Death Houses

When Obamacare was first announced, conservatives attacked, rightly, provisions to limit healthcare to the elderly. “Let them die off,” one Colorado pol said in support of the bill. It was a rallying point in opposition to Obamacare.

What most people failed to realize is that “death houses” already existed and had existed for years. The situation was brought to light in this recent story.

California woman dies after nurse refuses to perform CPR

Published March 04, 2013,

A California retirement home is backing one of its nurses after she refused desperate pleas from a 911 operator to perform CPR on an elderly woman who later died, saying the nurse was following the facility’s policy. 

“Is there anybody that’s willing to help this lady and not let her die,” dispatcher Tracey Halvorson says on a 911 tape released by the Bakersfield Fire Department aired by several media outlets on Sunday.

“Not at this time,” said the nurse, who didn’t give her full name and said facility policy prevented her from giving the woman medical help.

At the beginning of the 7-minute, 16-second call on Tuesday morning, the nurse asked for paramedics to come and help the 87-year-old woman who had collapsed in the home’s dining room and was barely breathing.

Halvorson pleads for the nurse to perform CPR, and after several refusals she starts pleading for her to find a resident, or a gardener, or anyone not employed by the home to get on the phone, take her instructions and help the woman.

There is more to this story than its distasteful headline. What the nurse did, to refuse CPR, was legal. Not only was it legal, the nurse was legally prohibited from providing any care. Her only recourse was to call someone, a doctor, her supervisor, or, as she was instructed, 911.

You see, the elderly woman had signed a DNR—Do Not Resuscitate order. A DNR is a legal document instructing physicians, nurses, EMTs, medical facilities and caregivers, to not perform any lifesaving procedures in an emergency. In other words, let her, the elderly woman, die!

What is not known by many is that many nursing homes, assisted care facilities and other “senior” residences have, in their contracts, a DNR or provisions to that affect. Residents are required to have a DNR as a condition of admittance. This is a growing practice, especially in California with their liability statues. The worse part is that the practice is spreading across the country. It’s being driven by lawsuits and liability insurance.

If you do a Google search on “DNR, nursing homes, liability insurance,” you’ll get pages of legal references by nearly every state in the nation. A common trait of these various state laws is that nursing homes cannot be sued for refusing assistance if there is a DNR, but they CAN be sued for providing assistance when there is a DNR. It’s more confused when, in some states, a verbal statement can be construed as a desire for a DNR.

The path for universal DNR in nursing homes is being greased by Obamacare. When Obamacare refuses to pay or decreases payments for long-term care and emergency medical procedures, someone will have to pick up the costs and it won’t be the medical/nursing facilities. As Obamacare is enforced, medicaid broadened, support for universal DNR to grow as a means of controlling costs. When that occurs, nursing homes and “assisted” care facilities will truly become Death Houses.

I am a Heretic!

You read the post title. I am not a believer in, nor a practitioner of…The One True Way!

That’s right. I refuse to use a CPAP. I “supposedly” have sleep apnea. I was tested back in the early 1990s at a local hospital. They declared I had sleep apnea. It was the first time I’d heard of the condition.

I’d gone to my family doc for something. During the session, he asked how I slept.  At that time, I was in a high stress job, worked long hours and, yes, I didn’t sleep well. I’d go to bed at 10pm and still be awake at midnight. When I did sleep, I’d wake frequently. I also had a lot of back pain. When the Doc asked if how I slept, I naturally said not well.

I do admit that on occasion, not frequent at all, I’d wake coughing and once gasping. When the hospital tech said I had obstructive sleep apnea and described the cause, I accepted it.

Then he tried to sell me a CPAP…a very expensive CPAP. I said I’d talk it over with my doc.  He, too, tried to sell me on the idea of a CPAP. In fact I tried one out.

It was pure torture.

For me, it didn’t work. I could not sleep with that infernal device strapped to my face.

I’m an engineer. Engineers have a peculiar mindset. When confronted with a problem, they tend devise solutions. I found one that works for me.

Sleep apnea, according to wiki, is…a condition when breathing is interrupted by a physical block to airflow despite respiratory effort, and snoring is common.

The CPAP is supposed to force air through the nasal passages forcing the palate aside and allowing air to reach the lungs. I’m sure there are more technical definitions but basically that is what is done. It’s one engineering solution to a physical condition. And, it works. It works for tens of thousands of people, maybe more.

It doesn’t work for me.

When I examined the problem with my engineer’s eye, I found an alternative. The blockage of air by the collapse of the palate in the back of the throat is caused by gravity. If there was no gravity the palate wouldn’t collapse.

