The cost of professional caregivers

Some of you may have read or heard about Caregiving In America, a comprehensive report released by the ILC and the Schmieding Center for Senior Health & Education published Fall 2006, which stated there is a crisis looming due to the increase in aging baby boomers, a severe (and worsening) shortage of professional caregivers, and family caregivers who do not identify as such.

To add to this crisis, hiring a professional home health aide through agencies in Manhattan can cost approx. $150K/yr, according to The New York Times article, "New Options (and Risks) in Home Care for Elderly." This rate is staggering – even for a professional physician as described in the article. Just imagine--- if it's too much for a physician at a prestigious medical institution, what about those who are in the lower middle class, or lower class? What about those still earning minimum wage? What are they to do?

Those who can't afford to hire home health aides through the agencies, hire them through the gray market -- "an over-the-back-fence network of women [who ] are usually untrained, unscreened and unsupervised, but more affordable without an agency's fee, less constrained by regulations and hired through personal recommendation."

Although there is a high cost to hire a professional health aide from the agencies, only about "$9 of the $20 hourly fee goes to the aide. In a gray-market arrangement, the aide might get $12, a 33 percent increase — although sometimes without benefits, worker's compensation or Social Security…' According to the graphic in the article, "since 1999, the number of home health aides in the United States has grown 15.8% [not including aides from the gray market], while their median hourly wage has fallen 4.4% after adjusting for inflation." It seems as if both parties -- the professional caregivers and the families needing these caregivers--are losing out in the current arrangement with the agencies. The professional caregivers are barely making above minimum wage (which accounts for the high turn over) and the families needing caregiving would have to exhaust their savings in order to pay for such services.

Boomers need to focus on getting long term care insurance--- especially one that will pay you, the caregiver -- and not the agency-- so that you are free to choose the home aide of your liking. (The government does not pay for them unless you are poor or unless it is immediately following a hospital stay).

In aid of the professional caregiver's plight, "the Service Employees International Union has been at the cutting edge of creating a more stable pool of workers. In New York, Local 1199 unionized 60,000 home-care employees. Unionized aides, many of them former welfare recipients, get a full array of benefits, rare in this industry, and opportunities to master English, study nursing or learn computer skills.

One of the union's newest offerings is a sort of consciousness-raising group, focusing on self-esteem and a sense of community among otherwise isolated workers."

We salute 1199SEIU in helping the professional caregivers get the support, aid, and benefits they need. There is a crisis looming and we need more professional caregivers --- however, first we need to respect them and their work by raising their wages and providing benefits so more people can choose professional caregiving as a career. At the same time however, we need to tell our governments --both local and national -- that it is more economical to have home health aides than to have our loved ones in nursing homes (which the government does pay for under certain circumstances).

Price comparisons--- for medical procedures

There are price comparisons for everything we purchase --- which is only natural because we want to purchase items/services at the best possible price (everyone loves a bargain). This is why sites like Froogle.com, shopping.com and shopzilla.com exist.

If we have to pay more and more out of pocket expenses for procedures we have to undergo, shouldn't we be able to compare prices and choose where we want to have the procedure (such as X-rays or CT scans?). Where in our lives do we just hand over our credit cards and say "charge it"—no matter what the cost? (ok, some people do this-- but either they have the money to do this or they're not fiscally responsible). With the economy where it is (and where it’s going) most of us can’t afford to do this.

We guess it would be "ok" if the prices for each procedure where fixed so that no matter where you go, what insurance you had, the price was the same for a certain procedure (ie. an X-ray would be the same price at hospital X and hospital Y--- and the price would be the same whether you had insurance A or insurance B). Unfortunately, this isn't the case. According to The New York Times article, "Bargaining Down That CT Scan Is Suddenly Possible," " the average provider — doctors or hospitals — has between 5 and 100 reimbursement rates for the exact same procedure. A hospital chain with multiple locations may have 150 rates for the same procedure."

Why is it so complicated?

Because each insurance health plan (more than 6,000) has a distinct reimbursement schedule the parent insurance company negotiated with the nation's 850,000 providers.

Considering healthcare costs are on the rise and it is already estimated that 12% of adults has out of pocket medical expenses greater than 5% of their annual income, there should be a better way to know how much you are paying for something --before you get that dreaded bill. Online companies with knowledge of the negotiated prices reimbursed by the insurance companies, are already tapping into this opportunity by providing the consumer an opportunity to lower their medical bill (the company itself would negotiate a lower fee for the procedure). Then there are the other online companies who try to estimate the fees negotiated by extrapolating the data from Medicare. Even the local hospital associations are starting to provide the information--"just this month, the Georgia Hospital Association started a Web site listing fees of common medical procedures at each of the state's 141 acute-care hospitals."

