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eavesdropper
Participant[quote=CA renter][quote=eavesdropper]
CAR, wish I had your faith, but I fear that if most of the citizenry started to design their own houses, it would be worse than what most of the big developers are doing.They’d have to start a new magazine: “Architectural InDIGESTion” (yeah, I know…that’s really bad. But it’s late in the day here in the east).
Call me a snob. But trust me on this one. If you want to get an idea of what happens when people have a construction loan, a yen to be a “designer”, and a little time on their hands, click on the link: http://homesoftherich.net/2009/06/inside-teresa-giudices-new-jersey-mansion.html
*Don’t miss the video house tour halfway down the page. See something you just gotta have? Link to the catalog for the October 3 bankruptcy auction:
http://www.ajwillnerauctions.com/index.cfm?AuctionID=559&fuseaction=home.auctionDetails%5B/quote%5D
Funny. 🙂 You’d be surprised how many spec houses around here try to look just like that.
Nothing says “tacky” quite like this does:
http://www.ajwillnerauctions.com/index.cfm?fuseaction=home.viewItem&AuctionID=559&ItemID=15
——————-Yes, I try to have faith in my fellow (wo)man. 🙂
There are lots of beautiful custom homes in some of the older neighborhoods. Wouldn’t it be great if we could get back to those standards again?[/quote]
It’s amazing, isn’t it? That huge mirror makes the vanity look like doll furniture. My person fave was this one:
http://www.ajwillnerauctions.com/index.cfm?fuseaction=home.viewItem&AuctionID=559&ItemID=12
I’m not even sure what the hell that IS! Looks like a giant chess piece. What really impressed me are the mold lines in the resin. After all, if you’re going to pay for quality, you want it to be in clear evidence.
And I confess to having my head turned (or was it my stomach) by the cherub on the floor in front of the fireplace: the creative use of a variety of metal finishes does it for me.
Don’t know if any Piggs are “fans” of the Bravo TV “Housewives” series, but these are pix from the short-term home of New Jersey-residing, dinner table-flipping, Medusa-like serpent-haired Teresa Giuduce. While she was conducting her new home tour for the less-fortunate members of her show’s audience, news reports were appearing that she and her husband were in bankruptcy court, having dropped $11 million in the previous year (on an income of $16,000/month, some of which was provided by relatives). Thus, your chance at getting some of the prized Giuduce booty for your own little slice of New Jersey.
Yes, CAR, there are some really great older custom homes out there. Here in the east, we have some going back to the 1700s. But it was criminal seeing what people were doing to them in the 90s and early aughts. Armed with HELOCS, they replaced hand-planed chestnut siding with vinyl, ripped out wide-plank heart-pine floors in favor of Brazilian cherry, put fake “Craftsman-style” facades on Victorians, and any number of heartbreaking “improvements.
They changed the character of entire cities here. Bethesda was a lovely near-DC suburb with large shade trees and other lush foliage, and loads of lovely tasteful family homes built between 1900 and 1960. Many were considered generously-sized for their day (2000+ square feet), and were balanced with their lot size (1/4 acre to 1 acre).
Bethesda has always been an in-demand area, not only because of its aesthetics, but because of its proximity to both DC and to large government installations like the NIH and Bethesda Naval Hospital. In the 90s, however, people started snatching up existing homes, and deciding that an additional 2500 sq ft wing would not be adequate for a family of four, they began to tear down the Victorians and the Craftsmans, the center-hall colonials and the mid-century ranchers. In their places rose McMansion monstrosities of 7000 and 8000 sf. Some houses that had boasted expansive tree-shaded front and back lawns, suddenly had room for only a few limited-growth shrubs in front. Lovely stone and brick facades were replaced with garage doors that fronted parking for 4 or 5 oversized vehicles, with lots of blacktop for overflow. Homes that had been a couple hundred feet apart from each other now had windows that permitted homeowners to see what their neighbor was cooking for dinner.
Many Bethesda residents were concerned about the changes to the character of their neighborhoods, but found little responsiveness to their pleas for restraint. Comparing aerial photos of these neighborhoods today with those of 1980 is shocking and saddening. In the meantime, many of these McMansions are on the market, and finding buyers for them is no easy task.
