(Policy) Medicare plan for long-term care, hearing, vision, and tackling PBMs.

I've said this before on here, but I graduated college in Fall 2010. I was raised by my grandma and uncle. My uncle passed away two weeks before I walked the stage. I came back home to live with my grandma and take care of her. The 1st year was not so bad. She was still in decent shape and was mentally well, however, because my uncle was her baby boy (she had already lost 3 other kids by then), she was pretty depressed during those months and I think it led to a decline in her mental health. Eventually her kidney's failed (she had to be on dialysis) and she started having signs of dementia. From 2012 to till she passed in 2016 it was rough. I lived with her up until the end of 2014, when I decided to move out and I asked her other son (my uncle) move in with her and take care of her.

During this time, I received very little family support and for the most part I didn't have much of a life during those years, besides the few times my cousins or uncle would relieve me to be able to go out. My wife (then girlfriend at the time) was pretty frustrated with the situation and almost broke up with me (it was fair, I was letting my family take advantage of me, so I wasn't upset at her).

I was trying to get my career started at time and also trying to enjoy life a little, but it was a rough period in life. I was pretty depressed. Not only was I not able to do what young men at that age get to do, but I also was watching my grandma slowly lose her memory. When I left home and had my uncle look after her, I still was helping out a lot and trying to do all I could to be there for her. Those were some rough years.

She was on both medicaid and medicare and I guess she was eligible to receive some help at home (essentially a lady would come by and help clean and look after her) but she was only eligible for 32 hours, so I would have the lady come by when I was working.

A program like what Kamala is proposing would be so helpful to many of us that were stuck in this situation. It sucks being a caregiver. It sucks giving up part of your life to have to be there for your loved one at all times. I loved my grandma and I was gung-ho on her not ending up in a home. I'm hispanic, we just can't put our loved ones in a home. I hope a program like this passes. I know it will cost quite a bit of money. I know we will need to get a lot more workers out there to be able to serve our older generation, but if as a nation we want to improve the mental health of caregivers and improve family situations, then we need to spend the money to provide this sort of program.

 

Man, I’m so impressed with you. I mean that seriously. If you do nothing else in life, you will have already done more than most people. Elder care is incredibly difficult, even with help and others pitching in. But you bore that burden on your own and I sincerely hope you are proud of yourself for that.

My mom passed two years ago from cancer and the many months of illness were the hardest thing I have done … and I had help, am a much older person than you were when you took care of your grandma, and I have financial resources … and it sucked. Again, I am so impressed with what you did. Incredible sacrifice and love.

 

People are living longer and longer and the need for elder care will only grow. This country needs more care providers and to make it available to more people. It will be incredibly expensive. But like universal pre K or financial literacy classes in high school, this is something that we need and that will pay off in the long run.

 

My father worked for a company called Brown And Root all of his life.
He got injured offshore.
Spent 2 months in ICU at UTMB in Galveston.
As a result he contracted mersa and had a leg amputation.
He still carries on this day. But the insurance has so many gaps that with continuing issues and needing to see Dr. Weekly He and my mother can't make ends meet.
I often have to send them money or pay the bills myself.
They fell through the cracks.
Even though I tell them I will continue to help.
It has to be completely demoralizing to them to have their son assist them.
I hear the sadness in her voice each time she reaches out.
No senior deserves this.

 

Silly Valley Visionaries are telling me that if I manage to stay alive for another 10-15 years then I can potentially live past 100.

Hopefully we can unburn that retirement bridge when we get there.

 

US life expectancy has been stagnant for 20 years now. Life expectancy in 2003 was 77.4 and 2022 is 77.5 - according to cdc data

That being said due to our constant decrease in fertility rates there is a greater burden on younger people to support the elderly that gets worse every year. This is the same for virtually every developed country.

 

My sister and I recently had a talk about what we would do if we needed to care for our parents at any point and let me tell you, it scares the hell out of me. My sister just retired from Academia, and I have about 8 years left, she just became an empty nester and we talked about all moving under one roof so we can take care of them when the time comes.......................scary stuff man

 

COVID-19 really screwed with the life expectancy in 2020-2022. Life expectancy in 2019 was 78.79. We'll be over 80 in the not to distant future.

It would be great that Medicare do more for Seniors, but never want to see paid for by reducing fraud. That is great and all, but if it were so easy to stop that fraud, why hasn't that already been done?

 

My family is also dealing with a situation of providing care for a relative who is in failing health. As a relatively well off family though we are able to take care her needs but it still
Is a burden. I’ve seen friends and an ex GF though deal with having to be a care giver of a parent with major health and mental problems.

 

I flew down to Texas to help my mother last year.
She had spinal stynosis? Surgery.

It's all good until you have to toilet your mother.
That's nothing any son wants to see

 

It was also 78.7 in 2010, it peaked at 78.8 in 2014. Obesity and drug overdoses were stagnating our life expectancy since before Covid.

EU data showed its life expectancy increased from pre Covid numbers in 2023, CDC hasn’t released out 2023 data yet so we’ll see how we fair in comparison on that end as well.

Hopefully the ozempic drugs help us out a bit.

 

@Scarface281 loves policy, can’t wait to hear their thoughts.

 

Sad situation: You have to crack down on Medicare fraud, but there are innocent (and suffering) people caught in the crosshairs.

Recently watched a relative in intense suffering stuck in a hospital's "give up" ward, and we could not get the person into hospice b/c of all the increased analysis; the hospices (multiple ones, multiple agents) coming to review the dying person's stats every day and saying "nope, not clearly dying enough yet." They were clearly and openly concerned about what they would be able to successfully bill, so they'd say things like "no, they don't have enough broken bones," (11 broken bones in their chest), and "well, these bones are not broken badly enough, they can heal," (in a person in their mid-80's). Hospice would have been the right place for the person, but I understand that the hospices get "burned" by people moving in too early, or in some cases, recovering and then moving to rehab.

That's not even fraud, per se, but I can see the intense scrutiny from the system for exactly "how sick" someone is, etc.

 

I don't know. Is this on Harris' website?

 

Thanks. Here I thought life expectancy was climbing into the 80’s.

 

Its great if they recover those funds. It is not an acceptable source of funding. We have to find the fraud. Prosecute the fraud. Recover the fraud. Prevent future fraud.

 

Some of the most common examples of Medicare fraud allegations include:

• Billing for Medically-Unnecessary Supplies or Services – Physicians will often face Medicare fraud charges based upon allegations of billing Medicare for services or medical supplies that were not medically necessary.
• Billing for Supplies or Services Not Provided – “Phantom billing” is the practice of seeking Medicare reimbursement for supplies or services that were never actually provided to a patient.
• Falsifying Patient Records – Submitting falsified patient records in connection with a reimbursement claim is another form of Medicare fraud.
• Making Prohibited Referrals – Under the Stark Law, physicians are prohibited from making certain referrals to companies with which they have a financial relationship. Stark Law violations are commonly charged as a form of Medicare fraud.
• Offering or Accepting Illegal Kickbacks – The federal Anti-Kickback Statute makes it illegal for physicians, pharmaceutical companies and others to make certain payments and provide other forms of compensation in exchange for recommendations or referrals.
• Unbundling Services – Under Medicare regulations, certain types of services must be billed at reduced, “bundled” rates. Unbundling services in order to claim higher reimbursement rates is a common form of Medicare fraud.
• Upcoding – Billing Medicare at a higher rate than is called for by the services performed or equipment supplied is a form of fraud known as “upcoding.”

The list goes on and on,

 

Inside the mind of criminals:
How to brazenly steal $100 billion from Medicare and Medicaid
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