I was sitting on Frank's couch while he shuffled around his apartment looking for his Medicare card. Why was he looking for it? I'll get to that.
In the midst of a very busy day and several inches of new snow atop a foot or so of old snow, I locked myself out of my maintenance office in a moment of confusion at the apartment complex where I try to keep everybody's stuff from breaking down and their feet from slipping on frozen white stuff, and so there I was suddenly unable to do much of anything productive, tools locked inside the shop with the keys, among other complications. So I decided to visit my friend Frank, the 94-year-old engineer, while I waited for my manager's return.
You've never met anyone like Frank, and I hadn't either until a few months ago. His long life has been filled with a multitude of experiences and accomplishments, such as sailing a yacht around the Bahamas for twenty years or so, singing with a quartet in New York City back before the Great War, working as an electrical engineer for a long time with a manufacturing company or two in New Jersey, having a couple kids along the way with a wife whom I don't know much about except I know their union didn't work out so well.
Being an engineer, Frank is a veritable fountain of knowledge and common sense for a fledgling maintenance man like myself. During this particular week (that just ended,) he had been consulting with me about the mechanics of salt-spreading, because I had been struggling to distribute various snow-melt substances on the sidewalks that adjoin the 94 apartments that I maintain. The cheapo plastic spreader that I had been using wasn't working out so well because the salt grains get stuck in the little door inside the machine that's designed (poorly designed) to let them tumble out so they can melt on the ground where they're supposed to prevent Frank and me and anybody else from slipping on the snow and ice. We had been having an ongoing discussion for several days about the mechanics of this task. Yesterday the dam thing had finally ceased working altogether when a plastic shaft broke in the middle. I had explained to Frank earlier that I had chosen the plastic salt-spreader thinking that it would not corrode and break down like the cheap metal one that I had used before purchasing the plastic one a few months ago.
So there I was locked out in the middle of the day in a moment of exhaustion and exasperation and therefore decided to visit Frank; his place is next door to the office/shop. I walked in; he was cooking onions to go with something in his lunch and boy did it smell good, although I wasn't hungry because I had just grabbed a hamburger on the fly some thirty minutes before.
I sat on the couch and had a few chocolates that he keeps in a jar on the end table. Old folks like to keep little sweet treats like that around, you know.
He was looking for his Medicare card and I asked why. He explained to me, after inserting his hearing aid (which he had earlier removed because it doesn't work well for phone conversations such as the one he had had just a few minutes before,) that a woman at a medical office had requested, during that phone conversation, some bit of information that would be printed on his Medicare card.
"It's not in here," said Frank, in his stunted 94-year-old voice, while flipping through the cards and plastics in his wallet. "I think I know where it is." He slowly righted himself from the easy chair with a maneuver that took some ten or fifteen seconds, then grabbed his cane. "...best thing an old guy like can do--use a cane. Dexter across the way won't use one, but it makes more sense to have three legs than two, I've found."
"What information from the card are they requesting?" I asked.
"The name of my doctor," said he.
"Well, you can tell them that, can't you?"
"Yeah, but she wants to verify that Dr. Birney's name is printed on my card. He's my primary care doctor, but I'm switching to another one, and we need to get all the paperwork straightened out." It took a long time, from my 58-year-old perspective, for Frank to vocalize all this. Meanwhile, at the nearby closet door, he's opening it and pulling documents from a stationery box with one hand while leaning on his cane with the other. "Dr. Birney's phasing out all his Medicare patients, or that's my understanding of it."
"Really, and why is he doing that?"
"I don't know." Frank turned his head slowly and peered at me through the bifocals with a goofy smile. "I guess he's had it with puttin' up with old guys like me."
Frank is lol, and I was amused as well, at his cheerfulness in the middle of a locked-out, snowed-in day.
94 years and still laughing; it doesn't get much better than that.
Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. Show all posts
Saturday, February 13, 2010
Friday, November 27, 2009
What's ironic is that Republicans are protecting Medicare, a program that originated in 1965 as a Lyndon Johnson extension of the Newdealian Social Security entitlements.
Great Societies make strange bedfellows. Forty years later, the Repubs endorse patients' end-of-life choices by protecting what already exists as government-financed health care.
