Howard Dean testimony on aging

[KaraokeKarlton]

Dean wants Medicare to make it easier for the elderly and disabled to get the support needed to allow them to stay at home instead of being herded into nursing homes like cattle. This official testimony from Howard Dean sure doesn't indicate he's a big meanie to the elderly and disabled as some here would have you believe.

http://aging.senate.gov/oas/hr71hd.htm

[eileen_d]

1. You mean he won't get the "big meanie" vote?

JUST kidding... thanks for posting. It's good to see testimony like this (outside of a campaign speech, I mean - shows commitment).

[spooky3]

2. LOL, eileen_d, and thanks, karokekarlton--interesting. (eom)

[depakid]

3. Dean is advocating the Oregon model

or should I say what used to be the Oregon model before the far right in the legislature tore apart our eldercare system. The medicare changes he's arguing for would make it easier for states (especially poorer states, red states) to fund and implement changes in the current system in order to provide in-home and community care for the elderly and the disabled.

This is a huge issue for many people, not only the elderly and disabled, but for the people who care for them and care about them. It's great to see someone knowledgeable on the issue endorsing such rational and dignified policy.

For anyone interested in eldercare, there's a great paper available online from the National Policy Institute.

[Eloriel]

7. I saw a friend of mine age literally 10 years in ONE

trying to take care of her mother, an Alzheimers patient, all by herself AND work fulltime (single woman, no kids). It was absoltely ghastly. Even after she found a nursing home suitable, she still spent many hours there at all hours of the day and night just to make sure her mother was getting appropriate and non-abuseive care, and this was at a GOOD nursing home.

Eloriel

[tsipple]

34. People Who Care for the Elderly Are Heros

Your friend is a good soul, it sure sounds like.

My cousin works full time caring for the elderly, with years of study and training to do the job well. I'm so proud of her.

[Upfront]

4. Go Howard

Dean leads again, and this is a big national issue. Go Dean!!!!!!

[tsipple]

5. Not Surprising Dean Has This Compassion

When he actively practiced medicine not too long ago (for many years), he had many, many elderly patients, as I understand it. (Many Medicare patients, in fact, so he knows a whole lot about Medicare as one of its providers.) It's something he's passionate about, making healthcare work. (His wife still practices.)

He's the strongest on mental health treatment and care, for example. He also helped start a wonderful program in Vermont where every mother who gives birth in the state gets a hospital visit, offering early childhood and maternal assistance and counseling. That's helped reduce infant mortality, and it actually saves money. There's also "Doctor Dynasaur," the program which provides medical care to all children with families at 150% of the poverty line or below. There are cost pressures in this program, but so far Vermont has kept its promise and balanced the budget.

How's that for some positive stuff for a change? :-)

[Nicholas_J]

6. GEE

Dean telling everyone How Great his ideas are, with NO evidence that anyone else actually agrees with him. This is propaganda, not proof. Lewts see what Dean actually recommended and how the Vermont Assembly of Home Health Agencies responded to it:

More Self sourcing from Dean, telling what he SAID, and not looking at what he has done or tried to do, but was stopped from doing it.

Home health care is just a TINY component of Medicare, and it is expensive, so Dean basically was saying, it is cheaper to let them die at home without instant access to medical care when it is most critical.

One bad factor of keeping the very elderly and infirm at home rather than in a hospital is that it allow a LOT of people who need complex care to croak on the way to the hospital. Way to go Howard


Lets look at how thew Vermont Assembly of Home Health Care Agencies viewd what Dean actually DID a few months after spouting this tripe.

Governor’s Budget Cuts Medicaid Programs

Governor Howard Dean, in his eleventh and last budget address, cut several Medicaid programs including prescription drugs, dental care and vision services. Dean told lawmakers times a tough and sacrifices had to be made.

The Dean budget for FY 2003 is $891 million in state spending, one percent more than the state expects to spend this fiscal year but nearly 3% less than the budget passed last year ($916 million). Revenues this year are expected to be $50 million below budget. Dean wants to use the "Rainy Day" fund to cover some of the $50 million shortfall but does not want to tap that fund for FY 2003. Next year’s budget is based on revenue estimates of $893 million.

