Tuesday, January 05, 2010

Our Health-Care System And The Nanny State

(Note to family and friends: The most recent update on Mr. AOW is here, updated December 12. Also see this post).

The essay below relates an aspect of my personal experience in dealing with our health-care system when Mr. AOW had a serious stroke last fall. He remained in medical-care facilities from September 15 to November 25.
No doubt about it, when Mr. AOW was released from the inpatient hospital stroke rehabilitation center on October 16, he was unable to be cared for at home. In addition to being completely paralyzed on the left side (limbs and trunk), his sense of balance was completely awry: he could fall forward, backward, or to either side at any given moment. His brain didn't know what direction up was! He also suffered from mental confusion. For example, he said, "I know I'm in the hospital here in Virginia, but I feel like I'm in California."

In fact, in spite of the ninety days of coverage supposedly provided by the health-insurance plan the hospital refused to keep Mr. AOW any longer than two weeks or to release him to home. Instead, the hospital and the nursing home teamed up to release him only to a skilled nursing facility, which costs a minimum of $350 per day.

At both the rehab hospital and the nursing home, both of which were in-network facilities of Mr. AOW's health-insurance plan, I was repeatedly advised to obtain Medicare and Medicaid. This mandate, in spite of the fact that Mr. AOW was not eligible for Medicare at the age of fifty-nine and has always had health insurance for, lo, three decades!

When I pointed out to the hospital and the nursing home that Mr. AOW and I had too many assets to qualify for either Medicare or Medicaid, I was advised to liquidate all those assets that Mr. AOW and I had spent a lifetime accumulating, go bankrupt once those assets were consumed by medical care, and become beneficiaries of the Nanny State. By the way, all assets were on the table, including retirement accounts (IRA's).

Looking back, I realize that both the hospital and the nursing home anticipated that Mr. AOW would always be a resident of the nursing home, never mind that he was admitted there for stroke therapy and not as a long-term resident.

After Mr. AOW made substantial progress after several weeks in the nursing home, the day arrived when I informed the health-insurance company and the nursing home that I would be bringing Mr. AOW home in a few weeks. The representative from the health-insurance company again advised me to seek out Medicaid coverage. Talk about having their needle stuck!

Once we established that Medicaid was not an option and that I was indeed determined to bring Mr. AOW home, I was threatened: "We'll have to report you to adult protective services."

So, how did I bring Mr. AOW home without getting arrested? I had in place the necessary paperwork: complete power of attorney and the advanced medical directive, both of which documents gave me conseiderable legal power. I also had on my side our family physician, who was willing to sign the release orders. This last is very important! Had I not placed Mr. AOW under the care of the family physician, the nursing-home physician could have refused to release Mr. AOW, thus forcing us into bankruptcy.

Also of help was a bit of name dropping, specifically, the name of my husband's personal attorney, famous as "the attorney of attorneys." Were he called in, he would own the nursing home by the time he was finished! At that point, the nursing home, recognizing the kind of legal proceedings they could be up against, agreed to starting the necessary paperwork for Mr. AOW's release from the nursing home. The one requirement: that Mr. AOW receive occasional visits from a registered nurse.

I have learned there is some truth in what some of my older relatives used to say: "Once I go into the hospital, I'll never come back home." Hospitals and nursing homes do have the power to hold patients and their families hostage.

Via the necessary legal documents and before illness strikes, arm yourself in advance so that you don't become a victim of the health-care system's trying to push you and your family under the care of the Nanny State. Believe me, the health-care system will try hard to push you in that direction!

And what would have happened under ObamaKare?

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posted by Always On Watch @ 1/05/2010 11:00:00 PM