Many may say giving this type of information is hurtful for the consumer because the consumer would naturally want to have the procedure where they can get it the cheapest -- which may not be the best place. First of all, the procedures would be performed by hospitals and doctors qualified and certified to perform such procedures. Secondly, consumers know that a diamond ring bought at Kmart is not the same quality and caliber as, say, a ring bought at Tiffany & Co. However, they still want to be able to make that choice.

Where will this all end?

Hopefully with the consumer being empowered to make informed decisions.

The battle rages on...

The battle between Google and Microsoft has heated up once again with the announced acquisition of MedStory by Microsoft which they described as a signal of "a long-term commitment toward the development of a broader consumer health strategy" and which they hope would provide them with the "specialized search engine tailored to deliver useful medical information to consumers."

We're sure you've heard about this all day – from bloggers covering it, such as Donna Bogatin, to the prestigious papers such as the Wall Street Journal and The New York Times (and many others).

Why so much action? Why is this so important?

Several reasons:

1. The healthcare field is a very hot field now --especially with the aging baby boomers. Therefore, when another major corporation enter the health care field, it is major news. Google and Steve Case (former head of AOL) are already major players in the health field with Google Health (yet to launch) and Revolution Health (launched last month) respectively. (We aren't holding our breadths for Yahoo to be a part of this battle on the health care field).
2. There seems to be a friendly (?) battle between Google and Microsoft. After all, according to Donna Bogatin, one of Google's strategies is "Death to the (Microsoft) hierarchy." Evidence of Google succeeding is seen in its relative success with Google Apps – a territory Microsoft has had a monopoly on.
3. Finally, finally, finally--- corporations are looking for ways to get information (our medical information) to the consumers. Doctors, hospitals, insurance companies (and really anyone who wants our medical information) has access to it--- anyone but us! Everyone else can have access to it, but we can't have access to our own records-- how does this make any sense? It doesn't! and finally companies are addressing this issue.
4. ANY news is more important than where Anna Nicole Smith gets buried. Let the woman rest in peace at last.

It will be interesting to see what unfolds though Microsoft might have a little bit of catching up to do. Adam Bosworth, the vice president of engineering at Google, announced in his speech in early December the need for a "health URL" (which we can all take to mean that Google is creating said "health URL"). In late January, Steve Case launched the (anticipated?) Revolution Health. Who will win this race – the race for the hearts, and trust of the consumers? Is the field big enough for all these titan players?

We'll see…. Though our money’s on Google.

Boomers on deck!

According to this week's February 26, 2007 Barron's cover story, "The Last Laugh" --

...the 78 million baby boomers are collectively richer than any group in
history. The 50-plus crowd now controls 50% of all U.S. discretionary income,
accounts for 75% of all prescription and drug spending, and has 65% of America's
household worth, according to Deloitte & Touche. By 2030, boomers will
control nearly 80% of private investments, forecasts the MetLife Mature Market
Institute. –

THE MIGHTY AARP, WHICH DROPPED THE WORD "retired" from
its name a few years ago and became simply an acronym, now has 38 million
members -- and expects that number to hit 50 million in the next five years.
"This is a pivotal moment," says Bill Novelli, 65, the group's Washington,
D.C.-based chief. "All these boomers are coming into their mature years, and
have more longevity than ever. Very decidedly, this country can afford to grow
older, and we'll be a better society because of it."

Let us hope the boomers, as the most educated generation in history and the most sophisticated information consumers, begin the process of facing up to the major responsibilities that come with the benefits and challenges as a result of this pioneering paradigm. Many powerful influences are positioning to maneuver (manipulate?) the boomers. The CareTALKGals believe that, with time on their hands as boomers navigate their unprecedented longevity, this generation will begin to FOCUS -- and MANAGE their third age.

Watch out establishment players!

Armed with powerful information resources, tools and utilities such as GoogleHealth, RevolutionHealth and other NEW players -- boomers, who are MANAGERS and DECISION-MAKERS at heart, will turn traditional third age on its head. Boomers are savvy customers and will become VERY politically active. Boomers are no fools. When they focus en masse -- and have TIME on their hands, watch out!!!

We are ALL depending on it.

Renata

A necessary evil: A visit to a health care provider

We all have our horror stories from when we visit our doctors, dentists, hospitals, or other health care providers—long waits despite a scheduled appointments, condescending/curt staff, doctors who rush through their exams.

Why so much disrespect? Why the condescension? Why the lack of interest from the doctors/staff to alleviate our concerns?

How can we tell whether one doctor treats his/her doctor with respect, and the attention s/he needs?

