{"id":146,"date":"2013-02-06T18:22:00","date_gmt":"2013-02-06T22:22:00","guid":{"rendered":"http:\/\/blog.cmhughesmd.com\/?p=146"},"modified":"2013-02-06T18:22:00","modified_gmt":"2013-02-06T22:22:00","slug":"how-medicare-fails-the-elderly-nytimes-com","status":"publish","type":"post","link":"http:\/\/blog.cmhughesmd.com\/?p=146","title":{"rendered":"How Medicare Fails the Elderly &#8211; NYTimes.com"},"content":{"rendered":"<p><\/p>\n<blockquote><p>Yet Medicare, which pays for all of the above, does not, except in rare instances, pay for long-term care in a supervised, safe place for frail or demented old people, or for home aides to help with shopping, transportation, bathing and using the toilet. <br \/>Nationwide, the median annual cost of a nursing home in 2010 was $75,000; room and board in an assisted living facility, with no additional help, was $37,500; and the most basic category of home health aide, who can perform no medical tasks, like the dispensing of medication, was $19 an hour. These expenses are left to the elderly (and their adult children) to pay for out of pocket until their pockets are all but empty. <br \/>Then they are eligible for <a href=\"http:\/\/topics.nytimes.com\/top\/news\/health\/diseasesconditionsandhealthtopics\/medicaid\/index.html?inline=nyt-classifier\">Medicaid<\/a>, the state-run safety net for the poor. While Medicare, a federal program, is financed by payroll taxes, and thus is an \u201cearned\u201d benefit, Medicaid is \u201ccharity,\u201d in the minds of the formerly middle class who worked their whole lives and never imagined themselves destitute. <br \/>In the case of my mother, who died at 88 in 2003, room and board in various assisted living communities, at $2,000 to $3,500 a month for seven years, was not paid for by Medicare. Yet <a href=\"http:\/\/health.nytimes.com\/health\/guides\/surgery\/brain-surgery\/overview.html?inline=nyt-classifier\">neurosurgery<\/a>, which I later learned was not expected to be effective in her case, was fully reimbursed, along with two weeks of in-patient care. Her stay of two years at a nursing home, at $14,000 a month (yes, $14,000) was also not paid for by Medicare. Nor were the additional home health aides she needed because of staffing issues. Or the electric wheelchair after strokes had paralyzed all but the finger that operated the joy stick. Or the gizmo with voice commands so she could tell the staff what she needed after her speech was gone. <br \/>She paid for the room. My brother and I paid for the private aides and bought her the chair and the \u201ctalking board.\u201d What would her life have been like without the skilled care she required and the ability to get around her floor and communicate her needs? I shudder to think. But none of this was Medicare\u2019s responsibility. <br \/>Yet Medicare would pay for \u201cheroic\u201d care for a woman who was dying of old age, not a disease that could be treated: Diagnostic tests. All manner of surgery. Expensive medications. Trips to the emergency room or the hospital \u2014 had she not refused all of them, in the last year of her life. So, in less than a decade, by my low-ball estimate, my mother spent $500,000 of her own money and uncalculated sums from her two children before winding up what she considered, with shame, \u201ca welfare queen.\u201d <br \/>A recent state-by-state study of long-term care, the first of its kind, by a consortium of researchers, has found that this kind of essential help costs anywhere from 166 percent to 393 percent of the average annual income of America\u2019s elderly. <\/p><\/blockquote>\n<p><a href=\"http:\/\/www.nytimes.com\/2011\/10\/16\/opinion\/sunday\/how-medicare-fails-the-elderly.html?_r=2&amp;pagewanted=print\">How Medicare Fails the Elderly &#8211; NYTimes.com<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Yet Medicare, which pays for all of the above, does not, except in rare instances, pay for long-term care in a supervised, safe place for frail or demented old people, &hellip; <a href=\"http:\/\/blog.cmhughesmd.com\/?p=146\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;How Medicare Fails the Elderly &#8211; NYTimes.com&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"sfsi_plus_gutenberg_text_before_share":"","sfsi_plus_gutenberg_show_text_before_share":"","sfsi_plus_gutenberg_icon_type":"","sfsi_plus_gutenberg_icon_alignemt":"","sfsi_plus_gutenburg_max_per_row":"","footnotes":""},"categories":[79,46],"tags":[],"class_list":["post-146","post","type-post","status-publish","format-standard","hentry","category-long-term-care","category-medicare"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/146","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=146"}],"version-history":[{"count":0,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/146\/revisions"}],"wp:attachment":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=146"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=146"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=146"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}