Posts Tagged ‘Department of Education’

Is End-of-Life Care Worthwhile?

Monday, August 27th, 2012

Even in the age of advanced healthcare directives and living wills, Americans still must cope with a dilemma when it comes to end-of-life healthcare for themselves or their loved ones.  Consider the fact that Medicare pays as much as $55 billion annually for physician and hospital bills during the last two months of patients’ lives.  That’s more than the budget for the Department of Homeland Security, or the Department of Education.  Estimates are that 20 to 30 percent of these medical expenses usually have no meaningful impact.  The federal government pays for a majority of the bills with no questions asked.  Medicare spends nearly 30 percent of its budget on beneficiaries in their final year of life.

Given this information, the question is whether extending someone’s life is worth the money it can potentially cost.  The solution potentially could have been a snap for Congress when it passed the Patient Protection and Affordable Care Act (ACA).  Unfortunately, the previously bipartisan issue quickly became a political hot potato.

According to Dr. Ira Byock, it costs as much as $10,000 a day to maintain someone in the intensive-care unit, even if the patient remains there for weeks or even months.  “This is the way so many Americans die. Something like 18 to 20 percent of Americans spend their last days in an ICU,” Byock said.  This discussion raises the philosophical issue of the value of human life.   According to Byock, “While many people question spending a lot of money to prolong the life of an elderly, frail patient, it was perfectly logical for a frail person to value life extension as much as a perfectly healthy person.  With advances in medical care, it can be argued that the value of hope has been increasing along with the statistical odds of staying alive until a cure is found.”

Over-treatment, according to Byock, is an unfortunate side effect of medical advances.   “We have enormous scientific prowess and remarkable diagnostic and treatment,” so that when you are admitted to the hospital, the system “moves you quickly towards the next diagnosis and then the next diagnosis after that for the next component problem in a whole picture that few people will see.  It’s a dysfunctional system that feels like a conveyor belt.  We have a disease-treatment system rather than a healthcare system caring for human beings.”  Byock notes that the same system can lead doctors and patients to regard any reduction in treatment, or even accepting that patients are going to eventually die, as failure.  There are amazing ways to combat disease and extend life.  “That’s all well and good.  The problem is, we have yet to make even one person immortal,” Byock concluded.

Dana Goldman, director of the Schaeffer Center for Health Policy and Economics at the University of Southern California and founding editor of the Forum for Health Economics and Policy, has a difference approach.  According to Goldman, “We think of healthcare as an expense, but we really should be thinking of healthcare as an investment.  We want to invest where we have the greatest return. I would put prevention in that bucket.  But the way we do it now, no one has an incentive to invest in things with a long-term return.”

New Illinois Congressman Is Declining Government Healthcare

Thursday, January 13th, 2011

One of Illinois’ newest Congressman – Republican and Tea Party favorite Joe Walsh, who represents the 8th district that consists of Chicago’s far northwest suburbs – has refused to accept the government-sponsored health insurance plan that typically covers lawmakers.  “I don’t think congressmen should get pensions or cushy healthcare plans,” he said.  Walsh’s wife is not thrilled with her husband’s decision; because she has a pre-existing medical condition, she is now forced to hunt for a pricey individual policy.   So far, Representatives Bobby Schilling (R-IL) and Mike Kelly (R-PA) have joined Walsh in turning down congressional healthcare coverage.

Representative Joseph Crowley (D-NY) called the Republicans’ bluff, writing a letter to GOP leaders asking that they refuse their federally subsidized coverage.  “If your conference wants to deny millions of Americans affordable care, your members should walk that walk.”  Crowley sent his letter to incoming Speaker of the House John Boehner (R-OH) and Senate Minority Leader Mitch McConnell (R-KY).

Walsh’s stated legislative goals are repealing President Obama’s healthcare legislation and making major changes to Social Security and Medicare.  Additionally, Walsh believes that reducing the size, scope and power of government is an end in itself.  “An end in itself,” he said.  “I think we were sent to D.C. to cut spending and grow the economy. We have to talk about cutting real programs” – as well as agencies — “like the Department of Energy and Department of Education.”

Does the High Cost of Medical School Deter Would-Be Physicians?

Tuesday, March 2nd, 2010

Dr. Michelle Bisutti will be paying off new student loans for medical school until she’s 70.  One reason for the nation’s physician shortage could be the cost of attending medical school.  Columbus, OH, family practitioner Dr. Michelle Bisutti ended up owing $550,000, thanks to a combination of putting off loan payments, default charges and compounding interest rates. “Maybe half of it was my fault because I didn’t look at the fine print,” Dr. Bisutti said.  “But this is just outrageous now.”

As tuitions soar, many attending medical school borrow significant dollars to pay for their education.  Unfortunately, student loans are one of the most toxic debts in existence and require extreme consumer caution and – as Dr. Bisutti learned the hard way – responsibility.  Additionally, the idea of not paying back student loans is virtually impossible because collection agencies typically are tapped to recover the money.  While lenders may trim payments, it is virtually impossible to have fees or principals waived.

Martha Holler, a spokesperson for SLM Corporation (also known as Sallie Mae), the nation’s largest private student lender, notes that loan terms, including interest rates, are disclosed “multiple times and in multiples ways”.  Sallie Mae’s website provides easy access to repayment tools and account information.

Dr. Bisutti is unhappy about the number of student loans she took, the missed payments deferring payments and the fact she didn’t completely fill out required paperwork.  Still, she didn’t like that the variable interest rates soared from three to 11 percent while she was in medical school.  She borrowed the maximum $152,000 from the federal government, took private loans from Sallie Mae, as well as two $20,000 loans from Wells Fargo & Company.  Ultimately, Dr. Bisutti’s father – who had co-signed the loans – agreed to pay $550 a month for one year.  Dr. Bisutti entered into a rehabilitation agreement on her defaulted federal loans, which now have a $31,942 collection cost.  She pays every month on those loans – now totaling $202,399 – at a rate of $990 a month.  Only $100 of that pays the original balance; the remainder pays the interest rates.  Dr. Bisutti’s federal loans will be paid off in 351 months.  At that time, the 41-year-old physician will be 70 years old.