Either You Want Medical Care Or Not But Don't Play Games-Vent Alert

W

WhatInThe

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I'm usually the last person that would want to see or justify something like health care rationing but after seeing someone going through a course of home treat not giving a hoot the thought actually crossed my mind.

The patient fell with no injury other than a cut. Cleared for home treatment including nurses and therapy. I've been present for visits ok per patient. But the patient treats their recommendations like poop. Then the therapist in particular sees the attitude and now has one themselves. If the patient doesn't care why should I. Their last session was less than 20 minutes. You can see & smell the attitude in the therapist. The patient never gave any credence to the importance of nutrition and fitness and wants a pill or procedure for everything. They won't do their homework/exercises the therapist recommended. They give a weak 'no' when asked have they been doing them. I warned the patient if the therapist thinks you don't give a poop neither will they. They've been told if they don't want home care including therapy they can stop it at anytime. I told them if you don't want the treatment just say no and when asked a question be honest, it's not about trying to please someone but giving the necessary information to treat you. I also told them they are being profiled and notes about their attitude & demeanor are probably going in their file. If nothing else you don't want this attitude to bounce back one day.

I never want to see rationing but I regretfully admit there are patients that should just go the back of the line and tough poop if something happens.

Point of vent-If you don't want treatment or have any intention of following instructions or recommendation just say NO. Do not waste people's time or muddy the data pool with lies.
 

"The patient fell with no injury other than a cut. Cleared for home treatment including nurses and therapy."
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Did the person pay for this out of pocket so that is why the attitude you descrbe later in your post?




I'd hate to think Medicaid or some other tax funded program was paying for the amount of care you described and was being ignored.
 
Knight said:
Did the person pay for this out of pocket so that is why the attitude you descrbe later in your post?

I'd hate to think Medicaid or some other tax funded program was paying for the amount of care you described and was being ignored.
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That's part of the problem insurance/medicare from a patient who is a big FDR fan. They've always been a pill and procedure person. The hospital docs said they should've had a week on the rehab floor/in patient but they said where possible home care is being used to cut costs-I guess paying a nurse and therapist to visit a patient 5 days week is cheaper than a hospital bed. The patient being sent home doesn't think it was that serious. But they have strength issues that need addressing. But have always poo pooed fitness & nutrition. The therapist and docs even recommended things like B-12 and they refuse.

The patient's old school gp doc doesn't help either. He's also a procedure and PILL person practicing cya medicine. The hospital docs had to reduce the gp doctor's bp medication script by 75% and eliminate others to raise the patient bp.

I told the patient one day something's going to happen and the police and/or doctors will recommend something like pulling their driver's license or demand they be sent into a facility. It woke them up a little.
 

WhatInThe said:
I'm usually the last person that would want to see or justify something like health care rationing but after seeing someone going through a course of home treat not giving a hoot the thought actually crossed my mind.

The patient fell with no injury other than a cut. Cleared for home treatment including nurses and therapy. I've been present for visits ok per patient. But the patient treats their recommendations like poop. Then the therapist in particular sees the attitude and now has one themselves. If the patient doesn't care why should I. Their last session was less than 20 minutes. You can see & smell the attitude in the therapist. The patient never gave any credence to the importance of nutrition and fitness and wants a pill or procedure for everything. They won't do their homework/exercises the therapist recommended. They give a weak 'no' when asked have they been doing them. I warned the patient if the therapist thinks you don't give a poop neither will they. They've been told if they don't want home care including therapy they can stop it at anytime. I told them if you don't want the treatment just say no and when asked a question be honest, it's not about trying to please someone but giving the necessary information to treat you. I also told them they are being profiled and notes about their attitude & demeanor are probably going in their file. If nothing else you don't want this attitude to bounce back one day.

I never want to see rationing but I regretfully admit there are patients that should just go the back of the line and tough poop if something happens.

Point of vent-If you don't want treatment or have any intention of following instructions or recommendation just say NO. Do not waste people's time or muddy the data pool with lies.
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I've been experiencing similar frustration in dealing with my sister, who also won't comply with doctor's and nutritionist's instructions (eating right, moving around a little bit). She doesn't like the diet they want her to be on, and says if the gets up and moves around it makes her feel worse. She is angry with me right now for suggesting she might feel better if she would do what the doctor says. She expects someone to wave a magic wand and make her better without any effort at all on her part (like she won't take her prescribed vitamins because the caplets are "too big to swallow" and when I suggested she cut them in two or crush them she says "if they want me to take these things they should make them smaller." I give up!
 
