Wow.  Where to start.  There have been so many articles about how bad Trumpcare is for everyone except insurance companies and rich people.

Vox analyzed the net financial impact of the Republican bill on premiums, after tax credits, plus cost-sharing. “We estimate that the bill would increase costs for the average enrollee by $1,542, for the year, if the bill were in effect today. In 2020, the bill would increase costs for the average enrollee by $2,409.”

“In general, the impact of the Republican bill would be particularly severe for older individuals, ages 55 to 64. Their costs would increase by $5,269 if the bill went into effect today and by $6,971 in 2020. Individuals with income below 250 percent of the federal poverty line would see their costs increase by $2,945 today and by $4,061 in 2020.”

Buzzfeed reported that Trumpcare  includes a tax break for insurance company executives making over $500,000 per year.  The average compensation for top health insurance executives is in the millions. In 2014 the Institute for Policy Studies found that this cap generated $72 million in additional tax revenue.

Companies can generally deduct employee salaries as a business expense but in 2013 the Affordable Care Act capped the deductions on health insurance executive salaries at $500,000.

NPR had a sober article explaining why the Republican plan will not fix any of the current problems with health care coverage. NPR explains why the law will not increase coverage, provide the consumers more chocie, or lower health care costs.

As part of Obamacare, the federal government increased payroll taxes to help pay for the Medicare Trust Fund. That fund is used to reimburse hospitals when seniors come in and need treatment.

Trump’s bill does away with those new taxes. As a result, the Medicare Trust Fund would go broke about four years earlier than currently projected, in 2025 instead of 2029. This would either force hospitals to either swallow the costs themselves, turn away Medicare enrollees, or both. Here’s what the tax repeal would do to the trust fund, according to the Brookings Institution:

Repealing the ACA’s tax on high income households and hospitals would exhaust the Medicare Trust fund by 2024 http://brook.gs/2hSsObR 

Contribution from freelance writer, Jessica Walter.

The U.S. Senate Lists Worst Scams Targeting Seniors

Fraudsters impersonating the IRS and conning thousands of people, have led to the U.S. Senate publishing the top scams targeting the country’s older people. The Treasury Inspector General for Tax Administration called these scams ‘the most persistent fraud in IRS history’. Targeting over 1.97 million people, they call seniors telling them that they will be arrested unless they immediately pay alleged tax debts.

Scams Covered More Than 21 States

A review of over 5 million complaints lodged with the Federal Trade Commission from 2015 to 2016, revealed that America’s over 60s population mostly reported imposter scams, tech support hoaxes and telemarketing practices. It’s believed that the IRS scammers conned victims in at least 21 states. One senior told a committee that he had lost around $8,000 to fraudsters impersonating the IRS, who threatened him that he would be arrested ‘within an hour’ if he didn’t pay what they said he owed in overdue taxes. Overall, in 2010, this type of theft cost seniors over $2.9 billion, according to the MetLife Mature Market Institute.

60% of Senior Survey Respondents Targeted by Scammers

In a separate survey conducted by Home Instead Inc, it was found that over 60% of American seniors who took part have been targeted by an online scam. 38% of seniors said that someone had tried to scam them online, while 28% said they had downloaded a computer virus by mistake.

Why are Seniors Targeted?

Unfortunately, many scammers see older people as easy pray for their scams. Sometimes, when an older person is quite isolated and lonely, they are more vulnerable to these types of crimes. When a professional and friendly person calls, and engages them in a friendly conversation, the senior can often end up trapped by the attention. Quite often the scammers are very experienced and can tell when someone would make a good target. But seniors shouldn’t automatically be seen as easy targets by scammers, just because they are older. In fact, while there are of course vulnerable elderly people, there are also a growing number of ‘superagers’, who stay active, both mentally and physically, enjoy being challenged and are on a par with the average 25-year-old.

What Seniors (or Anyone) Can Do to Protect Themselves

Social Security, the IRS and Medicare & Medicaid Services do not make phone calls asking for Social Security details or bank information. People should not give out their private details over the phone. If people believe they are victims of fraud, they should call the relevant companies directly, make a report with local police and inform the Federal Trade Commission.

