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I am 67 years of age and have a for the kind of care my wise receives the government is depriving us of the
$20,000 pension. The social-securi- are more or less standard in most ma- $1,000 a month in bank and dividend ly payments my wife and I receive total jor cities. Some institutions are even interest that could go toward my wife's $9,400. Our income from interest on more expensive.
upkeep. If that income could be resavings and dividends amounts to ap- Other than Medicaid (government tained, the nursing-home cost to Medproximately $12,000 a year. We have no insurance for the impoverished) there icuid would be $600 or so a month. debts. Yet in a year or so I could be is practically no insurance that covers Were I permitted to work it would be virtually penniless, living on an al- extended care in a nursing home. Med- even less. Instead, it will cost the taxlowance similar to that given to welfare icare will pay most nursing-home ex- payers, through Medicaid, more than recipients.
penses for up to a hundred days, but $1,600 a month. My wife is in a nursing home. only under certain conditions: if the Divorce: The fact is that if I were
About 15 years ago I learned that my patient must be fed and medicated in- placing my parent or an incapacitated wife had Parkinson's disease. This con- iravenously, suffers from bedsores, is child in an institution, under the law I dition triggered other problems, and kept on blood-thinning medication or would not be financially responsible. A four years ago a massive internal infec. requires throal-suctioning. The calch year ago an accountant suggested that tion necessitated the removal of most of is ihat most nursing homes will not since I was neither a millionaire nor a her small intestines. A chronic bladder admit such a person to their custody. pauper the sensible thing to do was to problem and unusually low blood pres
get a divorce. That way my wife would sure required that she take extremely
be entitled to a share of what we own large doses of medication. Because of if I were a murderer and I would not be left without a cent. her weakened condition she required
Certainly it is logical. But why should constant assistance with even ordinary
my pension could not
we be compelled to do something that is chores, such as going to the bathroom be touched, but having so contrary to the feelings we have for or dressing. Then, three months ago,
each other? Half of everything a husshe suffered a stroke. Her speech is still a sick wife carries a band has should and does belong to his unintelligible and the state of her health special penalty.
wife. Why can't the same rule apply for is such that she can no longer be cared
us? Moreover, I believe that half of for at home.
whatever I might be able to earn should Paid Help: We have been married 35 Once I've spent my savings and dis- go to her. I would willingly return to years and in all that time have never posed of other assets, my wife will be work to lighten Medicaid's share of the been separated. Even after her intestin- eligible for Medicaid. If there is an alter- bill. Why should people who have been al operation she had refused to go to native to insolvency, I am not aware of together as long as we have, and who a convalescent home and insisted on it. It is my understanding that I will be feel about each other the way we do, be coming home to me. For my part, I was allowed to keep $2,600 for myself and forced into a divorce? more than willing to have her. We were $2,600 for my wife, essentially for bur- The one bright spot in all this is that I forced to take in paid help costing close ial expenses. My pension, earned after was able to get her placed in a good to $400 a week but, still, I was on my 33 years with the New York City Police nursing home where she is well cared own nights and weekends, doing laun- Department, will be attached. If I were for. As long as I've known her, my wife dry, shopping, preparing meals, clean- involved in a swindle and owed money, has agonized over the fact that her ing our small apartment, seeing that she if I were serving time in jail for murder, grandmother, who raised her, ended her took all her medicine, attending to her my pension could not be touched. Hav- life in a charity ward. That was during every need. I was seldom able to sleep ing a sick wife carries a special penalty. I the Great Depression and thoughts of more than an hour at a stretch. will no longer be able to own anything. how things were for her beloved grand
Since the stroke, however, my wife If I work I won't be able to keep my mother have always haunted her. I requires even more skilled and time salary. What I will be allowed is a set know that whatever happens, even if I consuming care, which can best be amount for rent and food. I will join the am not around, she is in good hands. provided in a nursing home. The cost ranks of the nonproductive members of Now, what about me? is $105 daily, roughly $3,200 a month society. or $38,325 a year, which is more than The odd part of this arrangement is David B. Gordon is a retired police our entire net income. These charges that by making us liquidate our savings, officer. He lives in New York City.
NI WSWEEK/SEPTEMBER 27, 1982
PREPARED STATEMENT OF JACK RAFFERTY, MAYOR, HAMILTON, N.J.
