US Goverment coul possible be able to shut down internet

I got smething like this for my mother, she recently fell in her bedroom broke her arm hit her head passed out and it was not till morning that her hospice worker found her.. I called her that evening before, but while the midnight hours lurk... I need something to watch over her.

I know its a big joke and all, but it is a bit of security for us when out loved ones refuse to not live on their own.

They are worth it to have if the person is willing to use it. I bought one for my wife's mother and grandmother but they refused to keep it with them.

Clarissa said, "I'll go with the input of people who know their stuff rather than any govt. study."

I have worked in health care, in direct patient care for decades. I'm an Independent voter, involved in local and state politics, and have little patience for the extreme views of either the far right or far left. It's funny to see those extremes even here in the remote SL forums world, but I'm not afraid to talk a bit here, Lord knows I've done enough talking to real life groups and newspapers. I do get a kick out of it when I see Rush-isms used here on the forums (good example: "Teleprompter-in-Chief", I actually listen to him sometimes so I can know what is really being said there. (The dude's insane..seriously.)

One thing I'd like to explain very clearly, because there is so much misinformation flying around, is about the "Death Panels". Please try to read this with an open mind, it's very important, and could also help you understand why many people "in the know" are very disturbed by the controversy.

There's not any death panel being proposed. What the bill is talking about has to do with Advanced Directives. Advanced Directives are NOT NEW. They've been around longer than me. They include a Living Will, Durable Power of Attorney for Health Care, and DNR (do not resuscitate order).

Living Will: This document is a voluntary legal document in which a person states his or her preferences for end-of-life decisions. Do they wish to be kept on a ventilator if brain dead? Will they allow placement of feeding tubes if they become unable to eat or drink?

Durable Power of Attorney: This is a relative or other close associate of the patient who the patient has chosen and legally written up documents identifying them as the person who will make medical decisions for them if they become unable to do so, i.e. brain death, Alzheimers, etc.

DNR (do not resuscitate order): This is a signed physician order that indicates the patient wishes NOT to receive CPR or cardiac defibrillation if he or she goes into cardiac arrest. If I'm at a patient's house, they have a DNR order and suddenly have a heart attack, I am not legally allowed to call 911, start CPR, but instead to stay with them as they pass away and provide any support the family needs. This order requires the patient or Durable Power of Attorney to request it and have it signed by their physician. Some people have a DNR because they have a limited life expectancy due to cancer, heart disease, etc. Others have it for religious reasons or other personal reasons.

The portion of the bill that has been receiving so much attention, and is the subject of quite a bit of deliberate misleading statements, is directly related to Advanced Directives. In the past and present, if a patient wishes to have an appointment with their physician to discuss their choices on end-of-life decisions, Medicare and other insurances generally deny to pay for this visit. It is considered "not medically necessary". This is the most important part. What the bill says is that it will require insurances to cover this visit. It absolutely does not say that all patients must have this visit with their doctor, or any imaginary death panel. Advanced Directives are simply a CHOICE that patients have had for a long time, and will continue to have, and requiring insurances to cover elective visits with their doctor to discuss it is the change proposed.

How I see this affect people on a daily basis, and what I wish Sarah Palin, Chuck Grassley and Rush Limbaugh would see, is the absolute fear they have driven into the elderly with their deliberately misleading statements. On numerous occasions I have had to comfort old ladies bawling their eyes out because they just saw Sarah Palin on Fox News telling them they will be taken before a stern panel of government officials who is going to decide if they go on a respirator or not. These are people who are already facing a complicated, stressful physical condition, they are already frightened, and they are being told they do not matter..when what actually is going on is that this bill portion is only clarifying the long-standing Advanced Directives and that voluntary (stress, voluntary) visits to discuss their own personal choices will now be covered by insurance. That's it. No death panel. The reason this is so important is because this particular subject is the primary reason why most people out there in real life are opposed to this bill. They have been led to believe it will rob them of their free choice over their own bodies, and they will be taken to some dark government room. Seriously.

I totally respect anyone who has taken the time to really research it, not on Fox or ABC but to really, objectively research it. No matter how you feel about this bill, please do take the care not to help spread the misleading information. This is why it is such a hot topic, because people who know about all this are aware of the huge amount of misinformation, and the people throwing it about will not listen. It's a killer cycle.

