Tuesday, September 25, 2007


I've Glimpsed the Face of Evil, and It's Blank

The story occupied the front page of the Sunday Times, along with a photo and an elaborate diagram. The photo was of an adorable woman cuddling her granddaughter. The diagram, which looked like a free market version of Dante's Circles of Hell, described the intricate corporate relationships that held all parties responsible for her death as, well, Not Responsible.

Alice Garcia, the aforementioned adorable grandmother who suffered from Alzheimer's disease, died of complications from infected bedsores after Habana Health Care Center was sold to a complex of investment firms that immediately slashed costs by cutting staff, supplies, and services, the better to return quick profits to its investors. Off went the nurses and aides who took care of the patients. Nursing supplies were in smaller numbers, the remaining caregivers told to Make Do. Mold-spewing vents were unserviced and ignored. Emergency exits were blocked.

And when the accounting for who was responsible for the death of Alice Garcia --and the decline of many of her fellow residents-- came in, the answer was, who can tell?

The ownership chart shows no fewer than a dozen different groups. Many nursing homes are part of larger chains, and they are increasingly sold for quick profits by huge investment groups. Profit concerns quickly outweigh those for care. The Byzantine organizational structures, defenders say, became necessary in an industry that was going bankrupt from lawsuits against it.

As we boomers age, services connected to our dear little graying heads are becoming hot properties for people looking to make a buck. And herein lies my objection to our societal academy's current worship of free markets. And as we pay into our modest retirement accounts, who knows? Perhaps our 401ks are actually investing against our future well being.

It's hard to look at the ownership chart in the Times (accessible via the link in the headline) and not feel a hopelessness regarding any meaningful health care reform. Whatever money remains in the Medicare-Medicaid systems are being piped to these elaborate complexes that prize profits over care. Insurance companies, investment firms--all have a stake in what will eventually become crucial stakes for us all.

The Times investigative reporting was admirably and distressingly thorough: reporters combed through data of more than 1200 nursing homes purchased by large investment groups since 2000, and more than 14,000 other homes. They were compared in significant care categories and plotted against national averages. In the current anti-regulatory climate, not only are nursing homes getting the short end of the stick via corporate cost-cutting, there are fewer regulators to keep an eye on care itself.

It's always an interesting experience to read the Times. In one part of the paper are important stories that are the province of the investigative reporting of a great newspaper; in the rest of the paper are lots of ads for and stories of people who have so much money that they can afford homes offered by Sotheby's and helicopter trips into the wilderness to experience 'real' wildness, among other options for all that super-disposable income.

As a culture we have become so distracted by the affluent (and perhaps so eager to be among them) that we can't pay attention to the concerns that are really a part of our ordinary, quotidian lives. A society as affluent as ours ought to place care for all in a different category from quick profits.

I fear for us.

The idea of Bushian Corporate Vampires storehousing our old folks scares the bejeebers outta me.
My mom is 94. We kids rent a nice, 4 bedroom house with a pool for her and employ a full-time, round the clock retired nurse who lives there with Mom.
We pay the nurse a living wage, pay the rent, cable and utilities, buy the groceries and relieve the nurse on weekends.
Even with all that, we still save about $2,000 a month by not warehousing Mom at some fancy shithole of a nursing home with a bunch of drugged out, GED-having nurses aides who don't give a damn.
When we siblings get too old to care for ourselves, I have no idea what we'll do.
Good for you,Karen!

I took care of my mom at home, using caregivers during the day and then being home at night.

I don't know, either. I hope I die before anything else is necessary, since I forgot to have children.

If you gals have not seen SiCKO yet see it as soon as you can.

The defused responsibility we see with Medicare and Medicaid is similiar to those utilized with the private contractors in the military..the end result. No one is accountable. There must be a better way. AARP is an arm of the insurance industries. Managed care is pure evil. Lulu , this is a great post and really important topic for everyone. WE all can get sick. We are considered profit centers..its not humane. My career was in social work, both medical and psychiatric in acute care settings and nursing homes..UGH !!!

..and finally in managed care for a fortune 500 company in San Francisco...it is truly evil.

I fear for us too. I fear for families where one broken bone can set a budget into ruin. It doesn't have to be this way. Our affluent society ah now there is concept..the top 1% are truly the affluent. The rest of us can rot. People all of us, rich or poor ought not to be profit centers.its immoral , hateful, and just plain wrong.
I have unfortunately come to accept what the future holds in store for me, unfortunate because you give up the fight. I hope to regain it one day. Right now, I have two parents, terminally ill, taking care of two grandparents, terminally old, and Sissy and I are miles away going to and fro and desperately trying to find solutions. One idea I had was kind of like what Karen Zipdrive did. Instead of getting them into assisted living, rent one place for all for of them and have round the clock care. When my turn comes to get sick, I will just be shit out of luck unless I can get to another country, which I have been trying to figure out a way to do that, get a job in another country. Medicine should not be for profit. Healing should be for mankind. And Hippocrates wept.
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