For me, that condition occurred only when I slept, tried to sleep, flat on my back. Given the conditions necessary to cause sleep apnea, what could I do to change those conditions?

1. Don’t sleep flat on my back. Sleep on one side or the other.

2. Change the angle of the pull of gravity, Elevate my upper body. That would change the direction of the pull of gravity. I don’t have any blockage when I’m vertical, standing that is. What angle is required that does not block my breathing when my palate relaxes? For me that was 15°. A surgical wedge available at medical supply stores would, when slept  upon, raise my upper body and fulfill that requirement.

Alternately, sleep in a recliner…one that raises the upper body, not one that lays flat when extended. That would defeat the purpose of preventing blockages.

3. All of the above.

My engineered solution works—for me. I do not endorse it for anyone else. It is a customized solution only for me.

You would think my doc and others would appreciate my design. It’s cheap, not like a CPAP. It doesn’t require frequent cleaning nor filters as do some CPAPs. It doesn’t require battery nor a electrical power outlet. It works. Most of all, it doesn’t require a CPAP.

Instead of having my solution accepted I have been called by some CPAP proponents ignorant, stupid for defying orders to use a CPAP, a murderer for proposing there was a solution that didn’t require a CPAP, and then the responses got personal.

My doc was more polite. He just didn’t believe my solution worked. He still asks if I want to be retested.

It seems that I endangered some rice bowls. There is an entire industry in manufacturing CPAPs, selling and marketing CPAPs and sleep testing. They have their lobbyists and supporters. They have sold the medical community on the CPAP as the ONLY solution to sleep apnea. Naysayers beware!

It didn’t occur to me until later that the organizations that conducted the sleep testing were also the same ones selling CPAPs. Most people would see that as a conflict of interest.

I have, over the years, asked people if they had ever had sleep testing. Many, many have. Not one ever passed the test. Most use CPAPs. Those who don’t are being constantly badgered to buy and use CPAPs. I’ve yet to encounter anyone who has been tested and didn’t have sleep apnea!

I was first tested over twenty years ago. I bowed to my doc’s insistence a number of years ago and was tested again. I knew more about the condition when I was tested the second time.

I arrived, was conducted to the test room and hooked up with all the expected sensors and told to lay flat on the bed. There wasn’t a pillow. I have bone spurs in my neck. I need some head support.

I asked for a pillow. One, a small flat pillow, barely a cushion, was provided. I asked for another because the single pillow didn’t provide enough support. At first the technician refused saying there wasn’t any more. At my insistence he found another.

Then he left.

I wasn’t sleepy. I’d had a full day working a problem for my employer. Like many, I continued to work the problem in my head. It’s one reason why I have difficulty sleeping.

I glanced at my watch from time to time. Thirty minutes passed. An hour. The tech looked in at one time. My back began to hurt. I couldn’t get comfortable. I tried to shift my position to relieve the pain. I rolled on one side. The tech rushed in. He said I had to lay flat for the test. My suspicions rose. The pain continued, growing. I still couldn’t get comfortable.

By now, over two hours had passed. I still hadn’t slept. The tech was supposed to be video taping the session. He came into the room every fifteen minutes or so. I made a game of waving at him whenever he entered.

At the three hour mark, the tech entered again and said the reading proved I had sleep apnea and that I’d stopped breathing, one time for over a minute.

What! How could that happen when I’d never been asleep?

He proceeded then to fix me up with a CPAP. They had a new model, he said. This one covered both my nose, like the old style CPAPs and my mouth. He tightened the straps—TIGHT!. The CPAP sealed my mouth and nose. I could get no air. That was the purpose of the design. Then the tech turned on the regulator and left.

My lungs blew up like two balloons! The tech must have put the regulator on high. The pressure was so great I had extreme difficulty exhaling. It was work to exhale every breath. At the slightest relaxation my lungs expanded again under the pressure of the CPAP.

I fought trying to breath for several minutes and was getting desperate. I was finally able to get the CPAP off. The tech was enraged. I’d ended his experiment. Now he would have to start it all over. He refused to listen to me.

I had had enough. I gathered my clothes put on my shirt and pants and walked out the door. When I looked in the mirror the next morning I had bruises around by nose, mouth and chin. I had large blue patches under both eyes like I’d had both blackened.

I called the testing company and spoke with the manager. He offered to test me again using another tech. I’d have to take a day off work to do so. I refused. I never went back. I wrote a letter to the testing company, copying my doc, and described by ordeal. I stated that I would not pay for the testing. They had run my credit card when I had arrived because my insurance wouldn’t pay. I was never billed.

