THE NEED FOR A FAMILY TRIAGE
One of my best friend’s mother had a stroke over the weekend. She is 84 years old and all nine of her children came to visit her bedside in the hospital, coming from across the country from Alaska to New York. The surprising part of this crisis was the anger that “Mom” displayed at finding herself in this situation; anger derived from wishing her husband had not called the ambulance and had let her die. Anger because she could hear, see, and understand everything. Anger because she could not talk, write, read or control her muscles.
It was not as she had planned to go. However, she somehow made it clear to every member of the family, and they accepted her wishes, that not a single step more be taken to prolong her life. She had a good life with her husband raising nine children and sending them all through college. The marriages, the grandchildren, the holidays and their travels she still remembers with loving regards. I was told she even remembered me and we had only met a few times many years ago.
There will, of course, be a protocol of vocational training to attempt to help her better communicate. But the issues relating to this situation go far beyond estate planning. These parents are that part of the World War II generation that began buying insurance the minute they were released from the military. The issue is not about working the Medi-Care system in your favor and still keeping what you have earned over your life, it’s not the possibilities of late steps that can be taken to rearrange your family will or trust, or create one if it’s not too late.
The only issue here in California is your Health Care Directive and your Durable Power of Attorney. These are the documents used to eliminate any misunderstanding as to who is in control to make your health care decisions such as whether you live or die. If you really want to ensure there is no misunderstanding use the Health Care Directive form issued by the hospital in which you will most likely be cared for, such as Cottage Hospital in Santa Barbara. Doctors, nurses and administrators are much more comfortable with their own hospital’s form created by the California Association of Hospitals, then any priced document you may present from the work of your personal attorney. Although you should still seek their advice on filling it out.
Here is the caveat, this must be done before the stroke or illness befalls you, not afterwards because you or your spouse may not be competent to enter into such a contract.
But as for my friend’s mother, a debilitating stroke such as hers is never going to come when everyone’s prepared. There is never a time to be prepared to see you mother go from a lively, intelligent, and happy Grandma to a fate worse than death. What would it be like to be dead on the outside but alive on the inside? How long can that go on? What is it like to want to scream and not have the required motor skills to do so?
Whenever there is a major calamity such as Hurricane Katrina or the tsunami in Haiti there is a federal team of emergency paramedics out of Washington D.C. that attempts to be first on the scene anyplace in the world. I know a young man who is on that team and regardless of what was said about response to the catastrophe caused by Katrina, this man and his team of heroes were in the Superdome within hours of the crisis. The first thing they do is set up medical centers called a “triage.”
The US Department of Defense defines "triage" as follows: "The evaluation and classification of casualties for purposes of treatment and evacuation. It consists of the immediate sorting of patients according to type and seriousness of injury, and likelihood of survival, and the establishment of priority for treatment and evacuation to assure medical care of the greatest benefit to the largest number
In other words, this young man, not yet in his thirties, in a matter of minutes, if not seconds, takes vital signs of the wounded, evaluates their likelihood of survival against the needs of a thousand others that may live or die. Given this necessity to assure medical care of the greatest benefit to the largest number makes “death panels,” of which there are none under the new health plan, sound rather civil.
At any rate, my friend’s family spent the weekend working on this issue, and upon Mom’s own request, the decision was no more life enhancement treatment. Perhaps she felt someone else would get greater benefit.
Monday, March 29, 2010
Monday, March 22, 2010
2010 Reconciliation Act
“THIS IS WHAT CHANGE LOOKS LIKE.”
President Obama
If this is what change looks like, I must admit it is not very charming. For all of you that may have had your weapons primed, your epithets at the ready, and your cross hairs focused on killing any kind of bill that changed health care, forget about it. The 2010 Reconciliation Act has passed.
I have been registered as an Independent since college because there was nothing I wanted to be affiliated with that was always Democratic or always Republican. There was never a platform where all of one party was right and all the others wrong. Voting down your party’s line never made sense to me. My father was Republican and my mother was a Democrat. Every election they would cancel out each other’s vote.
The lack of bi-partisanship cooperation on both sides in making this historical legislation was shameful. The Democrats only won because there are more of them then Republicans in the House of Representatives, plus one more asset. Above all else they had the leadership of President Barrack Obama. If there is anything to be learned from this undignified procession of debates and name calling it is the qualities of a man that holds no fear for his convictions.
The full quart press he put on in and outside Washington D. C. against his dissenters earns him a place in history that very few presidents can be proud to say they won. Even though he did not get one Republican vote he put his entire presidency on the line just to hold his own party together. Yes, he compromised, but that is how things change. If you want to see what change looks like, look at President Obama.
If you want to know how the 2010 Reconciliation Act affects you is a lot more difficult to discern. The problem is you can’t answer the question because you have no knowledge of how whatever has been bestowed upon us will be implemented. We know it mandates another huge government administrative agency and that is never good.
