Shortage of doctors

With the boomers aging, a shortage of doctors is the last thing this nation needs--- yet, this is what is expected to happen by 2020 (with 5 states demonstrating a very critical need) according to the Wall Street Journal article, Nevada Tops List of States At Risk for Doctor Shortages (as you can surmise from the title, Nevada tops the list of states most in need of family doctors).

We don’t know what the answer is but perhaps there should be (government) incentives for med students to go into family practice, instead of going into specialties (which pay more). Hey, there are incentives to join the military (college tuition paid, etc), why not offer incentives for med students to become family doctors, especially in the states that are in dire need of them? When there was a shortage of nurses (and we believe there still are in some states), there were incentives to join nursing school programs.

As one physician put it “Every day, we hear candidates for public office talk about the situation in Iraq or threats to our national security. Those are important discussions, but the number one concern of voters -- health care -- is being largely ignored. Candidates for public office owe it to the people …to tell us how they would fix our health-care system before it is too late, and voters owe it to themselves to question the candidates.”

We couldn’t agree more!

Hospitals with fireplaces and pianos?

This is not such a crazy idea according to the NYT article, What Healthcare Should Look Like. Imagine, a hospital with community rooms offering relaxing piano music, fireplaces that invite warmth (and not the coldness/antiseptic feeling usually associated with hospitals). Imagine being able to pass the time with some community activities offered by the hospital. Contrary to popular belief, not every patient admitted into the hospitals is contagious (for example, those admitted for chemotherapy treatments are not contagious) and they too want to keep their minds off their conditions. Nobody likes hospitals--- it is too soulless. There is no life (and the hospital is the last place you want to associate as having “no life”).

What if architects could come into each hospital and completely redo them—make them friendlier, comforting, caring, less scary --- and even have a soul? What if you can spend your visiting hours with loved ones on a couch playing a game of chess? What if there were courtyards available to the patients/caregivers (so that during visiting hours they aren’t confined to 4 white, antiseptic walls in a room separated from the next patient a few feet away by just a curtain?)

What if...?

LTC education & outreach; Caregiving in America

We wanted to take this opportunity to applaud our friend, Hunter McKay, and Health & Human Services for making long term care a priority. In conjunction with AoA, ASPE, and CMS, HHS announced earlier this week the “Own Your Future” long term care education and outreach campaign in Georgia, Massachusetts, Michigan , Nebraska , South Dakota and Texas. Everyone should get this kit and start the planning with their families. (Please see announcement on the left).

For those who may have missed it, this afternoon the International Longevity Center-USA released a new report, Caregiving In America which, through extensive research, concluded the “current caregiving system for older adults is insufficient and that the boomers are going to be facing a ‘crisis.’”

Thank you for this wonderful, detailed and extensive report which everyone should take seriously because there is a crisis looming.

However, CareTALK believes we ALL have a part in helping to prevent this crisis—not just the professional caregivers whom the ILC seemed to focus on during this afternoon’s press briefing teleconference. We are ALL caregivers. It is our natural duty/responsibility to help care for our loved ones. (If we don’t, who will? The government?). However, we need to manage effectively, intelligently, and efficiently – while not giving up our individual lifestyle. This is where CareTALK will help.

It's all about family time

A worldwide study released today “It's a Family Affair: the Media Evolution of Global Families in a Digital Age,” by Yahoo and OMD found many interesting points including the fact that families are “harnessing pervasive technology and media to help them manage busy households and achieve more balanced, satisfying lives.” According to the study about 70% of those surveyed “agreed that technology allows them to stay in touch with family.” This is especially true for those who live hectic lifestyles and need technology in order to manage their daily responsibilities---including caregiving.

As we’ve said before, we are all caregivers --- whether it is for our parents, our children, our friends, or ourselves. We are all caregivers.

The study also found that, on average, we tend to pack into a 24 hour day, 43 hours worth of activities (talk about multi-tasking!). But consider this… how many of you actually just sit down and do just one thing? For instance, while working/doing homework, don’t you also have the tv or radio on in the background? While commuting to/from work, how many of us are also talking on the phone making last minute appointments or checking in on our loved ones?

We are definitely a culture of multi-taskers! And CareTALK is going to help you manage all your responsibilities efficiently (and help with the multi-tasking)--- leveraging the newest technologies ( and our partners).

Healthcare costs out of control!

If anyone needs further evidence that we need a better, more efficient, more cost sensitive healthcare system, perhaps you should read the article in the Wall Street Journal, Health-Care Premiums Rise 7.7%, Outpacing Wages and Inflation. Health Care premiums rose 7.7%!! No wonder the percentage of uninsured Americans rose to 41% in 2005. No one can afford health insurance.