If passed as presented, Dean’s budget would:

Eliminate the VScript Expanded Program.

Reduce the Vermont Health Access Plan pharmacy benefit.

Increase the co-pay up to $750/year for medicines under both the VScript and VHAP pharmacy programs. (Those eligible now pay only a few dollars for each filled prescription).

Eliminate the Medicaid dentures, chiropractic and podiatry programs.

Reduce the adult dental programs (cover pain and suffering only, not preventative care).

Add a 50% co-pay to adult vision programs.

Add a $250 co-pay per admission to VHAP inpatient hospital benefit.

Reduce the hospital outpatient payment by 10%.

Establish a hospital outpatient co-pay of $25.

These cuts would save about $27 million, $11 million in state money. Few advocates for the elderly are happy with the budget and have vowed to restore the money lost to these programs. A coalition of over a dozen advocacy groups held a rally and press conference at the Capitol building to denounce the budget cuts.

http://vnavt.com/vahhavoicewinter2002.htm

Typical of Dean, he talks the talk, but when it comes to doing, he is good at screwing, particularly those receiving the benefits.

What one actually DOES is far more critical than what one says

[Name removed]

8. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Nicholas_J]

12. Sorry

Kerry's record needs NO defending.

Dean's does However.

Virtually ALL of Deans heath initiatives in Vermotn could have been written in the marketing department of Kaiser Pemanente or any H.M.O.

Even the hospital and home visit program for women who have just had children is simply a way of "Dressing up a turkey".

It is a cost cutting method, these type of "Send mother ho,e to bond with the child programs" are another way to get the mother out of the hospital as soon as possible to cut costs.

Again, Dean simply decided to start a program that was of greater value to the health care companies who gave campiagn contributions than to the patients.

In order to save money, they simply decide that it is cheaper to send the mother home as soon as the child is born, have someone visit them in the hospital to check that they are not obviously havingv some sort of post - birth trauma or complications, have someone visit them later, and wrap it up with the warm fuzzies of a bag full of books and a visit at home, in order to save the money that keeping a mother and child in the hosptal for the first few days when most complicatiions would occur, and they find that the risk to the mother and child that could occur, and the possible death due to complications is an "ACCEPTABLE RISK" in the grand scheme of things.
All noice and tidily figured from actuarial tables.

They print up nice glossy pamphlets about how natural childbirth is, and how being in one's own bed and home and with the family is so much warmer and environment.

A a man I dont know what it is like to have a child, and it is a natural process, but to be honest, so is passing a kidney stone.
I'd rather be in the hospital , myself.


They find that a few deaths are acceptable in order to save some money.

Deans record of fiscal coservatism stays intact, the insurance companies save a bundle, and only a small percentage more mothers and children die, but money is saved.

For my money, I'd rather have my wife stay in the hospital for a few days to make certain she will not risk serious infection hemorage, or death and go and buy the books myself.

Unless those books that they give out give instructions on how to stop a hemorage or infection or the results of an unexpelled placenta, and all of the other things that can go wrong with pregnancy.

Lets not try to dress Deans desire to save money for the insurace companies up in some sort of attempt to do something nice.

That would be out of character.



Perhaps the most alarming data are those showing a rise in the maternal mortality rate in the US in recent years. ( 2, 3) We have always known maternal mortality in the US to be underreported -- in one State in one year 5 of the 16 maternal deaths had not been reported.(4) But the latest evidence suggests a recent rise; "The actual pregnancy-related death rate could be more than twice as high as that reported for 1990."(3) Because the data give only the leading cause of death and not underlying causes, it is quite possible that the leading cause of death, namely hemorrhage is, in many cases, hemorrhage associated with, for example, cesarean section. There is good research showing the maternal mortality rate for cesarean section is four times higher than for vaginal birth(5) and is still twice as high when it is a routine repeat cesarean section without any emergency.(6) With all the unnecessary cesarean section done today in the US(1), this could be part of the problem of rising maternal mortality.