Esquieval, great comments regarding community health options earlier. I work in the field for many years. Here's how things work in our state. The agency is reimbursed an average of $2500 for a month of care at home following hospitalization or other acute change in health. (Comparison: most nursing home stays of 30 days around here cost about $300 a day). If a person needs therapy at home, say after a broken hip, or has a wound requiring more visits and expensive dressings, the reimbursement is 2-3 times higher. The easiest and most efficient insurances to work with are the government-run agencies (Medicare, Medicaid, and Veterans Administration). Requirements are clear, limitations are clear, and deadlines are set. We're required as home care providers to teach the patient and family to learn to manage their disease at home. Years ago, if I had someone with a large bedsore that would take months to heal, Medicare would pay for daily nursing visits until the wound was completely healed. After the Medicare reform years ago, the key now is education. Basically what they did was, in order to help control costs and improve outcomes, instead of reimbursing agencies for each visit made, the agency is instead paid according to patient needs and outcome. For example, if I see a woman who is continent, able to walk with a cane, and able to dress and feed herself with minimal effort, the agency will receive significantly less reimbursement to heal that wound. Why? Well, wounds are more likely to heal faster if the patient is ambulatory, has control of their functions, and has decent nutrition and activity. If I see a woman who is stuck in bed due to paralysis, has to wear Depends, and relies on someone else for all her personal needs, the reimbursement rate is much higher because Medicare knows already that the cost to heal this wound will be 2-3 times as much.

So we also teach. Family members or sometimes even the patient are taught how to perform their dressing changes. The nurse comes by 3 times a week, instead of daily, to monitor healing and continue providing teaching and look for complications. We now use dressings that often cost more per dressing, but that research shows provide significantly better, faster healing and less frequent dressing changes and nursing visits..saving money AND improving outcomes.

The Medicare reform a decade or so ago caused a lot of groaning at first. It was largely based on outcomes, which frankly shouldn't it be? Outcomes mean your care is effective or not effective. But it did require that hospitals, home health agencies, etc get in a TOTALLY different frame of mind. No longer was it just about providing dependent care but about making sure what you're doing is effective both in outcomes and cost. A lot of home care agencies went under at first. Big changes like that are hard. What we have today though, is patients healing faster and at greater cost savings, and patients and families taking a more active role in their disease process. They can't just rely on the nurse to keep coming every day for a year and make it all better. The agency can't rely on $125 a day coming in to go see them every day for a year.

Private insurance in the home care field is a nightmare. Claims are denied left and right, and sometimes for stunning reasons. We had a case, for example, where about $18,000 was denied reimbursed to our agency because the patient had to be seen on an emergent basis over the weekend, and because there was no one at the insurance office to deal directly with it, pre-approval was not received. We saw the patient anyway because they needed it and had a physician order. All following visits were denied by the insurance company because of this. I wish I was kidding. We have one insurance nurse at the office whose only job is to deal with the incredible demands of the private insurance agencies. They also TOTALLY control patient's lives: We can have a signed doctor's order stating the patient needs this care, and the private insurance agencies will go to any length possible to deny coverage for visits. Yes, we go anyway, and lose a lot of money. Sometimes the patient winds up paying out of pocket because they need the care, yet the insurance says no way. And the agencies cannot be expected to provide everything for free and still stay afloat.

All Medicare, VA and Medicaid require for "pre-approval" is that the patient needs the care (you're not just going out seeing them to make money when they don't need the help) and that a physician has ordered it. The government-run agencies are extremely efficient and cost-effective.

Anyway, for anyone who has bothered to read this entire long-winded post, I hope this helps. The nice thing about SL forums is my letter won't be cut to 1/8 its size by the newspaper, or shoved in a drawer at my congressman's desk

Clarissa said, "I'll go with the input of people who know their stuff rather than any govt. study."

I have worked in health care, in direct patient care for decades. I'm an Independent voter, involved in local and state politics, and have little patience for the extreme views of either the far right or far left. It's funny to see those extremes even here in the remote SL forums world, but I'm not afraid to talk a bit here, Lord knows I've done enough talking to real life groups and newspapers. I do get a kick out of it when I see Rush-isms used here on the forums (good example: "Teleprompter-in-Chief", I actually listen to him sometimes so I can know what is really being said there. (The dude's insane..seriously.)