So, let’s get this straight… not only did the health insurance premiums rise (and you can bet they will keep rising every year) but even if you are insured, coverage can be canceled retroactively (please see posting from September 23 below) thereby giving you no sense of security that when you really need the insurance, it will be there to cover your expenses (that is, after all, the reason you are paying the premiums in the first place).

Doesn’t anybody think we need a better system? Perhaps (dare we say) universal health coverage?

Dolce & Gabbana for less

There was a time, when yes, boomers would spend hundreds (if not thousands) on designer collections. Despite the boomers being the richest age group, they realize that with the economy as bad it is and the fact that there might not be much government assistance to cover their healthcare costs (not to mention, even if they have private insurance, it doesn’t guarantee their coverage should they become ill-- see posting "Retroactive cancelations" below), and they cannot afford to spend frivolously. (This by no way means they won’t continue to buy luxury items--- they’ll just think twice about it now.) As they age, they are looking at the requirements for retirement and the money that is needed to age comfortably and continue with their lifestyle.

The designer fashion companies are now taking this into account (and probably also realizing that the younger generation doesn’t have as much money as the boomers have). According to the Wall Street article, Luxury Fashion Lite, Messrs. Dolce and Gabbana (of the Dolce & Gabbana label) are focusing on their D&G line, a mid-priced collection, after taking back the license and control of the brand last year. This is “part of a wider trend in which the world's luxury fashion houses are looking to their lower-priced secondary labels for growth.”

They will have to compete with companies such as H&M, Zara, and Mango. However, we think this will be successful. The Dolce & Gabbana brand stands for quality--- hopefully, they can create fashions specifically for boomers with certain conditions such as Nicole Miller who created water resistant black stretch pants for those with incontinence.

Times are changing

Yes, our representatives in Washington are finally realizing times it is they who need to control the cost of healthcare/prescription medication. According to the Wall Street Journal article on Thursday, Republicans Agree to Ease Ban On Prescription Drug Imports, the US House of Representatives agreed to allow Americans to carry a 90-day supply of medication into the US from Canada. This is a major step in putting pressure on the pharmaceutical companies to lower the cost of prescription drugs. Hopefully this is a precursor to legally allow the sales of prescription drugs over the internet from Canada and abroad. Once this occurs, domestic prices for medications will decrease--- and as a result, so will healthcare costs (and then, health insurance costs, etc).

Lowering healthcare costs will be greatly needed, especially with public employees retiring and receiving healthcare coverage as part of their retirement pension. According to the NY Times article, Retiree Health Care May Overwhelm Gov'ts, the estimate of these benefits is currently in the “hundreds of billions of dollars over the next three decades, threatening some local governments with bankruptcy and all but guaranteeing cuts in services like education and public safety.” The main reason for this staggering amount is because of the rising costs of health care.

We need to do something about this! We need to encourage our representatives to continue pushing for the legalization of international prescription drug sales over the internet. This will at least put some pressure on the pharmaceutical companies to lower their domestic prices.

A bank to release its first music album?

Yes, you read right.

According to the article in the NY times by Rob Walker, Branching Out, Umpqua Bank, based in Portland Oregon, is diversifying into other ventures. Not only do they call their branches “stores”, but they are releasing an album, have Umpqua brand coffee, and offer their “stores” as settings for “sewing groups, yoga classes and movie nights.” They want to be the place to hang out. (Hey, if you run low on cash you don’t have to worry about having to run out to find an ATM).

This is what banking should be—not an overly, pompous, stuffy institution.

Even they realize that banking is part of your life--- part of your lifestyle. It is now coming to pass that fields all around us—health, financial, etc,-- are realizing that they CAN (and need to) integrate themselves into the consumer’s lifestyle. This is the goal of CareTALK. We aim to integrate caregiving and your caregiving responsibilities into your everyday lifestyle. We are all caregivers already--- but we do not identify as such. CareTALK will elevate the profile of the caregiver so that we all wear the title proudly.

We are all CAREGIVERS.

We applaud Umpqua Bank for thinking of the consumer!

Retroactive cancelations

If you thought there was something wrong with the health insurance company--- you’re right. Paul Krugman’s Op-Ed, Insurance Horror Stories, in the NY Times hits it right in the head--- just because you have insurance, does not mean you’re covered.

What? How is this possible?

There have been cases where coverage has been canceled retroactively--- in a growing trend where “more and more health insurers are finding ways to yank your insurance when you get sick.” (Hey, if companies can find ways to backdate options and grant them to people after they’re deceased, anything is possible.)

Until this great (and wealthy) nation can provide healthcare to every American like other nations do with their own citizens (Gasp! universal healthcare??), we have to look out for ourselves. Therefore, take a good look at your insurance and familiarize yourself with the fine print.

Yes, even “The Donald” is targeting the boomers.