From your last post I think I understand you to say the person you are writing about has Medicare as the health Care provider. The care provided should be provided because payment was made into the system that pays for the care. If you were to estimate the annual cost to Medicare what would your estimate be?




It's known that emergency rooms are being used now more often due to the addition of newly insured. In your opinion how would a single payer system similar to Medicare work to support the cost of providing care for the kind of person your describe?




To be clear both my wife and I have Medicare as our provider, we both are in excellent health and only have yearly check ups. My interest is in what someone such as you thinks about the chance of a single payer system operating cost effectivly with people like you describe.


You mentioned health care rationing, who would make that choice? Especially since you mentioned that a CYA kind of practice is what drives the kind of care that person receives.
 
Butterfly said:
I've been experiencing similar frustration in dealing with my sister, who also won't comply with doctor's and nutritionist's instructions (eating right, moving around a little bit). She doesn't like the diet they want her to be on, and says if the gets up and moves around it makes her feel worse. She is angry with me right now for suggesting she might feel better if she would do what the doctor says. She expects someone to wave a magic wand and make her better without any effort at all on her part (like she won't take her prescribed vitamins because the caplets are "too big to swallow" and when I suggested she cut them in two or crush them she says "if they want me to take these things they should make them smaller." I give up!
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Basically after 2 weeks of "home care" and several lectures along with some existing health issues and/or what they currently can't do there is some daylight. But they still think a healthy and fit body is a project to be worked on like cleaning the garage. But this is one project that can't be delayed or procrastinated on. But yes the excuses and rationalizations piled on top of each other-ooy
 
Knight said:
From your last post I think I understand you to say the person you are writing about has Medicare as the health Care provider. The care provided should be provided because payment was made into the system that pays for the care. If you were to estimate the annual cost to Medicare what would your estimate be?




It's known that emergency rooms are being used now more often due to the addition of newly insured. In your opinion how would a single payer system similar to Medicare work to support the cost of providing care for the kind of person your describe?




To be clear both my wife and I have Medicare as our provider, we both are in excellent health and only have yearly check ups. My interest is in what someone such as you thinks about the chance of a single payer system operating cost effectivly with people like you describe.


You mentioned health care rationing, who would make that choice? Especially since you mentioned that a CYA kind of practice is what drives the kind of care that person receives.
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I don't advocate it but after seeing a certain type of patient up close and personal I see why many have no problem with rationing planned or as a side effect of a new national health care plan. Ironically they were told 'home care' will be the wave of future to save money on a hospital room for a week of in patient therapy/observation. My guess on cost could any where from 100-200 dollars per visit. But that's cheaper than in patient therapy and observation at 3000-5000 a day.

Nurses and therapists require more than a physical trainer who does much of the samething including home visit. The medical industry has done a poor job at selling senior fitness and supplemental nutrition
 
Thanks for the reply to my questions about cost to care for the person you described. When people pay into Medicare they have the expectation that their health care expense will be paid for. Possibly not 100% but leaving them with a smaller bill. The amount and cost will vary but your example of cost when a person doesn't follow instructions has to be factored into what could be expected if a single payer system were to be implemented.




People that could afford to pay for care outside a single payer system will most likely be a small percent. Looking at the population of the United States in 2016 there are 324,118,787. For conversation sake lets suppose 250 million were to be in a single payer system. In your opinion what would the impact be on the cost to provide the care needed for people like you have described. Keep in mind that they have paid into the system and have the right to expect the best care.




I guess what I'm really interested in. You seem to have insight into what could amount to abuse of the health care system under Medicare. Given the expectation by those wanting a single payer system do you think they understand the impact supplying care for those millions will be possible without rationing? Do you think there would be a massive amount of complaints if rationing was the only way to contain the cost?
 
If people really don't want a particular course of treatment they should just say so. If they think it's not working tell someone. But don't be like a lying junky and tell the providers you've been doing x,y & z when you haven't. Or make ton of meaningless promises and/or excuses. What's going to happen the providers will pick up on the liars or problem patients and will take them into consideration when making treatment plans for anyone under their care. Not only prioritizing or triaging their patients that will include budgeting as well. So if a problem patient changes their mind they might not be able to get the treatment or issue resolved.
 
I don't like the idea of rationed care as such, but perhaps a way of screening chronic hypochondriacs, crocks and so on needs to be implemented.