As one concerned recipient famously objected: We don't want the government messin' with out Medicare.
The Dems, bless their bleedin' hearts, want to enact new programs (of course) so that everybody, young and old, rich and poor, can have immediate, subsidized access to the system. It's a noble idea; but the government-wary conservatives ask: will that public option thing really work as cost-effectively as you predict? The repubs don't think so, and believe that it's just a slippery slope into more bureaucracy, taxes, and probably poor health care.
But the Dems are pretty dedicated to this thing. They're searching out ways to locate the obligatory, deficit-defeating appropriations (at least on CBO paper) to legitimatize their proposed near-universal coverage. Meanwhile (back in September) the Washington Post reports that "a quarter of Medicare costs--totalling $100,000,000,000 a year--are incurred in the final year of patients' lives, and 40% of that in the last month."
So the progressives take a hard look at that big pile of Medi-money that we just know is wastefully expended to keep the elderly extended.
The repubs bellow and get all melodramatic about death panels when what they're really hittin' on is: advanced care planning consultations, palliative care and hospice care replacing extreme interventions where appropriate, medical councils setting policies to reprioritize taxpayer money spent on both artificial and authentic life supports.
And thus do we Americans discover that government health care programs are not unlike artificial life support. Dead if you do, dead, sooner or later, if you don't. Either way, you're a goner. Or aunt Em. Question is: how long does it take? And who pays for it? I mean, there are kids down in the ER just dyin' to get into this place.
Up on the fifth floor, here's an old guy strung up in a high-tech hospital bed. His feeble, comfort-seeking attempts to dislodge self from those irksome tubes and wires is, medically speaking, ill-advised.
The family hovers at the bedside; they're unsure of what to do. Perhaps they've never been in this situation before, or maybe they've seen it all before in some other relative's slow demise. Either way, their decisions are not easy.
The doc walks in. He's doing a good job, protecting that elusive, electrified heartbeat, enabling that regular intake and output of precious oxygenating air. In the back of his mind, tucked strategically behind the costly medical knowledge (expensive to acquire and expensive to dispense), he feels vaguely threatened by the ever-present possibility of a malpractice suit. It could be lurking anywhere between the pulmonary edema and the abdominal aneurysm; even now it could be adjusting its briefs in preparation to impose shock and awe upon a hapless jury. Or the doc could be preoccupied with someone down the hall who's in even worse shape than the unfortunate guy that he's now smiling at because the family is in the room and how many times a day does he have to do this, and doc's mind is troubled by the dim awareness that there's something he forgot to do, or some question he forgot to ask while in that other patient's room an hour ago. The busy doc doesn't really have sufficient time to spend with each patient and family in order to thoroughly discern their unique requirements and intents and end-of-life preferences and accompanying documents thereof and after all he's only human and how much more hectic and depersonalized would this pace become if it was all "socialized?"
Meanwhile the nurse palliates and monitors, with the aid of her arsenal of life-extending paraphanalia. She keeps the old guy hydrogenated and his electrolytes balanced. She facilitates the ongoing operation of bodily functions, some of which are quite disagreeable, just like the patients from which they efflue. She dutifully administers the meds, but only, of course, the ones that doc allows, even though she knows in some cases doses are inappropriate and orders are obsolete or insufficient. On this particular day, she may be my wife. But that's not my point.
The pressure's on. Life and death situations are hitting the fan every hour.
Downstairs in the ER, more patients are sitting in chairs, delauded by the droning TV, opiate of the people up on the wall. They wait expectantly to receive what the hospital has to offer; they're limping in with wounds, dragging in with their diseases, some with cancer who don't even know it yet, some with nothing more than sprained ankles.
On the third floor, the hospital's financial legions are trying to reconcile the bills--the hospital's own and also the ones being sent out to cover the complicated expense of all those life-extending services. Statements are being prepared for the patients and their families, their insurance companies, their Medicaid and Medicare, blahblahblah...
Oops. There goes an alarm. It's a code being called. The appropriate personnel gather and do all they can, but one on the sixth floor slips away in spite of their skillful efforts.
"Goodbye," she whispers.