Now it seems that Donald Trump, who recently turned 60, is building his latest luxury development specifically for the boomers. According to the article, Trump building boom, in the NY Daily News, if you’re looking to buy an apartment in this 141 unit complex, you (or one of the buyers) need to be at least 55 years old. This is perfect timing because as the boomers are entering retirement, they will start buying property as an investment (boomers are after all the nation’s richest age group).

A very interesting point the article makes is that just because it is for the “55-and-over crowd,” it by no means signifies they will be inactive. Mr. Trump calls the housing “active adult housing” whereby there will be “indoor and outdoor swimming pools and biking and walking trails to keep everybody moving.”

Aging is no longer for those 50+

To those who have not yet seen the trend line… the internet is where the consumers are—even makeup consumers. As Marjorie Lau, the VP of Estée Lauder Marketing North America was quoted in the Wall Street article, Estée Lauder Tests Web-Ad Waters, “Today, consumers are more savvy, more involved and do a lot of research online."

Of course! Consumers do almost all their research (and their shopping) online. Why wouldn’t they do the same for cosmetics? It’s about time Estée Launder got with the program. At least now, they have realized this and are launching an interactive website that allows for consumers to post their testimonials (word of mouth buzz is really important in the cosmetics industry).

One very important goal for the online marketing push is to reach the younger consumers because they realized that “people in their early 30s are thinking about aging and they're talking about it online.” (This should not come as a surprise since everyone is talking about everything online.)

But this is a very important point--- even Estée Lauder, typically a brand targeted to the boomers is now targeting the younger generation for aging products. Aging is not only for those 40, 50+. Aging and healthy living needs to start at a young age. You can read more about what should be done for each decade ( 20s, 30s, 40s, 50s, 60s, and 70s. ) in our blog on Yahoo! Health “Aging & Caregiving: Healthy Aging for a Lifetime.”

Conflicted insurance consultants/brokers

There is something wrong with the system when consultants and brokers hired to give independent assessments and advice on the best health insurance or prescription-drug coverage are excused for receiving bonuses from the insurance companies they are evaluating as a “thank you” for their loyalty. They believe it’s ok to receive such gifts because the payments are “standard in the industry.” The article in the Wall Street Journal, Health-Care Consultants Reap Fees From Those They Evaluate, describes three separate cases where the consultants/brokers were receiving bonuses for their loyalty. The article says “Aetna gives brokers a ‘retention bonus’ for staying loyal” (we call this a kickback). In the first case described, the consultant was hired for $35,000 a year to help pick the best insurance. Little did the employer know, the same consultant was paid a total of over $500,000 in payments and other compensation by the insurance company he had recommended. And the consultant’s son claims there is no conflict of interest? That he did nothing wrong because the “payments he received are standard in the industry… ‘All [insurance] companies offer bonuses.’” Sorry, but that’s a load of ****.

Insurance companies say that the incentives and bonuses are not built into the premiums the clients pay and they don’t raise health care costs --- We, respectfully, disagree.

It’s time to clean this mess up! It’s a good thing New York state Attorney General Eliot Spitzer brought this to light in the public eye about two years ago through a widely publicized investigation of several brokers and insurance companies.

Everybody needs to be vigilant. As the article says, one question that needs to be asked when hiring consultants is “"Who are you working in the best interest of, yourself or the client?"

Mozart at age 70?; Google has done it again!

If Mozart Had Had Better Health Care, written by Anthony Tommasini for the NYTimes is a very interesting article that gives us pause--- What IF Mozart, and all the other great minds/talents, had better health care? Mr. Tommasini focuses on Mozart and presents a very realistic scenario of how many things in music would be different. For one, we would have many more musical pieces from Mozart (he wrote 22 works in the span of 23 years).

However, as we had written in a previous entry (see the entry for August 31st), recent studies have shown that your longevity is not necessarily due to your genes. Therefore, it does not matter that Mozart’s father, mother and sister lived to a ripe old age—perhaps even if there was better health care. Today, we do have better health care and yes, we are living longer every day; however, we are still fighting diseases for which we do not have a cure and do not fully understand-- for example, cancer.

Even with better health care now, most people can’t afford to receive the health care they need—the treatments that would cure them. As written in previous entries—30% of those between the ages of 18-24, 25% between the ages of 25-34, and overall about 16% of all Americans have no health insurance. Yes, we have better health care—but what does it matter if there are so many millions of Americans who can’t afford to receive this better health care?


Google has done it again—and now with its new philanthropic entity, Google.org. The quote by Andrew Cassel (The Economy Google tries to refresh our notion of charity, The Philadelphia Inquirer) explains quite nicely the decision to make Google.org a for-profit entity, instead of the traditional non-profit organization: it is “a conceptual breakthrough.” (Mr. Cassel shouldn’t be surprised-- everything Google does is a “conceptual breakthrough”).