The article in the Wall Street Journal, "Putting 'Care' bank in Health Care" asks these same questions. After years of putting up with bad health care providers (including dentists), the author came across a hospital where the staff members put the patient (a child) at ease prior to a surgery while answering all the questions the patient's caregivers had and alleviating their fears. One would think this is normal-- this is what health care providers should do. Unfortunately, this is the exception, not the rule.

Why put up with this?

Unfortunately many people don't have much of a choice due to the limitation imposed by their health insurance companies (they fully cover visits only to doctors within their network.) However, we hope this will change with the new requirement for hospitals (and eventually individual practices) to "participate in the federal government's national patient-satisfaction survey program to receive full reimbursement from Medicare."

Take destiny into your own hands!

We have all heard, in one form or another, about the saga of Anna Nicole Smith -- during life and after. Today, the judge finally made a ruling regarding where Anna's body will be laid to rest—after days of hearing testimonies and exactly two weeks after Anna died. However, the saga is not over. Not only is Anna's mother appealing the decision, but now it will need to be determined who will be the legal guardian of her baby girl (not an easy task especially since it is uncertain who the father is). To add to the complexity, the legal guardian of the baby will probably also be the trustee of her inheritance which would be worth possibly hundreds of millions of dollars (though this, in and of itself, is questionable because the courts have not yet ruled whether Anna was a rightful heir to her late husband's estate – a case that has been going on over a decade).

The tragic thing is… a majority of this saga, stress, sensationalism, and heartache could have been avoided had Anna had a legal will. Especially if you have children, a will stating who the legal guardian for you child(ren) is (are) extremely important. Who will take care of them? Who will provide for them? Godparents are usually assigned when children are first born--- and the main purpose is to guide them in their spiritual upbringing. If we can choose godparents, why not choose who the legal guardians would be if the child(ren) is (are) left orphaned?

Aside from this important fact, why let the courts decide where you will be buried? Why put that additional stress on your loved ones--- especially after they have had to deal with your death. Issues like this causes sever tension and stress among loved ones/family. Besides, wouldn't you want to be in control of your own destiny--- even if it is the destiny of your body after you have passed away? Take the example of Mr. James Brown. He sadly passed away on Christmas Day 2006; yet as of February 22, 2007 – almost 2 months since he passed away—he has not been laid to rest as a result of family members and loved ones fighting over the right to bury him in the place of their choosing. Why did this occur? Because Mr. Brown did not have a will (which is also why the family members and loved ones are fighting over his estate).

Again, why do this? Why leave your destiny and the destiny of what you worked so hard to earn in the hands of a court? Why not take proactive action yourself? If you don't have a lawyer yet, or don't know where to turn, you can go to Elderlawanswers and they will help you choose the right lawyer for your needs in your hometown.

No one should be without a will. No one.

Take destiny into your own hands--- even after death.

Google Health on Dilbert

There's no question now...Google Health has made it into our everyday lives (and it's not launched yet). Check out this Dilbert comic strip.



Courtesy of Dilbert.com

Another Inconvenient Truth

It should come as no surprise there is a fiscal crisis looming.

The problem: Boomers are retiring (ie. not paying income taxes and utilizing their Medicare, Medicaid, and Social security benefits), healthcare costs are exploding, and there aren't enough people in the younger generations to sufficiently cover the discrepancies.

It is estimated that in less than 40 years (more likely 20-30 years), Medicare and Medicaid expenses will use up approximately 20% of the national GDP. (To give you an idea of the magnitude of this, currently the ENTIRE federal budget absorbs approx 20% of the GDP).

This is the reason there is a campaign, the "Fiscal Wake-Up Tour," to educate the nation and encourage voters to ask the presidential candidates tough questions pertaining to how they would help alleviate this fiscal crisis. (And to think it took less than 6 years to go from a surplus in our economy to an enormous deficit. Shameful. This fiscal crisis IS real—just like global warming IS real.)

We as a nation need to take a hard stand now. "People are starved for truth and starved for leadership." We need to hear the TRUTH and the lawmakers/leaders have to TELL the TRUTH. No, it's "not nice" and it's "inconvenient," but we need to listen and take action.

Special Posting: MISSION CONTROL: American Healthcare!

Healthcare consumers ARISE!!!

The distractions of modern life, disastrous troop surges and the soap operas of new mothers -- Ms. Spears and Ms. Smith -- have overtaken our senses and common sense. Boomers' third age is on deck and our corporatized healthcare infrastructure and delivery systems are about to co-opt our (Internet) healthcare information resources as well. As the military industrial complex rachets downward (which it must as boomers begin signing up for Medicare en masse), the same lobbyists and financial interests who drive it will be refocusing on healthcare as the bastion of HUGE returns.

How will Congress and the next President allocate these redirected resources? Who will decide?

There is already evidence the money-guys/gals are staking out (Internet) healthcare information resources for the very same establishment interests who have held 40+ million Americans from a basic human right -- healthcare insurance. Many millions more fear the loss of insurance if jobs are lost.

