Friday, September 11, 2009

Been there, seen the mess UPDATED

I am inspired by Janette's post on health care. I can never begin to compete with the plethora of logic she dispenses there - I only want to add to it for one reason. I worked in health care and since I am a queen of forming an opinion - I formed a strong one about the Government's hand in health care.

The argument that scares me the most is that a government run health care plan won't take away from the private market. IT ALREADY HAS!!!

I'll speak about the therapy world because that is what I know. MEDICARE dictated all of what would be paid and not paid in the therapy world. My job was a constant learning process - not of what were the best practices in Occupational therapy at the time, but of what would and would not be paid for by Medicare. All other insurance plans rapidly followed suit on what Medicare was paying so the idea of free market competition was all but dead already in my opinion.

The other frustration was that each company I worked for was all about how to capitalize on Medicare's inefficiency. Instead of case by case authorization - Medicare had four or so categories that patients fit into - Like:
In-patient rehab candidates that can tolerate 60 hours a week of combined therapies earned the facility $10,000/ month
Candidates that could tolerate 40 hours a week earned 8000.00 and so on and so forth - down to those who could only tolerate 20 hours a week and it didn't pay enough for the facility to accept the patient so they told the family they were ready to go home or to a nursing home (which wasn't really the case but it's all about the money).

Then because Medicare rewarded the path of least resistance, which was tolerating 60 hours a week of therapy whether or not performance increased - we kept patients as long as possible without overall concern about when they could go home or not (unless they stopped tolerating therapy - then they were out!)

Now I have to interject here that I worked with an excellent team of therapists who were all trained excellently so we did care about the well being of our patients and we worked to get them all as independent as possible - but this was for our own intrinsic value - not because it was what the system created by medicare wanted or even cared about.

I was trained immediately to be creative with billing and to overcharge Medicare at every opportunity. For instance I was taught that when I put a heat pack on a patent's shoulder for 20 minutes and have them squeeze a ball at the same time - I was to charge 20 minutes for the pain relief and 20 minutes for the "exercise" - saying I had worked with the patient for 40 minutes when in reality I had only been with them for 20 minutes total. This is why I HATED my job. I loved what I had learned to do, I loved working with patients - but at the end of each day I had to do my paperwork. If I was honest and billed according to how much time I spent with each patient I "failed" in comparison to all my peers in productivity. If I lied I was rewarded with praise but was heavy hearted in church every Sunday. And it was all to bow down to the Medicare god.

I always felt like if the government run machine would just be reviewed by a few efficiency experts the system could save billions and billions it no time at all. But what I daydreamed about even more was what if the system was to be done away with completely. Therapy centers would compete for RESULTS not billing codes and government reimbursement.

Without huge Medicare cuts from every one's paychecks - people could save for their own health care and then have a choice in where they and their loved ones receive care. And with the money they saved they could give to their charities of choice to assist those still in desperate need for care.

I had one patient when I worked in home health that I had the freedom to work with as I saw fit. On the way to see her I read the summary of her care - A woman in her 40's had suffered a severe stroke - she had regained the ability to walk but she had no use of one hand and her speech was impaired. She was a single mother of three boys (one with Cerebral Palsy), she was a full time teacher. Her insurance had lapsed at the time she had her stroke.

The notes said that her church was covering medical bills and they asked for regular updates on her condition and that the focus was on her regaining as much independence as possible.

It wasn't until the end of my first session with her that I had enough courage to ask her what church she was a member of -- She said "Mormon" with difficult speech and my heart swelled.

What a joy to be part of an organization that really takes care of its members.

That is my plea in this national argument. We do need organizations that take care of the nation's weak and to arrange health care for those in true need of it.

People do need health care.

BUT THE GOVERNMENT IS NOT THE ANSWER FOR THIS DILEMMA.

We need more of our paycheck so that we may give - give to our churches and charities so that we can OUT GIVE THE GOVERNMENT.

Out give the government - let that roll around in your brain for a bit.

That is a right we have - a right more important than health care.

The freedom to give our money by choice not by force to help our fellow man.