One thing I'd like to explain very clearly, because there is so much misinformation flying around, is about the "Death Panels". Please try to read this with an open mind, it's very important, and could also help you understand why many people "in the know" are very disturbed by the controversy.

There's not any death panel being proposed. What the bill is talking about has to do with Advanced Directives. Advanced Directives are NOT NEW. They've been around longer than me. They include a Living Will, Durable Power of Attorney for Health Care, and DNR (do not resuscitate order).

Living Will: This document is a voluntary legal document in which a person states his or her preferences for end-of-life decisions. Do they wish to be kept on a ventilator if brain dead? Will they allow placement of feeding tubes if they become unable to eat or drink?

Durable Power of Attorney: This is a relative or other close associate of the patient who the patient has chosen and legally written up documents identifying them as the person who will make medical decisions for them if they become unable to do so, i.e. brain death, Alzheimers, etc.

DNR (do not resuscitate order): This is a signed physician order that indicates the patient wishes NOT to receive CPR or cardiac defibrillation if he or she goes into cardiac arrest. If I'm at a patient's house, they have a DNR order and suddenly have a heart attack, I am not legally allowed to call 911, start CPR, but instead to stay with them as they pass away and provide any support the family needs. This order requires the patient or Durable Power of Attorney to request it and have it signed by their physician. Some people have a DNR because they have a limited life expectancy due to cancer, heart disease, etc. Others have it for religious reasons or other personal reasons.

The portion of the bill that has been receiving so much attention, and is the subject of quite a bit of deliberate misleading statements, is directly related to Advanced Directives. In the past and present, if a patient wishes to have an appointment with their physician to discuss their choices on end-of-life decisions, Medicare and other insurances generally deny to pay for this visit. It is considered "not medically necessary". This is the most important part. What the bill says is that it will require insurances to cover this visit. It absolutely does not say that all patients must have this visit with their doctor, or any imaginary death panel. Advanced Directives are simply a CHOICE that patients have had for a long time, and will continue to have, and requiring insurances to cover elective visits with their doctor to discuss it is the change proposed.

How I see this affect people on a daily basis, and what I wish Sarah Palin, Chuck Grassley and Rush Limbaugh would see, is the absolute fear they have driven into the elderly with their deliberately misleading statements. On numerous occasions I have had to comfort old ladies bawling their eyes out because they just saw Sarah Palin on Fox News telling them they will be taken before a stern panel of government officials who is going to decide if they go on a respirator or not. These are people who are already facing a complicated, stressful physical condition, they are already frightened, and they are being told they do not matter..when what actually is going on is that this bill portion is only clarifying the long-standing Advanced Directives and that voluntary (stress, voluntary) visits to discuss their own personal choices will now be covered by insurance. That's it. No death panel. The reason this is so important is because this particular subject is the primary reason why most people out there in real life are opposed to this bill. They have been led to believe it will rob them of their free choice over their own bodies, and they will be taken to some dark government room. Seriously.

I totally respect anyone who has taken the time to really research it, not on Fox or ABC but to really, objectively research it. No matter how you feel about this bill, please do take the care not to help spread the misleading information. This is why it is such a hot topic, because people who know about all this are aware of the huge amount of misinformation, and the people throwing it about will not listen. It's a killer cycle.

Esquieval, great comments regarding community health options earlier. I work in the field for many years. Here's how things work in our state. The agency is reimbursed an average of $2500 for a month of care at home following hospitalization or other acute change in health. (Comparison: most nursing home stays of 30 days around here cost about $300 a day). If a person needs therapy at home, say after a broken hip, or has a wound requiring more visits and expensive dressings, the reimbursement is 2-3 times higher. The easiest and most efficient insurances to work with are the government-run agencies (Medicare, Medicaid, and Veterans Administration). Requirements are clear, limitations are clear, and deadlines are set. We're required as home care providers to teach the patient and family to learn to manage their disease at home. Years ago, if I had someone with a large bedsore that would take months to heal, Medicare would pay for daily nursing visits until the wound was completely healed. After the Medicare reform years ago, the key now is education. Basically what they did was, in order to help control costs and improve outcomes, instead of reimbursing agencies for each visit made, the agency is instead paid according to patient needs and outcome. For example, if I see a woman who is continent, able to walk with a cane, and able to dress and feed herself with minimal effort, the agency will receive significantly less reimbursement to heal that wound. Why? Well, wounds are more likely to heal faster if the patient is ambulatory, has control of their functions, and has decent nutrition and activity. If I see a woman who is stuck in bed due to paralysis, has to wear Depends, and relies on someone else for all her personal needs, the reimbursement rate is much higher because Medicare knows already that the cost to heal this wound will be 2-3 times as much.

