in now? If I am unable to take her in to live with me? I work full time and she has to have insulin shots and meds 4x a day.
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Genita, sorry you are having trouble finding a Memory Care that takes Medicaid. It is my understanding that Nursing Homes will take Medicaid, if they have a bed opened. There might be a waiting list.

The reason why it is so hard to find a Medicaid open bed has to do with cost. An Assisted Living/Memory Care needs to make a certain amount of money to keep afloat and they can do that if the residents are mainly self-paid.

Some States will offer a waiver where the State pays a certain percentage, and the patient pays the rest, thus they can get into Assisted Living/Memory Care.

Otherwise, you will need to check your local nursing homes as they are more apt to accept Medicaid. There will be a mix of residents who are self-pay, and those who use Medicaid to pay for their room/board and care.
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Have started the Medicaid process for the second time. DSS has informed me that my mother must be moved into a Medicaid-approved facility as well as monies spent down before she is approved!
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JoAnn29 Jul 2019
This is true. In my situation, Mom paid two months privately in LTC facility. I started the application process in April. She moved into LTC May 1st, paid two months upfront for May and June then July 1st Medicaid started.
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What I plan to do with my mother who currently resides in private pay memory care is this: apply for Medicaid about 6 months BEFORE her money runs out and get her into a skilled nursing facility (at that time) that takes Medicaid. I'll private pay her money down while awaiting approval. That way, she'll already be in the facility (they always accept private pay) and when Medicaid comes thru, we're all set. We are not responsible for paying their monthly fees for care, but if we don't do our due diligence, we may wind up taking them into our homes! That thought keeps me awake at night because there is NO WAY I can handle my 92 year old mother's issues at home......she can barely take a shower without falling and that's with caregivers helping her!

As far as getting your mom into the hospital goes, YOU can have the facility call an ambulance for her if you think (or they think) she's having a health issue that requires more attention. Ie: pneumonia or a UTI infection, vertigo or extreme dizziness, etc. She can be sent to the ER for evaluation at which time a social worker gets assigned to her case. You then tell the SW that you CANNOT, under ANY circumstances, take mother to live with you and she needs placement in a Skilled Nursing Facility (SNF). The social worker can help you find placement and apply for Medicaid as well. You may also want to consult with an Elder Care Attorney now and he can help you cover your options.
This is a VERY stressful situation, I know, as the only child of a 92 yo mother with tons of issues and running out of money herself. Rarely a day goes by where I don't worry about her future as well as my own. The elder care crisis we face in this country is REAL, and it's scary as hell. Modern medicine wants to keep us alive for a century or more with no plan in place for how to care for us with dementia and 14 other age related health issues. And our "golden years" are getting ruined with all the worrying and stress that goes along with managing THEIR lives and finances. A real mess, isn't It?
Best of luck
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JoAnn29 Jul 2019
In my state of NJ, you only have 90 days to supply all the info needed and find a facility. If its not done in that time frame, you have to reapply. Check with ur state Medicaid on this.
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Genita, may I ask a few questions? When she initially was admitted to this private facility did you sign to be financially responsible for her? Also, did you realize at that time that she only had funds to cover a certain amount of time? What has the private care facility told you as far as what they plan to do with her once the money runs out?

Hopefully you can find a nursing home that they can transfer her to that takes Medicaid. Maybe the private facility can help with that. You can spend the remaining amount of her money there and then they will help you get her on Medicaid. If you are somehow financially responsible to the private facility based on what you signed upon her admittance you should get her out now. If only she is responsible, I would assume the facility will start looking for places to send her, make sure you don't feel the need to pay her bill out of your money. Also make it clear you don't have a safe place for her. They will likely send her to the hospital but that's OK, the hospital is efficient at finding placement.
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MC where I live is tied to Assisted Livings which are private pay. Some will take Medicaid but only after u have paid for at least 2 yrs. And they haven't the % of medicaid residents. The others have not met medicaid accreditation for what ever reason. You may have to have Mom placed in a LTC facility with Medicaid paying for her care.
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Does Mom have any money left? Depending where you live a LTC will cost at least 10k a month. I replied to one of the posts that Mom paid 2 months privately, this took her down under the cap allowed. Medicaid allowed me 90 days to get Mom spent down, provide paperwork and get her in a facility. Yes, it is overwhelming but can be done.

