[lit-ideas] Re: States' Rights, Islamism, and the Cordoban Mosque

  • From: "Veronica Caley" <molleo1@xxxxxxxxxxx>
  • To: <lit-ideas@xxxxxxxxxxxxx>
  • Date: Tue, 17 Aug 2010 04:08:38 -0400

Robert: "Who signed 'release papers' and why were any required? Care facilities 
aren't prisons (unless you're in a locked Alzheimer's unit). If you were able 
to get out of bed, dress, and walk out the front door, I wonder how they 
thought they could prevent your doing so."

If one does not get a doctor to sign a release form, the insurance company and 
Medicare will not pay.  In the case I cited re my out-patient surgery, the 
whole thing was patently absurd or there was fraudulent intent.  Why would they 
want a person to stay hospitalized for two days only to have out-patient 
surgery the third day?  I was not intending to refuse treatment.  I just had to 
wait until Monday since my situation was not life threatening.

Sorry about the delay in response Robert.  I overlooked this as I have been 
preoccupied with an animal health crisis in one of our dogs.  Which is to say, 
as if it were one of our kids.  Which he sort of is.  And no Medicare for this 
little guy.

Veronica Caley 


  ----- Original Message ----- 
  From: Robert Paul 
  To: lit-ideas@xxxxxxxxxxxxx 
  Sent: Saturday, August 14, 2010 6:19 PM
  Subject: [lit-ideas] Re: States' Rights, Islamism, and the Cordoban Mosque


  Veronica Caley wrote


    Robert: I'm afraid I don't know what you mean when you say that people with 
Medicare are being 'pushed into hospitaliztion whether it is needed or not.' 

    Hospice medical care for dying patients : The New YorkerI read this article 
a few days ago.  One of the comments of the doctor was that the hospitals put 
pressure on doctors to admit patients, many of whom are terminal, in ICU, will 
never come out and nothing more can be made to help them.  And the really sad 
thing is that that isn't where they want to die, but many will.
  I've read the New Yorker piece and highly recommend it. There was to have 
been funding for counseling and support for terminally ill persons and their 
families in the recently-passed health care reform bill. This led to the 
Republicans' outcry over 'death panels,' (killing Grannie) and this provision 
was dropped. Patients, families, and doctors are left with the same tangled 
emotional/medical/psychological confusion and heartbreak described the article.


    My own personal experience: I was admitted to a hospital a year or so ago 
with an inflamed organ.  It required IV anti-biotic and out-patient surgery two 
days later.  The IV was administered over night on a Friday.  The inflammation 
was gone I was told, so I got up, dressed and waited for release.  To my 
surprise, they told me to stay the whole weekend for out-patient surgery on 
Monday.  When I argued, they finally signed release papers.

  Who signed 'release papers' and why were any required? Care facilities aren't 
prisons (unless you're in a locked Alzheimer's unit). If you were able to get 
out of bed, dress, and walk out the front door, I wonder how they thought they 
could prevent your doing so.


    My problems have never been with Medicare, but with providers.

    I had a knee replacement five years ago.  I was in an awful rehab facility 
and requested release.  It required two days, my connections with a health care 
VIP in another system, arguing with a doctor and starting to talk about 
lawyers.  All that finally got my release.  Then I met a woman who had been in 
the same situation, two years earlier, same story, same facility, but her 
lawyer actually turned up. 


  This talk of releases worries me. You had a right to leave rehab or to stop 
whatever treatment you were getting at any time. It's sad that your 
acquaintance had to have her lawyer intervene.
    
    Recently I had a friend in a rehab facility and her husband finally got her 
out because he thought she was going to die.  So far so good with her.

  Again, 'finally got her out,' is disturbing. I hope there's more to this 
story.

  In the spring of 2008 I broke my right femur. The EMTs took me to the ER of 
the hospital we go to and I was quickly x-rayed and moved to a regular room. An 
orthopedic surgeon came in and discussed things and I agreed to his putting 
some large titanium screws in me to hold the bone together. (They're still in 
place.) I couldn't be operated on that day because I'd had breakfast; the next 
day the surgeon did his work and I stayed in the hospital overnight. I was 
expecting to go home in the afternoon, but a nurse told me one of the 
physicians had asked that I stay another night because she wanted to do some 
sort of tests. I said, no, I thought I'd go home. When I entered the hospital 
I'd been giving an advance directive form and a copy of Oregon law on patients' 
rights. One phrase leaped out at me: under Oregon law a patient has 'the right 
to refuse any medical treatment or procedure.' I showed this to the nurse and 
she quickly, efficiently, and calmly rounded up the relevant forms, let the 
people concerned know I was on my way out, gave me a hug and said goodbye.

  Since we began this discussion, I've googled around and found that every 
state whose website I visited gives patients this right. You don't really need 
to invoke them though: Federal civil rights provisions cover this sort of 
thing. 
    
    What happens to people who can't afford a lawyer?  I also have other 
insurance, so that probably didn't help my cause.  In case anyone doesn't know, 
without release signed by a physician, insurance doesn't pay.

  No doctor can refuse to release you, if your state has a law governing 
patients' rights such as Oregon's. That is, a doctor might not, in fact, do it 
but he or she has an obligation to. Of course, if you refuse treatment, there's 
no treatment for which the insurance company would have to pay.

  Thanks for this conversation, Veronica.

  Robert

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