Family inHome Caregiving Blog

Health care costs are, unfortunately, something every senior has to worry about.  I wrote recently on my blog that Fidelity recently came out with a report stating that a 65-year old couple could expect to spend almost a quarter of a million dollars in out of pocket medical expenses throughout their retirement.  So I have been watching this trend closely and noted that S&P issued a press release on Friday nothing that data through March 12 shows:

The S&P Healthcare Economic Composite Index indicates that the average per capita cost of healthcare services covered by commercial insurance and Medicare programs increased by 5.68% over the 12-months ending March 2012;

Healthcare costs covered by commercial insurance plans, as measured by the S&P Healthcare Economic Commercial Index, increased by 7.84% over the year ending March 2012, up from +7.69% reported for February 2012;

As measured by the S&P Healthcare Economic Medicare Index, growth rates in Medicare claim costs rose by 2.41%, down from February 2012s +2.72%;

The Professional Services Medicare Index annual growth rate also decreased from its February 2012 rate of +5.68% to +5.58% in March; and

The Hospital Index annual growth rate increased marginally to 5.50% in March from its 5.49% February rate.

As you will notice, two of the indices are up, one is flat and the Medicare index is down slightly, but they all show significant inflation despite the fact that the index that the government uses to calculate increases in Social Security has shown no inflation in two of the past three years.  There is a concerted effort in Washington D.C. to switch to another index which would reduce the growth in future Social Security payments even further.  Seniors should be frustrated by the fact that the cost of every day goods and services continue to rise and yet the government wants to further reduce Social Security payments.  I am urging all of my clients at Family inHome Caregiving to get out and vote this year, or get an absentee ballot if they are unable to.  There are too many important issues at stake this year to sit and watch what happens in November from the sidelines.

Comments (0)     

Many people are confused when they go to the doctor when the physician discusses blood test results and refers to HDL (so called good cholesterol) versus LDL (so called bad cholesterol).  We're not the only ones!  A recent study showed that the jury may be out on whether HDL is actually good for you.  The theory that the medical community had before was that the more good cholesterol in your blood, the lower your risk of heart disease.  I've written a number of times recently on my blog about various research projects which have been done using a database of genetic information.  The most recent to be released studied this data and found that raising HDL levels might not make any difference in your risk for heart disease.  That's, well, disheartening.  The study, published in the journal The Lancet on Wednesday, found that people who inherit genes that give them naturally higher HDL have no less risk of heart disease than those without the genes.  The results were disturbing for those in the medical community as well as drug companies which are working on new drugs which would raise HDL.  So exercise, dieting or taking niacin might not do the good one thinks it would.  In fact a recent clinical trial found just that.  I would say the HDL hypothesis is on the ropes right now, Dr. James de Lemos, a professor at the University of Texas Southwestern Medical Center, told the New York Times.  Although the results of this study are a bummer because they could throw out the window what doctors have believed for years regarding heart disease, they show how powerful this genetic information which is being collected can be.   The data that was used in this study looked at more than 100,000 people so it was a very significant sample.  I'm sure more research will be done to try and unlock clues as to what causes heart disease.

Comments (0)     

My grandmother used to love a good cup of coffee, and she believed it was good for you too.  Although I was always skeptical of this, a new research study proves that she was right (she lived to be 97).  An article in the New England Journal of Medicine  said that those drinking coffee at the beginning of a 13-year study funded by the National Institutes of Health (NIH) were at a slightly lower risk of death than others.  What was surprising was that the coffee lovers lived longer despite the fact that they were more likely to smoke, eat red meat, drink more than three alcoholic beverage and less likely to exercise.  Researchers found that coffee may reduce the risk of stroke and coffee drinkers are less likely to die from some very specific causes including heart disease, respiratory problems, strokes, injuries and accidents, diabetes and infections. Coffee, however, was not found to help when it came to cancer.  Men who drank six or more cups of coffee per day had a 10% lower risk of death than non-coffee drinkers.  For women, it was 15%.  "It's interesting that coffee is more healthful than harmful," says Frank Hu, a professor at the Harvard School of Public Health.  But cardiologist Steve Nissen from the Cleveland Clinic said that coffee consumption over a 13-year period wasn't enough to give sound results.  Still, it's interesting.  Let's see if someone picks up on this research and studies coffee drinkers who also eat a healthy diet and exercise frequently.