Try your local Office of Aging and see if they can help u thru the process. You can talk to a Medicaid case worker.
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I am using a service called carepatrol.com. He, Rick, is doing the legwork to find a place that fits my mother's needs and finances. There is also the My Choice Waiver. But I'm still learning about that and dont want to provide inaccurate information.
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Medicaid doesn't pay for memory care, as you found out. Even though it's probably way too much care, a nursing home/long term care facility is where you will need to place your mother to get Medicaid assistance. This is one of the "holes" in elder care -- Medicaid rules need to change to include coverage in lesser-care (and less-expensive) facilities! My mother is in a nursing home, but there are folks there that (it seems) should be in an assisted living facility. I'm sure they are there because this is the only place Medicaid will pay for them. So nursing home beds are taken by people who should otherwise be in AS/MC. Sitting down with a Medicaid attorney and also an organization that assists with Medicaid applications was very enlightening for me.

The system is so broken and there are no advocates in government to change this -- if anything, for many politicians Medicaid is a system that needs to end. Can you imagine what would happen if Medicaid weren't available to the elderly?? We need to vote according to our family's needs.
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worriedinCali Jul 2019
Medicaid pays for memory care in some states.
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Hi! I am not sure where you live but I would look to see if you have any supportive living facilities in your area.
What is supportive living for seniors?
What Supportive Living is much like assisted living, most Supportive Living communities are designed for seniors (those age 65 and over*) who are no longer able to live on their own safely, but do not require the high level of care provided in a nursing home.
I live in Illinois and we have a handful. They often have waiting lists but are more likely to get in if you pay cash until you spend down and the can transition on to PA.
Good luck!
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It's not that they WON'T accept Medicaid, in most states they can't.

It's crazy because skilled nursing (aka a Nursing Home) is the most expensive care there is and the vast majority of people living with dementia don't need it. But, until the laws change, that's the way it is. Some states have waiver programs that can provide for AL (which is the licensing that memory care usually falls under), but, to my knowledge, most don't.

Once your Mom's assets are 'spent down', she will be eligible for long term care through Medicaid. Never sign anything that makes you personally responsible for your mom's expenses.
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Ganita, it would help if we knew what state you are in. Regardless, have you considered a small group home setting? We live in Tucson and they are all over the place. They may say AL, but many will take residents with dementia as MC is a type of AL.
Check with your state regarding options. In AZ, there is a website that lists facilities under the Health Department that evaluates them ever year.
Good luck!
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Genita Jul 2019
Thank you Judy. Already got the list from Department of Social services near me. Contacted all on the list and then some, as they expect you to do this on your own. No luck as of yet. When I placed my mom in Brookdale, I was told that she would probably be grandfathered in when money ran out! This I found out, was just a sales pitch to get her in to their facility. She has been there now over 4 years.
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If your mom has some money left, you should look for a nursing home that accepts Medicaid now and get her admitted private pay. After her money runs out, she'll get a Medicaid bed.

Be completely transparent about your plan. They will help you with it and take on the arduous task of applying for Medicaid.
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Each state has their own medicaid rules. Nothing is standard. Here in Orange County, CA, property values/taxes are VERY high so it's very expensive to own/operate a medicaid/Cal Optima facility/home. AND even though a home might "accept medicaid" (or a waiver), most often they fill their beds with private pay...for the obvious! $$$$$$$$$$$
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What state? I have dealt with this very issue and won in 3 states.

Congress has legislated an adequate program in Medicaid, but it is thwarted by industry greed.

I have found a new respect for our Congress.

Medicaid requirements are very fair but rigorous, is why facilities will not accept.