We are told the immediate effects are that children cannot be denied insurance due to preexisting conditions, and we can keep our older children on the family plan until they are 26 years old. That must be helpful to a certain percent of the population. But that’s no trillion dollars worth. And how 30,000,000 more Americans are going to become insured over the next ten years begins to boggle the mind – particularly when they say this is legislation drafted to include more of the middle class. Just how far down does the middle class go?
The most important part of the Bill affecting my life is the right to purchase new insurance at a reasonable price even though you have a previous condition. This otherwise means not being able to purchase insurance if you have been to a doctor in the last ten years as a result of atria fibrillation, or fluttering heartbeat. Never mind if you have climbed 100 mountains over 16,000 feet since then. You may presently still be uninsurable.
That is all suppose to change, but not until the year 2014. That means Anthem Blue Cross and Blue Shield can still more than double my monthly premium from $778.00 to $1584 every month for one reason: A week ago I was 59 years old and the next day I was 60 years old. I mean this very sincerely when I say one day’s difference is not worth almost ten thousand dollars a year for insurance.
But they are allowing it to go on for four more years! I understand there were eight lobbyists for every House Representative voting but Obama stated after it passed, “This reform just gave you more control by reigning in the worst excesses and abuses of the insurance industry.” It’s hard to understand why they would make us wait four more years unless this is not considered one of the worst excesses. Perhaps Obama should have made more than the 92 personal calls they report to rally the Representatives.
I am happy the Bill passed because I have sued insurance companies to get people their proper due for twenty-five years and insurance companies have been abusing as much as they can during that period. At least this Bill recognizes some of those abuses and can be called a start. All it can do is get better.
Mark S. Cornwall, 3/22/2010
President Obama
If this is what change looks like, I must admit it is not very charming. For all of you that may have had your weapons primed, your epithets at the ready, and your cross hairs focused on killing any kind of bill that changed health care, forget about it. The 2010 Reconciliation Act has passed.
I have been registered as an Independent since college because there was nothing I wanted to be affiliated with that was always Democratic or always Republican. There was never a platform where all of one party was right and all the others wrong. Voting down your party’s line never made sense to me. My father was Republican and my mother was a Democrat. Every election they would cancel out each other’s vote.
The lack of bi-partisanship cooperation on both sides in making this historical legislation was shameful. The Democrats only won because there are more of them then Republicans in the House of Representatives, plus one more asset. Above all else they had the leadership of President Barrack Obama. If there is anything to be learned from this undignified procession of debates and name calling it is the qualities of a man that holds no fear for his convictions.
The full quart press he put on in and outside Washington D. C. against his dissenters earns him a place in history that very few presidents can be proud to say they won. Even though he did not get one Republican vote he put his entire presidency on the line just to hold his own party together. Yes, he compromised, but that is how things change. If you want to see what change looks like, look at President Obama.
If you want to know how the 2010 Reconciliation Act affects you is a lot more difficult to discern. The problem is you can’t answer the question because you have no knowledge of how whatever has been bestowed upon us will be implemented. We know it mandates another huge government administrative agency and that is never good.
We are told the immediate effects are that children cannot be denied insurance due to preexisting conditions, and we can keep our older children on the family plan until they are 26 years old. That must be helpful to a certain percent of the population. But that’s no trillion dollars worth. And how 30,000,000 more Americans are going to become insured over the next ten years begins to boggle the mind – particularly when they say this is legislation drafted to include more of the middle class. Just how far down does the middle class go?
The most important part of the Bill affecting my life is the right to purchase new insurance at a reasonable price even though you have a previous condition. This otherwise means not being able to purchase insurance if you have been to a doctor in the last ten years as a result of atria fibrillation, or fluttering heartbeat. Never mind if you have climbed 100 mountains over 16,000 feet since then. You may presently still be uninsurable.
That is all suppose to change, but not until the year 2014. That means Anthem Blue Cross and Blue Shield can still more than double my monthly premium from $778.00 to $1584 every month for one reason: A week ago I was 59 years old and the next day I was 60 years old. I mean this very sincerely when I say one day’s difference is not worth almost ten thousand dollars a year for insurance.
But they are allowing it to go on for four more years! I understand there were eight lobbyists for every House Representative voting but Obama stated after it passed, “This reform just gave you more control by reigning in the worst excesses and abuses of the insurance industry.” It’s hard to understand why they would make us wait four more years unless this is not considered one of the worst excesses. Perhaps Obama should have made more than the 92 personal calls they report to rally the Representatives.
I am happy the Bill passed because I have sued insurance companies to get people their proper due for twenty-five years and insurance companies have been abusing as much as they can during that period. At least this Bill recognizes some of those abuses and can be called a start. All it can do is get better.
Mark S. Cornwall, 3/22/2010
Subscribe to:
Posts (Atom)