American jobs are portable. Their insurance is not.

Boomers and their children have been otherwise engaged. New technologies and amazing medical advances have lulled us into a state of ignorance that would be unthinkable in any other area of our lives. We receive the healthcare and long-term care services and security we deserve.

GoogleHealth is coming.

CareTALK will be part of this REAL healthcare revolution. We are meeting with Chairman Rangel in two weeks. I pounded the pavements for his first campaign against the wonderful, but flawed Adam Clayton Powell, Jr. many years ago -- and that deserves a meeting! We have seen the movie over the last 7 years and we know all the entrenched and arriving players. Not many care very much for caregivers -- professional or family/friends -- who have been served pabulum for years, and have been deliberately kept ignorant or worse, misinformed. Medicare does NOT cover long-term care expenses. Families need to arm themselves NOW with modern, cutting edge information resources, tools, utilities -- and we, as Americans, all have a RESPONSIBILITY to MANAGE a change in course. Government resources have been SQUANDERED. A PLAN for how to reconcile boomers' HUGE Medicare and long-term care requirements with the needs of younger generations must be prioritized. That plan will not and should not exclusively come from entrenched interests. The plan must be driven by an informed and resourced American healthcare consumer. A demographic tidal wave of seniors will make demands on us all. Corporate interests cannot and should not define Americans' healthcare future -- alone.

GoogleHealth is coming.

YOU will be in the drivers' seat -- FOR REAL! Information comes with responsibilities.

Sorry, Brittany and Nicole -- we're changing the channel.

- Renata

PS. Visit The Concord Coalition, as mentioned in 'Baby Boom' about to lower boom on overextended U.S. budget ..., to see what we, as a nation, can do to help our lawmakers and the 2008 presidential candidates focus on the growing fiscal crisis we are currently in-- and will be in with healthcare costs rising and the ratio of "workers paying into Social Security and Medicare relative to the number of beneficiaries will fall by roughly one-third."

Tell us your thoughts regarding PHRs

If you're looking for Renata's special weekly commentary, come back later today (Sunday).

In the meantime, we would love to read any comments you may have regarding Personal Health Records (PHRs) and Electronic Medical records (EMRs). According to The New York Times, "Warnings Over Privacy of U.S. Health Network" "The Bush administration has no clear strategy to protect the privacy of patients as it promotes the use of electronic medical records throughout the nation's health care system."

Special Reading

There have been many books regarding coping with diseases, deaths, and the aftermath -- especially when it comes to cancer. The New York Times reviewed one such book in "A Quest for Knowledge Inspired by a Devastating Loss": "One in Three" -- which refers to "One in three of us will develop the disease [cancer] in our lifetimes." (This is a frightening statistic).

This book was written as a way for a son to deal with his father's struggle with cancer—which can be said about many other books. (Writing tends to be good therapy for dealing with issues). However, in conducting the research, the author wrote that he would have a "horrifying effect" on people he would casually talk to about cancer --- ie. his "listeners would shiver or quail or walk away." Therefore, he purposely wrote a story that is more "gripping than frightening."

This is a similar effect we want to evoke with caregiving. As Renata (Founder & CEO of CareTALK and a CareTALK Gal) wrote in her previous entries, caregiving was considered toxic. Consumers did not want to identify as caregivers and caregiving was viewed as a burden. More often than not, caregivers would view themselves as "victims" (of circumstance?). We want to change that understanding. We want to make caregiving more "gripping than frightening", more proactive, not reactive with a more "go get 'em" attitude, not a "woe is me" attitude.

There are two choices: you/we can either wallow in self pity or you/we can roll up our sleeves and deal, head on, with circumstances that are beyond our control.

We choose the latter.

An aging brain: it's not as bad as you think

We all worry about aging— whether it's the wrinkles that will dare to appear on our faces or the fear of losing our cognitive abilities.

According to the Wall Street Journal, there is a new study that has found that aging actually helps with some of our brain capabilities. Reaction speed, memory, attention, and other cognitive functions do decrease with age, but the other functions, such as vocabulary skills, stay the same or improve with age. Another benefit of an aging brain is that older adults have a plethora of expert knowledge – that only comes with experience. The article describes a study made between younger and older air traffic controllers to compare their abilities. According to the findings, the older adults performed as well or better than the younger counterparts—not because they were quicker and did well on memory tests but because their experience allowed them to "skip" steps and to better handle the situation.

This finding and study brings up the issue of delaying the mandatory retirement in major companies. Some companies have mandatory retirement ages as low as 55 years of age—which is truly amazing considering boomers will not want to golf all day in Florida when they retire. After all, 55 is extremely young for retirement considering the number of centenarians is on the rise.