And we agree with Mr. Cassel, nonprofit organizations may be limited due to our laws for nonprofit organizations. In addition, as Mr. Cassel writes, just because an entity is nonprofit does not necessarily mean it is altruistic—or established for the common good. (You know those tax incentives for nonprofits are VERY enticing.)

We applaud Google for this “conceptual breakthrough” – but again, we’re not surprised.

After all, they are Google.

Health Insurance age limit for children increases; Discussing the inevitable

Everybody knows that in this country of riches and opportunities, about 30% of those between the ages of 18-24, and 25% of those between 25-34 do not have health insurance. As a result, many states are increasing the age limit until which children can be covered under their parent's insurance. For example, according to the article in the New York Times, For Insurance, Adult Children Ride Piggyback, New Jersey has now increased the age limit to 30 under which children can be covered under their parent’s insurance.

This is a good step to help insure some of those without health insurance. However, this will, in no way, solve the problem of ballooning healthcare costs. Also, what about those who don’t have parents with health insurance to piggyback or those who don’t fit the criteria that need to be met?


We know it’s tough.

However, it needs to be done.

No Longer Avoiding That Talk About the Inevitable, an article in the NY Times, offers great advice on how to approach the topic with your parents or loved one. Unfortunately, no one is immortal and leaving adult children to guess what funeral their parents would have wanted is unnecessary. According to Joshua Slocum, executive director of the Funeral Consumers Alliance, “many parents assume they know what their kids want … They say, ‘It’s all taken care of, honey,’ but that doesn’t mean a darn thing. What’s been taken care of? Kids usually want to honor their parents, and that can lead to a lot of guilt — I don’t know what Mom would want.”

Therefore, take the time, sit down with your parents, and discuss what they would prefer (or perhaps what they would NOT want in their funeral). It’s better to ask beforehand than regret never asking.

Marketers redefining the image of the modern mother; Yes, Pharmaceutical companies are needed

In an article today on NYTimes.com, Marketers Look Past Jelly Stains and See a Mom Who Has Needs, marketers are finally noticing, respecting the needs of mothers (they finally realized that mothers not only take care of their children, they are also the decision makers and generals of their family) and redefining the image of the modern mother.

“…we are recognizing that anyone who has been out in the world as a smart, beautiful woman will not give that up because she’s a mom,” Gary Armstrong, professor of marketing at the Kenan-Flagler Business School of the University of North Carolina. This is applicable for ALL caregivers.

Currently, marketers are focused on mothers and their needs in the parenting of their children. What will occur when mothers start focusing on the parenting of their parents or caring for themselves? CareTALK is working on focusing the marketers and media distribution channels on this concern now. CareTALK is redefining the image and needs of caregivers/mothers.

If this group aims to serve her, then everyone else should also step in to help.

In previous posts we have called into question the motives for certain pharmaceutical companies to push drugs, whose long term (and short term) effects were not fully tested. We still question some of their motives—yet at the same time, we understand we are dependent on the pharmaceutical company to create the medication that will cure a condition (or at least make it manageable). The article in the Wall Street Journal, Study Shows Proposed Merck Drug For Diabetes Lowers Blood Sugar is regarding a study in which a proposed Merck Drug, Januvia, has been found to lower blood sugar when taken in conjunction with another diabetes drug. According to another Wall Street Journal article, another study found a “GlaxoSmithKline PLC drug used to treat Type 2 diabetes can also prevent the disease from occurring in people at high risk of developing it.”

Yes, the pharmaceutical companies are needed, however, it is in the interest of EVERYONE that these drugs be FULLY tested—along with the short and long term effects/risks.

Bionic Woman/Man: Concept of the future? Think Again.

Some of you may remember the shows “The Six Million Dollar Man” (based on the novel Cyborg by Martin Caidin) and “The Bionic Woman” from back in the 70s. (Shirley, one of the CareTALK Gals, LOVES those shows). Back then, having bionic limbs you could control automatically with just your thoughts seemed something out of this world and VERY futuristic.

Well, the future is now!

The articles in the Washington Post For 1st Woman With Bionic Arm, a New Life Is Within Reach and Man's Bionic Arm Provides Hope for GIs, describe the advances in prosthetic limbs that have occurred. Now, the latest version of the “bionic” arm designed by the Rehabilitation Institute of Chicago, allows the person to move their prosthetic arm with just their thoughts—just like they would with their natural arm. According to the article, the rehabilitation lab was funded by DARPA, an organization within the Department of Defense. (In “The Six Million Dollar Man”, the first bionic man came about as a result of a military experiment). This is wonderful news to all the amputees from the wars—but also to all amputees in general.