I have to laugh (or cry!) at the interpretation of architectural terms these days. I’m sorry, but nothing over 2000 sf should be termed a “cottage”. Here’s an excerpt from the website of a builder in the DC area:
“The Craftsman lifestyle offers friendly streetscapes and sensible, ecologically oriented homes that nurture families.” Not sure how you accomplish “friendly streetscapes” when you stuff a 5400 sf “bungalow” onto a 8300 sf lot. Sounds like more of a “bungalot” to me.
These architectural philosophers go on to say, “The antithesis of the “McMansion”, Arts & Crafts Builders’ homes are deliberately smaller, very comfortable inside and extremely efficient, cozy, and energy efficient. They are luxury homes but not in terms of size.” Pardon me, but when did 4000 or 5000 sf become “cozy”?
Some additional pearls of wisdom: “Mutt and Jeff decided from the start that they would not sacrifice quality for size. They committed themselves to building a comparatively smaller home (3,500 to 4,500 sqft) in order to deliver a higher quality product overall. The homes they build are luxury homes due to their superior components and finishes.”
These guys have actually built some of the better-looking structures – but keep in mind that everything is relative……There have always been ugly and tasteless homes out there. Lots of them. The difference is that they were smaller, and typically build on appropriately-sized lots. Nowadays you’ve got builders erecting 14 or 15 5,000 sf McMansions on 2.5 acres. There are several areas of gorgeous pristine rolling pastureland near where I live where they’ve done this, and these little mini-developments are made even more prominent and garish by the large amounts of open acreage around them. Many houses are still in the process of being built while their next door neighbors are in short sale proceedings.
Someone stop the madness!!
September 25, 2010 at 9:43 AM in reply to: OT: Anyone hear the NPR interview about the person getting dependant care coverage from parents #609265Participant[quote=bearishgurl][quote=SK in CV][quote=bearishgurl]SK in CV, I don’t know how 60 minutes came to that conclusion, then. IMO, insurance companies and Medicare should be willing to pay for hospice up to six months or about $50K. Acc. to 60 minutes, that’s roughly five days in the ICU.[/quote]
Not sure, I’ll take a look at the video later. But the date on the article is 11/22/09. The bill underwent hundreds, maybe thousands of changes before it passed 4 months later.
Medicare does pay for hospice. As does most private medical insurance (in addition to Medi-Cal and TRICARE). For those uninsured or covered by private insurance that doesn’t include hospice care, hospice care is still available at little or no cost for those that can’t afford it.[/quote]
This is very good to know. Thank you, SK in CV![/quote]
Actually, I heard quite a bit of discussion about hospice/end-of-life options from some of the politicians who were proponents of the health reform bill. It’s not surprising that it didn’t make it into the forefront of media coverage at that time. After all, calm and reasoned discourse about a humane and relatively inexpensive way to care for terminally-ill patients can never hope to trump visions of death panels by politicians and attendees alike at Jerry Springer-like town hall meetings when a news show producer is selecting footage.
Medicare has been quite good about encouraging and covering hospice care for some time now. Again, most Americans, including our esteemed lawmakers, are woefully uneducated about the health care delivery system in which they are seeking to make profound change. Most know absolutely nothing about the hospice option, since they, or members of their family, have not been in a position to require it. However, Medicare policymakers have recognized both the economic and sociological advantages.
This happens in situations where the legal obligation to provide across-the-board services exists. Private health insurance companies are well aware of the cost advantages of hospice over hospitalization. However, no end-of-life care is far cheaper than hospice, and private insurers have that option.
When physicians stop cure-centered treatment of a patient, either because none exists or because the patient/family has requested it, the patient enters the realm of palliative care. Most private health insurance carriers will not provide coverage of palliative care-related hospitalization. The hospital alerts the family that there will be no further third-party payments, and the family then has the options of moving the patient to an assisted-care facility, to a hospice provider, or to their home where they will have to provide the patient’s care themselves (they also have the option of leaving the patient in the hospital and paying the entire bill themselves).
While there are some private carriers who do assist in paying for some or all of these options, many do not. There’s no financial incentive for them to do so. They know that the patient’s family will continue to pay the premiums until the patient’s death, so they’re not concerned about loss of income. They realize that the patient’s family will probably provide the care if forced into it by cost. But, overall, what happens to the terminally-ill patient is of little concern to them.
This disparity between Medicare and private health insurers is due to demographics. Medicare is an entity whose enrollees are, overall, much older, and their illnesses tend to be more serious and complex than those affecting younger people (below age 60), and the age- and lifestyle-related deterioration in their physiologic systems cause more negative reactions to treatment. Because Medicare is a congressionally-mandated program which ostensibly offers the same coverage to all, and because the vast majority of enrollees requires advanced (read as expensive) care, it is essential that Medicare exercise some creativity in finding ways to reduce their costs while providing mandated care for patients. Enter hospice care.