Happy Valentine's Day

Dear Readers,

As you all know, today is Valentine's Day --- a day of love. However, as much as the market pushes us into buying chocolates, flowers, plushed toys (they don't call it the "Hallmark holiday" for nothing) -- remember the true meaning of the day. It is about love and friendship...family, significant other, friends ... even pets :-)

As we noted in the "Special Programming" section (look on the right hand sidebar), there is a special on the NBC Evening News -- Caring for your Parents - Baby Boomers Taking Care of the Greatest Generation.

Caregivers are usually thrust into the role of caregivers--- sometimes without even knowing it (we are all caregivers at one time or another). However, these caregivers take up these caregiving responsibilities --- because of the love they have for their loved ones, whether it is for a parent, a child, a spouse, a family member, or a friend. You can read some stories from real-life caregivers like us-- like you-- here.

Happy Valentine's Day!

- The CareTALK Gals.

Bacteria fighting hospital gowns?

Well, we have anti-bacterial soap, anti-bacterial tissue, anti-bacterial air fresheners, why not have anti-bacterial gowns?

To be specific, the gown has a coating of a "bug-busting ingredient" called Permagard that "rips through the invader's [ie. the bacterium's] cell wall and annihilates it. The physical attack means bacteria are unable to develop a resistance like they could against a[n] [anti-microbial chemical] substance."

Interestingly enough, according to the article "New Hospital Gown Fights Deadly Bacteria," the designer of the gown simply wanted to create a gown that "promote[d] patient dignity, comfort and safety" by having completely covering a patient's backside. (Don't you just hate the current hospital gowns that leave your bum completely exposed so you have to use one hand to keep the back of the gown closed?)

Granted, these gowns will need to be examined and go through clinical trials (which they currently are undergoing) but if this could help shield a patient from bacteria in the hospital, this may be a very useful tool.

This is just to prove that disease management and disease fighting affects all fields—even fashion.

Special Posting: Congratulations to Revolution Health!

Congratulations to our friends at RevolutionHealth on the launch! We are delighted to see respect of consumers and their empowerment as the defining motivation for this new product/service offering. It is high time in a field that devours one-third of the Nation's GNP with very few REAL established controls and virtually no accountability. Steve, Ron and the team have put consumers into the driver seat via utilities and tools to navigate and manage their future healthcare experience -- and those of loved ones, near or far. Together, with our partners at GoogleHealth, we expect caregivers to be front and center as THE definitive managers of modern healthcare. Caregiving is a superior identity for consumers in this new paradigm. Proactive vs. reactive should infuse the spirit of any healthcare product, good or service experienced by consumers.

Thus far, the modern family caregiver has been given short shrift by the medical/clinical and non-profit establishment(s). The past identity of caregiver has been stuck in a time warp, reflective of an era dating back to the 1918 Flu Pandemic. Women now work long hours out of the home and families are spread around the globe. Technology has created utilities/tools that would have been unthinkable pre- WWII -- yet, when media puts forth the identity of a caregiver -- if they do at all, it is exclusively as a victim of circumstance. Toxic, as I was recently told by those who should know better.

CareTALK doesn't intend to trivialize the caregiving experience. Yet, it is TIME for a refresh of the consumer identity that reflects a REAL MANAGER who, in the modern era, has at his/her disposal a myriad of assets with which to take on the challenges of self-care and caregiving unknown to previous generations.

WHO is this modern caregiver? It is you. It is me. It is we.

The most sophisticated information consumers worldwide in history can and should take up this challenge in a modern identity that garners RESPECT and complements the new technologies available to manage the challenges we face, including unprecedented LONGEVITY. How can more than half of the boomers believe Medicare covers their long-term care expenses? Top/down (from on high?) information flow and education have not worked. We are facing a disaster if consumers do not take responsibility and control of their own caregiving -- including PLANNING from a young age.

Steve Case and Adam Bosworth are MODERN CAREGIVERS. (Read Adam's recent speech here.) They inspire. They challenge. They are agents of CHANGE. They are savvy and driven to not only elevate our management experience of healthcare complexities -- but to elevate the identity of MODERN CAREGIVERS in the process. We are not children or chattel. Time for the establishment(s) of healthcare and long-term care to recognize this pertinent FACT, and fully participate in our speedy education process. Caregivers and patients want and need a seat at the table in order to rein in the out-of-control, special interest-driven healthcare system.

Thank you Steve and Adam for pulling up chairs -- for us. The CareTALK Gals are with you!