A facility that will not accept Medicaid does so because they are not capable of guaranteeing the required, 'needed' level of care, long term, That tells me that they would not guarantee the needed care for private pay either.

Medicaid says of itself that it is intended to be equal to private pay.

Bottom line is the 'now dollar' in the cost of care.
I was facility engineer for an 80 bed skilled facility in the 1970's.
Daily, I saw the compassion for people with various needs.
I had much admiration for the workers and management until a corporation took over.

We opted to keep my wife home and Medicaid is very supportive.
This state happens to be one of the best in administration.
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raspberryfarm Jul 2019
Oh my, what state are you in? Even applying for Medicaid in Virginia is a nightmare and you are pretty much guaranteed not to succeed. Virginia, as a commonwealth, has it's own version of Medicaid, and is determined not to use it.
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Go talk to the social workers at the facility where she is and ask these questions. It is very likely they can give you the names of other facilities she can move to. Unfortunately, the name of the game is money. They can make more money from private pay so if they can keep beds full with priv pay patients, there is no real push for them to open up Medicaid beds.
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Nursing homes can be 100% private pay, if that is how they have been established; they are not required to accept Medicaid.

Homes where most of the patients are Medicaid-only patients tend to be grossly understaffed and have a shortage of supplies, such as bed linens. That's because they operate on a shoestring budget and there is no money for "extras."

You'll need to find a nursing home that accepts Medicaid. Even some of those will limit the percentage of Medicaid-only patients that they accept, so that they can stay afloat financially.

The bottom line is that Medicaid does not reimburse enough in medical costs to make it worthwhile financially for places to accept it. For example, many physicians had to stop accepting Medicaid patients in their private practice, because the rate of reimbursement was so low that they could not even pay their office staff and utilities. For example, on a $100 office visit, Medicaid might only pay $31, and a follow-up visit for the same problem might only reimburse $11. So, Medicare-only patients cause medical practices to lose money.
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Winkers Jul 2019
Her question wasn’t about finding a Nursing Home but specifically a “Memory Care Facility”
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Key issue imho is your state legislature, gonna be a long rant....
Last millennium, MediCARE & Medicaid went into law. Medicare was totally federal for support & availability to almost all the US population over age 65. As it’s federal, it’s portable, so Medicare works whether your at home or fall & go to ER while @Disney with grandkids. As long as provider takes MediCARE, coverage assured in US.
We pay into Medicare via FICA while working or from SS once retired.

- Medicaid was federal “dedicated funding” for “at need” (both medically & financially) for specific health programs with joint state funding alongside federal $. Medicaid programs are term limited, like CHIP for kids or WMH for pregnancy & relatively routine care & w/controlled costs; & a lot fall into preventive services which feds pay a higher % of.
Included in Medicaid was funding for skilled nursing care in a facility with the states paying a required % share of those costs as determined by their populations demographics. Basically means federal & state $$ assured to pay for care in a LTC facility that is a NH as that’s “skilled”. Medicaid LTC covers all ages who need skilled LTC in a facility.
BUT
- medicaid as it’s a joint program, has it set up so guidelines are under a overall federal umbrella but administered uniquely by each state. So each state can determine what criteria is for financial “at need” but based on federal poverty guidelines; and state determines what they will pay for daily room & board, & some states pay very little, like under $150 a day; and state is who reviews application to see if the applicant is medically “at need” based on chart or an on-site in person evaluation; for couples, state determines what degree of $ the community spouse can have; state determines how MERP can happen.

AND more importantly
- state decides if they want to divert or “waive” federal $ from NH to instead go to others like AL, or MC or community based program, like PACE.
Most states don’t see any need to deal with waivers at all as they have to have their own management & waivers are NOT permanent $. You gotta go every 3,5,7 years to get $ for your waiver program to be renewed or approved by state legislature. You gotta show cost benefit, yada yada.... Waivers are a bother as $ can just go into well established NH system. & NH have long existing lobbyists as for ages it was only NH in the aging care game.