Undoubtedly, these bionic arms are expensive and need further testing prior to mass consumer use. However, it would be interesting to know what plans, if any, they have for mass consumer use (ie. will insurance companies pay for this? will the government (Medicare/Medicaid) cover this?).

Clicking for a loved one’s updated condition; Which exercise is best for weight loss?; More risks associated with Vioxx

There is now a new way to inquire about the condition of a loved one --- go online. According to the NY Times article, Support for Patients, Just a Mouse Click Away, many new sites are offering webpages that a patient and their caregiver can set up to update all their loved ones, family and friends about the status of the patient. In this way, they don't have to answer the same questions numerous times--- and perhaps they can feel more comfortable sharing intimate details than they would normally on the phone or in person. These web pages are personalized and can include as much (or as little) information, photos, links, etc--- but most importantly loved ones can leave messages of support. These web pages are an excellent (and efficient) way to connect a network of family, friends, and acquaintances.

If you are trying to figure out which exercise will make you lose more weight, you should read the NY Times article Exercise = Weight Loss, Except When It Doesn't. Just because you exercise, it does not mean you will automatically lose weight. According to the article there are numerous criteria to consider--- though one thing IS for certain which every doctor would agree with---

Exercise is good for you!

A new threat is now associated with Merck's Vioxx: contrary to Merck's claim that the cardiovascular risks increased only after long term usage, a study released online yesterday stated the risks began when the treatment was started. Another study found there was an increase in kidney-related risks. (You can read the Wall Street Journal article here.) Spending millions (if not billions) of dollars in R&D, why is it necessary to market a drug prematurely (and before tests of all risks involved are completed) knowing the increased risks to consumers? Just so they can have a brand name drug be #1 for a few years? For market share? What about the (fatal) risks to the consumers--the people they are supposed to be curing--not killing?

If you didn't think you needed to plan for financing your healthcare, you should read this:

According to a recent NY Times article, Medicare is now planning on charging a surcharge for the standard monthly premium such that by 2009, those making over $200K will be paying 3.2 times the standard premium (of course, by 2009, the standard premium will also increase).

As a result of this increase, it is now very important to start planning ahead regarding your finances for healthcare during retirement. Life insurance, long term care insurance, health insurance, health savings accounts, etc. There are various options which can be further explored on ElderLawAnswers (the link is also on the right hand side under “links”).

Over the weekend we had written about UnitedHealth Group taking on the pharmaceutical industry by refusing to include Nexium in its coverage. We had hoped the savings the company would get would be transferred to the consumers. Hopefully this is not an indication to the contrary: According to the article When Choice of a Doctor Drives Up Other Bills in the NY Times by Richard Péréz-Peña, it seems Oxford, whose parent company is UnitedHealth Group, can (arbitrarily, we think) consider a hospital (normally in network) out of network just because the doctor chosen is out of network. Therefore, say there is a doctor (out of network) you absolutely love in an in-network hospital. You would assume all you have to pay is the deductible for using an out of network doctor—and all the hospital expenses are covered by the insurance. WRONG! A couple found out the hard way. Now, a formal complaint has been filed by the Healthcare Association of New York State regarding the case with Attorney General Eliot Spitzer’s office (if anyone can resolve this, he can!).

This, again, is further evidence that you need to plan ahead regarding your finances for healthcare.

New Finding regarding the Pandemic Flu virus

According to an article in the Wall Street Journal, a recent study conducted in Vietnam found the reason the H5N1 virus (or most commonly known as the bird flu virus) is more deadly is due to its ability to replicate more vigorously then the common flu virus in humans. This is further validation, we believe, that there is a distict possibility of a pandemic outbreak--- if it is not contained by the scientific community, governments, and World Health Organization.

Many may dismiss this finding as the media just overreacting--- but (fair warning) don't be so quick to judge. Say, best case scenario, the H5N1 virus is contained and the general public hears no more of this threat. This would be wonderful news!

However, what if a pandemic does occur? Are you prepared?

CareTALK will be releasing a VOD series available online later this year focused on the Bird Flu virus and how you, as a caregiver to your parents, children relatives and friends, can be fully prepared. Another great, up to the minute resource is the official pandemic flu website created by the government (link is also found under our “Links” section on the right hand side).

The CareTALK Gals believe it is better to be safe (start preparing, research information, etc) than to be sorry and regret not having adequately prepared for a possible pandemic.

A New Model for Retirement

We are here to tell you--there is a new model for retirement (many of you may have already seen/experienced this).

Gone is the “old-school model of golf course retirement” as the NY Times article, At New Rentals, the Aim Is to Age With Creativity describes it. The nation’s first apartment community, Burbank Senior Artists Colony, brings people together who want to let their creative juices flow. Residents can take classes at the community to refine (or in most cases learn) their skills in painting, sculpting, acting, writing, etc.