Another possible cause of the rising maternal mortality rate in the US is the epidemic increase of epidural anesthesia for labor pain. This is not far fetched since epidural block carries a maternal mortality risk and, for example in Great Britain where there is a careful audit of all maternal deaths including underlying causes, epidural block is one of the reported causes. Again, the fact that the woman who died received an epidural block for labor pain may not appear in the maternal mortality statistics. There is an urgent need for careful audit of all maternal deaths in the US with a thorough analysis of causes, including underlying causes, and presentation of results to the public. American women need to know that their chance of dying around the time of childbirth is increasing and they have a right to know why.


http://www.geocities.com/Wellesley/5510/wagner.html

[dsc]

19. shock of shocks wrong on this too

http://www.cnn.com/HEALTH/9707/22/nfm/nfm.drivethru.babies/

You will note in this link that drive by deliveries were banned by Congress in 97. The program dates from 93 and is still in effect. If you were correct the program would have been disbanded due to it not being needed. And according to the article the cost of deliveries increased by a grand total of 90 bucks with the end of drive bys.

[Name removed]

23. Deleted message

Message removed by moderator. Click here to review the message board rules.

[KaraokeKarlton]

9. Home Health Care is A LOT cheaper than a nursing home

And it's not only better for those who require care, but for the families and the budget. The fact that Medicare makes it harder for people to get home care is exactly why Dean has complained about the program in the past. It's bogged down with so much red tape that it hinders people getting the best care for them. Dean wants to eliminate all the problems with eligibility that keeps people who need services from getting the help they deserve. It's really a shame you hate Dean so badly, because he'd actually do more that would help you personally than any of the others would. But you can't see the forest through all the trees.

[Nicholas_J]

13. It is simply cheaper, and this isa Deans motivation

And all of the attempts to dress this up in poor medical statistics will not change that fact.

[KaraokeKarlton]

15. Oh for the love of God, Nicholas

Are you saying that you'd rather be in a nursing home than live at home with support services? Everyone has concerns about this because we all are going to get older and eventually face these kinds of situations. But you are so goddamned convinced that Dean is the devil that you would say some of the most ridiculous crap that no one in their right mind would ever say just because you want to put Dean down.

You remind me of Adam Sandler's mother in The Waterboy. But with you, everything is "Howard Dean is the devil". It's pathetic.

[Nicholas_J]

18. If its is safer, and more likely to preserve the life of

the person in the home, yes, I would prefer the nursing home route to the Home Health Care route.

I would rather have care immediately available.

But it is cheaper to treat the dead than the living.

[KaraokeKarlton]

21. I don't buy what you're saying for a second

No one wants to be in a nursing home. The fact that you are claiming to prefer that over staying at home is highly suspect, and most likely something you're just blowing out your ass so you can calim to disagree with Dean. It's pathetic.

[Nicholas_J]

29. Nope

If I were ill, I would prefer to be where the health care IS available, not having a stroke in front of my television.

being disabled, when I need to be in the hospital or in some rehabilitative facility, I go there. Even if I would feel warmer and fuzzier with my family.

[KaraokeKarlton]

32. There is NO emergency care at nursing homes

You have a nurse on duty and a bunch of aides. In the home I worked in when a woman had all the symptoms of an oncoming heart attack the senior staff person didn't take her seriously and thought she was "just looking for attention". No doctor or ambulance was called and the woman died. You will ALWAYS get more reliable assistance from your family and in your own home because YOU retain some control.

[dsc]

10. My mom is in a substantially similar program

to what is described here. And I can tell you without equivocation it is the one and only reason she isn't in a home. It is the one, and only, good idea Taft has come up with in 5 plus years of governence. Here it is called Passport and provides my dad with the things needed, and they are needed to keep here at home. She gets an aide for four hours five days a week, transportation to doctors appointments, some home modificiations, and has gotten a wheelchair. She also gets Medicaid outright due to my dad's insurance being too expensive. It has been an outright God send.

[Nicholas_J]

14. And what happens

If she needs a procedure to be done at a monets notice in order to prevent serious health consequences.

Medicare does already allow for home health care, and so does medicaid. Again, what is necessary to protect the health of the patient, their lives, should be dcided by those best suited to make the decision, the doctors and the family. Not ste manddates in order to save money. Which is really what Dean is about.

