WHO needs Health Care?

WHO don't?! 

WHO, also known as the World Health Organization, together with the World Bank, released a 300+ page study on disability this week.  (Click here for the easy version.)

The foreword was written by Professor Stephen Hawking, the 69-year-old British physicist who was diagnosed with ALS when he was 21.  

"Disability need not be an obstacle to success...Governments throughout the world can no longer overlook the hundreds of millions of people with disabilities who are denied access to health, rehabilitation, support, education and employment, and never get the chance to shine."

For the past couple of decades Stephen has not been able to speak or walk, but human ingenuity has given him a voice (albeit with an American accent, according to his website) and wings. 


Friday I interviewed WHO's Alana Officer, the coordinator for the disability and rehabilitation team and executive editor of the report (and Kiwi Do-Gooder). She told me one of the key findings of the report is the barriers people with disabilities face. 

There are 1 billion people on the planet with disabilities that leave them on the fringes of society and life. 

Education, jobs, health care and prevention are limited to the disabled, Alana said, and thus far, "No country is doing it all, or has got it all right." 

And while communicable diseases used to be a big cause, preventable diseases like diabetes and heart disease are  now largely increasingly responsible. (Do you want fries with that cigarette?) 

The good news is that the report shows progress in the right direction around the world. 

Alana listed the U.S.'s Americans with Disabilities Act (which grants civil rights & physical access to public buildings to those with disabilities) as one of the most progressive pieces of legislation in the world. She also noted that the U.S. is ahead of the world's curve in the area of information and communication. 

But if we've got our own American Stephen Hawking out there in those 50 shining states, what are the chances that instead of his creating and discovering, that he sits silenced in an old wheel chair, stuck at home or a Medicaid nursing facility, unable to live the life he desires? Where's the freedom for him? 

In the next couple of weeks I'll be reporting for the WMNF News on folks in Tampa Bay with disabilities and how they get by. I'll keep you posted.  

The Cost of Growing Old in America

Howard Gleckman is a journalist who has covered health policy for the last ten years. Currently, he's a columnist for Kaiser Health News and a fellow at the Urban Institute. Earlier this year he wrote an article for AARP's Bulletin magazine on adding long-term care to the health care debate. Also this year he wrote Caring for Our Parents, an engaging book that provides a holistic look at the aged and frail (yeah, I'm talking about Medicaid here, not just the people it supposedly serves). I chatted with him earlier this week.

First, a quick Medicare/caid rundown: Medicare is the goverment's health insurance plan for persons aged 65 and over. Medicaid was designed for poor women and children, people with (designated) disabilities, and those few folks in need of long-term care. Both were created by Congress in the 1960's. Gleckman explained why long-term care is consuming more and more of Medicaid:

"In the 60's, Congress drew an artificial line between long-term care and medical care. For the most part, health care reform is focused on insurance and acute care. Not chronic and LTC. Congress is still in that box. It's not two different issues for families."

As Caring for Our Parents highlights, long-term care insurance is so expensive and plagued with all the same problems as health insurance (pre-existing conditions and the like) that several of the big companies selling it have gotten out of the business. Yet, countries like Germany, France and Japan (you know, the ones with decent health coverage for all their citizens) rely on government long-term care insurance - and their populations are almost twice as old as ours. The late Senator Edward Kennedy introduced the Community Living Assistance Services and Supports (CLASS) Act as a possible solution.

"It would be the first time a government program would help people finance long-term care needs," Gleckman said.

93-year old Natalie was among those featured in the book. A three-time widow who was left very well off, she lived at a nonprofit assisted living facility, then later moved to its nursing home unit. Over a period of just a few years, she used up half a million dollars and ended up on Medicaid. Because she outlived her money, spending $16,000 some months just on her care, now she lives among the impoverished, sharing a room in that same nursing home. Isn't that the opposite of the American Dream?

"While there's an urban myth about people hiding money to get on Medicaid, the truth is most don't have it. Natalie had half a million. You get dementia, you spend all your money," Gleckman said.

According to Gleckman, 1/3 of those 65+ will not need any long-term care before they die. But 2/3 of those will need some to varying degrees, from an extra pair of hands to help with activities of daily living like dressing, cooking and cleaning, to those who can't do anything for themselves and require skilled nursing care. Often times, those who need just a little help end up in nursing homes because Medicaid in some states doesn't pay for adult day care or home health care.

Currently 1.4 million people are in nursing homes. Another 1 million are in group homes, and the biggest group, 7.5 million, are getting long-term care at home, with lots of the help provided at no or low cost by family and friends (perhaps one of the places the government saves the most money right now). Less than 10% have long-term care insurance.

Everybody Loves Jules II

Jules played his own benefit show last weekend at the Whistle Stop Bar & Grill in Safety Harbor. Sick with cancer, his health insurance premium doubled, though they didn't drop him. (Does that make him a best case scenario?) His son Joe, 25, has been working with Jules as a mortgage lender since he graduated from USF in '06. (Jules takes the apps, Joe does the rest.)

Last Saturday, Joe chatted with me about his dad and the tough financial times.

"It got scary when we realized we couldn't meet our end...what are you gonna do? Keep the lights on or make sure the health insurance is paid?"

Below is a short video I produced of the benefit show, including the interview with Joe. (It'll also be available on Vimeo later tonight.)

Ronny Elliott and avid WMNF

volunteer Bert Gunthner

Kathy Stafford