I now have a note in my medical records. “Subject diagnosed with sleep apnea and has refused to use a CPAP.”

Every time I see my doc, he asks how I sleep. Much better now that I have a solution. I still wake frequently and like many my age, I have difficulty getting to sleep. Those conditions aside, I sleep reasonably well. The doc also asks if I wake with headaches? No. Do I wake gasping or dreaming of suffocating? No to both.

Will I use a CPAP? No. I don’t need one. I don’t have high-blood pressure, another symptom of sleep apnea. It was 121/72 at my last visit. I have no symptoms nor, according to my wife, do I snore when I sleep. I don’t gasp, nor stop breathing. She’s listened as instructed by my doc.

But that one statement is still in my medical records. My wife and I applied for some extended care health insurance recently. The insurance company had a nurse visit us. She weighed us. Had us fill out a medical questionnaire. Checked our blood pressure noting that mine was very good and gave us several tests to check our mental acuity. We both passed those tests with ease.

We received a note from the insurance company last week. My wife was accepted. I was not. Why? I was overweight and refused to use a CPAP. They would reconsider if I lost some weight and would use a CPAP.

I’m still a Heretic and the Powers that Be have not forgotten. I won’t bend nor bow to The One True Way.

AARP: Not a non-profit organization.

Like many, when I hit 50 I received an invitation in the mail to join AARP, originally the American Association of Retire People. I tossed it. Every year since then I get more invitations…several times a year. If they were big enough to line our cat’s litter box, I’d use them. They’re not so I toss them. Now that I’m Medicare eligible, I get something from AARP several times a month wanting me to sign up for their Medicare Supplemental plan. I ignore these too. Why? Because I will never be an AARP member. I’ll not support one of Obama’s cronies.

AARP purports themselves to be a non-profit association to benefit seniors.  They’re not.  Terrance Scanlon writing in the Washington Times has investigated AARP. His findings did not surprise me.

SCANLON: Picking seniors’ pockets

AARP doesn’t care about elderly members

By Terrence Scanlon, Monday, May 28, 2012

I’m going to come right out and say it: AARP is about money and power. That’s all it’s interested in.

Formerly known as the American Association of Retired Persons, the nation’s largest seniors group hasn’t cared about its elderly members’ well-being for eons. It’s been too busy building a financial empire.

With $1.6 billion in assets and $1.2 billion in revenue in 2010, AARP is a moneymaking powerhouse. The bulk of its money comes not from membership dues but from product endorsements and business agreements with insurance companies.

These mountains of money and the generous salaries that AARP lavishes on its corporate executives recently drew the attention of members of Congress who have asked the Internal Revenue Service to review AARP’s tax-exempt status. Their findings appeared in an eye-opening investigative report, “Behind the Veil: The AARP America Doesn’t Know,” that was issued by Republican members of the House Ways and Means Committee.

Much of the self-described “nonprofit” group’s revenue comes from the sale of supplemental Medicare insurance provided by UnitedHealthcare, which pays a royalty fee to AARP to use its name for marketing purposes. This licensing earned AARP $284 million in 2007, a figure that ballooned to $427 million in 2009 and $670 million in 2010.

As it amasses huge profits, AARP also has become the 800-pound gorilla of special-interest advocacy groups.

As journalist Fred Lucas writes in the current issue of Capital Research Center’s monthly newsletter, Foundation Watch, AARP has a much deserved reputation for throwing its weight around on Capitol Hill.

AARP burned through $198 million in lobbying fees from 1998 to 2010, according to a recent congressional report. That places it behind the U.S. Chamber of Commerce, the American Medical Association and General Electric but ahead of PhRMA, the trade association that represents pharmaceutical manufacturers.

AARP has run afoul of the tax man before. In 1994, it forked over a one-time settlement of $135 million to the IRS to settle an audit over its tax returns from 1985 through 1993. The IRS found that AARP had engaged in commercial activities and had to remit “unrelated business income tax” or UBIT. That same year, AARP also paid $2.8 million to the U.S. Postal Service to resolve claims that in 1991-92 it improperly mailed health-insurance solicitations at nonprofit rates.

Like other “liberal” organizations, AARP lies. They lie about their goals. They lie about their methods. They lie about their motivation.  To top it all, they are tax-exempt to boot!

Why should AARP be tax-exempt while it rakes in hundreds of millions of dollars in royalties by sponsoring health insurance and offering hotel and travel discounts and deals on auto rentals? That’s the question former Sen. Alan Simpson, Wyoming Republican, asked at a 1995 hearing on AARP’s operations.