Great Societies make strange bedfellows. Forty years later, the Repubs endorse patients' end-of-life choices by protecting what already exists as government-financed health care.
As one concerned recipient famously objected: We don't want the government messin' with out Medicare.
The Dems, bless their bleedin' hearts, want to enact new programs (of course) so that everybody, young and old, rich and poor, can have immediate, subsidized access to the system. It's a noble idea; but the government-wary conservatives ask: will that public option thing really work as cost-effectively as you predict? The repubs don't think so, and believe that it's just a slippery slope into more bureaucracy, taxes, and probably poor health care.
But the Dems are pretty dedicated to this thing. They're searching out ways to locate the obligatory, deficit-defeating appropriations (at least on CBO paper) to legitimatize their proposed near-universal coverage. Meanwhile (back in September) the Washington Post reports that "a quarter of Medicare costs--totalling $100,000,000,000 a year--are incurred in the final year of patients' lives, and 40% of that in the last month."
So the progressives take a hard look at that big pile of Medi-money that we just know is wastefully expended to keep the elderly extended.
The repubs bellow and get all melodramatic about death panels when what they're really hittin' on is: advanced care planning consultations, palliative care and hospice care replacing extreme interventions where appropriate, medical councils setting policies to reprioritize taxpayer money spent on both artificial and authentic life supports.
And thus do we Americans discover that government health care programs are not unlike artificial life support. Dead if you do, dead, sooner or later, if you don't. Either way, you're a goner. Or aunt Em. Question is: how long does it take? And who pays for it? I mean, there are kids down in the ER just dyin' to get into this place.
Up on the fifth floor, here's an old guy strung up in a high-tech hospital bed. His feeble, comfort-seeking attempts to dislodge self from those irksome tubes and wires is, medically speaking, ill-advised.
The family hovers at the bedside; they're unsure of what to do. Perhaps they've never been in this situation before, or maybe they've seen it all before in some other relative's slow demise. Either way, their decisions are not easy.
The doc walks in. He's doing a good job, protecting that elusive, electrified heartbeat, enabling that regular intake and output of precious oxygenating air. In the back of his mind, tucked strategically behind the costly medical knowledge (expensive to acquire and expensive to dispense), he feels vaguely threatened by the ever-present possibility of a malpractice suit. It could be lurking anywhere between the pulmonary edema and the abdominal aneurysm; even now it could be adjusting its briefs in preparation to impose shock and awe upon a hapless jury. Or the doc could be preoccupied with someone down the hall who's in even worse shape than the unfortunate guy that he's now smiling at because the family is in the room and how many times a day does he have to do this, and doc's mind is troubled by the dim awareness that there's something he forgot to do, or some question he forgot to ask while in that other patient's room an hour ago. The busy doc doesn't really have sufficient time to spend with each patient and family in order to thoroughly discern their unique requirements and intents and end-of-life preferences and accompanying documents thereof and after all he's only human and how much more hectic and depersonalized would this pace become if it was all "socialized?"
Meanwhile the nurse palliates and monitors, with the aid of her arsenal of life-extending paraphanalia. She keeps the old guy hydrogenated and his electrolytes balanced. She facilitates the ongoing operation of bodily functions, some of which are quite disagreeable, just like the patients from which they efflue. She dutifully administers the meds, but only, of course, the ones that doc allows, even though she knows in some cases doses are inappropriate and orders are obsolete or insufficient. On this particular day, she may be my wife. But that's not my point.
The pressure's on. Life and death situations are hitting the fan every hour.
Downstairs in the ER, more patients are sitting in chairs, delauded by the droning TV, opiate of the people up on the wall. They wait expectantly to receive what the hospital has to offer; they're limping in with wounds, dragging in with their diseases, some with cancer who don't even know it yet, some with nothing more than sprained ankles.
On the third floor, the hospital's financial legions are trying to reconcile the bills--the hospital's own and also the ones being sent out to cover the complicated expense of all those life-extending services. Statements are being prepared for the patients and their families, their insurance companies, their Medicaid and Medicare, blahblahblah...
Oops. There goes an alarm. It's a code being called. The appropriate personnel gather and do all they can, but one on the sixth floor slips away in spite of their skillful efforts.
"Goodbye," she whispers.
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