Virtually all of his ideas are the types of things that are touted and bounced around in the board rooms of the insurance companies, and by conservatives trying to cut costs, not by doctors making sound medical decisions.


Try checking out what is available under medicare to begin with, and then see if Dean did anything "EXTRORDINARY" or simply was creating the required legislation that the states must enact in order to comply with changes made in Medicare and Medicaid.

You may find that what Dean is taking credit for, was created in Washinton, and not Montpelior.

[dsc]

24. are you nuts?

First, we had to beg, borrow, and call our county commissioners to get into this program. She was by no means forced to get into the program.

Second, if she needs medical care she pushes her 'panic' button and the fire department (with ambulance) arrives in less than one minute (yes I mean less than one minute). She gets taken to the ER and arrives in less than 10 minutes (all total from button to hospital). You can't get much better than that. Nursing homes don't have night duty doctors around here.

[tsipple]

27. Nicholas, Nursing Homes Have No Urgent Care Capabilities

Nursing homes are not emergency rooms, and they're almost never adjacent to a hospital.

It is a proven and well-studied fact that patients do better in home healthcare than in nursing homes. They are psychologically better off -- which translates directly into physical well being -- and they are less prone to the spread of disease. (On edit:) Seniors know that when they go into nursing homes they don't come out.

The Dean Plan (which we'll hear the details of tomorrow) offers seniors greater choice, i.e. the realistic option to have quality home healthcare as they wish. That is exactly what the overwhelming majority of seniors wish: to live at home, with quality care, in familiar surroundings, with independence, dignity, and quality of life.

I know John Kerry agrees.

A reminder to all: we are feeding the troll here a bit tonight, but make sure you also feed the goal at Trolls for Dean. Make Howard Dean's plan for improved elder-care a reality in 2004. Thanks.

[dsc]

11. BTW

had you bothered to read the post you would have seen that it is designed to keep people out of nursing homes not hospitals. Which makes your first agument plain out stupid. My parents live closer to both the fire station which would transport her and to the hospital to which she would be transported than the county home here is to either.

[Nicholas_J]

16. A good nursing home

Is a lot better than home health care, and supporting good nursing home practices far safer and better for the patient than being at home and getting a "HOME HEALTH CARE WORKER" to come to the house a few days a week.

Again, the doctors and the families should decide, not the state.

A cost cutting procedure designed to up the profits of the insurerers, cut the costs to the state, and if a few people have to die prematurely, its not big loss. After all, they are old anyway.

Thats what is the basis for the ideas and the philosophy, not kindness.

[KaraokeKarlton]

20. Now this is ridiculous

I worked at a private retirement home. It cost an outrageous amount and I felt the people were NOT treated properly. This was one of the BEST homes in the area. Some of the workers were abusive to residents and didn't care for them properly. I hated how it was run, so I told family members of what I saw that I felt was wrong and I quit. This was in YOUR state, by the way. I saw the same thing in a group home down there that I worked in. It was a home for older disabled people. Even the better ones are never better than being at home if you can be.

[dsc]

25. again

It would have been immensly easier for us to put my mom into a home. That is what we were offered in the first instance. I haven't a clue where you get the idea this is forced upon people except in some paranoid alternate universe. It took me many phone calls and many months to get this set up. And that was as a college educated, aware, unemployed, and a little bit politically connected person. I literally can't imagine what someone who wasn't those things would have had to do to get that done.

[KaraokeKarlton]

17. Nicholas thinks Nursing Homes are great places

and best for all elderly and disabled people JUST because Dean prefers home care whenever possible. I suspect he'd also cut off his nose to spite his face, but I digress... :D

[Nicholas_J]

22. Again

The home health care professional seem to not agree with what Dean DID, which did not match what he did. Read it again:


These cuts would save about $27 million, $11 million in state money. Few advocates for the elderly are happy with the budget and have vowed to restore the money lost to these programs. A coalition of over a dozen advocacy groups held a rally and press conference at the Capitol building to denounce the budget cuts.

http://vnavt.com/vahhavoicewinter2002.htm

This is documentation from the Vermont Assembly of Home Health Agencies.

What do they say...That FEW ADVOCATES FOR THE ELDERLY are happy with what Dean was actually DOING to the budget to these programs. and were holding a rally to DENOUNCE, Deans actions.