AARP remains a steadfast enemy of even the mildest entitlement reforms. The group would prefer to send the bill for previous generations’ spendthrift ways to young people and those who have yet to be born.

AARP attacked Rep. Paul Ryan, Wisconsin Republican, when he advanced an extremely modest proposal last year aimed at getting a handle on exploding Social Security and Medicare costs. Even though it knew the plan would not affect today’s seniors or anyone over the age of 55, a disingenuous AARP-produced TV ad said, “Some in Congress want to make harmful cuts to Medicare and Social Security, cutting your benefits so Washington can pay its bills.” It was complete nonsense, but AARP didn’t care.

AARP CEO Barry Rand doubled down, misrepresenting the Ryan plan in an effort to scare seniors. Although the Ryan plan would not reduce Medicare spending, Mr. Rand told lawmakers in a letter that Mr. Ryan’s “proposed budget caps” would “very likely trigger cuts to Medicare benefits for today’s seniors.”

At the same time, AARP gave its enthusiastic support for Obamacare, which would slash $500 billion from Medicare’s budget. AARP’s cheerleading for President Obama’s socialist health care plan was decisive.

It is quite likely that without AARP’s lobbying for Obamacare, it would not have passed.  Their support gave liberals an appearance of support by seniors. Support that, if Obamacare had been fully described and documented, would not have been granted.  AARP, through their endorsements exemptions and the new medical referrals and provider pools under Obamacare, would reap huge profits under Obamacare. AARP pursued their own interests at the expense of their members.

At its core, AARP is, in essence, a fraud. Instead of turning their profits back to their members as should a true non-profit organization, they use those funds to support various liberal organizations—like the democrat party and other liberal social organizations.  Yes, crony socialism at its best, that’s AARP.

When I signed for United Healthcare’s Medicare Advantage program last Fall, I didn’t know UHC paid royalities to AARP for the use of their name.  When it’s time to choose again this Fall, I’ll find another alternative. I do not want any of my money supporting AARP.

I’ve been advised to never feed a fraud. AARP’s political policies do not reflect that of their members. In fact, when members object, AARP ignores them.  I’ll follow that advice and will not feed them either.

Home Insurance: Democrat style

I listened to a radio interview this morning (while in the shower) and the discussion was a variation of Obamacare that is floating around Washington and blue-states.  Instead of ruining health care, this time they’re aiming at Home and property insurance.

I have to add a caveat.  I’ve been Googling the web for confirmation of various disaster insurance proposals.  There are many from institutions, the insurance industry, and from members of Congress. I haven’t been able to confirm this specific proposal.  Many of those I did find echo some of the proposals I heard during the interview.

The basic proposal is this:  when disasters strike, insurance companies are hard pressed to pay the claims and to later recover their liquid reserves.  Most often, the insurance companies recover by increasing premiums.

Some areas of the country are always at risk, such as Florida, the Gulf Coast and the eastern seaboard, for hurricanes.  The Midwest is at risk for tornadoes and floods. In California, the western seaboard, and Alaska the risk is for earthquakes.  Tsunami risk includes Hawaii and those states frequented with earthquakes. Finally there is the near-continual volcanic eruption on Hawaii’s big island.

There are few, if any, areas in the country not at disaster risk for something.

All those disasters cost the insurance companies money.  They also makes insurance premiums high in those areas. Some people choose not to have insurance due to the cost. They accept the possibility of loss.

That’s not fair, according to liberal/democrat dogma!  Something must be done!

One proposal is to equalize premium costs across the entire country.  The problem with that is that those states/areas of the country at lesser risk, end up paying higher premiums to subsidize those in high risk states.

Another proposal is to freeze premiums.  That can’t be done because, in short order, insurance companies would soon drop disaster insurance or go out of business.

The last variation is the proposal above and have the Feds (read FEMA) under-write the losses.  Once again, the tax-payers end up subsidizing the cost of insurance for those in high risk areas.

When liberals find an issue, they will always screw it up.

This is another liberal agenda that attempts to make life an ideal that does not exist.  There is no perfect world where risk does not exist.  Life isn’t fair.

If these proposals are allowed to continue, we’ll end up with another boondoggle like Obamacare.  A solution that makes the situation worse for everyone.

It’s time for the feds to leave well enough along.  The insurance business plans work.  If you choose to live in high risk areas (I live in tornado alley), you have to live with the risk and manage that risk as best fits your circumstances.  For some folks, that means doing without insurance.

It may not be pretty, but that, is reality.