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Here is Janette's post that was so inspiring to me - Since her blog is private and many of my blog friends won't get to her blog I got permission to re-post it. She managed to summarize how I feel on many levels so almost anything else I would add to this topic would have just been a repeat of what she said so without further ado:

This has not been approved by Gary ... which means that he'll be embarrassed later when he reads it. I was really upset at the time. I've since chilled out. There was something so comforting about getting my thoughts out of my head. Continue at your own risk.

1. I don't give a rip if any President of the US wants to deliver a speech to my child during school. Looking back to when I was in school ... I would have slept through it anyway. Any child of mine would do the same.

However, if I am lucky enough to foster a child with Gary's intelligence level, and said child DOES stay awake ... and listens ... and then remembers it enough to come home and tell me about it ... and I don't agree with what the President said ... I'll say something. And if my punk kid doesn't listen, I'll just tell said kid that the President isn't real. And if my punk doesn't believe me ... then I'll ask him if he'd like to give the {current} President 40% of his hard earned money so that the kids who don't work/won't work/refuse to work/or are currently 'in between jobs' can have his hard earned money instead. When he says 'no', that will be sufficient.

2. I really wish that people would quit voting based on moral ethics,
ie: abortion, gay marriage, etc, and start voting on actual political and economic issues; we fought against all odds to earn this free country ... where people had the right to be rich or poor. Their desires and work ethics decided their destiny; not whether or not the current President was going to offer a supplemental income in the form of a welfare check or not.

3. Democracy has been tried hundreds of times throughout history. It fails every. single. time. Every time. The United States' democracy is the oldest/longest running democracy in history ... and it's hanging by a thread. Why? Because we have now hit the point where the 'have
nots' out number the 'haves' ... and said 'have nots' will continue to elect whatever President promises the most handouts. It's a simple, historical, mathematical equation.

4. I have very little sympathy for people who are out of work ... insisting on some inflated pay check because their education and/or experience warrants it. Guess what? My husband and I both have degrees. My smarty pants husband graduated with the highest GPA in his major (Finance), and graduated
Summa Cum Laude (less than 2% of graduates graduate SUMMA cum laude). Gary is brilliant. The smartest guy I know. And when he found himself unemployed, he took a job making less than half of what society would say he's worth. And he's getting ready to start his second job, working for UPS ... to make up the difference. To sacrifice. To sacrifice so that our kids will have better. That's what being a dang grown-up means. Start baggin' groceries, selling pest control, or loading up freight trucks, why don't ya?

5. When I hear democratic figures telling me that we aren't headed for socialism ... and that the rich can afford to help out the poor ... it makes. me. want. to. scream. READ THE STUPID DEFINITION OF SOCIALISM ... and THEN tell me, straight faced, that our government is not acting like a socialist economy. Who do these clowns think they are?! We live in the United States of America. And somehow, we've elected a President who thinks he has the right to take taxpayer money ... and then distribute it amongst people who refuse (yes, I said refuse) to work hard. Nothing is off limits in this country. Nothing. If you want it. There is a man at our church, also with a finance degree, who works hard and provides a wonderful home for his family. AND, when he gets done with his first job, he heads over to his second job -- bagging groceries for less than $10/hour ... because that's what it takes. He (and his wife) decided they wanted a nice home/cars/life ... so he makes sacrifices for it to happen. When did {so many} Americans forget what it was that our ancestors fought for?

6. I'm not really sorry for this rant ... this is just what happens when I read the following comment {on
Facebook}:

"__________ is tired of the
obamanoia and socialismobia"

and then the reply below it:

"I think we are suffering from mine-o-phobia. The fear of sharing."

Un. Freakin. Believable.

News Flash:

I'm not over here taking in 18 kids a week to teach colors and shapes to ... and Gary isn't working from 8a-5p and then heading straight to another job to work 5:30p-9:30p; leaving the house at 7am and getting home at 10:30pm ... just so that we can 'share'.

AND, for the record ... I share all the time. I don't think I could possibly count the number of paintings that I have done for. free. Or the times I've watched some one's kids for. free. There have been times when we have had plenty ... and during those times, I've given and given and given.

REVISED TO ADD:

7. Politicians who promise handouts and health care and boat loads of government spending (democratic or republican) are only promising those things because ... they need a job! They're in a job interview. They're promising the world, the moon, the stars, etc. ... because they don't want to lost their jobs and they know what it takes to stay employed.