Be wary of emails or messages that request urgent action, such as a problem with a bank account or taxes. These are very likely to be a scam. If you are unsure at all, contact the companies directly by phone to check whether the messages are legitimate. Be cautious about what you share on social media. Remember you can adjust privacy settings to limit who can see what information.

If you’re interested in Jess’s writing, contact her!

The New York Times reported that The American Medical Association, a powerful lobbying group representing the nation’s doctors, announced that it opposed the House Republicans’ proposed legislation to replace the federal health care law, because the bill “would result in millions of Americans losing coverage and benefits.”

All of the major hospital groups, including the American Hospital Association, also came out against the bill. Trumpcare will most likely “lead to tremendous instability for those seeking affordable coverage,” the hospitals said in a letter to Congress. The hospitals also raised concerns about Republicans’ plans to significantly alter Medicaid, which they said could result in a loss of coverage and cuts to health care services.

The American Nurses Association, which strongly backed Obamacare, tweeted,“The #AHCA threatens health care affordability, access, & delivery for individuals across the nation. Therefore, we oppose. #ProtectOurCare”

The Wall Street Journal emphasized the backlash from senior groups including the AARP.  The AARP, which represents nearly 40 million older Americans, opposed the legislation in a letter to Congress arguing that the act would increase the cost of health care for older people. The criticism also took the form of a snarky video in which a squirrel helps explain the harmful impact of what the group calls the bill’s “age tax.” Older Americans generally spend more on health care, but under Obamacare, insurance companies couldn’t charge them more than three times as much as younger clients. The replacement bill pushes that ratio to 5-to-1. According to the group, the age band provision is “Washington politician speak for overcharging older Americans for their health insurance while lining the insurance companies’ pockets.”

Jonathan Chait at the New Yorker Magazine had a great article on the social catastrophe that is Trumpcare.

“The Congressional Budget Office’s analysis of the American Health Care Act describes, in dry budgetary language, a social catastrophe. The bill would deprive 14 million American citizens of their health insurance next year, a number that would rise to 24 million by the end of the decade.

The changes Trumpcare would impose upon the health-care system are easy to understand. It is, quite simply, a redistribution bill. It would reduce taxes on the rich, and thus reduce the amount of subsidies for coverage for people who can’t obtain it through their job or Medicare. By 2026, CBO finds, the average subsidy would be about half as large. But the cut would not be distributed evenly. Middle- to upper-middle class customers buying insurance, especially young and healthy ones, would get larger subsidies. Poor, sick, and old customers would get enormous cuts in their subsidy levels. CBO has a graph showing the bill’s effect on Americans who make less than 200 percent of the federal poverty level. The dark-blue bars represent the status quo. The light-blue bars show what Republicans hope to “achieve”:

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In an article from SC Lawyer’s Weekly, written by Phillip Bantz, the highest pretrial nursing home settlement is discussed. Poliakoff & Associates and Jackson Law Offices represented Daniel Gouveia, who died after less than a month in Pepper Hill Nursing & Rehabilitation Center, a nursing home in Aiken, SC. Gouveia developed a stage 4 sacral ulcer which became infected, leading to his death. In addition to the obvious care deficiencies Gouveia received, there were a number of other issues related to Gouveia’s care, including false documentation. Medical documentation is a vitally important component of care, as it communicates medical issues with caregivers. Missing, edited, or false documentation is a serious breach in the standard of care. For more information, read the full article here.

Contribution from freelance writer, Jessica Walter:

Living at home alone can sometimes be unnerving, especially for seniors as falls could cause trips to the emergency room. Knowing how to make your home safer is easy, and can bring peace of mind to all. Where there are hazards, there is the risk of injury, but there is something you or a family member can do to help lower the chances.

  1. Bathrooms: You should make sure that tubs and showers have non-slip surfaces, and shower doors should be made of safety glass or plastic.
  2. Staircases: They need to be clear of obstructions and lit well so that each step is clear to see. A secure handrail should be installed at every staircase.
  3. Kitchens: A working fire extinguisher is necessary. A sturdy stool with a handrail should be used to reach higher cabinets.