Renata McGriff


* Here's a very interesting article we found that you may also be interested in:
Healthcare 2.0: Revolution Health: ambitious, as it should be

Hospice Care

Most people equate hospice care with end of life. While it is true that hospice care is primarily targeted to those who are terminally ill, those who enter hospice care don't necessarily pass away. A famous and recent example is satirist Art Buckwald. He entered a hospice program expecting to live only a few weeks--however, he recuperated well enough to leave the hospice care after 5 months. He passed away 5 months after he left the program (approx. 10 months after he initially enter the program).

There are other examples like this. Why this sudden improvement is health when people normally go into hospice care "to die"?

It may primarily be due to the palliative care -- a specialty aimed at improving a patient’s quality of life-- that is offered in the hospice programs. The New York Times has three articles dedicated to hospice care this weekend. In "There Is Life After Hospice, and Even Golf in Florida for Some" a director of palliative medicine at the Dartmouth-Hitchcock Medical Center, stated "hospice should be viewed not as giving up all hope but about getting the care one needs. If the disease continues to progress, the patient is likely to die,… But patients may also be able to gain the weight and strength necessary to prolong their lives."

Hospice programs are changing so as to promote helping the patient recuperate (as opposed to helping them prepare for death). In "A Chance to Pick Hospice, and Still Hope to Live," programs are now offering patients the option to receive treatments (such as chemotherapy or dialysis) while being enrolled in a hospice program. Previously, patients had to pick between getting treatment at a hospital to try to combat the illness or enter a hospice care program. Fortunately, now they don’t have to choose.

The third article in The New York Times, " Hospice Basics" gives a list of some basic (and advanced) services the hospices provide which you should be aware of--- for yourself but most importantly for your loved ones. Sooner or later, you will be the caregiver who will have to make these choices. Be informed about what to keep an eye on.

Finally! A candidate with specifics.

Yes, it is still early in the presidential race (earlier than usual) but there is one candidate that has finally gone beyond the "we need universal health care" speech to actually provide specifics regarding how to go about insuring the uninsured --presidential hopeful John Edwards.

According to the Op-Ed by Paul Krugman in the New York Times, "Edwards Gets It Right," Mr. Edward's health care plan has "extra features" that "take it a lot closer to what the country really needs."

Thank goodness!

His plan incorporates those of others—such as Gov. Schwarzenegger's health care plan in California—but goes several steps further.

• A "community rating" on insurers will basically require the insurance companies to sell insurance to everyone at the same price (thus eliminating covering only healthy people)
• Low income families will be given financial aid to buy insurance. Rolling back tax cuts for those households with income over $200K will pay for this aid.
• All American residents will be required to get insurance (thus eliminating the high costs due to frequent visits to the emergency room--- when preventative treatment would have worked).
• There would be a "Health Markets" (run by the government) established through which those who do not receive insurance from their employers can purchase insurance without having to deal directly with the insurance companies themselves. In essence, these "Health Markets" will negotiate with the insurance companies on the public's behalf – which will reduce overhead and marketing, thus making the insurance more affordable. With cheaper public insurance plans available, private insurers will need to lower their premiums in order to compete and not lose customers.

EXCELLENT!

Now we need to hear the specific plans of the other candidates.

What a shame …

Many of you may have read about our president's 2008 budget proposal which he unveiled on Monday and which calls for a staggering $50 billion budget hike for the Pentagon and an additional $240 billion to be sent to Iraq while simultaneously cutting the budget for Medicare and Medicaid, health research and heating subsidies for the poor. (Correct us if we're wrong, but wasn't the war in Iraq supposed to pay for itself with all the oil we were supposed to receive? Wasn't the real reason we went there just so we could get control of the oil?)

It's a crying shame when we have to cut our domestic programs so we can help rebuild another nation. What about our nation? What about our citizens?

Did you know that as a result of this proposed budget, some clinical trials for certain cancers will have to be shut down? According to the Wall Street Journal article, "Funding Fears to Halt Some Cancer Trials," the National Cancer Institute (which provides funding for the cancer cooperatives that enroll patients across the nation in cancer trials) is slated to have a budget cut of about $9M. As a result, cancer cooperatives are shutting down cancer trials and are stopping the study of certain cancers. This is the second year in a row that cancer rates have declined but the reason is because of cancer research and clinical trials. "Many of the trials that led to the approval of those [cancer fighting] drugs by the Food and Drug Administration were sponsored by cancer centers participating in the various cooperative groups."

We agree that cancer societies should begin studying "ways it can support cooperative-group trials, including the possibility of raising private funding" on their own. However, it's a crying shame when they are forced to do this because our president would prefer to spend the money on defense and on rebuilding another nation rather than on this country's citizens.

One other question: why keep the tax cuts during wartime?

The Fountain of Youth

Yes, there maybe a fountain of youth after all… though many of you may be disappointed. It's something doctors have been preaching for years—

EXERCISE!