For states that do waivers, the impermanence & uncertainty are a reason why a lot of facilities flat will not have waiver set aside beds. If you can fill your place with private pay, it’s not worth dealing with waivers.

Other states, like AZ, are more realistic about incoming tsunami of over 65 needing care & have heavily shifted to AL & community program waivers.

Right now, feds are encouraging (by add $) waivers to be done but to go for PACE. So elders stay at home but picked up by PACE staffed handicapped van then go to PAcE center 2-4 days wk w/all medical care being done at center or participating hospital group. For those more infirm, weekend caregiver visit(s) done. But they stay at home & family or private pay caregivers hired fill in as needed. If you have PACE, your elder may need to be evaluated for it before they can go into a NH or apply for another waiver, like AL or MC. We have one nearby (Benson Center) & it’s got a waiting list as super popular; it’s administration provider is Catholic Charities health care system & they do 4 PACE statewide.

Really it’s up to your legislature to do waivers.
Get politically active, find legislators who understand aging issues & support them.

As others have said, get mom “at need” medically for a NH. There’s gonna be a Medicaid bed in a NH somewhere. It might be a good idea to have your mom become the patient in private practice of the MD who is also a medical director of a NH or two. They will know what needs to be in her chart. Good luck.
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cherokeegrrl54 Jul 2019
Good information. Thank you for taking time to post this...
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My question would be if your LO has Medicaid why is she in a privately owned facility to begin with. Nursing homes accept Medicaid. It won't be as nice I'm sure
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worriedinCali Jul 2019
Because up until now, she’s had the money to self-pay for the private facility. That’s why the OP mentions her mother’s money is nearly gone.
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The bottom line is money. With all this free healthcare it's going to get harder and harder to find places. The facilites only get a very small amount compared to what they are suppose to get...I can hardly blame them. Money doesn't grow on trees and it's going to get bad. If she or you has money; admit her private pay and when that runs out they will do the medicaid thing. Remember; facilities are ony required to accept just so many medicaid clients. Save the legislation stuff. It's the politicians who are in control and they're to busy ripping our president apart to care.
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cherokeegrrl54 Jul 2019
So true...
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California has a new program called ALWP, Assisted Living Waiver Program. It is designed to get people out of Nursing Homes because they cant afford assisted living, into Assisted Living (if they qualify). Its too long to explain, but it may be the answer to your problem. Please respond to me directly if you think this may be something you are interested in.
There may be similar plans in other States, but I am in California so wouldn't know.
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worriedinCali Jul 2019
That’s not a new program, it’s been around for years and it’s medi-cal (medicaid). The OP isn’t in California. Her mother has Medicaid but needs a facility that takes Medicaid. An assisted living waiver IS Medicaid.....
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Hardly an answer, but I'll be facing this soon w my 98-year-old mother. She came to live with me in Florida. Anyone deal with this in Florida? I haven't applied for Medicare because she's been so healthy, but I see it coming. She has very little money. Thanks
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Lasvegas06 Jul 2019
I recently brought my mother who suffers of dementia to live with me in Florida. I researched forever and finally phoned someone who agreed to help. I have been able to place my mom in a program that accepts Medicare and Medicaid The Hope Pace Program. It’s a program that helps keep my mom in my home as long as possible and they bring her to the center two times a week the three the fouretc until she can’t go. They will then provide all medical supplies and nursing care until the end. It doesn’t provide LTC but the have resources to help with placement if it’s needed. Hope this helps.
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I have the same issue with my mom. There are “Nursing Homes” which also include care for patients with Alzheimers / Dementia. Which may be your only option. However, in Texas, I have yet to find a Memory Care facility that accepts Medicare/Medicaid. I guess as long as they have patients who will pay full price (out of pocket), they don’t need to accept insurance. Sorry
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igloo572 Jul 2019
Winkers - I’d suggest you get in touch with the DFW Area on Aging to see what’s out there in your area. There’s gonna be something & more up McKinney Sherman. Your gonna need to cast a wider net imho.