Comments (0)     

An exciting new development in Alzheimer's Research was reported in the New York Times today.  Clinical trials will begin shortly to give Genentech's drug Crenezumab (which attacks amyolid plaques in the brain) to people that are genetically predisposed to develop Alzheimer's disease.  Scientists are hoping the new drug can stop the debilitating disease in its tracks.  Crenezumab is currently being tested in two clinical trials on people who have mild to moderate symptoms of dementia to try and discover whether it can help reduce cognitive decline or amyloid accumulation.  The study in Columbia will be "the first to focus on people who are cognitively normal but at very high risk for Alzheimer's disease," Dr. Francis Collings, Director of the National Institutes of Health (NIH) told the Times.    I wrote years ago about an extended family in a village in Columbia where, because they have a specific gene and have inbred, many of them start developing dementia in their 40's and 50's.  It's one of the most heart breaking stories I have ever read and profiled a woman who at the age of 82 was forced to take care of three children between the ages of 48 and 55 who all developed early onset dementia.  The woman had to feed them and change their diapers as she did when they were children.  When the Times profiled them in 2010, researchers were very excited about studying this pool of about 5,000 people.  However, drug cartels made the area too dangerous to travel in and the studies never came to fruition.  Thankfully, a $100 million five year study will now begin on 300 of these family members, some of which are in their 30's.   â€œBecause of this study, we do not feel as alone,â€� said Gladys Betancur, 39, a family member who will take part in the research project. Her mother passed away from Alzheimer’s disease, three of her siblings have developed symptoms, and she has had a hysterectomy because she fears having children that will develop the disease. “Sometimes we think that life is ending, but now we feel that people are trying to help us,â€� she told the Times.  The Obama Administration has made good on their pledge to ramp up funding for Alzheimer's research and pulled $50 million out of the NIH budget to research promising groups like the one in Columbia.  Genentech also pledged $65 million for the study, and $15 million is coming from private donors via the Banner Institute.  I applaud all of these groups both public and private.  A cure for this disease can't wait.  In addition to the pain and suffering inflicted on those suffering from the disease and their family members, it could in fact bankrupt Medicare if something isn't done soon.  Regular readers of my blog know that both my father and my grandmother had Alzheimer's disease when they passed away.  I am a big supporter of the Alzheimer's Association, which has a 24-hour help line at 800-272-3900.  They are also the largest private supporter of Alzheimer's research in the United States.  Please help them with their important mission if you can by clicking on this link for the Family inHome Caregiving fundraising site for Alzheimer's Association. 

Comments (0)     

I've written many times on my blog about the difficult time many seniors have making ends meet in their retirement years.  Costs are going up dramatically for things that seniors buy daily, while Social Security has only gone up once in three years.  Fidelity Investments recently released a report stating that health care costs for retirees have increased, on average, 6% per year since 2002.  It estimates a 65-year old couple would need $240,000 just to cover out of pocket medical expenses during their retirement years, about 35% of their Social Security checks.  And that doesn't include long-term care costs like the private duty caregiving services that we provide at Family inHome Caregiving.  Those services are only covered by Long Term Care (LTC) Insurance, which most people don't have.  "Today's workers must understand that the cost of health care is expected to continue rising in future years," Fidelity EVP Brad Kimler told USA Today.  Unfortunately, many baby boomers haven't factored in this huge expense when planning for retirement.  Most figure that Medicare will take care of them in their older years.  Unfortunately, it's not true.  If you are planning for retirement, talk to an investment advisor and get LTC Insurance if you can afford it.  This may be the only way for you to remain in your own home and independent if your health starts to fail. 