To find out more about making your home safer, take a look at this Home Safety Checklist for the Elderly.

The Idaho Press-Tribune reported on a recent report criticizing Holly Lane Rehabilitation and Healthcare Center highlights the need for a sufficient number of nursing staff at long-term care facilities, officials say.  In July, Holly Lane was found to have numerous, serious infractions during a surprise state inspection. A follow-up visit in October confirmed many of the same problems were still happening.

The state investigators found Holly Lane did not have enough licensed nurses or certified nursing assistants to meet the needs of its residents.  Residents told stories of waiting for at least an hour for someone to answer call lights to help them get out of bed or to be helped off the toilet.

 Staff complained that they were pulled into duties they aren’t paid or qualified to do because they were short-staffed.

Debby Ransom, the bureau chief of facility standards for the Department of Health and Welfare, said the federal requirement is  have to have “sufficient staff” to meet the needs of residents.

Slate had an interesting article about the millions of Americans in dozens of rallies protesting to keep ObamaCare.  “At each of the rallies, speakers talked about specific men and women whose health and/or finances were saved by the ACA in an effort to build up opposition to the Republican repeal efforts.”

Speaking on CNN, Sen. Rand Paul gave broad details about what could be in the Obamacare replacement package but pointedly did not say whether the almost half a million people in his state that have insurance under the current law would be able to keep it.

Why repeal ObamaCare without a replacement?

 

The Chicago Tribune reported that two social workers, Kenneth Allen and Olufunmibi Ogunyipe, allege they were fired from Burnham Healthcare now known as Bria of River Oaks nursing home after refusing to fabricate medical records related to incidents of patient abuse.  Some of their patient-abuse allegations were investigated separately by the Illinois Department of Public Health, which cited the facility for safety violations, records show.

The nursing home has withstood years of state citations for violence, patient neglect and filth. Last year it received $16.5 million from Medicaid and Medicare while reporting $1.38 million in profits.  Records show that some of those federal health-care dollars went to Weinfeld’s uncle, nursing home magnate Morris Esformes, whose son and close business partner, Philip Esformes, is being held without bond in a Miami federal detention cell on charges that he orchestrated a $1 billion Medicaid kickback scheme in Florida.

Allen alleges that a supervisor told him to falsify the medical chart of a female resident who was hospitalized in 2012 with facial bruises and black eyes. Allen believes the woman was beaten by a fellow resident, but he was told to write that she had fallen. A state inspection report later found that the facility failed to properly investigate her family’s complaint that she was assaulted.

Allen alleges that after he documented a resident’s rape complaint, a supervisor ripped Allen’s report out of the medical file and tore it up. The state health department inspection concluded the facility had failed to thoroughly investigate the sexual assault allegation and to notify authorities.

Ogunyipe alleges that, in the case of a 60-year-old resident who had repeatedly requested a discharge, a supervisor told him in 2013 to write up medical notes falsely stating that Ogunyipe had tried repeatedly to transfer the man but couldn’t find a program with an open bed. A state health department inspection cited the facility for failing to assist the resident’s request for a discharge.

Ogunyipe alleges that a supervisor tried to deceive state inspectors by removing disheveled residents who might trigger state scrutiny because they appeared neglected. A supervisor gave him $30 to $50 to take the residents out of the building, buy them cigarettes, feed them at a McDonald’s and claim they were going on a field trip, saying: “They can’t be in the building,” the suit states.

Ogunyipe said that the administration wanted to conceal residents with untrimmed hair and soiled clothes because “you would know that they were not being cared for.”

He witnessed fellow employees entice residents back to their rooms with a cigarette or snack, then punish them. “They would just close the door and — boom, boom, boom! Deal with the resident. Beat him up. Spit on his face and then walk out, close the door,” Ogunyipe said.  (A 2012 state inspection report said two residents alleged guards beat or roughed them up in separate incidents. The report says that at least one guard at the home was fired as a result.)