8. I know that Gary and I do not currently fall into the 40% tax bracket; however, for my entire life, my parents have. AND ... I plan on following suit when it comes to monetary success. And I hope that by that time, we've gotten back on the path that our ancestors started for us. The brave men and women who fought to make this a free country (free from GOVERNMENT running people's lives, free to be able to be filthy
stinkin' rich without someone deciding they were 'too' rich, etc.) have GOT to be cringing at what the US has become. The entitlement kills me.

9. The current administration believes that health insurance is not a luxury, it's a right. I agree. That's why you pay for it before you pay your mortgage and car payments. If you can't afford your mortgage and car payments after it ... you 1. get another job, or 2. move & down grade your cars.

10. If health insurance is a right ... how come housing isn't? Someone should pay all of our mortgages because we live in America and we should all have housing. No one should be homeless. And how about clothes. I suppose that clothing is a right too. And food ... and in Texas, air conditioning. We're on a very slippery slope. Trust me, health insurance is just the first hurdle towards providing everyone everything ... so that we are all equal ... and the 'have
nots' can have the same things as the 'haves' ... without having to actually work for it.

I sorta go a little crazy ... when I hear things like $900 BILLION to pay for other people's health insurance because they refuse (yes, I said REFUSE) to take care of themselves ... I get a little heated. I understand that we do need to take care of the handicapped ... and those who
literally cannot take care of themselves ... but the population of people who fit into that category is so unbelievably small ... it would be a drop in the bucket to care for them. And that, is how it should be.

When/where the crap will the sense of entitlement end?

And please, don't bother arguing with me. I will never, ever, ever, see your side. Never. (But we can still be friends ... because there is more to life than politics)

It's been said that you can measure the character of a man based on what he does when he's backed up against the wall. Does he sit down and cry ... or come out swinging?

I choose to come out swinging. Every. Single. Time.

21 comments:

Tony said...

I see what you're saying about government inefficiency and waste via Medicare. However, I don't think that private insurers are always the most efficient, let alone caring entities, either. But we'll probably continue to respectfully disagree on which "devil" we'd rather live with.

One of the things I admire most about the Mormon faith is the willingness to help each other and even sometimes those beyond your community when times get tough.

However, I personally would not want to rely on the kindness or benevolence of individuals as a primary safety net in general, but particulary regarding for health care. Not everyone is in a family or community as connected as Mormons are. I also believe that people of considerable means would be much less likely to contribute to charities today if not for tax incentives. Perhaps I'm cynical, but I think the percentage of truly altrustic people in the world is below 50%.

Therefore, taxes to cover things such as Medicare allow both the charitable and the self-absorbed to contribute to the greater good. Of course, those truly generous souls are free to give even more.

You say toe-may-toe, I say toe-mah-toe. :)

InWeighOverMyHead said...

This post has me in tears. Our church helped me with physical therapy after my stroke. It is wonderful to be LDS and know our church family helps those in need.

My name is Andrea said...

I love you, Janie.

Gary Church said...

I'll admit. I cried. I'm so proud to be an American Latter Day Saint!!!!!

Beth said...

Amen, Janie!!!

cplatt said...

Janie,

Loved your perspective...thanks, it was very interesting. I believe most people that can afford to, give freely to help those in need. That is the best way. So sad it will be less possible under new plan for many paying 60% tax.

Nikki said...

Very well put. Totally agree with you and your friend.

Kleanteeth said...

So here's my thing...you make a very nice article and a nice read and I agree with you and I know a lot of people agree with you...but that's it? What do we do, what can we do? Some of us try to be involved with politics and we watch Glen Beck and Bill O'Reilly, etc, and stay "informed". Then we get more pissed off and say something must be done and then we go to our jobs, two sometimes, so we can live in a 3000 sq. ft. house and have 2 cars and vacations and nice clothes etc. So we feel like we work hard for what we need, but most of our needs are wants anyways. We watch the debates and vote, but it doesn't matter who wins or loses, we still get pissed and write venting blogs and say our county is headed for disaster in the same sentence that states how proud we are to be American. Some of us pretend we don't care what goes on, we don't watch the news, we don't vote. In the end, it doesn't matter. We piss and moan all the same and as much as we want and it doesn't matter if we get the biggest barrel in the world and fill it to the brim of piss, it will still just be a barrel of piss that can be kick, rolled, and manipulated any way it can.