Talk is cheap, and Deans "TESTIMONY" just talk.

Doing is a different thing. Thats what it is really all about.

The real problem with Dean,as I often have said and often repeat, is WHO he chooses to cut, and what programs he chooses to axe when the pressure is on. His behavior towards health care programs and programs to the disabled, blind and elderly when the heat was on is what is most revealing of Deans character.

He did not choose to follow the route of controlling cost though cutting deals with large pharmaceutical companies, or get costs of administration through large insurance companies down but instead:

Medicaid cuts will affect thousands of Vermonters


In an effort to curb costs in a rapidly expanding part of the social services budget, Dean is proposing to require many people who got coverage under his expansions of Medicaid programs to pay for a greater share of their health care.

Medicaid is the state-run program that uses both state and federal money to provide benefits to the poor and disabled. Over the past several years Dean has expanded the programs by allowing participation by Vermonters with incomes higher than the federal guidelines.

Under the proposed budget, about 3,200 elderly or disabled Vermonters who get half the cost of long-term drugs paid for under a program called VScript Expanded would see their benefits disappear. This would save the state nearly $2.5 million. A single Vermonter with an annual income up to $19,332 is currently eligible.

Dean’s plan would also lower the amount the state pays to hospitals for treating Medicaid patients, rolling back an effort by the Legislature last year to beef up the reimbursement level and reduce “cost-shifting.”

That’s what occurs when the state and federal government don’t pay enough to hospitals and doctors to cover the cost of treating patients on Medicaid and Medicare, the health care program for the elderly. Doctors and hospitals must then charge more to patients with insurance coverage, driving up insurance costs.


http://timesargus.com/Legislature/Story/41169.html

AND:


Senate adds money to budget, angers Dean
May 9, 2002

By ROSS SNEYD The Associated Press

MONTPELIER — Senators passed a 2003 state budget Wednesday that the governor made clear he would veto if it ever reached his desk

Even the governor’s closest allies in the Senate ignored him. Sen. Nancy Chard, D-Windham, recommended restoring $440,000 to one of the pharmaceutical assistance programs and the Senate voted 22-7 to go along with her.

“I’ve become convinced that we have a philosophical difference between the governor, the Republican House and this Senate,” said Senate President Pro Tempore Peter Shumlin, D-Windham.

“The governor and the Republican House want to balance this budget on the backs of our most vulnerable Vermonters. The Senate wants to balance this budget on the backs of the pharmaceutical companies who are charging too much for drugs.”

http://timesargus.com/Legislature/Story/46513.html

Lets get real...what did he do, what did he try to do. I am not much interested in campaign gimmicks or testomoy or talk in order to get votes.

I am interested in what he did, and the choices he made when the going got tough.


Lets see what did Dean choose...balance the budget on the backs of the most vulnerable.

The governor and WHO, wanted to do this...not the Democrats, but the REPUBLICAN HOUSE OF REPRESENTATIVES.

[Larkspur]

31. Home Health Care is for those who don't need 24/7/365 care

Many elderly can live at home, which is best for their psychology because they are surrounded by things that they know. Many elderly, and my mother was one, suffered bouts of dementia and dementia increases when one is away from familiar surroundings for long periods.

Nursing home care should be use for those who need 24/7/365 care or rehab from injuries. Home Health Care with periodic visits from social workers and visiting nurses is much better for the elderly that regulating them to a nursing home.

[Nicholas_J]

35. Again

rationale?

Home Health Care agencies have been found to offer more opportunities for fraud, elder abuse, as well as not being well regulated, and having no standards and only RECENTLY have come up with procedures for accreditation.


It is cheaper, but provides not standards fo the agencies, and there is little or no enforcement of the minimal regulations regarding these organizations.

[Mairead]

39. Nic, could you possibly separate the quotes from your own words?

It's very hard to figure out what's what.

Thanks!