My sister drives me nuts because she always says they "don't do anything for" her, but she refuses to comply with instructions and expects a pill to fix everything. It won't. Then she expects me to spring into action and take care of everything for her. I can't do that anymore, and I won't, and I've told her so. Now she's mad as hell at me, but so be it. I don't mind helping her out, but I'll do what's reasonable and on my terms. She wants me to take her to Wal-Mart tomorrow, and I can do that, but I've told her if we are going, we are going early in the morning because I get to feeling quite ill in the heat and I am not going to be carrying groceries into her house in 104 degrees, nor am I going to be driving around in a hot car, either. She says she can't get up early and I said "fine, then I can't take you to Wal-Mart. You decide."
 
I have little sympathy for a person who refuses to "participate" in their own health and well-being. If they refuse to follow a doctor's recommendations, or are not satisfied with those recommendations, they always have the option to get a 2nd opinion. If they Still think they don't need to do anything, their treatment should consist of a bottle of cheap pain pills, and "wish them the best of luck".
 
Don M. said:
I have little sympathy for a person who refuses to "participate" in their own health and well-being. If they refuse to follow a doctor's recommendations, or are not satisfied with those recommendations, they always have the option to get a 2nd opinion. If they Still think they don't need to do anything, their treatment should consist of a bottle of cheap pain pills, and "wish them the best of luck".
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Agreed, but it's sad when that person is someone close. But, I have to tell myself that I can't be 'responsible' for another person's health, if they won't lift a finger to do so.
 
I work hard to stay healthy re thread on vitamins/supplements. Get daily exercise playing golf and long walks. Yet, I'm the world's worst about following doctor's orders.

2009, total knee replacement. Mowed our lawn with a push mower 2 1/2 weeks after surgery. Wife was VERY unhappy. Started playing golf again at 6 weeks out when wasn't supposed to pick up a club for 3 to 4 months.

2016, carpal tunnel surgery on both hands. Left hand done first. Doc said to not swing a golf club for 3 months. 7 days out, I played. Pulled some stitches out. Was able to get it back together myself and the thing healed fine. Right hand, I gave that 8 days... one day longer. Pulled it open enough had to go back to the doc and get it sewed back up. Was out on the course a couple days later and it healed fine.

Know that someday I won't be as lucky as I've been over the years of various surgeries and broken bones. Should be more careful to follow doc's orders. Just too stupid to do so!!! Some of us are stubborn. Some of us are lazy. Some of us think we know more than a surgeon. Some of us feel the surgeons have to be super-conservative in order to protect themselves. We all are different. Spent too much time around those who go to the doctor if they sneeze and make full-blown drama out of even a bruise.

Friend's wife has some sniffles. Just knew she had lung cancer. MRI was clean. She didn't believe it so went to a second doc for an opinion. Second MRI clean. That second doc said she probably just had an allergy. That resulted in a trip to an allergist and test after test after test. Could find no allergies. He said she probably just had experiences a common cold. Now, she won't leave the houses without a mask over her mouth and nose. Really puts on a display.
Another friend had colon cancer surgery 5 years ago. Cured. Still today complains about the cold, the heat, the mosquitos that bite him "because he had cancer", etc. If he puts on gloves in 70 degree weather, don't ask why. If you do, you get "Well, you've never had cancer!" If the moon changes, it's because he had cancer.

I'd rather let things slide by and probably push the envelope of not seeing a doc enough or following their orders, but don't want anyone to know if I feel a little punk. Just get too aggravated by those who seem to want every ache and pain to make the headlines of the newspaper.
 
In my sister's case, doctor's orders ARE those vitamins, exercise and a decent diet. She just won't make an effort; she has a whole host of things that are directly attributable to her not making an effort -- the worst of which is morbid obesity.
 
Butterfly said:
In my sister's case, doctor's orders ARE those vitamins, exercise and a decent diet. She just won't make an effort; she has a whole host of things that are directly attributable to her not making an effort -- the worst of which is morbid obesity.
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Your Sister has Plenty of company. The latest reports from the CDC indicate that over 35% of the people in this nation are substantially overweight. The CDC also says that over 30% of our nation's medical costs are Obesity related. Obesity accounts for more medical care costs than tobacco, alcohol, and illegal drug use, combined. I have seen so many older people go through months and years of misery and running up huge medical bills, simply because they allowed themselves to get miserably out of shape. The best medical care in the world is of marginal value, if a person doesn't make a decent attempt to take good care of themselves.

The old saying...."You can lead a horse to water, but you Can't make him drink"....certainly seems to apply to a major portion of our population.
 

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