So we also teach. Family members or sometimes even the patient are taught how to perform their dressing changes. The nurse comes by 3 times a week, instead of daily, to monitor healing and continue providing teaching and look for complications. We now use dressings that often cost more per dressing, but that research shows provide significantly better, faster healing and less frequent dressing changes and nursing visits..saving money AND improving outcomes.

The Medicare reform a decade or so ago caused a lot of groaning at first. It was largely based on outcomes, which frankly shouldn't it be? Outcomes mean your care is effective or not effective. But it did require that hospitals, home health agencies, etc get in a TOTALLY different frame of mind. No longer was it just about providing dependent care but about making sure what you're doing is effective both in outcomes and cost. A lot of home care agencies went under at first. Big changes like that are hard. What we have today though, is patients healing faster and at greater cost savings, and patients and families taking a more active role in their disease process. They can't just rely on the nurse to keep coming every day for a year and make it all better. The agency can't rely on $125 a day coming in to go see them every day for a year.

Private insurance in the home care field is a nightmare. Claims are denied left and right, and sometimes for stunning reasons. We had a case, for example, where about $18,000 was denied reimbursed to our agency because the patient had to be seen on an emergent basis over the weekend, and because there was no one at the insurance office to deal directly with it, pre-approval was not received. We saw the patient anyway because they needed it and had a physician order. All following visits were denied by the insurance company because of this. I wish I was kidding. We have one insurance nurse at the office whose only job is to deal with the incredible demands of the private insurance agencies. They also TOTALLY control patient's lives: We can have a signed doctor's order stating the patient needs this care, and the private insurance agencies will go to any length possible to deny coverage for visits. Yes, we go anyway, and lose a lot of money. Sometimes the patient winds up paying out of pocket because they need the care, yet the insurance says no way. And the agencies cannot be expected to provide everything for free and still stay afloat.

All Medicare, VA and Medicaid require for "pre-approval" is that the patient needs the care (you're not just going out seeing them to make money when they don't need the help) and that a physician has ordered it. The government-run agencies are extremely efficient and cost-effective.

Anyway, for anyone who has bothered to read this entire long-winded post, I hope this helps. The nice thing about SL forums is my letter won't be cut to 1/8 its size by the newspaper, or shoved in a drawer at my congressman's desk

You're a funny little thing, aintcha?

I do have a "dog in this fight". We have socialized health care up here and you people are falling over each other in declaring it the worst thing since Bergen Belsen. As Canadians, we are closely tied to your fortunes and once again we're scratching our heads, thinking "Oh, those crazy Americans are at it again."

As a nation, we're a pretty healthy lot. Why are you assuming that your government is less competent than mine in trying to figure out a process that works, not just for rich people, but for all?
Yes, there will be growing pains no matter what system is going to be worked out.

Some of your assertions are just plain nonsense, if not just a bit loopy. You can shout all you want, but you won't convince people by getting ruder and more strident with every post.

Yes, now of course you'll call me rude for calling you loopy and so on, but after reading these last pages I absolutely can't figure out what you're trying to accomplish with this. You accuse your government of tyranny and oppression yet you feel free to browbeat those who oppose you here? It's practically Limbaughian.

So my original question stands: if you are so right in what you believe, isn't there a more effective audience for you than an international forum about an online environment?

The USA has the best health care system in the world. 80% of the citizens are happy with their health care. What crisis?

How does the "best health care system in the world" have an infant mortality rate that ranks up there with third world countries?

We have POTENTIALLY the best health care system in the world. Oh, and we do have the best health care system in the world if you're wealthy! I will give you that much.

More bullshit. I told you, both sides can sling these sorts of accusations.

The basic question is: Do you want to be responsible for obtaining and paying for your own health care, or do you want the government to do it for you?

The basic question is: Do you want to be responsible for obtaining and paying for your own health care, or do you want the government to do it for you? Do you want to pay for your own health care, or do you want to throw your money into a pot with everyone else, let the government skim some off the top, and then decide how and who to allocate the remainder to?

More bullshit. I told you, both sides can sling these sorts of accusations.