[bread_and_roses]

26. Like most choices in health care

home care, hospital care, and long-term care should be determined on individual basis. When it is possible, home care is the choice of most elderly people, from what I have read and seen. One need not dismiss home care to have some concern about the issues Nicholas raised regarding the cuts to services in Vermont. Nor does concern over Dean's former stances on medicare and Social Security mean one is falling to the level of calling anyone a "big meanie." These are legitimate issues, this is a Primary, and raising your opponent's record is legitimate. I don't understand these constant comments of "flaming." Over all of this, and giving anyone who cares about the uninsured pause is Dean's non-support for Universal Health Care. Anything less will be so confusing it will not gather support, and will set back the effort to bring American citizens the same standard employed in the rest of the industrial world: access to health care. Anything less benefits no one but the insurance companies.

[dsc]

28. I have no problems discussing Dean's record

but I have big problems with clipped quotes which come with no links. I found out that the context of the Medicare quotes were in regards to the adminstration of Medicare and in particular their sloppiness in reimbursing his dad for bills. Gephardt knew that too but chose to lie instead. Since his website wouldn't give links to any of these quotes one had to try to catch as catch could on them. So far he is 0 for 2 on the honesty meter. I was a Simon supporter in 88 and I know a pattern when I see it.

[bread_and_roses]

42. Medicare spends 2-3%

of its' total oulay on administration, according to the figures I have read. Private insurers typically spend around 10%. Perhaps Medicare should spend a bit more on administration to make the process easier and faster? Advocating cutting an essential service because it is not well administered (rather than correcting the problem) is surely tossing out the baby with the bathwater?

[tsipple]

30. A *Democratic* Congress Couldn't Pass UHC

And that was universal healthcare that was not a single payer plan.

Now we have a Republican Congress.

Dean's plan is good, affordable, and a huge amount of forward progress, though (as he's the first to tell you) not perfect. (It happens to be best with mental health and now probably elder-care.) And it happens to be passable in Congress, although even his plan will be difficult.

I'm not thrilled that's reality either, but do we have to keep suffering and going backwards? I reject that. People are dying. This is serious.

[bread_and_roses]

43. I am well aware

that this is serious. We are not at the stage of trying to get a plan through Congress. We are at the stage of putting forth visions of what is possible. As far as I am concerned any candidate not out there saying that it is criminal that people go without health care in the richest country in the world is trimming his sails for the insurance and pharmacutical industries.

[KaraokeKarlton]

33. Seeing as he gets most of his "facts" from NON-Democrats

and radicals, the stuff he brings up is usually a load of crap. Opinions pieces aren't facts and what few "facts" are included are snipped and spun so badly they don't even look anything like the reality here in Vermont. Dean was a damn great governor that my state re-elected 5 times after he replaced Snelling. People don't keep a governor around that long if he sucks as bad as Nicholas would have you believe.

[InkAddict]

36. Assisted Living a Godsend

My spouse is an only child - My f-i-l is an 86-yr. old widower. Once we lived 250 miles apart, and it was very difficult to see that his medical care was properly handled. Since his multiple chronic illnesses began, we've had to relieve him of the car keys and remove him from his home-alone lifestyle. At first, he had a home health aide at HIS home, but after she found him nearly comatose with complications following surgery (sepsis), we turned our dining room into a bedroom and moved him right in before the snow flew. Yup, his wonderful doctors pulled him through and helped us coordinate his Thanksgiving move. In the spring, he thought he was well enough to handle a nearby apartment. We found a nursing aid to visit him weekdays' but he continued to balk at our fussing and soon "let her go."

One day, he left the kitchen faucet slowly running in the stoppered sink of his second floor apt, and it was everywhere when we checked in on him the next day. He was still experiencing problems following his hospitalization, and wound up in hospital a couple more times. Boy, when your electrolytes go haywire, you are truly in unbelieveably bad shape!!

Following his last discharge, we were lucky to find a "home" for him. An assisted living center, which has been a true blessing. His room was cleaned, but he could do it if he chose; he had help with his laundry, medication minders, and best of all, they allowed him to piddle around outside in the dirt and make his beloved "crafts." He enjoyed the pets too. The crafts were just given away to staff and visitors, but he finds such pleasure in doing the "spinner bottles" and "hand puppies." He charms the aides, and orders up his meals from the Love Boat dining room menu like he's on the cruise. He helped the other residents, too, without orders to do so. To say he's not much of a talker is putting things mildly, but he ALWAYS looks at the positive (not always a good thing) and hasn't an iota of interest in politics. The economy has taken it's toll on this household, and it doesn't seem it's going to get better any time soon, so Gramps is back at home with us. How wonderful and grateful we are, that this Center has created a Day-Care situation for this saintly old man.