TX has 2 types of AL and MC facilities tend to be licensed to be within the umbrella of AL for staffing & regulations. So the rules for AL guide what a MC is.

TX actually does have AL waiver.... but here’s the rub....only 1 type of AL can get the limited waiver.
2 types of AL are:
-CCF, continuing care facility, this one does custodial care 24/7. This care can include medication management as that does not usually need “skilled nursing care” to dispense. A aide or pharmacy tech can push the medications cart & dispense meds under RN oversight. CCF are not able to get Medicaid waiver.
Most AL & MCs are CCFs.....
-CBAAL, community based alternative assisted living. This type can apply for Medicaid waivers. CBAAL require more professional health care providers on staff. Maybe are part of a “tiered” facility. By that I mean a larger campus that usually go from IL (private pay) to AL & MC (private pay, LTC insurance, has with CCF & CBAAL beds) to NH and probably has in unit hospice wing. So in theory there is all kinds of licensed staff from within the overall facility so a higher level of care can be provided & provided ASAP for the CBAAL beds as needed. State has a limited enrollment for waivers.
The number of vendors are limited as well as not many. The big tiered facilities are unwieldy. Those that are out there are older - like established last millennium, so property owned, no debt service - and are more likely to be in or nearby midsize towns closer to the big 5 (Austin, Dallas, ElPaso, HTown, SA) as they are gonna have docs & services affiliated with Baylor or UTHealth Science Systems gerontology depts.
My mom started out in IL at a tiered facility & it had about 20% of AL beds as CBAAL. In theory as promoted & I envisioned, mom moved along seamlessly from IL to death, LOL to that! Regular AL beds were pipeline for CBAAL beds which in turn went into the NH sector. & yes the place was not transparent as to how structured (& involved) it would be to actually do this.

If no tiered places, then in my experience Your other option is to get your mom to have enough health care issues in chart to show that she clearly needs a higher level of care that needs skilled nursing care to do; so she can move into a N.H.Right now, I’ll bet, she’s totally “custodial care”. The place she is in has had other families face your predicament. I’d ask the social worker or your new BFF in nursing as to how to get her documented needing a higher level of care. If this place has no interest in doing this & to get beyond this will take work on your part as she is gonna need to see new doctors. An MD who is medical director of NH will know what criteria will pass state review for her to be considered “at need” for skilled nursing care. For my mom, it took about 5 months of every 3-5 week to her gerontologist to get to that point. Visits & lab work. She did the jump to hyperspace & went from IL to NH & totally bypassing the AL phase. Moved her within weeks of her MD orders to a free standing NH & she moved in Medicaid Pending. If you go this route, clearly find out if she is required to do a 30 day notice to the MC. If so, you have to synch when she moves out of MC so that doesn’t happen as she will need almost all her monthly income (but $60) to be paid to the new NH starting day 1 due to Medicaids required copay or SOC (share of cost). There’s gonna be NH with open Medicaid beds that are more periphery to DFW she could move into. Once she’s in & clears Medicaid eligibility, you can put her on waiting list for a Medicaid bed closer to wherever you live.
Good luck, be focused & stay organized
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Your LO will have to apply for Medicaid and if she qualifies, she is allowed to own $2K of countable assets to move into an NH. You are not financially responsible for her care.
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Depends on how/who signed all the paperwork. If you are a real guardian (court appointed) absolutely not. If you signed her in without any POA, etc they could potentially consider you responsible. Also beware that some states have filial laws,, which they *could* potentially use, if you are a child of the person.