The best part? No prior experience required!

As the article describes, one neighbor can write the screenplay while the upstairs neighbor stars in the play and the downstairs neighbor does the actors’/actresses’ hair. The ages of these fun-loving, creative, full of life people, youthful people are 60+ (one young actress is the leading lady at age 81). The creators of this colony are hoping to expand it nationwide (we hope this succeeds--- it sounds like fun!).

Another point we want to make is that the mentality of the aging population is changing. People are realizing--- life is not over at age 50 or even 60. To those in their 60s, life has only just begun! (Now that’s the attitude we should all take!)

In order to make sure you stay healthy so you too can enjoy your 60s, 70s, 80, 90s, and 100s, there are many new programs in hospitals and universities specifically geared to longevity such as the Geriatrics Department of Aging at Mount Sinai and the Princeton Longevity Center (you can also link to them from our “Links” section on the right).

Walk-in clinics; Remote monitoring systems for aging-in-place; UnitedHealth to stop paying for Nexium

Many of you may have heard about, read, or even visited one of the new walk-in clinics that are popping up in your local drugstore chain-- namely CVS, Wal-Mart, Walgreen, and Duane Reade. These are not such a bad idea especially if you just need a quick prescription (or even over the counter medication) to get rid of a cold, sore throat, skin rash (eg. poison ivy), insect bite, diarrhea, etc --- ie. mostly non-severe medical conditions. They even provide vaccinations (now you don’t have to wait for a doctor’s appointment to get your child the vaccination s/he still needs for school). Another big plus--- most stores are open 7 days a week. Please note, these walk-in clinics should not replace following up with your physician for a thorough examination. You should still see your doctor regularly so s/he can monitor your progress/health through the years.

For those who need to see their doctors regularly to monitor their medical conditions, such as heart problems, diabetes, etc, usually due to aging, now won’t have to. As a result of the new technologies available, the elderly can now age-in-place (just in time for the aging Baby Boomers, too). The article in the NY Times, Remote Control for Health Care, describes the case of an elderly woman with heart, circulatory, and kidney problems who can age in her home and have longer periods of time without having to be hospitalized for her conditions. This is due to the remote monitoring system she has at home which allows her doctors to take in important daily data (such as blood pressure, etc) and which alerts the doctors to any changes in her conditions.

With the aging Baby Boomers, these remote monitoring systems are very much needed and we believe will become a staple in each home in the years to come. Constant monitoring will allow the doctors to prevent a medical setback (eg. in the case of the elderly woman in the article, the system alerted the doctors of an irregularity which, after speaking with her and performing a CAT scan, revealed she had the beginnings of pneumonia). This will reduce the number of hospital and emergency room vists, thus lowering the cost of overall healthcare. Perhaps the Centers for Medicare and Medicaid and the insurance companies will help cover the cost of these systems in the near future.

As we all know, most, if not all, brand name prescription drugs are overpriced. Pharmaceutical companies just keep raising the prices because they believe insurance companies, and consumers, will pay for it. What other choice do we all have right?

Wrong.

According to an article in the Wall Street Journal, UnitedHealth Group has decided to not cover Nexium because “there are less expensive, equally effective options available.” This move may finally force pharmaceutical companies to start lowering the prices of their brand name drugs if they want to compete with the generic drugs. Perhaps other insurance companies will follow suit.

In addition, United Health is expected to save about $150 million. OK, now… this is fine, as long as the savings are passed onto the consumer. Why should only the health insurance companies benefit? Ultimately, it’s the consumer who is paying for the drugs.

Legal contract to care for your mom or other loved one?

Yes, that is the growing trend now according to the Wall Street Journal article Who will Mind Mom? Check her Contract.

The article states several good reasons in which all parties involved are advantaged, namely, that the caregiver is compensated for his/her time/energy while the care recipient has the security that they will receive the services they need. There have been, unfortunately, too many stories where caring for the care recipient is considered a “burden” by the family member (after all, the caregiving services provided are done gratis) and and thus, have been neglectful. The contract also allows for a reduction of the care recipient’s estate so that they would have a better chance to be eligible for long term care coverage under Medicaid.

We think this will stir some controversy—on the one hand, you have those who believe they are entitled to some sort of compensation for providing care services and their time for their loved ones, be it mom, dad, or Aunt Mae. However, we believe there will be many who will argue about the morality of receiving payment for a service that should be done gladly and not considered to be a burden. After all, wouldn’t you gladly take care of your mom, dad, and beloved Aunt Mae?

