Health care system treats the dying like an ATM

Joseph Andrey, 91, just wanted to go home to die.

The reasons he couldnt constitute todays must-read piece in the New York Times that reveals anew that our health care system is broken.

He was stuck in a nursing home. The forces of the health care system hospitals, nursing homes, home health agencies, insurance companies, and the shifting crosscurrents of public health care spending conspired against Andrey and his daughter.

A hospital released him to a nursing home for rehabilitation. But no rehabilitation was happening. He was only getting worse.

He ended up back in the hospital and, this time, his daughter wanted to honor his wish to go home to die.

But in the health care system, the wishes of a dying patientand hisdaughter dont matter.

Theres money to be made. The nursing home gets nearly $700 a day from Medicare.

Home care agencies abruptly dropped or refused high-needs cases like her fathers as unprofitable under changes in the states Medicaid program. Hospitals, eager to clear beds, increasingly sent patients to nursing homes. The nursing homes were often too short-staffed to reliably change diapers but still drew premium Medicare rates, ordering hours of physical therapy and other treatment that studies showed was often useless or harmful.

Even hospice was limited. Now mostly for-profit, hospice companies would provide supervision and visits at home a few times a week through Medicare if a doctor certified that Mr. Andrey had only six months to live. The hidden catch: He would lose all Medicaid home care, the daily help he needed to be home at all.

A home-care agency refused to help because he was in an out of the hospital too much and the girls as the office manager for the agency reportedly referred to the aides couldnt make any money.

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Health care system treats the dying like an ATM

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