:bounce: O8) :bounce:

My question is: So why are the REPUKES tryin' like H to kill him off, financially knock off his only son and his d-i-l, and heap a humongous national debt onto his grandchildren? The State mandates we take care of Gramps and has also "selected out" his kid - GO FIGURE!

Folks, the Class War has just begun, and it ain't going to be pretty. Persons who have "adjusted" to lowered expectations with regard to their healthcare costs/services, even when they've had the good fortune to make all the correct moves, may be sadly disappointed to slip still further down the tubes because so many more have ABSOLUTELY no help and must make the hard choices between medicine, communication with the outside world, or malnutrition/hyper-/hypothermia.

I'm paranoid that Snow's rickety old container ships sold to Carlyle are destined to shove off the piers for burials at sea and they'll be taking this poor old PEARL HARBOR vet and his VIET-NAM era kid, et al. There's no grandkids yet, unless you count the dog/cats - November, 2004, can't come soon enough!!!

;( ;( ;( ;( ;( ;( ;( ;( ;( ;( ;( ;( ;( ;( ;( ;(

[depakid]

38. People who have never been caregivers- or never would be

don't understand stories like this. Nor, I suspect, will they ever until they need some form of long term care themselves. At that point, you can bet that they will be the ones crying the loudest and the hardest for a tiered system like that envisioned by the Oregon model which allows for them to live in the most dignified setting possible. In other words, the very thing that they've toiled so long and hard to deny others.

[KaraokeKarlton]

44. That's what nursing homes are for

But they aren't for people who CAN manage at home with some support and WANT to do that. Both should be available for people in need of the two kinds of services and one should not be pushed over the other. The current system makes it very difficult to get home care. It shouldn't be that way.

[Pastiche423]

37. My biggest fear

is to be forced into a nursing home. Once you get into one of those hell holes, it's impossible to get out. Don't believe the trash about them being a good thing. I've lost too fucking many disabled friends to nursing homes. Do you know who is one of the largest lobbyist? The nursing home industry. They are HUGE!

Instead of paying for in-home care, which is one hell of a lot cheaper, the lobbyists get their money for the death houses. Don't believe me? Google.

The 1st thing that caught my ear about Dean was his healthcare program and his reaching out to the disabled. (We have our very own Dean for the Disabled group.)

In the not too distant future, I am going to need in-home care. (I need it now, but Oregon's budget no longer can afford it.) I hope and pray (agnostically) everyday that Dean will be our president in 2005. If not, I'm a goner. (Fuck you asscroft!)

[Mairead]

40. "I am going to need in-home care"

Really? Why? (If it's not too prying a question!)

[Mairead]

41. I think Dean should get high marks for this

Many people are shunted off to 'nursing homes' (warehouses, really) when they could get by fine on their own if they had a bit of help to take up the slack. Obviously some people need full-time custodial care --dementia patients, for example, or the bedridden-- but people who've only become a bit too slow and stiff/frail are happier and live longer in their own familiar surroundings. There's plenty research to support this. If folk can have someone come in and do the cleaning or shopping or meal prep or meds minding, whatever's become too much a chore, then the put-them-in-a-'home' approach is overkill...with emphasis on the 'kill', sadly.

[KaraokeKarlton]

45. Dean has been testifying on this issue for years

And he's done what he could in Vermont to make home care easier if that's what people want. He's damn good on health care issues, and this is why I get so disgusted with those who claim differently. There is some false information circulating on this site about Dean. Mostly it's the stuff that criticizes him on health care and the environment...two things he's absolutely GREAT on. A lot of my state has mandatory recycling and car dealerships HAVE to offer environmentally friendly cars...it's the law. We also have the toughest environmental standards as you'll find anywhere. There is A LOT to like and respect about Howard Dean. That's why we re-elected him 5 more times.