Celebrex: good or evil?; Nail polish: you can breathe easier now

Many of you may have read this article already but we thought it is worth bringing to your attention in the event you hadn't. The NY Times article When Hopes for a Drug are dashed, what then? by Denise Grady poses a very interesting dilemma many may be facing—taking a prescription drug to treat a medical condition other than the condition it was intended to treat. For example, this article states that several doctors recommend Celebrex to cancer patients because studies have suggested it could “shrink or prevent precancerous intestinal polyps, and some doctors reasoned that it could help patients who already had colorectal cancer.”

However, this is not fully tested yet. The article describes some research studies conducted (paid for partially by Pfizer, the maker of Celebrex) that the drug did prevent the types of polyps most likely to turn cancerous from forming; however, it also showed an increase number of heart problems. So this begs the question, would you be willing to risk the possibility of a heart attack in exchange for cancer prevention?

We’re not sure we can answer that ourselves.

On a lighter note, you can breathe easier now (literally)…your nail polish is now safer for you. No, we’re not crazy (yet). The NY Times reported in the article Nail Polish Makers Yield on Disputed Chemical that cosmetic makers have agreed to remove a certain chemical used to increase nail polishes’ flexibility but which is suspected of interfering with the endocrine system.

Who would have guessed?

Hospital Preparedness; Bionic Heart; Dr. McClellan stepping down

With the 5th year anniversary of Sept. 11, there are many articles focusing on the preparedness of hospitals nationwide, especially those in highly populated urban areas like New York. Hospitals Step Up Disaster-Preparedness by Laura Landro in the Wall Street Journal describes how, despite $4 billion dollars in federal aid to state, local, and hospital preparedness since 2001, hospitals are still vastly unprepared for a mass number of casualties the likes of 9/11.

A bionic heart? Not quite-- but close. Today, the FDA approved the world’s first self-contained artificial heart for sale. While it’s not perfect (the heart extends the patient’s life an average of 5.2 months), this is at least a step in the right direction. With the technology we currently have, it will only be a matter of years until the artificial heart can extend life for years. However, thinking about this now, do we really want this? We already have hip replacements, knee replacements, and other body part replacements--- now a heart replacement too? We really will be bionic by the time the younger generation is ready for retirement! As Renata, one of the CareTALK Gals, always says—as long as the brain is still functional, Boomers will keep going back under the knife for replacement body parts.

The only issue we have is, like everything else in health care, the new technology available will be mostly for those who can afford it. According to the article in the Wall Street Journal FDA Approves Artificial Heart Sold by Abiomed by Sylvia Pagan Westphal, the artificial heart will cost $250K. What about those who can't afford it? Should they not be given a chance to live longer too?

Dr. Mark McClellan officially declared his plans to step down as administrator of the Centers for Medicare and Medicaid Services (the agency of the government responsible for Medicare and Medicaid programs). One of our internal sources says he [Dr. McClellan] was a better administrator than most (as you may know, we work closely with Medicare and HHS). However, one comment made gave us pause – he/she said it “would be nice if one [administrator] would stay and make training them worth the effort”. We looked into this and realized the tenures of administrators are very short--- the longest one lasting only 4 years (you can see a list of all the administrators here). We have had 24 administrators, including Dr. McClellan, since Medicare was formed in 1977. Perhaps this is the reason why it takes years to implement a change in the Medicare/Medicaid programs? As soon as one administrator gets into the groove of things in his new post, it's time to move on. This is very unfortunate.

Perhaps Mr. MedicareGuy will have a comment or two regarding this topic... :-)

CareTALK debuts on the Women's Health Tab on Yahoo Health; Boomers and younger generation aggravating housing downturn

Today’s post is a collection of different articles which you may not have read (but definitely should).

To begin, as further validation that CareTALK is expansive and universal, the first link listed on the Women’s Health Tab (as opposed to aging or caregiving tab) on the front of Yahoo! Health links directly to an article (one of many) provided by CareTALK titled Forever Young: Mind & Body.

If you were planning to use the proceeds from selling your home for retirement, you need to read this New York Times editorial, It was Fun While it Lasted. Not only are the analysts predicting the end of the housing boom, but unfortunately, the housing downturn will coincide with the first boomers eligible for social security. Many boomers are home owners, and analysts assume that many of them will want to sell their houses to receive extra cash driving the prices even lower (rules of supply and demand).

To further aggravate the housing downturn, not only will there be a huge supply of houses in the next few years, but according to the NY Times article by Steven Greenhouse, Many Entry-Level Workers Feel Pinch of Rough Market, there won’t be any demand either. Those between the ages 20 to 35 have delayed buying a home because they can’t afford it. College graduates are considered lucky if they can find an entry level position, not to mention one with health insurance and other benefits (such as a 401K or other retirement plan). However, Greenhouse also points out that the economy itself is not solely to blame--- it is also the “cavalier” attitude of the younger generation towards saving. If the younger generation is to help itself and survive the economic severe downturn we will face in the near future, their attitude definitely needs to change--- and they need to start saving and planning.

