Here’s another one:
the new $1,740 annual limit for Medicare coverage on each of two categories of “medically necessary” physical therapy at outpatient facilities not affiliated with hospitals.
Translated, this means that if a person is in need of rehabilitation services, he/she must obtain them in a hospital, as opposed to a rehabilitation facility. And, it is necessary to point out that there are rehabilitation facitlities that specialize in certain types of treatment that hospitals do NOT.
And,
Thousands of nonhospital physical therapy facilities nationwide – including more than 100 in San Diego County – are affected. Some said they hadn’t heard of the change while others are being accused of not promptly informing their clients about it.
continued
When I first read this, I thought back to my experience with traumatic brain inury (TBI) rehabilitation. My doctors specifically referred me to an out-patient day treatment program. And, at the BIA (Brain Injury Association) Conference that I attended in September, the majority of the tbi providers that I met/know went through some of their rehabilitation at a non-hospital facility, as tbi rehabilitation is detailed at this page of the BIA website.
Tbi rehabilitation can include, but is not limited to the following:
Intensive Care Unit,Acute Rehabilitation Unit, Subacute Rehabilitation, Day Treatment (Day Rehab or Day Hospital), Outpatient Therapy, Independent Living Programs, Home Health Care…
It is my understanding that it is standard medical practice to transfer/refer a patient who has sustained a tbi to a non-hospital setting, as these specialize in tbi rehab.
5.3 million Americans, a little more than 2 percent of the U.S. population, currently live with disabilities from traumatic brain injuries, according a to a new report by the Centers for Disease Control and Prevention.
…80,000 Americans experience the onset of disabilities resulting from brain injuries, the report says…
Other TBI statistics reported by the CDC indicated that each year, 1 million people are treated and released in hospital emergency rooms, and 50,000 people die.
The three leading causes of TBI are motor vehicle crashes, violence – mostly from firearms – and falls, particularly among the elderly. The risk of TBI in men is twice the risk in women. The risk is higher in adolescents, young adults and people older than 75 years…
And,
a TBI takes place when an external physical force hits the brain, producing a diminished or altered state of consciousness. It results in impaired cognitive abilities or physical functioning, and sometimes disturbs behavioral or emotional functioning.
TBI can affect a person cognitively, physically and emotionally. A person might experience memory loss, lack of concentration, slowed ability to process information, seizures, double vision or even loss of vision, headaches or migraines, loss of smell or taste, speech impairments, anxiety, impulsive behavior, depression and mood swings.
Another point to consider:
The current administration looks at the concept of the VA as just another expense. They treat veterans’ benefits as another expense line on the budget. They’re not dealing with a moral obligation.
And they ignore the existence of tbi in veterans that are now in Iraq!
xposted at mlw and dkos
Also, the medical definitions of tbi can vary (went thru this nonsense). That was a worse nightmare than Medicare D! (Had to sue to get treatment, and it cost a few hundred thousand in 1991).
What a mess. I’m glad you included Veterans with TBI. I thought about that right away. Wonder why you didn’t once hear Bush talk about Iraqi Veterans? They’re pushing all kinds of fees… annual fees just to go to the VA, higher co pays and other fees. Who knows what kind of cuts they’re making for treatment of ailments like TBI.
Telling someone that they aren’t entitled to the care they require is like saying they’re just not worth the money. It’s nuts.
Read something somewhere (couldn’t find the link) about the incidence of tbi in those serving in Iraq. Found the first article that I linked to and immediately thought of tbi. And that is nuts–the cap.
Telling someone that they aren’t entitled to the care they require is like saying they’re just not worth the money. It’s nuts.
I also noticed that gwb has a habit of ignoring things and hoping they’ll go away, as he did by not mentioning the veterans in the SOTU. Something has got to be done–and, for that reason, is why we need a single-payer system…I like what Teddy Kennedy is advocating, I really do. But, the devils in the details.
And, w/this being an election year, I am beginning to have doubts about what the repubs will do to Teddy Kennedy’s Medicare For All in order to be re-elected. Have to keep a really close eye on this, IMO.
First, the low “cap” on what they will pay for expensive rehab services, and they can count on a large percentage of patients not incurring any rehab costs since the facility that provides the services they need are ineligible!
Thank you Street Kid, for your hard work on this.
I am very glad that your TBI did not affect your Bullshit Filter 🙂
In my instance (my tbi was worker’s comp), I had to retain an attorney to sue the insurance carrier at a former employer’s so I would be able to go thru rehab. And, the insurance carriers appear to be the ones that are benefitting financially from Medicare D, right? And gwb has been carrying on about tort refom, which, if I understand it, might apply to insurance carriers? If this is the case, would that (tort reform) further prohibit rehabilitative treatment in the instance of a severe disability, i.e, tbi, spinal cord injury, etc…?
Your sig says it all!
None of any of this surprises me anymore, because as a nurse, I’ve been watching it all develop from the front lines for a long time. Even thirty years ago there was a two tiered medical delivery system, where taking care of the insured patients first was commonplace. It has progressed to where the only way I can describe what I am seeing is socially sanctioned genocide. Let the (too expensive to care for) poor disabled, elderly, and chronically ill sicken and die from lack of health care services, conserving resources for the fittest. Meanwhile, turn health care into a profit making business that can be explonted, (and is)by corporations, at every possible point of delivery.
How this can be seen as anything BUT exploitation of the misfortune of the most vulnerable among us, is way beyond me.
is exactly what it is. Or economicide. Thank you for not mincing words. I feel for the nurses, all the health care professionals who chose their careers because they wanted to relieve suffering, and where possible, cure disease, and are too often instead obliged to ignore both.
Patient ‘preferential treatment’ angers nurse
I wonder just how many ‘surprises’ we are going to find in this Plan…if the bill was at least several hundred pages long(I thought I had read 500?)then I can’t even begin to imagine what kind of loopholes are in there to make sure people really don’t get the medical treatment and help they need.
I don’t think I commented in the computer diary but that was a very good diary..and another way seniors/disabled are getting screwed as so few have computers-even ones with the money to have one.
I read(think I have that article saved somewhere) that the monthly premium the people will be paying is going to double over the next several years and the approximately 30 dollar payment will go up to almost 70 dollars..how fucken nice.