Brain Injury Law Blog : Head Injury : Coma : Personal Injury : Las Vegas Nevada Lawyer & Attorney Tim Titolo

According to the Society of Actuaries, the leading cause of U.S. long-term care claims is Alzheimer's, the brain disease that renders over 5 million Americans unable to handle all the acts of daily living unaided.

President Obama states in an article he wrote "What Health Care Reform Means for the Alzheimer's Community" -- that the recent health reform legislation, the Affordable Care Act, will assist Alzheimer's sufferers and their caretakers in several ways:

-- Require new health insurance plans to cover preventive services;

-- Reduce out-of-pocket prescription drug costs for Medicare beneficiaries;

-- Make Alzheimer's-related training available for long-term care employees; and

-- Offer a new long-term care insurance public option -- the CLASS Act.

Part of the Health Care Reform that becomes effective is the annual wellness visit for Medicare beneficiaries beginning January 2011. The care is part of the comprehensive health care reform legislation known as the Patient Protection and Affordable Care Act. 

New reforms under the Affordable Care Act  begin to bring to an end some of the worst abuses of the insurance industry. These reforms will give Americans new rights and benefits, including helping more children get health coverage, ending lifetime and most annual limits on care, and giving patients access to recommended preventive services  without cost-sharing. These reforms will apply to all new health plans, and to many existing health plans as they are renewed. Many other new benefits of the law have already taken effect, including rebate checks for seniors in the Medicare  donut hole and tax credits for small businesses. And more rights, protections and benefits for Americans are on the way now through 2014.

As the leading research, advocacy, and support organization for Alzheimer's disease, the Alzheimer's Association®  has been actively involved in efforts to increase early detection of Alzheimer's and other dementias. To provide better medical care and outcomes for individuals with Alzheimer's and other dementias, possible dementia must first be detected, followed by diagnosis and notation in a patient's medical record. To provide this foundation for better care to Medicare beneficiaries, the Alzheimer's Association® is pleased that cognitive impairment has been included in the Annual Wellness Visit for older Americans.

As baby-boomers move into the after-65 age group, they will benefit from the health care modifications and reforms. The Alzheimer's Association® has established the Medicare Cognitive Impairment Workgroup comprised of stakeholders and national thought leaders with expertise in the detection of cognitive impairment. The group will come together in January to build consensus around appropriate methods and processes that can be used in the primary care setting to detect possible cognitive impairment during the Medicare Annual Wellness Visit.

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Political Commentary

First let me disclaim what I am about to write by asserting my apolitical views on politics. Second, I am not without opinion, but feel they are similar to AHs and everybody has one. But I do get caught up in the media, who can’t? So here I go.

 Obama

Why are some conservative (Republicans and Tea Partiers) still claiming our President is somehow not American because his dad was from Indonesia and returned shortly after Obama’s birth? My father’s parents were both from Italy but my father is both a taxpaying, card-carrying American. (Who also collects a tidy pension from the State of New York as a retired policeman, disability for a condition that does not stop him from enjoying his retirement, and social security). DISTRACTION.

Was FDR castrated when he developed socialized retirement care? Taking from a younger working, income producing group, to pay for the non-working, non-income producing group? Did change happen overnight? How is that not the “socialism” decried by conservatives.

And I just got back from Canada. Only so much health care to go around and that is how they keep costs down. It means you may have to wait longer to get an MRI – unless it is an emergency. It actually sounds like a conservatives dream: deprive benefits in the name of cost savings. Canada has a surplus and law against carrying a deficit. Instead U.S. conservatives want to keep their “choice” of physicians as the hold card when health care reform is proposed.

Give Obama a fair shake. It took Clinton several years to balance the budget and put us in a surplus! Does one year of getting policy in place really give President Obama a fair amount of time? No.

We now know that the conservative movement happily gave over the economic tragedy former President Bush created with, among many other things, an incomprehensibly expensive war. Where were the conservative cheers to “cut spending” then? Is the effort to democratize other countries a social agenda? Or are we ready to admit it was about securing dirty energy – oil? 

So Obama steps into a Wall Street Market and Real Estate meltdown and Bush leaves with a goodbye “stimulus” that lacked effective oversight. 

Does anyone remember that? Has the past year wiped out all memories? We’re riding a new horse; we should not switch midstream. Let it play out I say. And if tax cuts to the rich means those making more than $200,000 to $250,000, that may be good for me but not the country I profess allegiance to. But the “let me keep what I earn” argument really slaps down those who can be helped. And the argument about “letting me choose where my charity dollars go, rather then the Federal or State Government,” is a bit lame.   And yes, if Wallstreet bankers make billions of dollars using the same commonwealth as other New Yorkers, Chicagoans, and other big city residents earning much less, they should pay more for that commonwealth, or higher taxes. Trickle Down/Reaganomics is not the saving grace conservatives espouse.

