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Archive for February, 2014

How the Koch Brothers hurt 600 retirees and their survivors in Northern Maine

February 19th, 2014 9 comments

Last fall,  I attended a family funeral with my cousins and Aunt.   She lives just down the street from my mother in Millinocket, Maine.  My Uncle and my father both worked at the paper mill there, which was owned by Georgia Pacific at the time of their retirements. Their respective unions negotiated healthcare benefits and they sacrificed other benefits to get great insurance coverage.  When they retired, they and their surviving spouses were promised those benefits for life. In 2005, Koch Industries bought GP.  My aunt told me that their insurance was changing, and that the enrollment had to be completed in the next several weeks.  So much for the excellent comprehensive lifetime benefit.  I’m confidant  that this decision puts more $$$$$$ in the Koch brothers pockets.  But, how does this affect seniors in my mother’s and Aunt’s neighborhood.

Many of these seniors are sick, disabled, and/or they have hearing, cognitive and other problems that makes this change difficult or impossible for them. They needed assistance getting through the insurance exchange process, and some of them have no one to help.   Because many of these surviving wives, including my mother,  had never dealt with insurance, and because it is so complex, I handled this new insurance enrollment for my mother who is 87 years old.  I am her Power of Attorney.  The letters and instructions, booklets, and rules, and so called choices, and all the other ‘stuff’ of insurance started to roll in.  Their old plan through GP was simple, never changed,  required no filling in of forms, and offered a $2 copay for any and all prescriptions.  They had this great coverage for almost 30 years.  The people who are affected by this insurance change  are all in their 80s and 90s.

Herbie Clark, the long time former State Representative for the Millinocket region started hearing about problems that these seniors were having with enrollment.  Then some colleagues at the Area Agency on Aging in Bangor told me that they had received many calls from concerned and confused seniors about this issue.  They tried to get some general  information from GP so they could help the seniors.  They were basically told to butt out and nobody would tell them anything unless they were a retiree or the survivor/beneficiary of one.   Herbie started going to people’s home’s to help them through this exhausting, complex and lengthy process of enrolling.  My mother’s enrollment took me 4.5 hours…and entire afternoon, and it was riddled with errors.  So far, Herbie has helped over 60 seniors get through this  process.   There was so much angst and confusion about this insurance business that I suggested community meetings about it.  Herbie and the AAA arranged the first meetings and I attended (I live 70 miles away).  One was held in Millinocket and one in East Millinocket just 8 miles away.  About 40 seniors showed up.  The AAA gave some great advice about medicare benefits and how their new insurance would work with it and Herbie gave what information he had, but those seniors had questions about Why??  How come a benefit that they had negotiated in good faith and worked and sacrificed for, could just be changed out of the blue like this??  They were angry…so am I!  Rep Mike Michaud’s aide attended this meeting also.  Mike is running for governor this year.

Susan from Mike’s office arranged for a GP rep and and Extend Care (the contracted insurance exchange company)  rep to come to Millinocket for two more meetings in the two communities,  to answer some questions and address problems.  Everyone on the list of beneficiaries was sent a letter about the meeting, but they were told to attend ONLY if they had not yet enrolled. In other words, “don’t come to complain”.  So, attendance was not what it could have been.  There were probably 30 people at the Millinocket meeting and fewer at the East Millinocket meeting.  We asked the tough questions, but nobody answered the question “Why would you change this insurance now, at our age?”  Their weak response was  “We wanted to offer you more choices!”  These seniors made their choice about 30 years ago and they had been perfectly happy with that choice.  Nobody in the room wanted any new choices.   We were told that about 30% of the affected and eligable seniors had not enrolled yet, and this was just a few weeks before the enrollment deadline.  We worried that these seniors would fall through the cracks and asked for a list of those people. We were denied a list because of HIPAA privacy laws.   I wondered how worried those people would be about HIPAA when their insurance is gone.  30% of 600 is 180 people with a benefit worth between $3500 and $4000 per year…that is around $720,000 that GP/Koch can keep if the benefit is not claimed.   I really do wonder how much HIPAA has to do with this decision to not give us names so we could help find and enroll these seniors.

When my father died 5 years ago, he went with the comfort of knowing that my mother had great insurance coverage, a comfortable savings account, and a solid nice  home that she owned outright. He would be livid about this change.  My mother’s first visit to the drug store after her insurance changed shocked her.  Her cortisone nasal spray went from $2 to $95! She left it on the counter, and the concerned pharmacist called me at home.   I was sold a policy that did not cover her medicine, even though they had a list of all her medicines.   Because I got such a run around from Blue Cross about this, the only option was to call her doc and ask for a comparable medicine.  That one cost $11.  My friend Herbie has told me many similar and worse stories.   Many of the seniors who are affected by this change are living on the edge financially.  They are now required to pay a higher copay, or full price for their medicines and they must pay the insurance premiums up front, to be reimbursed down the line.   This may mean financial ruin for these elderly people, or that they will be forced to choose between rent/food/heat and medicine.