Private insurers are under no such obligation. They’ve winnowed out as much of the risk as possible by refusing to enroll at-risk people (including those with at-risk spouses and children), creating a very favorable risk pool. On the rare occasions that one of the enrollees develops metastatic cancer, or a heart condition, or an autoimmune disorder, the focus is not on finding cost-effective ways of providing health care for that patient, but on not paying for care at all. From the moment that diagnosis code is entered in their system, the patient is subjected to special attention from their insurer: receiving letters questioning their eligibility (even though they’ve been paying premiums for 20 years, without using benefits), denial of coverage for myriad reasons, and, often, termination of their coverage. Even in cases where the insurer is legally obligated to provide contracted services, they will often refuse to do so, attempting to delay such time as they have to part with money. They are hoping to hit the jackpot, and often do: the patient is too sick, and their families are too inexperienced or too busy to maneuver thru the morass, and they simply give up fighting.
I believe this is the reason for much of the public’s aversion to health reform: circumstances in their lives have been such that they have not experienced a need for major health care services. As such, they cannot be expected to know that, not only is the deck stacked against them if they should become ill, but that the current “system” is unsustainable in the wake of the health care tsunami headed our way in another few years when half the Boomer population is over 70. Spurred on by opportunistic politicians, corporate executives, and media talking heads, they’ve been worked up a ill-informed lather that will work against their interests and those of their families in the future.
September 25, 2010 at 9:43 AM in reply to: OT: Anyone hear the NPR interview about the person getting dependant care coverage from parents #609351Participant[quote=bearishgurl][quote=SK in CV][quote=bearishgurl]SK in CV, I don’t know how 60 minutes came to that conclusion, then. IMO, insurance companies and Medicare should be willing to pay for hospice up to six months or about $50K. Acc. to 60 minutes, that’s roughly five days in the ICU.[/quote]
Not sure, I’ll take a look at the video later. But the date on the article is 11/22/09. The bill underwent hundreds, maybe thousands of changes before it passed 4 months later.
Medicare does pay for hospice. As does most private medical insurance (in addition to Medi-Cal and TRICARE). For those uninsured or covered by private insurance that doesn’t include hospice care, hospice care is still available at little or no cost for those that can’t afford it.[/quote]
This is very good to know. Thank you, SK in CV![/quote]
Actually, I heard quite a bit of discussion about hospice/end-of-life options from some of the politicians who were proponents of the health reform bill. It’s not surprising that it didn’t make it into the forefront of media coverage at that time. After all, calm and reasoned discourse about a humane and relatively inexpensive way to care for terminally-ill patients can never hope to trump visions of death panels by politicians and attendees alike at Jerry Springer-like town hall meetings when a news show producer is selecting footage.
Medicare has been quite good about encouraging and covering hospice care for some time now. Again, most Americans, including our esteemed lawmakers, are woefully uneducated about the health care delivery system in which they are seeking to make profound change. Most know absolutely nothing about the hospice option, since they, or members of their family, have not been in a position to require it. However, Medicare policymakers have recognized both the economic and sociological advantages.
This happens in situations where the legal obligation to provide across-the-board services exists. Private health insurance companies are well aware of the cost advantages of hospice over hospitalization. However, no end-of-life care is far cheaper than hospice, and private insurers have that option.
When physicians stop cure-centered treatment of a patient, either because none exists or because the patient/family has requested it, the patient enters the realm of palliative care. Most private health insurance carriers will not provide coverage of palliative care-related hospitalization. The hospital alerts the family that there will be no further third-party payments, and the family then has the options of moving the patient to an assisted-care facility, to a hospice provider, or to their home where they will have to provide the patient’s care themselves (they also have the option of leaving the patient in the hospital and paying the entire bill themselves).
While there are some private carriers who do assist in paying for some or all of these options, many do not. There’s no financial incentive for them to do so. They know that the patient’s family will continue to pay the premiums until the patient’s death, so they’re not concerned about loss of income. They realize that the patient’s family will probably provide the care if forced into it by cost. But, overall, what happens to the terminally-ill patient is of little concern to them.