Frankly, I like getting my mail, going to the library, driving on resurfaced streets and I am willing to pay for those American qualities of life. But I do not like giving money to foreign countries, whether to destroy or build up, while at the same time denying and not contributing to the disrepair in this country.

Democrats want to pay (Republican’s frame it as “tax and spend”) for things to bolster this country and this economy. But you do not accomplish that with a war with no clear purpose other than the knee-jerk reaction of 9/11.

My idea (although not really my hope) is that if the Republican or Tea Party Movement takes over congress in the coming election, they inherit the same lackluster economy President Bush left to President Obama. We now know that conservatives were giddy that a democratic president could be their fall guy when things did not change in one year. Won’t it be interesting if the Republican congress becomes the fall guys/gals for a too slowly recovering economy?

Angle v Reid

This to me is a no brainer. Let’s compare apples to apples. Lets for a moment accept that both Sharon Angle and Harry Reid are both good for the State of Nevada – all things being equal. Reid is the Senate Majority Leader. SENATE MAJORITY LEADER! He has the ear of the president and the entire Senate. Whatever your political slant, why replace this coveted, most high, position with a freshman Senator with no proven record. This, I have been told by more than one educated person, would be “bad for Washington.”

Now let’s take sides. More of an apples and oranges approach. Why can’t folks allow a party to have control in the name of getting things done? I mean how bad can it really get? If democrats continue implementing their theories on health care, tort reform, marriage, religious tolerance (not to mention the polarizing issue of abortion), what is the worst that can happen? Alternatively, if Republicans regain control of congress, democrats may draw the line in the sand like republicans have done this past year with filibusters. End result, nothing gets done. Compromises are viewed with suspicion and we go nowhere. 

So let the process work. I personally hope democrats or liberal republicans are put in place to keep the policy change coming. And let’s remember none of us are totally on one side or the other and that means compromise. We are “bi-conceptual.” For example, I agree with some conservative ideas and some democratic ideas. Some ideas I reject all together; from either side. Point is I am bi-conceptual as to issues – not a blind party line voter.

Vote for Reid, whatever you may dislike, get over it; he will be able to rally change with the president and Angle will not.

Dis-Information

And remember the power of the media, its hypnotizing, and trance inducing power. You make important decisions regarding your representatives. And so much of our information and decisions are based on our own deep seated biases. Karl Rove was very good at getting into the deep seated biases and causing people to act the way he wanted. That is indeed a talent, one I experience as a lawyer every day.

But who owns the studios that bring you the news. How much of it supports one side or the other? Do you even have a clue? There must be so many back deal discussions and events that we, the weary public, have no insight to. And sometimes there are leaks, but I would wager not nearly as often as you might think. Here again, Obama ran on the promise of a transparent government. But be realistic, we just do not know much. And if we did it would most certainly guide our choices for representatives.

Instead we have smear campaigns. I am most familiar with the trash between Angle and Reid. And that contributes so much to our decisions.   God, force or human nature, help us.  And so it goes.

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Frankly, I am not one of those bleeding heart plaintiff lawyers.  I absolutely believe in compensation for preventable injuries, too often mislabeled "accidents."  But I also believe in accountability and reasonable expectation of risk assumption when engaging in many of life's activities.  In essence I believe the pendulum swings both ways - too far one way is no good nor too far the other.

My biggest upset about the Massachusette's election of a Republican Senator to replace long time Democrat Senator Kennedy is not the "shift in power."  Rather it is the amount of time, money and energy that went into crafting health care bills in the House and Senate which, by many accounts, will all be for naught.  That is a shame.  Health Care reform could have failed, but it was never given a chance.  What has failed is the time, money and energy that was expended and wasted by one election.

Politics suck.

That said, here is the latest from the Wallstreet Journal:

 JANUARY 25, 2010, 9:19 A.M. ET

Democrats Focus on Key Elements of Health Bill

By JANET ADAMY

WASHINGTON—The White House, with its health-care initiative in doubt, on Sunday zeroed in on several elements it hoped would survive, including measures to extend the life of Medicare, lower prescription drug costs for seniors and cap consumers' out-of-pocket medical expenses.

As Democrats regroup on plans to overhaul the health-care system after a Republican win in last week's Massachusetts Senate election, comments Sunday indicated that any revamped legislation would likely focus on the least-controversial elements of earlier proposals.

White House officials notably didn't emphasize that any revised legislation should include a major expansion of health insurance. Expanding coverage to the uninsured was the key plank of the separate health bills passed by the House and Senate last year, but such efforts largely accounted for the about $1 trillion cost of the bills, and Republicans decried them as too costly.