This corporate decision and action by Georgia Pacific, owned by Koch, borders on elder abuse.  This is an unforgivable burden placed on elderly people in my hometown and region ……by all appearances,  to make rich people richer.   Unforgivable. 

ADDENDUM:   I wrote this blog in early 2014.  Since then, my mother has had numerous incidents at the Pharmacy including reaching the “donut hole” which I was told would not happen with the plan chose.  An inhaler she uses to keep her from having asthma attacks was not covered and would cost her $150 until her new plan year started.  She didn’t buy it and left it on the counter.  This lead to the pharmacist calling her doctor.  Her doctor then called me concerned about my mother’s memory, which is not good, but she does incredibly well with help from neighbors and my family.  People with dementia need routine and consistency, and this new Koch insurance plan changed everything about her medicines, and did not meet my mother’s needs.  Because of that, her doctor questioned whether my mother should even be driving?  My mothers driving is excellent, as witnessed by me and her neighbors, and she never leaves her tiny community.  All of this discomfort and confusion is just part of the snowball effect of complex, tricky, expensive and NON comprehensive insurance that was forced onto my mother and 599 other northern Maine elders by a remote, detached, cold hearted and greedy corporation.   Again…Unforgivable.

 

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What they say after they hurt you

February 17th, 2014 12 comments

doctorexpounding

 

 

 

In my work as a Patient Safety Advocate, and as the survivor of a harmed patient, I have heard many things that patients and families are told when things go wrong.  This is just a starter list.   I want friends and colleagues to add to it.  It seems that many of us have been on the receiving end of a widely used script that is used when bad things happen in Hospitals.

1. We did every thing we could.   (really?  When, before the harm or after?)

2. These things happen all the time.  (not to me or my family they don’t)

3. This is a very rare event.  (What about my aunt, and my classmate and my next door neighbor?)

3. There really isn’t much we can do about it.  (then, this must be your  way of doing business)

4. That is your perception of what happened and not necessarily what actually did happen.    (I saw it happen!)

5. We have met the accepted Standards of care.  (Honestly?  Then how come my loved one walked in with a minor problem a week ago and ended up sicker, with an unrelated problem?  I’d suggest changing your Standards of Care.)

6. You have an infection.  (what kind of infection? is it catching? is it curable?  will I be affected by this or disabled by it? how do I protect my family against it?)

7. You most likely carried that infection into the Hospital with you.  (Then I must have carried it around at home too.  Why didn’t I get an infection at home  and why didn’t my family get it too?)

8.  Just leave it to us, we will take care of everything.  (I already tried that)

8. You haven’t been a compliant patient and that probably contributed to the problem. (Seriously?  Just because I didn’t “obey” your commands, I got this horrible condition that is completely unrelated to what I came into the hospital for?  Are you blaming me for a problem that you caused?)

9. You knew that this complication could happen,  because you signed an informed consent.   ( You never once told me that I could become disabled or die from this procedure. My consent for treatment form was handed to me when I was medicated and scared, so I did not have the opportunity to look it over carefully before I signed.)

10.  Of course we expect you to pay for the treatment necessary after your complications.  (You infected me and now I am supposed to pay a thousand dollars a pop for an IV antibiotic??)

11. Oh, you are losing your home because you can no longer work and your bills are so high?  We are so sorry to hear that.  (No you are not!  I became disabled because of dangerous harmful hospital care and then you sicced  your collection agency on me when I couldn’t pay the bills for lousy care!)

12. You are overreacting.  (no, I am not.  My loved one is not doing well and you and your staff are not paying attention to him/her.  I know him/her better than you do)

13. Perhaps you should consider comfort care.  (he just took a turn for the worst this minute and you us to give up hope right now?)

14. If you do what your doctor tells you to do, you will be fine.  (Funny how many people do that, and more. But they are still harmed by their healthcare.)

15. At least his death was peaceful.  (He has spent the last several weeks losing weight, unable to do anything or walk, getting bedsores,  and isolated in this room because his hospital infected him….you think that was peaceful for him?  He mourned the loss of independence and inability to live with beloved wife for the past several weeks,)

16. Oh, but that IS the complete health record.  (Where is the information about when you operated on the wrong site? or the hospital acquired infection? or when he/she was given the wrong medicine? or when he/she fell out of bed and broke an arm?)

17. The family is being difficult.  (It might be  because nobody is paying attention to their concerns, or their right to safe high quality care and to advocate for their loved one)

18. We will do an internal investigation and a Root Cause Analysis.  (What part to I get to play in your investigation, and when do I get the answers I deserve?)

A colleague mentioned that I should add  “Nothing” to this list of what providers say….Providers sometimes respond to our questions with silence…no answers at all.  No responses to emails, letters or phone calls.   Ignoring the harm does not make it go away.

Another said this

“I was told it was my fault my father died because I was the one who put him in a nursing home for rehab, rehab that his primary care insisted on. The administrator who told me this somehow forgot to tell me they had drugged my dad with antipsychotic drugs which led to deadly side effects, dehydration, kidney failure, falls AND a MRSA infection. The administrator actually told me that I should have known all this would happen.”

Let’s all add to this list of things that providers/Hospitals  tell us when things go wrong.