Health Care Eye-Opener for Me

breamfisherbreamfisher Senior MemberPosts: 4,608 Senior Member
A few weeks ago (just after the forum died) I had an interesting occurrence. I got a knock on my door, and was asked by a teenager to come and help her grandparent, who had fallen down and was unable to get up. The other grandparent and the teenager were unable to help the grandparent up. Long story short, I got over there and the grandparent was on the floor with cold, clammy, gray skin, pain radiating out of their shoulder up their neck on the side opposite that which they fell on, and was beginning to babble incoherently.

911 was called as we could not move the grandparent and I did not feel comfortable rendering aid with neck pain and a possible head injury from the fall. Paramedics showed up and started taking a history, whereby it was revealed the grandparent was diabetic and had not monitored their blood sugar for several days. It was 591! The grandparent was taken to the hospital, where it was revealed that person had suffered a heart attack 2 days prior. Additionally, fluid was accumulating in the lungs.

The grandparent suffered a second heart attack and passed away after 5 days stay in the ICU of the hospital under constant monitoring, respirator use, and other heroic measures. The grandparent had to be ambulanced from 1 hospital to another to get the care. They had not monitored their blood sugar because they were on a combination Medicare/Medicaid, and the funds had run out for diabetic test strips and such when all the other meds for both grandparents were paid for.

It's brought up an interesting line of thought for me: how much did 5 days of that care cost? Considering the costs of the care and the 2 ambulance rides, how much in the way of diabetic monitoring supplies would that have paid for? These are all taxpayer-incurred costs, and I have no doubt they occur nationwide on a daily basis.

It then lead to my final thought: how much money is spent by taxpayers on an annual basis trying to provide intensive care for people who are low income and have conditions like heart disease and diabetes, disorders that will lead to hospitalization and expensive hospital bills if not monitored and maintained? In these cases, how much taxpayer money would be saved if monitoring was provided for free (still at taxpayer expense, I will grant) so that these expensive hospital visits were avoided?

Replies

  • JulietJuliet Posts: 0
    Weel I see that the GOP death panels are functioning properly
  • SaraSara Senior Member Posts: 512 Senior Member
    What a sad story. Sometimes having home visit nurses can help in those types of situations. Sometimes the patient doesn't drive anymore and may even become forgetful about their medications and health care routines. Even though home nurse care would be expensive, it would be less expensive than the hospitalization, ambulance, etc. Maybe you would not even have to have RN but LVN do the visits?
  • P.DieterP.Dieter Super Moderator Posts: 968 Senior Member
    this is right there with the cry of "I don't want to pay for other people's healthcare".

    people, you already do. And you're getting hosed on the deal
    ___________________________________________________________________________________
    it is the mark of an educated mind to be able to entertain a thought without accepting it
    - Aristotle



    Northwest Fly Anglers
  • breamfisherbreamfisher Senior Member Posts: 4,608 Senior Member
    Heck, just getting test strips in this case might have averted the problems. Paul's right, we're getting hosed.
  • JulietJuliet Posts: 0
    By the way

    Medicare does cover test strips, etc as diabetes coverage has become pretty universal in understanding the benefits of preventive care

    Medicaid coverage varies state to state and is managed by the individual states. I am not familiar with Florida's coverage or current status of Medicaid funding

    point being ... don't always be sure that the patients complications were neccessarily due to a lack of funding because one key issue to Medicaid patients and treatments/benefits is a problem with patient compliance in chronic care ... while this is a legitimate concern in managing funding of programs it isn't acceptable to use it as an excuse to eliminate funding (if we in fact consider ourselves a compassionate society)

    anyway bottomline ... not enough accurate info (and the patients family may not be a credible source ... just sayin')
  • breamfisherbreamfisher Senior Member Posts: 4,608 Senior Member
    The patient said they didn't have test strips because they lacked the money, and the spouse said that either the Medicare or Medicaid (they were unclear as to who) allotment had run out for the month. Just sayin'....
  • JulietJuliet Posts: 0
    Sara wrote: »
    What a sad story. Sometimes having home visit nurses can help in those types of situations.

    Sara, my aunt was a Public Health nurse when first out of Nursing School. In those days they actually did go house to house to check in on indigent patients. My comments above apply ... do not constru those comments to mean we discard people because but keep in mind that even among patients who are effective at managing their money, their jobs, etc that the number one reason any treatment plan or therapy fails is still from lack of patient compliance ... even something as a simple as a once a day medication barely achieves anything more than a compliance of ~ 86% (maybe even less) ... so you can imagine what compliance is with a person checking their blood sugar multiple times a day

    it seems like such common sense but the level of common sense or lack thereof is the flas inherent in the system
  • Brian D.Brian D. Senior Member Posts: 4,011 Senior Member
    It's brought up an interesting line of thought for me: how much did 5 days of that care cost? Considering the costs of the care and the 2 ambulance rides, how much in the way of diabetic monitoring supplies would that have paid for?

    It's a wash. If that old effer had monitored his blood sugar, he would have lived longer and wound up in a nursing home that would have cost more than the 5 days in the hospital. Now he is no longer a burden on the system, leaving more taxpayer money to pay for Viagra for old Republican retirees.

    bd
  • P.DieterP.Dieter Super Moderator Posts: 968 Senior Member
    The patient said they didn't have test strips because they lacked the money, and the spouse said that either the Medicare or Medicaid (they were unclear as to who) allotment had run out for the month. Just sayin'....