Yes, fortunately (or unfortunately) exercise is the key to living a longer, healthy, more enjoyable life. "Weighty Issues", an article in the Wall Street Journal, contains an interview with Dr. Karl Knopf, "author and professor of adaptive physical education at Foothill Community College in Los Altos, CA" in which he preaches his philosophy "grow strong, not old" and describes some exercises that should be done by all older adults. In his view, exercise can improve your looks if you are an older adult. He believes strength training (or to use the proper term "progressive resistive exercise") can make you look younger by improving your posture and stature.

Is this really true?

Yes! It has been proven in several studies that exercise can add years to your life--- not to mention keep you healthier, make you feel younger, help prevent/manage chronic ailments, etc.

"Strength training empowers older people to do things they never thought they could do. ... women who say they feel better now at 75 than they did at 50..."

Home monitoring

Wouldn't you sleep better knowing your elderly loved one was safe--- even though s/he was living independently? Most older adults don't want to be a burden or an imposition on their children. In addition, they want to live alone and have a certain sense of independence. But how do we reconcile this with having to keep an eye out on them to make sure they haven't fallen, or that they have taken their proper medication, or that they are just ok?

Now new home monitoring products and services are entering the marketplace that will help reconcile these two issues. There have been some home monitoring services available in the marketplace for some time now but they, as with all technology, have been vastly improved. The New York Times article, "In Elder Care, Signing on Becomes a Way to Drop By," provides several examples of home monitoring systems such as QuietCare which is a "home health alarm system provided by ADT Security Services" that works with motion sensors installed throughout your loved one's home. If there are any pattern changes -- such as no one entering/leaving the home (very important if you are expecting a nursing aide to check up on your loved one), taking a long time in the bathroom, not opening the refrigerator door, etc, -- the alarm company will alert you (or the proper designate). In today's world where everything (and everyone) is online, you can also check on your loved one's whereabouts online. Other systems mentioned in the article were SeniorSafe@Home and iCare Health Monitoring.

Now, some may question whether this is invasion of privacy--- especially if you have video cameras installed (in the example given in the article, the daughter had video cameras installed in her father's home). However, it is up to each individual to place the cameras appropriately and only where necessary--- and of course, all this should be discussed with your loved one and have her/his FULL consent and cooperation.

The prices vary for each system – but if you can afford it and it will give you the piece of mind you need to reassure yourself your loved one is doing fine while they have their freedom and independence, don't you think it would be worth it?

Special Posting: Speaking the Truth

After 7 years developing CareTALK as a branded, multimedia common sense approach to consumer-directed healthcare management, I am still amazed at the resistance I have found across-the-board. First, there remains an institutionalized resistance to allowing consumers a full seat at the decision-making table. The dollars annually spent in America on healthcare have manifested a special interest driven, carved-up and politically charged debacle where consumers are, in my view, the LAST interests considered. I was advised "caregiving is TOXIC" two years ago by a key senior communications executive at Medicare -- as they were advised by the self-serving research data of a well-established Internet media brand. I was laughed at when I suggested a) they were both dismissing as TOXIC their own audience -- and, b) why don't they/we use our multimedia platforms to CHANGE this perception of the caregiver identity? Where is COMMON SENSE? Consumers need a management identity that is proactive and respected. Caregiving represents that identity.

TOXIC? I think not.

To be fair Medicare has since embraced the consumer identity as caregivers in a more or less formal way; however, CareTALK is working to prevent the usual suspects who have entrenched influence and who have not adequately served consumers (thus far) from defining Medicare's caregiving agenda from being hijacked to serve the agendas of those very same entrenched interests. Consumers don't need think-tanks and conferences. Consumers need CONTROL.

A recent poll indicated a majority of boomers believe Medicare will cover their long-term care expenses. How can the most sophisticated and informed consumers in history be so misinformed about something so important -- so late in the game? Where are the hundreds of millions of government dollars annually spent to help Americans become informed consumers? Where is the accountability for the complete lack of consumer education? Reacting versus management is no longer a sustainable role for consumers. Information is key -- and CareTALK is happy to partner with GoogleHealth and Adam Bosworth's team, in particular. In Adam's recent speech * during the Connecting Americans to Their Healthcare conference in December and his entry in the Google Blog he explained some of the rationale for Google Health and said

"The system didn't fail completely, but struggled with these phases."

Putting the power of healthcare management into the hands of consumers to plan and make informed decisions is key, as it is in every other aspect of our lives. Personal Health Records (PHRs) control/management will empower consumers in an unparalleled way.

We are all obliged to speak the truth to those in power and the runaway healthcare system literally screams for consumers to ENGAGE and become generals of their own healthcare management. What's missing is common sense. What's missing is YOU. The big money is running to healthcare, as boomers make their ascent into "third age." Many of the very same players who created and/or participated in the current Iraq debacle, are positioning themselves to benefit by the trillions of YOUR tax dollars that will be spent (or misspent) to care for the boomers in the years to come. Take charge of YOUR care!

