Is it Time for a Radical Paradigm Shift Seeking Economy in Care?
I have posted two articles in my archive. They are:
EXPECT TO BECOME POORER!
This post questions the very foundation of our economic system. Something is going very wrong in our country. Most of us can no longer afford to live here. The cost of care looked at through the prism of Dementia accentuates this fact. It isn't as though there is a shortage of capital sufficient to sustain all of us. It is a distribution that gives so much to 1% of our populace leaving the balance of 99% high and dry. Capitalism was not intended to give more to one group and little to another group. Certainly 1% vs 99% was not part of the plan that suggested each person competing with the next would keep each in check. Something happened on the way to the bank that is not been good for most of us.
If this problem is left unattended it will destroy us. The Senior Stampede is bringing the risk of destruction to a head. Should we do something about it or keep our heads firmly buried in the sand like a herd of Ostriches?
Historically, deep down historically, back 500 years as source, our culture has followed the rule of “Survival of the Fittest. This rule was based on the absolute right of man to compete one with another. It was believed that all men competing with one another would hold each other in check denying any one the advantage over another. Reliance on this automatic checkmate would secure for each man in the society the greatest return on his efforts. They called it capitalism.
Is this bold way still effective today? Whether or not we want to admit it:
- It is no longer protecting us;
- It is impairing and limiting all of us.
- That it limits all of us but for the rich who are accumulating more wealth.
- It is this accumulation by a specific few that is bringing the rest of us down.
- The rule of the survival of the fittest now exists for the benefit of a select few.
- It can be argued this has made the rule ineffectual.
We are entering an age that needs a new rule to follow. We need to put aside a belief that balance, fairness and good will come from getting “one up” on the guy next to you trusting the fairness of that. Fairness, equity in life, now need a new doctrine. That new doctrine calls on us to help one another. We take that guy next to us and instead of trying to be ahead, to be “one up,” we ask him: “What can I do to help, what can I do for you?”
What is capitalism as we know it in the U.S. doing for us? Unless you’re among the favored rich, it is not doing one thing. We are losing our income, purchasing power, savings and retirement every step we take. Prices keep going up and nothing seems to quell the onslaught of cost of living, particularly in Drug, Health Care and Health Insurance Costs.
If the cost doesn’t get you, and I do not know how it won’t, the financial crash of ‘08 or the two before that, the dot.com Crisis or the crash that followed 9-11-01, probably did.
All three of these crashes had their foundation in deregulation, risky and shoddy investments by Wall Street and the disregard shown by the financial industry for those it is supposed to serve, namely, us.
It is in the aftermath, in this toxic climate those of us affected by Dementia are forced to look at Professional and Long Term Health Care. Its cost is unreasonably expensive, prohibitively so, and confiscatory of the life savings of the people faced with paying it.
It is the middle class this hits like a runaway train. The rich have the disposable income for it, the poor have Medicaid, however long that program lasts. The rest of us have whatever we saved, whatever we have for retirement, not protected by the few protected pension funds that have existed and survive the cutbacks the employers and backers are now making of them.
It is the middle class that pays for it. It is the joint obligation of both the husband and wife. It is their obligation if one of them needs In-Home Professional Care, Assisted Living Care or Nursing Home Care. When the spouses funds are paid down to the level of qualification for Medicaid, if Medicaid then continues to exist, Government, if it is still solvent, will pick up the cost.
This is wonderful until you start thinking of the other spouse who is left with little or nothing to live on.
Dementia will not go away. Ultimately most of us will need In-Home Professional Care, Assisted Living or Nursing Home Care. The first way to insulate us from the cost is to work whatever programs available while in the Early Stage of Dementia to prolong that Early Stage.
Prolonging Early stage produces saving on the Cost of Care all the way around. It also enhances the quality of life of the one afflicted and the affected around him/her.
We need to find Economy in the Cost of Care when it comes time for In-Home Professional Care, Assisted Living or Nursing Home Care. The current way of doing it is far too costly. We must look for and put together a less expensive way of doing it.
Currently 65% of the Assisted Living and Nursing Home Care facilities are owned by for-profit Corporations. For supposed economy they are built large, services are made uniform; one model fits all, what I like to call homogenization. They are Big Box, too many are the profit making creatures of Wall Street, too often sold with subsidy obtained by lobbyists working government.
Once formulated they are then commission sold, marketed as investment packages and marketed as investment throughout the county. They have financial aid in place to build large and expensive infrastructure for which fees are paid lawyers, salaries, commissions or cuts to building contractors, organizers, building and management consultants, land acquisition that turns profit in a variety of ways, all of which is absorbed in the cost of acquisition and as development fees.
All of the money is leveraged in by the speculators forming each system. That money is borrowed by the speculators, taken as investments in marketable chits of one kind or another, or received as subsidy from government. It is a much longer list but starts with the above.
Each step of income is accompanied by a step of outgo as salaries, fees, commissions, and a whole variety of vehicles used as return to the organizers and developers. The repayment of all of this is leveraged down to the ultimate operator and people served.
The people served are us.
The end result of this leaves the operator short of money after payment for services for operation and providing the services paid for. The fees for service are high, the return on the high fees paid for service are negligible.
It comes down to this proposition. We can’t afford to pay the going rate. If we do, too much of the percentage of what we pay goes to payment of return on investment and not to operation and service.
This is the reason we need to re-invent this wheel. It is this that needs a new design. I will in subsequent posts discuss ways that might be considered.
The field of Long Term Health Care readily evidences the fault of capitalism let loose to run wild. There is just too much profit for too little service. We need to devise a way to help one another as make a profit off one another.
The balance is gone that once protected everyone in our capitalistic system. The system has been rigged where one segment has the advantage over all the other segments. We are not protected from the imbalance of the system according the rich the ability to take more at our expense.
It is done at the expense of helping one another that is not now being done.
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