Posts Tagged ‘Care’
Many seniors enjoy living in their own home with the freedom to do as they please. While some health problems may limit a senior’s ability to do so, with the right home health care, a senior can enjoy an independent life in the presence of illness or other health conditions. When a senior receives adequate health care, it can keep the senior out of a convalescent or nursing home.
For many seniors, just knowing that they will be allowed to recover at home will put them in better spirits, which is more conducive to faster healing. The goal of home health care is to provide the senior with any necessary treatment as the senior heals from an illness or injury in the home setting. Home health care concerns medical treatments and services would otherwise be done in a hospital or other health care setting. Home health care can include services such as nursing, physical therapy, occupational therapy, counseling, social services and speech therapy.
A doctor will prescribe home health care when the doctor feels that a patient may recover successfully at home. The doctor may order of services of a nurse, homemaker, physical therapist and a personal care worker as part of the home health care plan. Each of these personnel members would perform different tasks as the senior recovers.
The nurse would administer medications, give the patient dietary tips and would arrange any other treatments or services that are necessary. The homemaker would do the household chores, shopping and preparation of meals. The physical therapist would perform such services that would help the patient get their strength back. The personal care worker would help the patient move around their home, including such tasks as dressing, bathing and walking with the patient. The people who provide home health care services are usually licensed nurses, homemakers, therapists and personal care workers.
Many products can be purchased for the purpose of home health care. Not all the products are related to the patient’s body and instead are used to make the home safer for the patient. Such home health care product and services involves the modification of the outdoor steps, seating, inside walls, bath and shower. A walkway may be built or railings may be placed inside the home. Mobility equipment such as a cane or wheelchair may be required. Any necessary medical equipment may be rented before making a purchase as well.
Home health care services may be performed by a public, private or other organization that is devoted to these services. Home health care workers are checked by most states for criminal backgrounds. Not all states perform a background check. If a state does not perform these checks, it is up to the person hiring the services of a health care worker to make sure that their criminal record is clear.
Home health care is not the same service as home care for seniors. Generally, home care revolves around house cleaning and other chores at the house. Home health care involves medical treatments or those services that are required to help the patient recover.
Home health care allows a senior’s life to go on despite any injury or medical condition. A health problem does not automatically mean that a person has to be cooped up in a health care facility or nursing home. Patients that receive home health care are grateful for the opportunity to avoid the hospital or nursing home.
Americans are deeply unhappy with the country’s health care programs and costs. And rightly so. As one author observed, “A recent survey showed that only 17 percent of respondents in the United States were content with their health-care system . . . Why the discontent? The superficial reasons are simple enough to describe: the system is hugely expensive, very bureaucratic, and extremely patchy. The expenses first: U.S. health care costs a third more, per person, than that of the closest rival, superrich Switzerland, and twice what many European countries spend. The United States government alone spends more per person than the combination of public and private expenditure in Britain, despite the fact that the British government provides free health care for all residents.”
The United States pays more for health care per capita than any other industrialized nation — and even then, Medicare is not a comprehensive, pay-for-everything national health program like those of many nations and United States per capita health care costs continue to escalate rapidly.
Here’s what you need to know about health care costs as you plan for retirement.
Americans age sixty-five and over spend four times more on health care on average than do Americans under the age of sixty-five. At the outset of this decade, the average per capita health-care outlay for a person under the age of sixty-file was about $2,800. For people over the age of sixty-five, it was $11,089. And for Americans ages eighty-five and older it was $20,001. Clearly, health care outlays are likely to get substantially larger as you age. You need to plan for them.
U.S. health care expenses have grown mightily. U.S. health care expenses have dramatically escalated each year as new medications, new treatments, diagnostic tools, and health care innovations have come onto the market.
For example, the median nationwide cost for a hospital stay — excluding physicians charges — was $11,280 in 1997; by 2004 it was almost double at $20,455. The average total cost for treating a heart attack climbed 40 percent in just seven years. All in, health care costs have escalated fast and the increases are gaining momentum.
Health care costs are likely to continue to grow unabated. Unlike in other countries, no laws meaningfully curb the continual climb of health care and drug costs in the United States. For example, many Americans continue to import drugs from Canada because Canadian prices are significantly lower. This is true even though the new Medicare Features introduced in 2006 offset the cost of pharmaceuticals for U.S. retirees. To curb the cost of medicines, Canada prohibits drug companies from advertising on its television channels. In the United States, on the other hand, the very legislation that created the new Medicare drug benefit (Part D) expressly prohibits the federal government from attempting to negotiate lower prices with drug companies.
