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Firefighters say they’re swamped by calls for routine care from senior homes

oregonlive.com

171–180 of 227 posts

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#171
post #133

Earlier quoted context omitted.

Medicare doesn't use QALY thresholds to decide which treatments to cover. From a pure economic efficiency standpoint it probably should, but the politics around care rationing are so toxic that it can't be done.

Medicare doesn’t cover every orphan drug known to exist so surely they must? Unless they technically do for every drug, with some enormous caveats that effectively bars coverage?

They cover some treatments and not others, but those decisions are made through debate and politics, not QALY measures.

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#172

Earlier quoted context omitted.

> call-out fee for frivolous calls Sounds like a typical neoliberal "free market" non-solution.

This snarky reply isn't a rebuttal of any substance. A frivolous call-out fee is a clear and simple solution. If you fix the price then the problem goes away because the incentive for the frivolous call-out no longer exists. It's cheaper for them to hire another staff member than rely on the fire department.

It's not a solution. The problem is that emergency services aren't always available to those who need them; if you attach the possibility of a fee to the service then you have ensured that problem exists forever.

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#173
post #121

Earlier quoted context omitted.

Not only that, but the United States' shift in mindset toward disinvestment came about during the civil rights era. Not hard to read between the lines in e.g. https://files.eric.ed.gov/fulltext/ED050960.pdf :/ "The time has come to ask what level of population growth is good for the United States. There was a period when rapid growth made better sense as we sought to settle a continent and build a modern industrial N…

I think the Club of Rome were the first major international policy group to take resource finitude seriously. Although I read a bit of their final report, and their projections were ridiculous and we've already blown well past them with no trouble at all. https://en.m.wikipedia.org/wiki/The_Limits_to_Growth

Not sure i agree with no trouble at all. It is done at great cost to the environment, and to ourselves.

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#174

Senior homes and assisted living centers are a national disgrace. They are entirely about profit maximization (what business isn’t?), and as such hire people at the exact minimum and have well over 100% yearly turnover. The staff commonly steal from residents, and the management do not care. They’d rather retain a larcenous pig who barely executes her duties than have to go back and scrape the barrel for a replacemen…

> Whoever spread that “death panels” meme should be forced to write America a check for five hundred billion dollars. Alaska governor and 2008 Republican Vice President candidate Sarah Palin started the “death panels” farse. See: https://en.m.wikipedia.org/wiki/Death_panel It’s quite disgusting as she is a mother with a disabled child.

What I found odd about that discussion or claim is that we have essentially the same system already, but it's operated by for-profit corporations rather than the government. As you probably know, insurance companies will fight you literally to your death to avoid paying for treatments that doctors say are necessary.

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#175

Earlier quoted context omitted.

Capitalism can't save this. This is fundamentally a social decay problem. Modern social behavior sweeps all "unpleasant" grief under the carpet. Out of place out of mind.

I’m fairly certain people of all classes, ranks, and social situations in ancient Mesopotamia, China, India, and Egypt sometimes swept ‘unpleasant’ grief under the carpet too… unless you have some credible reason to believe otherwise?

The proportion of multi-generational homes in modern western cultures is far lower, and the emphasis on taking care of your parents as a sacred social duty is gone. I'm sure that there were plenty of individuals in those historic cultures who fell short of what was expected, but widespread care homes are a relatively recent change.

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#176

Earlier quoted context omitted.

The necessary innovation is ethical/political. People over age 80 should be able to request to medically cease their life for any reason.

You can buy gun. Why do you have to request anything?

Someone has to clean up incidents such as that. I've known people who worked for companies who were contracted to clean up homicides and suicides (ServiceMaster). They were kids barely out of high school and the experience was traumatizing for them.

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#177
post #172

Earlier quoted context omitted.

This snarky reply isn't a rebuttal of any substance. A frivolous call-out fee is a clear and simple solution. If you fix the price then the problem goes away because the incentive for the frivolous call-out no longer exists. It's cheaper for them to hire another staff member than rely on the fire department.

It's not a solution. The problem is that emergency services aren't always available to those who need them; if you attach the possibility of a fee to the service then you have ensured that problem exists forever.

Many places outside the US have a fee associated with call outs (Australia), not even just frivolous call outs, and there's no issue.

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#178

If there is an industry that needs startups, it is long term care and senior care in general. Expensive, nearly universally badly done, and it seems like a lot of people could stay in their homes with some automated appliances/thoughtful redesigns of everyday items. Hoping that when my grandparents start needing it in 5-10 years that the options have dramatically improved.

> with some automated appliances/thoughtful redesigns Can you give some examples? I guess I can start: something that monitors gas cookers, which already exists: iguardfire.com

> I guess I can start: something that monitors gas cookers, which already exists: iguardfire.com

Induction stoves are the much better option here. They will only heat up ferromagnetic material (i.e. actual pots and pans) and most can sense when nothing is on them and turn off automatically.

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#179

Senior homes and assisted living centers are a national disgrace. They are entirely about profit maximization (what business isn’t?), and as such hire people at the exact minimum and have well over 100% yearly turnover. The staff commonly steal from residents, and the management do not care. They’d rather retain a larcenous pig who barely executes her duties than have to go back and scrape the barrel for a replacemen…

> They are entirely about profit maximization (what business isn’t?), [...]

And yet, most businesses are rather pleasant to deal with. Perhaps it's something other than the desire for profit that makes them so awful?

(Btw, there are also not-for-profit senior home and assisted living centres around the world. They aren't necessarily better.)

Re: Firefighters say they’re swamped by calls for routine care from senior homes

#180
post #172

Earlier quoted context omitted.

It's not a solution. The problem is that emergency services aren't always available to those who need them; if you attach the possibility of a fee to the service then you have ensured that problem exists forever.

Many places outside the US have a fee associated with call outs (Australia), not even just frivolous call outs, and there's no issue.

Ah yes Australia, that noted bastion of equality where there is definitely no social underclass.
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