Janie said...

I am not sure exactly what your point is Kristi? give up??
I do write venting blogs but I also write to my representatives and I have even visited local politicians in their office about topics that were really important to me. Many of my friends attend Tea Party rallies.
I educate myself before I vote.
But most importantly I teach my kids the danger of BIG government.
I'll never give up - bucket of piss or not
I do love America because I can piss and moan all and I want anywhere I want. And I will stay proud, but at the same time always calling black black, and white white and socialism, socialism.
What Kyle and I have did not come from our parents' wealth or our governments goodwill. We worked hard for it all and we will fight for it all.

Tony said...

Late last year, I wrote in my own blog late about the fear that many had during the last administration that we would be moved toward a "free-market theocracy"... and I predicted a subsequent concern about morphing into a "secular socialist state" during the current administration.

Bush did not accomplish the former, whether he wanted it or not, and I don't believe that Obama wants the latter.

Janie said...

Its not only about what the President hopes to accomplish its how much the people desperately want all these government programs.

this is old - from the campaign but still its what scares me:

http://www.youtube.com/watch?v=OTDmGt1Pafw

Kleanteeth said...

You teach your kids the dangers of big govt., you write your people, visit them in fact, you watch news, you vote, you rally, you piss and moan whenever, to whoever..I get that, but why? Will it change anything? It'll let you sleep better at night, give you something to talk about, an excuse not to get to other things, whatever. You love a country founded on ideals that exist in my dreams, by people who nowadays would never make it in govt. because they have too much integrity. You love a country that now represents everything you despise. You think politicians give a crap about what you think or what a million of you think? Not a chance. It's like Gladiator, but real life where Ceasar always wins because even though the majority of his own country hates him, he has the power to entertain and sidetrack a mob. So that's my pessimistic view of politics and politicians. Oddly enough, I'm always happy and optomistic. I expect nothing from govt. and media except a load of crap and if I come across something/someone great I'm happily surprised instead of always disappointed. There are a lot of good people still how here in our country, however, I don't see govt. ever representing us again.

Melissa Jones said...

Bravo Janie and Janette! I think sometimes people forget that the unalienable rights with which we have been endowed are life, liberty, and the pursuit of happiness. NOT health care. NOT a home. We aren't guaranteed happiness, just the pursuit thereof.

My blood boils whenever I think that people in Washington have the audacity to assume they know how to take better care of my family than I can. When they push for big government, they are basically telling us that we are incapable of taking care of ourselves. That they know better. How dare they!! Of course it is unfortunate that a lot of people like (and think they are "entitled" to) handouts and are willing to give up some freedoms here and there as long as the freebies keep rolling in. Bottom line? Much of my happiness stems from following the example of my Savior, Jesus Christ. He taught us to look out for one another, and to love our neighbors as ourselves. My ability to help others is dramatically stifled when the government takes a massive chunk out of our income before we ever even see it. One might even go so far as to call it an infringement upon my pursuit of happiness. Come on!! Let's just fire 90% of the IRS and have an uncomplicated Flat Tax! (It works for the Lord!)

There is a huge difference between decent, responsible, hard-working people who have fallen on hard times, and people who just roll over and want everything handed to them from the cradle to the grave. Sign me up first to help people who have hit a rough patch, or can't help themselves, but everyone else can just take their hands off of my wallet. I'm just not going to stand for it. I worked all kinds of crazy jobs to pay for my college education. My husband and I have EARNED what we have.

I can't wait for the 2010 elections because as far as I'm concerned, it's time to send EVERYONE who voted on a bill before they actually read it packing. To Cuba, perhaps. (Hey, they have universal healthcare, right?) Let's send actual honest Americans to represent us -- not career politicians -- and put term limits on them once they get to the District of Corruption. I don't want representatives who HAVE walked in my shoes .... um, 20 years ago. I want representatives who are walking in my shoes NOW. I want to send my neighbor who's job went overseas. I want my Home and Visiting Teachers representing me. I trust them, and they don't want to rob me blind.

Melissa Jones said...