Count on it: medical costs are sky-high and likely to keep climbing unless there is a radical overhaul of the system.
More and more corporations are cutting back on health care benefits as medical costs soar. Recent statistics show companies cutting health care benefits and requiring employees and retirees to pay more for them. As one survey of corporate benefit trends concluded, “[Benefit] reductions have become not just common, but expected, with the only question now being of how much more of a reduction in benefits and or an increase in cost will be directly placed on individuals . . . In the end . . . individuals, either as taxpayers or consumers, will need to pay the bill.
I believe this trend will gain greater momentum over the next decades. It will be part and parcel of the continuing erosion of employment benefits — like the demise of traditional pensions — that is taking place throughout the country. Just like pensions, more and more health-care expense is going to become a do-it-yourself responsibility because heath care insurance costs are simply becoming too great for companies to shoulder competitively.
Taken all together, you can count on: (1) higher and higher health care costs, (2) more health-care-benefit cutbacks by U.S. employers, (3) the need to factor large health-care expenses into your funding plans, and (4) the need to buy supplemental health-care insurance to shield your savings from cost attack.
Of course, these views will not come as a surprise to most folks. Recent polls show that — immediately after the foremost financial concern of having enough money for retirement — the next great concern of most Americans is health care. More than half of adult Americans are “very worried” or “moderately worried” about being able to pay for serious illness or catastrophic health-care expense.
We hardly come across a person who may be fully satisfied with the health care delivery system run by either the government or the private sector. This is true not only for developing but for all the developed countries as well. Every law abiding, contributing individual has some legitimate expectations from the state. Disenchantment with present dispensation of health care compels people to seek better options across the borders. Even the present flow rate of patients from developed to developing countries has assumed the proportions of Medical tourism. Medical tourism is not a one-way traffic. Poor from India are known to visit Rashid Hospital at Lahore for kidney transplants. Medical tourism will definitely bring in world class equipment and services in our corporate hospitals. These corporate tertiary care hospitals can act as excellent referral hospitals. Lack of enough clinical material, as the patients are often referred to in medical parleyences is prompting the doctors from developed world into medical adventurism. Very recently two NGO’s headed by renowned plastic surgeons of Indian origin were in India, claiming to their credit hundreds of cleft lip and palate surgeries conducted in one week. During my brief interaction when I asked them one basic question that how do you justify single step surgery by a single specialist for a clinical entity that require 3-5 set up surgeries by 10 specialists over a period of 20 years, there was no answer. On record local doctors conduct all these surgeries. These NGO’s bring in a battery of trainee resident doctors for hands on training. Dumping of questionable services and drugs continues unabated in the absence of stringent regulations. Clear-cut up to date guidelines by health authorities have yet to be issued to safe guard the health interests of this nation. Most of the drugs banned in developed countries are still being dumped in the Indian market. Commerce alone dictates the policies of multinational companies in health sector of developing countries. State and national medical councils, the watch dogs of our national health interests are controlled by elected representatives from among the doctors. Competitive populism for being elected to these high offices takes away the very sting off these regulators. In this ‘market forces’ driven health sector, apart from other factors, size of the population, economic prosperity and literacy levels dictate the out look of key players. Subjective as well as objective assessments of the health care operations leave people confused with huge piles of data and endless interpretations. At the tail end of govt. health care delivery system is the rural dispensary or the slum revamping center, and the end user an illiterate or semi literate villager or a slum dweller. Dispensary is the humane face, the welfare state can present to its people. In yesteryears the service providers were from among the same social class they used to serve. Doctor can be a friend, philosopher and guide to the locals. Unfortunately the economic and social disparity between the service providing doctors and the service user population has grown enormously. Ad-hocism in health care delivery should be done away with immediate effect. Doctors and paramedical staff appointed on yearly contract basis are not showing any interest in the national programmes. Established private health care providers also have not shown any meaningful commitment for national programmes. Middle class itself has fragmented. Now it is fashionable to assign economic values to any issue like gender, but for social responsibility and justice. In this era of fast paced growth, the unorganized, silently suffering millions can not be wished away. Once reading on biodiversity I stumbled upon a very interesting quote, “only the species with economic importance will survive”. In our active pursuit for magnetizing economy, we assigned economic values to any thing except for morals. Commercialization of education has produced a new breed of professionals who have scant regard for professional ethics. Privatization is the buzzword with governments, because it takes away government responsibility. Private sector players are eyeing many ‘viable’ health institutions. There are no takers for commercially non-viable rural institutions. Rural health institutions dispense social medicine. Very recently one of the key players from private sector health care quoted the cost of developing one bed in corporate hospital at Rs. 30-60 lacs. These corporate health services are definitely out of each of the common man. These type of hospitals are definitely required for a nation with the present rate of growth but ‘bharat’ definitely needs different kind of hospitals. There are very strong social under currents against the exploitive private healthcare, inadequate government sector health care resources and the indifferent approach of welfare state. Health for all is a very lofty but expensive proposition. There are ways and means to reduce the pressure from government institutions. Private-public partnership, health insurance, monitoring and regulation of private sector health care can all make the things bit easy. Preventive health care education can go a long way in improving the public health. Community participation in health care has produced few but wonderful examples. Complementary community participation can make up for minor but critical deficiencies in the government run health care system. Setting up of health system corporations with World Bank assistance has already improved the working of govt. sector health care institutions considerably. Community participation through NGO’s can still improve the system, but most of the meaningful NGO’s turn their back on govt. run health care institutions because of their doubts on the integrity of government officers. Government health care institution are increasingly seen not as caring hospitals but like police stations, where medico legal reports are written and postmortems conducted. Most of the government doctors’ time is spent in courts appearing as medico legal experts witnesses. Emergency, post mortem, and then the VIP duties in addition hardly leave the doctors free for any meaningful job at government hospitals. There is an urgent need to have separate curative, preventive, legal, administrate and health intelligence wings. Government hospitals attract the poorest of the poor, mostly people from the unorganized sector. Their contribution to national GDP is by no means small. With the present growth rate, upward social mobility is seen in every strata of society. Many segments of this unorganized sector can be organised so that they also enjoy the patronage of welfare state in the form of health insurance policies. Apart from direct benefit to these segments of society, the state will benefit from the ‘off loading’ of burden from government run health care system and loading it on insurance driven private sector health care institutions. Poorest of the poor will repose faith in welfare state. Sanjivini, health insurance policy with the Punjab Milkmen Cooperative Societies is already a big success. ECHS (Ex servicemen Contributory Health Scheme) is an other success story. These success stories can be replicated with countless groups like, panwallas, dhabewallas, autorikshaw drivers etc. Simply organize the unorganized sector. There is no dearth of role models from among government doctors also. Their inclusion rather than drift after dissent from the present dispensation of health care will immensely improve the system. Stability of tenure is an excellent incentive government can give to its doctors without costing anything to exchequer. Yet tenure beyond decades should be discouraged as it leads to development of vested interests of the old incumbents and denial of chance to the youngsters. Resource mismatching is a major problem in the govt. run health care system. There are dispensaries where specialists are posted and still many more civil hospitals where non-specialist are posted. These mismatching result in defective and inefficient health care. Nodal Hospitals can be created for round the clock emergency services by cannibalizing defunct and sick institutions where equipment worth crores is lying unused and salary bills are bleeding the exchequer white. Most of the medical officers retire in the same administrate rank. This undue stagnation has forced many a brilliant doctors out of service. By simply seeking options for place of posting, honestly implementing with minimum displacement on merit can also revitalize the govt. doctors’ cadres. Private sector health care delivery system is a totally market driven commercial enterprise. So called ‘market forces’ have least respect for ethical and moral value systems. Multi level marketing chains have evolved in the name of referral systems. End result is exploitation of the unsuspecting common man, who still regards his healer a holy person. This ‘incentive’ system is strengthening the hold of unqualified, unscrupulous and unregistered medical practitioners on illiterate masses. Not many qualified doctors are unscrupulous. A large section of private health care providers feel genuinely threatened by blackmailers of all sorts. Consumer protection act is a very convenient beating stick in the hands of their tormentors.
Under the constant threat of being blackmailed, the private health care providers are becoming more defensive in attitude. More patients are being referred to tertiary care institutions for this reason only, thereby flooding the referral institutions. People have a common feeling that sickness is an invitation for exploitation at the hands of private health care providers. Even the charitable hospitals are charging as heavily as fully private hospitals. Medical profession is fully responsible and capable of self-correction. Medical councils and associations can jointly evolve a fail-safe mechanism to keep their black sheep under check even without government help, but the buck stops with the government. Welfare state is duty bound not only in providing health care delivery system but also proper health care administration and social justice through its health care delivery mechanism.