It would be best to find an alternate location before the money runs out. No place of business wants to eat the cost of someone who cannot pay, for whatever reason. IF you can get her Medicaid approved, and move her to the first place that has an open spot, you can always look into moving her again if you find a better/closer place (yes moving sucks on many levels, but you don't need some collection agency hassling you, which they would likely do even if you have no financial responsibility - your name is associated with her!)
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Check with your local Dept of Social Services or Office for the Aging. I volunteer at our local OFA and found out quite by accident that a much nicer facility than I had Mom in that Medicaid had an agreement with for lower cost rent. So I was able to move her to the nicer ALF and pay the same rent that she was paying. Most Medicaid offices know the ALF that have agreements with them for lower cost rent. Check it out early as there is often a waiting list to get into these places. The place I moved Mom to only had 4 Medicaid beds available. My mother is on what is known as a Medicaid Spend Down and must pay the amount of her income that is above the Medicaid allowed amount to the ALF in addition to the agreed Medicaid amount. It also qualifies her for free Part D drug insurance with low copays and Medicaid insurance to go with her Medicare coverage. Check with her current ALF as to how the paperwork is filled out as to who is responsible for payment. You don't want to be stuck with that expense.
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Interesting how viciously people attack someone they don't even know and make assumptions about my experience and/or knowledge, etc. Even some interesting assumptions about economics on here. All I'll say is the type of healthcare some people seem to want is not as simple to make happen as they think. "The rich" - the hated rich apparently (including your insurance companies) will never pay for anyone to get free or really low-cost anything. (Farmers don't grow you free food do they?)
Don't get me wrong - I'm not in love with insurance companies denying coverage if they think they can get away with it - it is not a perfect system, and I've been on the receiving end myself. I have fought many a battle over coverage & care for my elderly father and my medically handicapped son - and myself.
The only thing the rich will give are jobs and often benefits. Instead of hating them, if you want it comfy - emulate them! Or just smile when they have a $17 million wedding for their daughter because all that money is going to the people doing the jobs - flowers, dresses, hotel workers, caterers, hairdressers, coordinators, photographers, jewelers, etc. - there is nothing unfair about this. Everyone's lives are effected by the choices they make - rich, poor - a great deal of your own outcome is up to you.
Someone cried "immoral" - what's immoral is thinking you deserve the fruits of someone else's labor. Or begrudging entrepreneurs their massive fortunes because they took the risk. Very few people, especially businesses/owners want to work hard and take huge risks to give someone else ridiculous amounts of the money they earn in say, taxes. Leaves little incentive for them to continue their pursuits, which may include developing equipment for diagnosing or treating disease - or scads of other beneficial things for society. Besides - the government wanting a monopoly on healthcare is a terrifying idea - they have enough power over our daily lives and can't seem to fix the simplest problems!
One thing I think it's important to address is countrymouse's reply. Dear, I HAVE had a colonoscopy without sedation, and I do not recommend it! The worst thing that will come of this is not the pain of the procedure (it was excruciating). It is the people who will die from colon cancer, ulcerative colitis, etc. Most people must be dragged by someone who loves them to get a colonoscopy WITH sedation. Many, many simply will not go if sedation is not part of the deal. And about pain telling you something is 'wrong' during your procedure - I've had a colonoscopy exam stopped while under sedation because my doctor knew he was in dangerous territory, so he stopped. And I'm not alone in this. Doctors in the US are well-compensated, so the best doctors stay in the US. Good doctors come here too - to make money. We have many good doctors from Canada - I know a few, esp surgeons. They came to practice medicine AND make money. That's one reason why we have good doctors.
Our healthcare system isn't perfect, but don't blame immorality, the rich, or the boogyman.
I know someone in this thread was saying they would not hide their parents assets, they would use these funds to pay for their care until the funds are depleted, then possibly go on Medicaid. That's integrity!
And I must apologize if I didn't 'reply' in the proper order. I rarely post on this forum. Now I remember why.
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Shane1124 Jul 2019
Very well stated. angeleyes1. I agree with everything you said.

And please let’s not attack someone with a different opinion. America is so divided these days & it seems we have lost the ability to accept everyone’s right to free speech & respect for those that don’t agree with them. That’s one of the reasons we have this President as middle America was tired of being forgotten by politicians who promise the world and then got caught up with power instead of constituent needs. The population of coastal cities should not determine how the rest of us “should” live.