The basic question is: Do you want to be responsible for obtaining and paying for your own health care, or do you want the government to do it for you? Do you want to pay for your own health care, or do you want to throw your money into a pot with everyone else, let the government skim some off the top, and then decide how and who to allocate the remainder to?

I've experienced both types of systems, having been a user of the military health care system for some years.

Given a choice, I choose to manage my own health care, thank you.

(and the wealthy get excellent health care no matter where they live. Don't try and single out the US with that one.)

Right this moment my mom is not answering her fone- if she is alright i am going to kill her when i get home!

(and the wealthy get excellent health care no matter where they live. Don't try and single out the US with that one.)

.

What I advocate is a choice. If you want to have your private insurance, go for it. But there needs to be competition.

The government getting involved, if done correctly, will achieve this..

And you never answered the question of how we're ranked so low in infant mortality.

Agree 1000%



That is a BIG IF. Our government can't pave roads,render disaster aid, fix bridges or run schools without it resulting in waste, corruption and incompetency. I want no part of any government run health plan personally, so yes ,choice has to be there. I would much rather our elected officials create a climate where a true free market can work, not the corporate fascism we see now, and let the private sector do what they are better equipped for than the government can ever be. Competition would happen naturally, people would have choices. But a fair, level playing field is not particularly attractive to the parasites and thieves who inhabit the halls of Congress these days. One thing is for certain, whatever plan they wind up foisting upon us, you can bet they won't have to abide by it. They always seem to wind up above their own laws.

Unfortunately, it is not just infant mortality (which I'm sure you know). The World Health Organization ranks the US 37th in the world for health care, just above Slovenia (3. The WHO ranks the US last in terms of preventable mortality. The CIA's World Fact Book ranks the US 50th in the world in terms of life expectancy. Over 46 million are uninsured. And US health care is the most expensive in the world. Americans are not getting their money's worth.

The corruption in the insurance and health industry...a private industry...is worse than in the government. Is the government perfect? No, but it is far better than what we have. Much was made of Obama's stupid comment about the postal service, but our postal service is better than most any country, that is widely accepted. I have no doubt that health care would be the same.

I'm more concerned with the thieves and parasites that inhabit the business sector. While the government is not perfect, they have a long way to go to achieve the level of soullessness, greed and flat out evil that resides in the CEO offices of many of our large corporations....insurance being near the top.

Just keep your plan away from me. I don't want it.

No problem, but I would appreciate that people would keep their insane, shortsighted and/or dishonest arguments to a minimum so that those of us who desire a change for the better can move in that direction. I don't want to take your plan away from you, but I would like something better for myself and others like me. Many of us are not so fortunate as you are, it seems. My wife recently racked up about 20k in hospital bills and we have no insurance right now. Bankruptcy is in our future. I'm that you're happy with your plan, just try to not fuck the rest of us over because you're paranoid about the government and Obama.

I'm more concerned with the thieves and parasites that inhabit the business sector. While the government is not perfect, they have a long way to go to achieve the level of soullessness, greed and flat out evil that resides in the CEO offices of many of our large corporations....insurance being near the top.

No one should die because they cannot afford health care, and no one should go broke because they get sick.

for those that can afford alternative health care...wonderful. but since many thousands have NO healthcare and no choices to make, they would be thankful for whatever the govt comes up with as a solution for them.

I think that people who have a plan through their employer or a spouse's employer may not have experienced the level you described.

When you're paying directly to the insurance co. (unaccountable corporation 1).....you're paying far more than through an employee plan. (screw #1)....and you're paying far more for far less (screw #2)....and you will most definitely run into the "allocation" problem, no matter how good your very expensive policy is (screw #3).....and you won't be aware of this "allocation" problem until you're in the midst of an illness (screw #4)....and then you receive the 200k hospital bill for a very short stay - check out those fees on that 35 page bill (from unaccountable corporation 2)...(screw #5).....during this time frame you will also deal with screws #6 through #20...bill collectors, charge card companies. credit counselors, attorneys (you can call them unaccountable corporations #3, #4, #5, and #6)....now if you make it through all those screws.....you will be ready for screw #21, in which you won't even be able to find a plan, at any cost.....then your mind starts to wonder how you will make it through the next round.....heaven forbid that ever happens.....

I think these people might be willing to give the gov't a shot at it.