    Bream I think monkey's point was like eyewitnesses, patients families' stories aren't always the most accurate. which is a valid point but I don't think it negates what all of us to know as the realities of these examples
    ___________________________________________________________________________________
    it is the mark of an educated mind to be able to entertain a thought without accepting it
    - Aristotle



    Northwest Fly Anglers
  • creekguycreekguy Senior Member Posts: 3,905 Senior Member
    I read somewhere that a third of medical costs go to treat people in the last 6 months of their life. There are similar numbers out of different sorts.
    Thats the way it will be until (cynicism alert) old people start "dropping out" of the electorate (well, except in Chicago and Texas)and lose political power. Alzheimer's alone will bankrupt the system unless an effective treatment is found.
    I admit I am a consumer in the system, though i'm 67 and healthy. My Medicare costs 4,000 less than my old medical insurance. My pancreas thanks you for staying on the payroll.
  • breamfisherbreamfisher Senior Member Posts: 4,608 Senior Member
    Paul,
    I get that after some re-reading. However, knowing these folks, they're pretty down on the poverty line. If anyone would be have health issues from lack of funds, it would be them.

    The deceased was also on some other meds, which I do not know, but when the paramedics saw them with the high blood sugar, they said they needed to get the individual to the hospital, fast.
  • JulietJuliet Posts: 0
    The patient said they didn't have test strips because they lacked the money, and the spouse said that either the Medicare or Medicaid (they were unclear as to who) allotment had run out for the month. Just sayin'....

    I understand what the patient is 'saying' or their spouse and that is my point ... many states do limit the number of strips per month and perhaps that is what is meant by 'allotment' I think most limit the number of strips they pay for to 100-120 which gives the patient 3 tests per day with some left over and that is for Medicaid ... Medicare's reimbursement is more liberal and in either case there are numerous online and 1-800 vendors who will fill an order, ship and bill either agency directly

    don't misunderstand and presume I am automatically blaming the patient but what I am trying to get you to understand is that with diabetic care and supplies and Medicaid and Medicare it's one of the more comprehensively covered medical conditions and your neighbor may not neccessarily be a symptom of a problem with economically distributing heathcare

    just a cursory search of the interwebs shows that test strips are covered
  • breamfisherbreamfisher Senior Member Posts: 4,608 Senior Member
    Like I said, I get what you're saying. On the other hand, these folks are in and out of the hospital multiple times due to health concerns that would be better taken care of with constant monitoring. However, being on the economic low end, they have limited access to some of these resources, and might be suffering for this.

    My point is, if we're trying to allocate health care on an economic basis, we're probably money ahead to pay for the monitoring care than if we are to pay for emergency care when these issues come up. Sara's idea of a visiting nurse has merit, as this might provide the impetus and education to get the problems under control.
  • JulietJuliet Posts: 0
    However, being on the economic low end, they have limited access to some of these resources, and might be suffering for this.

    ..... Sara's idea of a visiting nurse has merit, as this might provide the impetus and education to get the problems under control.

    First point .... we don't know this without actually seeing their actual medical history (which often times varies dramatically from a verbal recollection) plus their existing plan of coverage (medicaid, etc) along with formulary coverage for said plan ... my point remains your presumption of lack of available resources to the patient may in all probability not be so

    Second point ... see my above post ... we used to do just that and what was demonstrated is it made almost no significant improvement in compliance without the nurse standing over the patient 24/7 therefore the resource of a trained nurse devoted to the activity was not cost effective (spread out over the larger patient population)

    BTW ... if they had called their doctor and said they were out of test strips for the month and need to get more to finish out the month it likely could have been done and test strips costs (per box of 50) start at around $7-8 ... I get they are waayyy down on the poverty line but I am also betting that on Medicaid they weren't using the $30/box brand and likely spent $7 on something non-essential in that month's time too.

    You and I are on the same page that much of our healthcare delivery system needs to be fixed but like I said I wouldn't neccessarily think that this is a prime example of it failing ... my dad's been a diabetic for 15 years and on medicare. There has never been an issue with his supplies only an issue with getting him to stay with the monitoring and diet.
  • GoldenladleGoldenladle Super Moderator Posts: 3,879 Senior Member
    monkeydoes wrote: »

    You and I are on the same page that much of our healthcare delivery system needs to be fixed but like I said I wouldn't neccessarily think that this is a prime example of it failing ... my dad's been a diabetic for 15 years and on medicare. There has never been an issue with his supplies only an issue with getting him to stay with the monitoring and diet.

    I agree, I being diabetic as well and my first thought was, isn't he on any medication in addition to monitoring his blood sugar? If he's taking his meds, there's no way he would have had that kind of blood sugar spike. So I think there's more to the story we're not hearing. Test strips can be expensive depending upon how your physician wants you to monitor (me 5 times a day) My pharmacist has told me that if I ever run out to just come in and ask for more and they will deduct it from or add it to my next order, which I do every 90 days.

    This story is tragic, but troubling as well.

    Moved to Montana, gonna be a dental floss tycoon.

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