Contradictions in the Bush administration’s health policy

Health Policy Malpractice by Paul Krugman is a must read article--- especially since the mid-term elections are right around the corner --- approx. 2 months away.

The article, a NY Times op-ed, describes the contraction in the health policy of the Bush administration:

On the one hand, the administration has limited access to the Veterans Health Administration, which provides “high-quality health care at remarkably low cost”, to only poor vets or those with injuries sustained during service (in other words, those fortunate enough to have escaped permanent injuries during service and are not considered poor won’t have access to the VA facilities). First of all, it’s a crying shame we don’t ALL have high-quality, low cost health service. Just imagine-- low cost, high quality UNIVERSAL health care (gasp!). Unfortunately, since this is won’t happen anytime soon (though we are still hopeful), the least we can do is provide high quality, low cost health care for the brave men and women who risked their lives at one point of another for this Country. However, this is not a priority, despite this resulting in cost savings.

What is a priority is pushing for and promoting the Medicare Advantage program since 2003, which (coincidentally) provides enormous subsidies to the HMO’s ---resulting in an increased government cost of 11% more per person than Medicare.

And the conservatives keep claiming the need to cut excessive spending and want to cut back on Medicare/Medicaid?

Read more about this contradiction in Paul Krugman’s op-ed.

Report shows employee benefits decreased in last ten years

For further validation of the point made in the last entry, CNN Money has special report in its Jobs & Economy tab titled Workers lose traction over past 10 years regarding the findings of a 2006 edition of The State of Working America from the Economic Policy Institute. Does the younger generation realize the current state of the economy and the trend lines in the economy? Can they see how, despite the 33% growth of “quantity and quality of what workers produce per hour” between 1995 and 2005, the hourly wage increase has only been 11%? Therefore, everyone is expected to work more and be responsible for more, but not be compensated commensurate to these added responsibilities.

One important finding: The number of private sector companies that sponsor a retirement plan decreased to approx 60% in 2005 from over 66% in 2000. Health insurance coverage also fell from approx. 45% to 40% during the same timeframe.

Given all this, the younger generation can’t depend on their employers to help them with their retirement (as we said in the previous post, the government won’t be able to help either—their resources will be depleted after helping the Boomers).

Therefore, it is time to get an action plan. You are never too young to start a plan for your parents, your children, and also, for yourself.

The younger generation

Today, the CareTALK gals were discussing with each other the attitude of the younger generation nowadays and how a change is drastically needed if they are going to survive the aging of the Boomers. There have been numerous articles written indicating that there will be little, if any, government (or corporate) aid for the younger generation. For example, the NYTimes article If Boomers Have It All, What’s Left? by Floyd Norris, explains how Dupont is changing its pension regulations so that those who begin working in 2007 or later so not receive pensions or health insurance after retirement. Unfortunately, according to the article, Dupont is not the only company lowering pension benefits or eliminating it completely.

What does this mean for the Gen X and especially for the younger (MTV) generation that seem more interested in spending their money frivolously (they just helped Madden NFL 2007 have the best opening-week performance for Electronic Arts) than thinking about their future? Being an Xer myself, I see how some in my generation--- but especially the MTV generation-- don’t seem to realize what is on the horizon—that there won’t be any aid left for them after the Boomers are gone.

Imagine this… in 15 years, the youngest Xer will be approx 40, possibly with the responsibility of a family, and the responsibility of helping their (Baby Boomer) parents. The Boomers are experiencing the same phenomenon now with their parents and children, but the difference is…some have pensions and government aid (ie. Medicare/Medicaid and Social Security) still exists for themselves. Xers won’t have this luxury.

It is time the younger generation take a very close look at what is happening and start planning for their future--- and their parents’ futures. For example, by paying premiums on long term care insurance for the parents now, Xers can receive some comfort from the fact that a devastating illness to their parents will not bankrupt them.

Parents moving in...

Most of us believe that once we move out of our parents’ house (or our parents kick us out--- whichever the case may be), we are independent of them and, in turn, they are independent of us. Isn’t that what aging in place is all about-- so that parents can age in their own home without having to be overly dependent on their (Boomer) children?

But…what if the parents want to move back in with the Boomers? Will the Boomers – who are the most independent generation to date—agree to this? It seems to have worked for one family as described in Build a Nice House, and Mom Wants In by Joyce Wadler in the NYTimes.

However, we don't believe this will be the norm--- not for the Boomers and their children. We can't see Boomers wanting to move back with their children. Judging from the comments being posted on the "Aging & Caregiving" blog on Yahoo! Health, those in their 50s and 60s are happy to not have any major familial obligations. They see their 50s/60s as the beginning of their second life.