Comments (0)     

The State Coastal Commission this week approved the Pebble Beach Company's (PBC) request to do a major expansion.  The development which is coming includes 90 new homes, a 100-room hotel across from Spyglass Hill Golf Course, a 301-car parking garage and a 17,000 square-foot spa with 40 underground parking spaces.  It also includes expansion of existing resorts but the hoped for affordable housing is unlikely to come to fruition at the current site.  PBC set aside $4.5 million in fees to pay for its affordable housing commitment.  Although the Coastal Commission has been discussing with PBC having the affordable housing in the Del Monte Forest, it wasn't required and it's likely these units will be built elsewhere.  But anywhere nearby would be welcomed.  We continue to get calls from seniors looking for affordable housing on the Monterey Peninsula and it's definitely not easy to find.  PBC also committed to pay $1.8 million in fees for developing affordable accommodations for visitors elsewhere along the coast.  The plan still must be approved by Monterey County, and pressure may be on for the local government to oppose approving it without new affordable housing commitments.  "While we are pleased at the progress towards a better project, there is room for improvements," Amy White, executive director of Landwatch Monterey told The Wall Street Journal.  She said the plan needs to adequately address the need for more affordable housing.  I agree.  PBC had put forth a larger proposal about five years ago but was forced to scale back plans and commit to preserving 635 acres of the Del Monte Forest to get the backing of environmentalists, the Coastal Commission and others.  This commitment ensures there will be no more development on the massive parcel in Pebble Beach in the future.

Comments (0)     

The Wall Street Journal reported today that marketing had ceased for the well-known cholesterol drug Lipitor.  Owner Pfizer had been loath to give up the billions of dollars in revenue from the drug as its patent expired on November 30, 2011 and the drug went generic.  The company went to great lengths to protect this cash cow, marketing it directly to consumers.  It offered coupons to consumers that covered all but $4 of their co-pays, and had signed up 750K patients to have the pills mailed directly to their homes.  By the end of March, it had convinced 12% of users to keep taking Lipitor despite having their insurances companies try to persuade them to switch to a cheaper generic.  But it appears that the name brand just isn't enough for Pfizer to protect the brand.  After spending more than $87 million marketing the drug, Pfizer is throwing in the towel.  At its peak, Lipitor generated $12.9 billion/year in sales, so it's no surprise that the giant pharmaceutical would try this expensive experiment marketing against generics.  It was an interesting plan and not completely unsuccessful.  Pfizer managed to hang onto 33% market share and bring in $383 million in revenue in the first quarter despite generic competition.  But with a number of new companies bringing generic versions of the drug to market this year, Pfizer must not have thought this business line was sustainable over the long term. 

Comments (0)     

I've written recently on my blog about the potential dangers of some osteoporosis drugs.  A report in the New York Times said that, unfortunately, the Food & Drug Administration (FDA) has just published a new report suggesting caution regarding the long-term use of these drugs.  Published in The New England Journal of Medicine, the FDA did not give guidance regarding the use of bisphosphonates such as Fosamax, Boniva and Reclast.  However, the FDA said it's concerned that after years of use the drugs may, in rare cases, actually lead to weaker bones in some women.  This can lead to serious adverse events including unusual femur fractures, esophageal cancer and osteonecrosis of the jaw.  The latter causes a painful and disfiguring crumbling of the jaw bone.  The FDA is now stating that there is little benefit from using the drugs after three to five years.  Although these types of side effects are rare, the fact that effectiveness is questioned after three to five years is likely to lead to a widespread change in how Doctors prescribe these drugs.  My grandmother was on Fosamax for years and, thankfully, never developed any of these debilitating side effects.  However, with the number of drugs many of the elderly are being prescribed by their Doctors for various ailments, side effects often add up.  These drugs should be used with caution.