One more rant. (Or perhaps two.) My father-in-law once made the comment, and I wholeheartedly agree, that if the government were to take everything from everyone and then redistribute everything (housing/cars/money/the works!) so that each person had exactly the same amount, that in five years people would end up just how they started before redistribution. People who want more would go out and work for more. And they'd likely get it back. People who didn't work for what they were given would slide right back into the hole they dug for themselves.

I look at current and projected employment rates and I have to shake my head. As I was running around town this past week I couldn't help but notice "help wanted" signs in almost EVERY window (DSW/Taco Cabana/Ross/Best Buy/Old Navy....)of every establishment. If my husband were laid off today, I would go put in an application at Target tomorrow. We could both work alternating shifts at McDonalds and keep our home. We might be riding bikes to get to work! But if we had to do it, we would do it. There are jobs out there. People may be drastically overqualified for them, but they do exist.

Beth said...

Janie, thank you for not giving up and giving in. If everyone had that attitude, we would all by now be signed up for Obamacare. And to the other commenters, thank you for talking sense. I completely agree that those who are poor and don't have health insurance don't have it because they don't really want it. My husband was unemployed when he left active duty in Dec. 2007. We moved to Michigan and got a decent job in a tough economy. However, a month later lost it and we were left scrambling. He took the only job he could find (Home Depot) and we were thankful for whatever money we could bring in. Since there weren't many option in MI, we moved to Florida. That cost a pretty penny, but thankfully we had savings and were able to pay for all our bills, even though we weren't making enough each month to cover them all. For over a year we struggled through unemployment, part-time jobs that didn't pay what some would say my husband deserved, and guess what - NO HEALTH INSURANCE! Yes, it scared the crap out of me not having enough money at the end of the day to make sure my children would be okay, but I knew the only way it would be resolved was to keep doing our best and working our hardest to get to the end goal - a job that would provide for us and with insurance. And guess what - after a year and three months of being very stingy, looking constantly for new jobs, and worrying every night about staying healthy, my husband got that job. I cannot begin to express how thankful I am for this job, but we had to be willing to work for it. We didn't just sit around and wait for someone to hand it to us. That is what being an American is about. Having a dream and desire and going out there and getting it done. We need to stop complaining about our situations, get off our butts, and take control of our own lives. That's not for the government to do, it's for us.

Tony said...

Apparently I'm the Alan Colmes of this thread. :)

Janie, that was an interesting speech. (Of course, the person who introduced it lost all credibility with me a few weeks ago. And you know I don't mean regarding my look-alike Van Jones.) Personally I would be nervous if any President relied on the advice of, say, Dr. James Dobson, Rick Warren or Gary Bauer to chart the course of the country. (No offense to anyone here who happens to support these gentlemen.) The extreme scenario this would be a mirror image of Saudi Arabia but with a Christian face. Of course, as I said earlier, that didn't happen under Bush's despite a considerable amount of concern from many - and perhaps the hopes of some others - just as I don't think after eight months we've become the Western version of Mother Russia.

Melissa, I would wager that a lot of those job opportunities that you mention don't offer health insurance... which is a major point of the health care reform discussion. And as someone who current has an individual health insurance plan, I can say that with a $6-7/hr job, buying one's own insurance these days would barely allow one to take care of oneself let alone a family.

To everyone, I'm assuming that you all consider yourselves part of hard-working middle-class households as do I.

I would agree that there are some in the lower-income range that aren't looking to improve their situation and contribute their fair share. I'll go ahead and say it: let's call them "welfare kings and queens". (It's okay: remember, I look like Van Jones.)

However, there are those on the other end of the spectrum who either came upon their wealth by pure luck - let's call them "trust fund babies" or "the idle rich" - or have the resources to access tax shelters that may or may not be legal. (Swiss bank accounts, anyone?)

And here we are, us hard-working middle-class folk, stuck between these two extremes. Depending on your personal/political viewpoint, you'd probably trust one group more than the other to do the "right thing" if/when given the opportunity by the government. It's probably obvious whom I would support.

If somehow the 2010 Congressional elections happen to turn out in the GOP's favor, I hope that they remember the "with us or against us" attitudes from 2001-2007. This whiplash see-saw of political policies will start to get tiring for all of us.

Gary Church said...