CONGRESSMEN RINALDO AND SMITH, I AM
AM JACK RAFFERTY, MAYOR OF HAMILTON, WHICH AS YOU KNOW IS JUST A FEW MILES DOWN THE ROAD. 1 DON'T PRETEND TO BE AN EXPERT ON HEALTH OR AN AUTHORITY ON MEDICARE BUT RATHER I SPEAK AS A GENUINELY CONCERNED ELECTED OFFICIAL OF THE SEVENTH LARGEST MUNICIPALITY IN THE STATE OF NEW JERSEY WITH A CONS I DERABLE NUMBER OF ELDERLY AMERICANS. THE SUBJECT OF THIS
HEARING IS ONE OF VITAL INTEREST TO NOT ONLY ME BUT ALL AMERICANS
AND CERTAINLY ONE ON WHICH I WANT TO RECORD MY VIEWS FOR THE RECORD.
CONSTITUTENTS, LOCAL EXPERTS AND OTHERS CONCERNED WITH THIS VITAL
SUBJECT OF HEALTH CARE TO THE ELDERLY AND ITS FINANCING. LIKE ALL
AMERICANS, I AM DISTRESSED BY THE EVER INCREASING DIFFICULTY OLDER
AMERICANS ARE FACING IN OBTAINING QUALITY HEALTH CARE AT THAT
PERIOD IN THEIR LIFE WHEN THEY ARE IN GREATEST NEED.
I NEED NOT
REITERATE TO YOU, HOWEVER, THE HORROP STORIES OF PEOPLE WHO HAVE
SPENT THEIR LIFE SAVINGS ON AN ILLNESS AND THEN WERE FORCED TO JOIN THE RANKS OF THE INDIGENT. THIS, TO ME, IS A POLICY QUESTION THAT
MUST BE AT THE FOREFRONT OF THE DELIBERATIONS OF OUR STATESMEN IN
WASHINGTON. I AM NOT GOING TO RECITE A LITANY OF TALES OF WOE, BUT RATHER EXPRESS MY VIEWS ON THE PRESIDENT'S BUDGET PROPOSALS FOR HEALTH AND IN PARTICULAR MEDICARE. I AM HEARTENED THAT FOR THE FIRST TIME SINCE THE INCEPTION OF MEDICARE, THIS ADMINISRATION HAS,
IN A BIPARTISAN FASHION, HAD THE COURAGE TO CONFRONT THE FINANCING
DIFFICULTIES THAT HAVE LONG BENIGNLY PLAGUED THE MEDICARE PROGRAM. I AM ALSO ENCOURAGED TO READ OF THE PASSAGE WITHIN THE LAST FEW DAYS
OF THE NEW PAYMENT SYSTEM FOR HOSPITALS THAT WILL PROVIDE THEM WITH POSITIVE INCENTIVES TO BE MORE EFFICIENT AND COST CONSCIOUS IN THE
PROVISION OF CARE. THIS IS AN ACTION THAT HAS BEEN BADLY NEEDED FOR
YEARS, BUT HAS BEEN
I GNORED AND OVERLOOKED BECAUSE IT WAS TOO
DIFFICULT AN ISSUE TO CONFRONT AND
NOT ESPECIALLY POLITICALLY
TO THE EXTENT THAT THIS PORTENDS FUTURE CHANGES THAT MAY BE UNDER CONSIDERATION, I AM TRULY ENCOURAGED.
I AM PARTICULARLY CONCERNED, HOWEVER, THAT THE NEEDS OF ALL OUR
OLDER AMERICANS BE GIVEN THE THOROUGH AND PROPER CONSIDERATION IN
THE COUNCILS IN WASHINGTON THAT THEY RIGHTFULLY DESERVE.
PEOPLE, IN THE TWILIGHT OF THEIR YEARS, THE AMERICANS WHO ARE
RESPONSIBLE FOR THE GROWTH AND DEVELOPMENT OF THIS GREAT NATION ARE
INCREASINGLY FINDING THAT
EVERYTHING THEY HAVE WORKED A LIFETIME ACHIEVING; THAT IS A HAPPY
AND COMFORTABLE RETIREMENT,
I FIND IT DISMAYING THAT MEDICARE, THE
HEALTH CARE PROGRAM FOR THE AGED, SPENDS LESS THAN ONE-HALF OF A
INSTITUTIONAL LONG TERM CARE,
MEDICAID PROGRAM, A PROGRAM FOR THE IND I GENT, SPENDS MANY BILLION OF DOLLARS FOR THE SAME TYPE OF CARE. I FIND THERE ARE OTHER
INEQUITIES THAT FROM MY PERSPECTIVE SEEM TO HAVE LITTLE RATIONALE
OR JUSTIFICATION. WHY, FOR EXAMPLE, MUST A PERSON BE HOSPITALIZED
BEFORE THEY ARE ELIGIBLE FOR NURSING HOME BENEFITS UNDER THE MEDICARE PROGRAM? WHY, ARE THE MEDICARE BENEFITS FOR THOSE GENUINELY IN NEED OF NURSING HOME CARE SO RESTRICTIVE AND LIMITED?