President Barack Obama spoke with congressional leaders over the weekend to determine how to move forward on the issue. Now that the Democrats no longer have a filibuster-proof 60-vote majority in the Senate, they are likely to need Republican support to pass any new legislation, something they weren't able to win last year. Officials stressed that discussions were still going on, and Democrats are also looking at ways to salvage the current legislation.

White House adviser David Axelrod, appearing on ABC News's "This Week," said the president didn't want to abandon several elements of the current bills. These include extending the life of the Medicare insurance program for the elderly, which the bills propose to do through payment cuts to health providers, and issuing tax breaks to help small employers provide insurance. Medicare will become insolvent by 2017 without more funding or payment cuts.

Mr. Axelrod also cited assistance to help seniors pay for prescription drugs. The bills would help close a gap in Medicare Part D insurance that forces some seniors to pay thousands of dollars a year for medicine. He also said the overhaul should help people with pre-existing health conditions buy insurance and cap out-of-pocket medical costs. He didn't discuss how these measures would be paid for.

A White House aide said Sunday those were just some of the provisions, among others, that the administration hoped to include in a final package.

Republicans agree that Medicare needs to become more sustainable, but argue that the Democrats' proposed payment cuts are the wrong way to do it. Some Democrats also fear they are too deep.

While Republicans have also emphasized helping small businesses and lowering consumers' out-of-pocket costs, their approaches have been different.

Senate Minority Leader Mitch McConnell (R., Ky.) said Sunday that Republicans wanted to start over and craft a plan that did more to lower the growth of health costs.

Mr. McConnell, speaking on NBC's "Meet the Press," said the plan should change the tax code to allow individuals who buy policies without the help of an employer to get the same tax break that companies get. He said the overhaul should also reduce the number of medical malpractice lawsuits and allow insurers to sell policies across state lines.
The Democrats' bills contain no substantive changes to the malpractice system and they don't make insurance tax-free for individuals, as is the case for companies.

Malpractice is one area where Democrats could show more flexibility in any revamped legislation. Reducing unnecessary lawsuits is an area that resonates with voters, regardless of party affiliation, and Democratic leaders have already added some malpractice provisions into the current bills, though they remain largely symbolic.
Mr. Obama signaled shortly after the Massachusetts election that he might be willing to sign a scaled-down version of the House and Senate measures. In addition to the provisions Mr. Axelrod outlined, revamped legislation could include new restrictions on insurance companies, such as limits on the amount they can reap in profit and a revocation of their decades-old antitrust exemption.

Congressional Democrats are also weighing several options aimed at salvaging the current bills. One idea is to make a series of modifications to the Senate bill, aimed at addressing House Democrats' concerns. Changes likely would include minimizing a tax on high-value insurance plans and stripping out sweeteners aimed at winning Senate votes, such as a deal to fund Nebraska's Medicaid expansion, Democrats have indicated.
The Senate would need fewer votes to pass the changes—a simple majority compared with the 60 they would need to block a filibuster—and the House could pass the package of modifications with the Senate bill.

But many Democrats consider that a complicated scenario that would be difficult to pull off.
Democrats are also still considering some mechanisms to expand insurance coverage, such as by broadening the Medicaid federal-state insurance program for the poor, and by allowing young adults to stay on their parents' insurance policies until they reach their late 20s.

Write to Janet Adamy at janet.adamy@wsj.com
 

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President Barack Obama can look to a variety of models as he seeks to fulfill a pledge to fund state tort reform experiments, a longtime wish-list item for physicians, the New York Times reports. States have so far tried a few approaches, with mixed results, and considered more.

They include, a cap on non-economic damages supported by the American Medical Association; medical screening panels that "attempt to weed out frivolous suits;" "apology statutes" that ban physicians admission of error from being used as evidence in court; early compensation offers by physicians and hospitals that preclude law suits; safe harbor systems that protect doctors from law suits when they follow practice guidelines; birth funds that compensate families for childbirth injuries and are financed by physician surcharges; and, special medical courts that would approach malpractice cases with more specialized expertise (Underwood, 10/13).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

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President Obama yesterday spoke with Veterans in Arizona.  He told them that traumatic brain injury and PTSD are the new wounds of war.  Those veterans in Vietnam and other wars who came home only to have depression, alcohol abuse, job loss, and the other "dominoes"  that fall for veterans can be substantially dealt with if treatment is received early enough for veterans of Afghanistan and Iraq.  The government, according to the President, is creating a culture of caring for veterans.

An excellent piece on PTSD in the military and what is being done to address it can be seen by clicking here.

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