Comments (0)     

I am normally a big fan of original stories done by USA Today, but the one they wrote entitled Healthy Profits in Home Health missed the point by a wide margin.  Like many people, the writer confused the home health care industry and the private duty caregiving industry.  We are a part of the latter, while companies that we work with like Alliance Home Health are in the former category, although we do face similar struggles.  Both industries are under pressure as new competition enters the market, insurance rates rise, and the economy rebounds putting pressure on wages.  The home health industry is under even more pressure than private duty because they rely mostly on reimbursement from government programs like Medicare.  Reimbursement rates have been falling dramatically from government funded programs, and anyone relying on these to make a living feels the pressure.  The reporter referred to a 2009 National Private Duty Association NPDA survey even though there is a newer one which was just released last month.  It went on to quote Dorie Seavey, director of policy research at the Paraprofessional Healthcare Institute who is an advocate for new rules the Department of Labor wants to implement which would remove our overtime exemption.  "I find it really hard to reconcile that one of the most profitable sectors is pinching pennies when it comes to workers," said Seavey.  First of all, the most recent report from the NPDA shows the average profit for home health and private duty companies combined before taxes and before paying the owner is 21.5%.  Paying the owner a market rate salary and deducting taxes typically would bring this number into the single digits.  But this study only included those which paid to participate, and most of those surveyed were members of the NPDA.  These are typically larger agencies which are faring better and can afford to belong to a number of trade associations.  Factoring in smaller agencies which couldn't afford to participate in the survey would probably bring the industry margin closer to 15% before owners profit and taxes, and in the 5% range after taxes and paying the owner.  To suggest that this is one of the most profitable sectors and we are pinching pennies is just out of touch with reality.  But to Seavey's credit, she doesn't work for a private duty company so she's probably not aware or what the realities of the day to day struggles this industry faces.  Regular readers of my blog know that I have lobbied vehemently against bills at the state level (AB 889 and SB 411) which would have costs seniors more money, as well as the one Seavey is hoping passes this summer at the federal level, RIN 1235-AA05.  For further information, please read my series of blogs starting with RIN 1235-AA05 Another Attack On Seniors Trying To Remain Independent Part 1, Part 2 and Part 3.  As I wrote extensively on my blog, these rules will have terrible implications for seniors and will force many that want to stay at home to go into a nursing home or hire someone illegally.  Although cheaper than hiring someone through an agency initially, this puts them at risk of a lawsuit, IRS proceedings and many other liabilities and could cost them much more over the long run.  It's sad to see articles in the paper like this from people outside of our industry which don't realize the actual implications these laws and rulemakings would have on our seniors.  Haven't they suffered enough with the cuts already made at both the State and Federal levels?

Comments (0)     

Disabled veterans and others which have problems getting around are getting help from automobile and motorcycle manufacturers, according to Dave Hubbard, CEO of the National Mobility Equipment Dealers Association.  A recent article profiled a man left paraplegic by a roadside bomb in Afghanistan who now plans to drive his wife and 2-year old son on a tour of national parks and monuments.  They'll be doing so courtesy of a 2012 Ford Super Duty pickup which will be towing a fifth-wheel RV trailer, specially designed to be driven by a paraplegic.  However, it looks just like a normal pickup.  "You can get out on the road and feel the wind in your hair.  You're not stuck in your house.  You can get out in your RV and take your medical supplies with you," he told USA Today.  At Family inHome Caregiving, we have a number of clients that are disabled but still have sharp minds.  One of the things that makes people like this deteriorate more quickly than they should is if they sit at home without social interaction and exercise.  I applaud the many manufacturers which are making custom vehicles for those that are wheelchair bound.  Many buyers don't want vehicles that look like they are owned by someone disabled.  They just want to fit in.  This is congruent with our thinking at Family inHome Caregiving, where we don't force employees to wear uniforms or name badges like some competitors.  These seniors just want to be seen as part of the normal population.  They don't want to stick out in the crowd.  Let's give seniors and adults with disabilities the respect they deserve so they can live with dignity. 

Comments (0)