Just wanted to say that I really like Tony (aka, Alan Colmes).

Melissa Jones said...

When the government can prove that the money they're taking from us goes towards legitimate needs and not towards ACORN and abortions, etc., they can have it. If anyone else wants something, they can go and earn it. Because THAT is the American way. Seven years ago I was working on Pennsylvania avenue between the White House and the Capitol. I worked for a small non-profit public policy research institution called the Heinz Center and let me tell you, I was the only Republican in the office. I think they kept me around because they could claim they were bi-partisan, since they had a Mormon Republican Texan working as a research assistant, but whatever. I can't tell you the number of times my coworkers were amazed that I was a Republican because I was "sweet" and "charitable" and "considerate" -- as if only Democrats could be such things. They just didn't get it. I'm sorry if some of the things I've posted have seemed harsh. Sometimes the kindest thing you can do for people is show them some tough love. There are other ways to get what you need besides taking from someone else. Why can't people see this and try a better way than taking and taking and taking? If you bleed the well dry, everyone suffers.

My point about working at McDonalds wasn't to imply that it would be a long-term solution. It would be a band-aid for us. We wouldn't expect health care out of the deal. We would work hard while looking for the next step up. And ANYONE can do that! Not just middle class white people. If you want a better situation, go get one. Be responsible for yourself.

This is America for crying out loud! We can solve the healthcare crisis without resorting to Obamacare, which in the opinions of many is paramount to thievery. There are other ways, and if we just put our noses to the grindstone, we can figure out a better way. America always does. The better way still won't be perfectly fair. Perfectly fair in Government doesn't exist in this world. But we can do better than this.

And, Tony, whoever you are, I love you and respect your opinion.

Tony said...

ACORN isn't helping its own cause that's for sure, Melissa. I respect your opinion on other uses of government funds.

Wow, I imagine it must have been lonely at the Heinz Center. I hope you at least got some good ketchup out of it. ;) That's interesting what assumptions your left-leaning co-workers had about you. Whatever I might think about Republicans, I'm sure the majority are considerate people. My opinion regarding the charity of upper-income households crosses party lines.

I see what you're saying about a McJob being a temporary fix. While I'd contend that there are still those that may withhold the proverbial bootstrap materials at some levels, I agree that the opportunity for most anyone to improve their lot in life is as good as it has ever been.

While some might consider a public option as "thievery", imagine what would have happened if we were able to invest our Social Security in private accounts.

I enjoy a spirited debate. I don't take anything said here personally. I knew I wasn't going to win any hearts and minds here. LOL I only wanted to present another side of the story for people to consider. There was similar nationwide hysteria from 2001-2007 from many progressives while many conservatives wondered what all the hub-bub was about. Now we're experiencing a mirror image and it seems that many politicians on both sides haven't learned their lesson. When the Democratic Congress members start demanding "up-and-down votes", the circle will be complete.

Thanks for the "luv" Melissa!

Janette, thank *you* for the like. :)

I'm sure no one here loves me more right now than Janie! ;)

Gary Church said...

I just appreciate that you can respect the other viewpoint. I have lots of Democratic friends ... if they 'ranted' on their blogs as I have, I probably wouldn't even comment; however, if I did, it would be something funny, witty, and light hearted.

On the other hand, I received an email this morning from a dear friend (someone I really respected) calling me a 'radical right-winged extremist scary' person ... and then asked to be deleted from viewing my private blog. It's sorta weirded me out all day. To say that it ruined my day ... that would be an understatement.

So. I appreciate when I meet someone who is clearly well-educated politically ... and they listen to the other side and then respectfully state their opinions. :D

Janie said...

I remember my mom telling me about Tony when they first started dating - and what a wonderful person he is - then she added the side note that he was a little liberal leaning - LOL

Tony is the BEST person ever - and the closest person to ever getting me to understand the Democratic Party perspective - even if I don't agree, I understand it better.

I appreciate anyone who is involved and educated enough to form an opinion - I have floundering respect for those who don't even bother to care about politics. Its not like say fashion - where you can choose not to care and it won't affect you. Politics affect all of us whether we like it or not.

As I read Horton hears a who this morning to Maiya I thought it was the perfect analogy to public policy - we need to make ourselves heard no matter how small