Your life may depend upon it.

Who are we? We are mothers, sisters and daughters. We are fathers, brothers and sons. We are caregivers -- too long asleep at the switch! Time to engage the establishment players to do better -- or we will, leveraging the power of GoogleHealth, PHRs and information resources meant to serve a higher standard of consumer decision-making.

Every Saturday, our CareTALKToday blog will highlight experiences we have had that highlight the challenges we face, based upon our 7 year journey to develop CareTALK as a proactive, management BRAND for consumers to have a respected identity as the managers we already are -- and must be, in the years to come. It's been a long 7 years and we have met with and/or attempted to collaborate with virtually every major player in the healthcare spectrum. Some of our columns will be hilarious. Some will make you very angry. We felt it was time for a blog about the behind-the-scenes world of consumer healthcare based upon common sense. We are ready to speak truth to power in the identity of what we are -- CAREGIVERS.

Are YOU?

- Renata McGriff

* Dec'2006: Adam Bosworth's speech during the Connecting Americans to Their Healthcare conference focuses more on the Open Data aspect. "Every ill person needs a "health URL," an online meeting place where the their caregivers - with express permission from the ill person - can come together, pass on notes to each other, review each other's notes, look at the medical data, and suggest courses of action... We don't need measures that merely help doctors manage their practices or get a few more images into the operating theatre. We need to put control into the hands of the sick and their caregivers and to gently suggest that those who treat them, medicate them, test them, or diagnose them, are out of date if they do not instantly deliver this information to the patient. Once this happens, we will see truly great decision support systems and specialists and health coaches help the hapless patients much more rapidly determine what is truly wrong with them."

Get the benefits of exercise -- without exercising.

Don't you hate going to the gym just so you could fulfill our daily exercise requirements? What if you didn't have to? What if we told you, you could get the benefits of exercise by merely thinking you are getting a workout from your everyday routines?

Wouldn't that be great?

Well, according to the findings of a study conducted by Harvard University ("Why Thinking You Got A Workout May Make Your Body Healthier", Wall Street Journal), it seems as if just thinking everyday activities (such as cleaning, cooking, running for the elevator, etc) are good exercise will give you some of the same benefits as actually exercising. For example, the women in the study that were told their daily activities were good exercise actually lost weight, lost some body fat, lowered their systolic blood pressure, and lowered their body-mass index.

This just shows the importance of the placebo effect—ie. mind over matter—and how effective it can be. In other words, if you think you're sick, then you will feel sick.

This is why it is so important to keep an upbeat attitude even in the direst of circumstances and when confronted with a series of responsibilities. Caregiving is not easy and it is stressful. But CareTALK believes we should all roll up our sleeves and do what we have to do. This attitude will help you shoulder the responsibilities.

Pay for sleep?

Instead of eating your lunch during your lunch hour, how about taking a nap at a "corporate wellness center" (aka, a sleep salon)?

We all know we don't get as much sleep as we should (there are days it's lucky we get sleep at all). According to the National Center on Sleep Disorders Research of the National Institutes of Health, almost 1 in 3 adults have some kind of sleep problem. Haven't we all tried something to help us sleep better—whether it's the "memory foam" pillows, luxurious blankets, or sleeping pills? In fact, according to The New York Times article, "Hey, Sleepy, Want to Buy a Good Nap?," about $3 billion was spent in the US during the first 9 months of last year on sleeping medications and more than $20 billion was spent on "nocturnal accouterments like pillowtop mattresses, adjustable beds, hypoallergenic pillows, white-noise machines and monogrammed cashmere pajamas."

Now, spas are including sleep as one of their services. According to "Spa Finder, a company that compiles spa directories and publishes Luxury Spa Finder magazine", sleep is being forecast as "a top spa trend for 2007." (who would've thought?) In one new "corporate wellness center"(aka, sleep spa) in New York City, you can take a 20 minute nap for approx $12. If you want reflexology treatments for your hands or feet, that's another $65.

Many may say this is unnecessary. Why pay for sleep? (Hey, many previously said --and some still say-- why pay for bottled water if water is free.) You are paying for the sleeping experience. You are paying for the convenience of being able to take a quick nap during the middle of your busy day – without having to travel back home.

This may not be such a bad idea.



Special note to all our readers:

The founder of CareTALK, Renata McGriff, will begin a weekly blog to be posted Saturdays. It will be a frank discourse of her 7 years worth of experiences pioneering a real media information resource for modern caregivers -- replete with histories, stories, observations and a focus on the challenges Americans face in the years to come.