OLDER AMERICANS CANNOT
SAFEGUARDED AGAINST CATASTROPHIC HEALTH CARE COSTS?
| CANNOT BELIEVE THAT A COUNTRY
THAT IS CAPABLE OF PUTTING A MAN ON THE MOON IN TEN SHORT YEARS
CANNOT REDIRECT THAT SAME CALIBER OF BRAIN POWER TOWARD DEVELOPING
A HEALTH CARE SYSTEM THAT WILL PROVIDE QUALITY HEALTH CARE AT A
PRICE THAT ALL CAN AFFORD. THE FACT THAT THIS ISSUE IS FINALLY BEING CONFRONTED HEAD ON AND NOT BEING AVOIDED OR SIDE-STEPPED IS A REFRESHING CHANGE TO OBSERVE. HIDING OR PRETENDING THAT A PROBLEM
DOES NOT EXIST WHILE THE HORROR STORIES CONTINUE TO MOUNT FOR MANY
MILLIONS OF AMERICANS YIELDS US AS A NATION NOTHING BUT DELAYED ANGUISH AND PAIN. I HAVE NO CONCRETE PROPOSALS FOR CHANGING OR IMPROVING THE MEDICARE PROGRAM, BUT I DO WANT TO REAFFIRM MY STRONG CONVICTIONS THAT THIS TOPIC BE GIVEN THE HIGHEST PRIORITY IN WASHINGTON. WHEN I READ OF THE FINANCIAL CRISIS THREATENING THE MEDICARE TRUST FUND, I AM PARTICULARLY ALARMED. THERE MUST BE A BETTER WAY. CONGRESSMEN, I, AS A MAYOR, LOOK TO MEN LIKE YOU AND YOUR COLLEAGUES IN WASHINGTON TO COME UP WITH CREATIVE AND VIABLE SOLUTIONS. I THINK WE HAVE MADE A STEP IN THAT DIRECTION WITH THE RECENT PASSAGE OF THE SOCIAL SECURITY AMENDMENTS AND THE HOSPITAL REIMBURSEMENT REFORM CHANGES THEY EMBODIED. CERTAINLY, THIS
REPRESENTS A CREATIVE, INNOVATIVE AND FARSIGHTED EFFORT.
THAT THIS EFFORT BE CONTINUED AND EXPANDED TO ADDRESS THE CONCERNS
OF AMERICA'S ELDERLY. Yes, I BELIEVE WE HAVE A COMMITMENT TO AMERICA'S OLDER CITIZENS AND THE SAME NATION THAT PUT A MAN ON THE
MOON OUGHT TO BE ABLE TO
WITH DIGNITY WITHOUT
BANKRUP TING OUR OLDEST AND MOST VULNERABLE.
THIS IS NOT A PARTISAN ISSUE AND SHOULD NOT BECOME AN ARENA FOR
RATHER AS A CONCERNED ELECTED LOCAL OFFICIAL AND IF MY MESSAGE TO
WASHINGTON IS ANYTHING,
IS THAT AMERICA DOES CARE FOR ITS
ELDERLY AND THAT WE ARE LOOKING TO YOU AND YOUR COLLEAGUES IN THE
CONGRESS FOR CREATIVE AND INNOVATIVE SOLUTIONS. 1, FOR MY PART, AND I AM SURE THAT I SPEAK FOR VIRTUALLY ALL THE MAYORS AND GOVERNORS OF AMERICA, STAND READY TO DO OUR SHARE TO ASSIST YOU IN
THIS NOBLE EFFORT IN WHATEVER WAY WE CAN.
I APPRECIATE YOU GIVING ME THIS OPPORTUNITY TO SUBMIT TESTIMONY BEFORE YOUR COMMITTEE AND | COMMEND YOU ON SHOWING THE FORTITUDE TO
TACKLE THIS MOST DIFFICULT AND TROUBLESOME OF HEALTH POLICY ISSUES,
I LOOK FORWARD TO FOLLOWING YOUR PROGRESS IN THIS VITAL AREA.