Myself, I can’t understand why anyone feels the government will run a single payor system efficiently. The government does nothing efficiently. Medicare for all will be a total disaster. We can’t even set up a system to improve sharing of medical records. Look at our VA system. Our vets can often have long waiting times for procedures and while I have heard about success stories in the VA system, they are more stories of inefficiency than success.

More Doctors will retire
if single payor comes to pass- there is a mass exodus of PCPs retiring in progress as we speak.

And why shouldn’t doctors make money? If it is a good doctor, they are worth their weight in gold. Shouldn’t a doctor be compensated well for the skills they have? All their education, internship, residency costs. Medicine as a career involves giving up much of their lives to the service for others.

While I do not place physicians on pedestals I have been working as a RN for 40 years and & have the utmost respect for about 95% of PCP’s. Their knowledge is amazing and yes, they do care. Matter of fact I can generally say that about the specialists I have worked with.

And there are still plenty of PCP’s that call their patients at home to discuss lab work, make follow up calls to patients, etc. Two weeks ago, a cardiologist returned a patient’s call while the MD was on vacation in Italy. There are still many physicians who verbalize to me how worried they are when a patient is ill. You’d be pleasantly surprised to know of how many physicians know the family situation of their patients inside & out as well.

There is a PCP shortage in the US now. Where will we get PCP’s to run single payor as not enough new MD grads are choosing Family Medicine? Some practices provide care through video visits now.

Please no arguments about politics. It’s clear the US is split 50-50 so we should be listening to each other POV out of respect for our fellow Americans & work to find common ground and move forward.

I have a great interest in this current healthcare debate. It’s healthy for people to disagree but how we work through those differences that is important. While I don’t agree I can’t say my way is the best way & the heck with your opinion. People these days are quick to argue instead of listening and accepting the view of others. Each of us are entitled to their own opinion without fear. We all count.

And oh my goodness- I do not want a colonoscopy without sedation. Just.No.
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Angeleyes you made this assertion:

"Great Britain no longer covers sedation for a colonoscopy"

and I happened to know that the assertion is not true. A patient who will not accept a colonoscopy without the assurance that they can be given sedation will be provided with it.

Reluctance to undergo colonoscopy at all is indeed an important problem, which the American paper I quoted does recognise. However, spreading a false belief that a person may be forced or tricked into undergoing the procedure without sedation is hardly going to help.
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Angeleyes1 Jul 2019
Obviously, you live there. I read the list of procedures that were being discontinued to save money, and that was on it. Supposedly your NHS did their research and decided many things were not worth paying for. On the list were other routine procedures - arthroscopy (knee), hysterectomy/ procedures for excessive uterine bleeding (this literally saved my life), and numerous other procedures. The sedation for colonoscopy was also listed. The list came from your healthcare system, and altho it implied that exceptions could be made for some things on their hit list, I know how that usually goes - I'd have bleed to death while my doctor desperately tried to get approval for my procedure, or spent much time desperately ill in a hospital. My guess is if you can pay for the sedation you can have it (which is not free healthcare), or maybe your doctor can beg for you to get an exception. Or maybe the right people complained & the NHS took that off their list, who knows. Bottom line - you're happy with your system, and I think it stinks and don't want it here. It's a socialist system and I don't agree with it. I've heard from so many people I know online, as well as people I know IRL who are very, very dissatisfied with their 'free' healthcare in GB & Canada. Others make the news - esp young children with terrible diseases. Your country refuses to even allow it's citizens to leave the country with these children to seek treatment when it's offered by hospitals & doctors elsewhere. (Wonder what they're afraid of? Being shown up, or losing control?) Here we have 'Right to Try' for those with incurable diseases, thank God. In any case - you have elderly there and we have them here. No system is perfect, but I'd rather keep my options open & my rights in place. It's about more than finding dad a free assisted living.
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Im in the same boat with my dad. Just yesterday I learned to contact our local Alzheimer's Association, as I was told they have free placement assistance to help find memory care facilities that are straight Medicaid. Hope this helps.
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Medicaid does not pay much. In a for-profit economy, IMO, that is the big issue.
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