As the Obama administration is working on a new plan for health care, I hope they are looking closely at what happens to elderly people needing long-term medical care. An editorial in the April 16, 2009 New YorkTimes notes that one-fifth of Medicare patients who have been discharged from the hospital have to be re-admitted with 30 days and one-third are re-admitted after 90 days. This is partly due to a lack of well trained, experienced social workers and the new breed of doctors called "hospitalists."
I had a year long expereince with this problem involving an elderly relative in Las Vegas. The medical care there is probably some of the worst in the U.S. and to make it even more serious, there were young, inexperienced social workers sending my relative home to an essential empty house with no plans for follow-up medical care, home health care, and no family member or friend close by. The individual had increasing dementia and the follow-up care was atrocious. Yes, he had to be readmittied three times to the hospital in the year before he died. At the very last, I found a marvelous. older social worker who monitored his medical care and kept in touch with the hospitalists. The private doctor said she didn't go to the hospital and she essentially wrote off her patient. The young doctor told me that she "worked from nine to five and didn't have time to go to the hospital!"
If the government can find a way to help standardize medical care and eliminate the insurance companies, the money saved (400 billion in administrative costs) could be used to hire more social workers, provide better oversight of the hospitalists and home health agencies and private physicians could be paid more adequately to care for sick elderly patients, as well as the rest of us.
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