Baldies' Blog began originally in the UK by a 26 year old journalist with a blood cancer on a mission to inform the world about bone marrow donation.

He has since died, and I took on the cause of making cancer care more transparent for everybody.

Cancer is a disease that will touch everybody through diagnosis or affiliation: 1 in 2 men will be diagnosed and 1 in 3 woman will hear those words, "You Have Cancer."

I invite you to read how I feel along my journey and
how I am continuing to live a full life alongside my Hodgkin's lymphoma, with me controlling my cancer, not my cancer controlling me.

I hope that "Baldies' Blog" will prepare you to handle whatever life sends you, but especially if it's the message, "You Have Cancer."

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Friday, October 14, 2011

Creative Banking and Cost Shifting: Senior's Cures for The CLASS Act Failure

Opponents of health care reform are claiming victory as a portion of The Affordable Care Act, The CLASS Act, standing for Community Living Assistance Services and Supports, which was intended to provide optional long-term care insurance at an affordable cost, has been suspended for not having a sustainable route of implementation.

Sec. of Health and Human Services Kathleen Sebelius told Congress in a letter,“I do not see a viable path forward for CLASS implementation at this time” (http://firstread.msnbc.msn.com/_news/2011/10/14/8325174-obama-administration-halts-part-of-health-care-law). The CLASS acts inability to maintain funding was predicted in 2010 by medicare's actuary Richard Foster who said the bill was at a significant risk for failure as those who were ill or likely to experience severe health issues would sign up for the plan while the healthy would not, leaving no way to offset the cost of care. Sebelius' letter drew the same conclusion.


Claiming victory over the loss of a safety net protecting seniors and their families from huge medical expenses during their final years is not a win for any individual who wants to age with dignity, whether Republican, Democrat, or Independent. The loss of this bill, and the failure to find a sustainable alternative, is likely to result in the spending down of a lifetime of earnings and liquidation of assets to qualify for medicaid as well as medicare. Removal of The CLASS Act will only encourage the practices of spending down and creative banking and cost shifting from individual health plans and insurances to medicare and medicaid. 


Creative banking practices are a common but unspoken aspect of obtaining long term care for an elderly loved one that allows money or assets to remain in the family but not in the hands of the individual or couple in need of services. Actions may be the creation of trusts for family members, gifts of money or equity while still living, and/or transferring assets into the name of caregivers.


With the economic downturn Medicaid has all ready seen a dramatic increase in participants. Sixty percent of Americans now rely on some sort of government assistance to survive. With the economical forecast remaining grim, some economists claim we shouldn't expect changes until 2013 when the economy will either recover or fail irreparably, these figures aren't likely to decrease anytime soon. 


What is guaranteed is America's population will continue to age, requiring all the services and care needed to assist them.  Our current system of providing this care, such as long term placement in nursing homes or rehabs, is no more sustainable than the CLASS act itself. The ultimate problem is not with The CLASS Act, it's with the environment that has created a need for The CLASS Act and made it unsustainable. 


As it stands now, no other options for offsetting the huge costs of long term care for the later years of life have risen from our representatives though there are existing health care practices that can be provided safely and cost effectively that have not been explored. 


Expanding home care and/or altering rules for hospice, such as allowing patients to receive palliative "curative" treatment for incurable diseases, such as terminal cancers, is an option of safely providing care without the use of long term care or acute care institutions. 


Improving transparency and communication practices among providers has also proven previously to lower consumer costs. In a 1999 article, Political Economy attributed a million dollar drop in the cost of life insurance to on-line comparison sites, which allowed individuals to make informed decisions where they could not. Freeing health care professionals to communicate through the implementation of an electronic communication system along with electronic medical records all ready being implemented would theoretically do the same. 


Unfortunately these measures require a community social change alongside any healthcare reform to be viable. It's a change that will need bipartisan participation, people interested in policy not politics, and leaders that care about human equity not monetary assets. It's a change American's will either have to make willingly or be forced by reduction in options. All we know for sure now is that CLASS can't survive in today's United States. 

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