Economy and General Discussion

I too have an elder care story to tell. Part of my skeptical attitude toward all things "official" and "bureacratic" comes from my caring for my mother for three years while she was in a nursing home. This occurred in Massachusetts 1993-96 and I was a naive layman with no experience dealing with either the Healthcare or the Legal System. I did a lot of research on both at that time and what I found horrified me.

One of the first books I read at a Probate and Family Court Law Library run by the MA government was a tome titled THE LAWYER'S GUIDE TO MEDICARE. I had read a few "civilian" books about MEDICARE by that time but this book was a real shocker. I can only describe it as a "nudge, nudge, wink, wink" guide to scammming MEDICARE. It described in detail methods to hide assets and get MEDICARE to pay fraudulent legal bills. This book really sat me up in my chair as to the state of affairs in the US since it was written by a Law Professor!

My mother stayed at the same nursing home for three years. One of the first things I had read was that normally, the patient will remain at the same home that is selected. So, I did a lot of research on that and made sure it was the best I could find under the circumstances. One of those circumstances is that Nursing Homes licensed for MEDICARE are basically a license to print money since they are tapped right into the US Treasury. I would suspect that the granting of these licenses is the subject of much political activity of a negative type. ( I will just say ex-Senate Majority Leader Bill Frist and HCA.) This also goes for "rehablilitation hospitals" where my mother went for a month and received very little effective care for exorbitant fees.

One general rule at that time was that if the patient had less than $2000 in assets MEDICARE paid everything! If more than that those assets were used until the $2000 was reached. So the techniques described in THE LAWYER'S GUIDE TO MEDICARE are used by many to get a free ride. These many, of course, tend to be the wealthy and well connected who can utilize sophisticated estate planning techniques.

One of the techniques used by the nursing home to raise additional revenue was quite a shocker. My mother had to be hospitalized two times outside of the nursing home. When that happens, the nursing home gave me the choice: do you want to reserve your mother's place if she returns from the hospital? If not, we do not guarantee that she can return to the facility. So, for each day that you pay, you may or may not be paying for a place that might have been empty anyway. Only the nursing home knows their occupancy rate. This is classic double billing.

Another shocker was that the nursing home dealt with only one drug supplier. At one point, they changed the supplier and the cost of a drug my mother was taking was tripled!

Another time I received a call from someone who said they were my mother's "audiologist". My mother had never had any trouble with her hearing. I did some research on this and found out that a private company was allowed into the facility to examine patients and sell their wares. I was never consulted on this. It sure looked like a revenue raiser for both the hearing aid company and the nursing home via fees paid to them.

On four occasions, ambulances were used and I thought the fees for these rides were exorbitant.

I can only imagine a room full of Healthcare Beancounters examining every nook and cranny of Operations and devising schemes and methods to maximize profits. In short, I am rather amazed that more Americans working in this vast system are not whistleblowing. Like many institutions in American society, one must ask if the corruption and venality are not beyond critical mass. (One might simply substitute the Mortgage Industry with its crooked appraisers, mortgage brokers willing to falsify paperwork, Wall Street ready to slice, dice, bury the paper and regulators turning a blind eye to all. It would seem that much ot the American Economy is predatory.)

You also state:
"I even have some darker stories how my brother and sister were stopped from stealing his money ."
Welcome to the club! In my case, I was at the same time as the above trying to fend off my two ATTORNEY brothers who were ready, willing and able to loot the till. My greatest worry was that my brothers would sell my mother's house so that if she did recover, she would have had no home to return to. This all played out over the years in Probate Court. I can only describe that as having been a living hell. There may be Justice somewhere occasionally in America but it does not darken Probate's door. To be avoided if at all possible.

The people involved in the Healthcare and Legal Systems have a Fiduciary Responsibility ( The moral, and sometimes legal, responsibility one party has to another in relationship to specific duties, such as those held by investment advisors or trustees.) to the citizens they represent. Well, the Professions do not live up to their Fiduciary Responsibility any more. Act accordingly.