This disparity between Medicare and private health insurers is due to demographics. Medicare is an entity whose enrollees are, overall, much older, and their illnesses tend to be more serious and complex than those affecting younger people (below age 60), and the age- and lifestyle-related deterioration in their physiologic systems cause more negative reactions to treatment. Because Medicare is a congressionally-mandated program which ostensibly offers the same coverage to all, and because the vast majority of enrollees requires advanced (read as expensive) care, it is essential that Medicare exercise some creativity in finding ways to reduce their costs while providing mandated care for patients. Enter hospice care.
Private insurers are under no such obligation. They’ve winnowed out as much of the risk as possible by refusing to enroll at-risk people (including those with at-risk spouses and children), creating a very favorable risk pool. On the rare occasions that one of the enrollees develops metastatic cancer, or a heart condition, or an autoimmune disorder, the focus is not on finding cost-effective ways of providing health care for that patient, but on not paying for care at all. From the moment that diagnosis code is entered in their system, the patient is subjected to special attention from their insurer: receiving letters questioning their eligibility (even though they’ve been paying premiums for 20 years, without using benefits), denial of coverage for myriad reasons, and, often, termination of their coverage. Even in cases where the insurer is legally obligated to provide contracted services, they will often refuse to do so, attempting to delay such time as they have to part with money. They are hoping to hit the jackpot, and often do: the patient is too sick, and their families are too inexperienced or too busy to maneuver thru the morass, and they simply give up fighting.
I believe this is the reason for much of the public’s aversion to health reform: circumstances in their lives have been such that they have not experienced a need for major health care services. As such, they cannot be expected to know that, not only is the deck stacked against them if they should become ill, but that the current “system” is unsustainable in the wake of the health care tsunami headed our way in another few years when half the Boomer population is over 70. Spurred on by opportunistic politicians, corporate executives, and media talking heads, they’ve been worked up a ill-informed lather that will work against their interests and those of their families in the future.
September 25, 2010 at 9:43 AM in reply to: OT: Anyone hear the NPR interview about the person getting dependant care coverage from parents #609908Participant[quote=bearishgurl][quote=SK in CV][quote=bearishgurl]SK in CV, I don’t know how 60 minutes came to that conclusion, then. IMO, insurance companies and Medicare should be willing to pay for hospice up to six months or about $50K. Acc. to 60 minutes, that’s roughly five days in the ICU.[/quote]
Not sure, I’ll take a look at the video later. But the date on the article is 11/22/09. The bill underwent hundreds, maybe thousands of changes before it passed 4 months later.
Medicare does pay for hospice. As does most private medical insurance (in addition to Medi-Cal and TRICARE). For those uninsured or covered by private insurance that doesn’t include hospice care, hospice care is still available at little or no cost for those that can’t afford it.[/quote]
This is very good to know. Thank you, SK in CV![/quote]
Actually, I heard quite a bit of discussion about hospice/end-of-life options from some of the politicians who were proponents of the health reform bill. It’s not surprising that it didn’t make it into the forefront of media coverage at that time. After all, calm and reasoned discourse about a humane and relatively inexpensive way to care for terminally-ill patients can never hope to trump visions of death panels by politicians and attendees alike at Jerry Springer-like town hall meetings when a news show producer is selecting footage.
Medicare has been quite good about encouraging and covering hospice care for some time now. Again, most Americans, including our esteemed lawmakers, are woefully uneducated about the health care delivery system in which they are seeking to make profound change. Most know absolutely nothing about the hospice option, since they, or members of their family, have not been in a position to require it. However, Medicare policymakers have recognized both the economic and sociological advantages.
This happens in situations where the legal obligation to provide across-the-board services exists. Private health insurance companies are well aware of the cost advantages of hospice over hospitalization. However, no end-of-life care is far cheaper than hospice, and private insurers have that option.
When physicians stop cure-centered treatment of a patient, either because none exists or because the patient/family has requested it, the patient enters the realm of palliative care. Most private health insurance carriers will not provide coverage of palliative care-related hospitalization. The hospital alerts the family that there will be no further third-party payments, and the family then has the options of moving the patient to an assisted-care facility, to a hospice provider, or to their home where they will have to provide the patient’s care themselves (they also have the option of leaving the patient in the hospital and paying the entire bill themselves).
While there are some private carriers who do assist in paying for some or all of these options, many do not. There’s no financial incentive for them to do so. They know that the patient’s family will continue to pay the premiums until the patient’s death, so they’re not concerned about loss of income. They realize that the patient’s family will probably provide the care if forced into it by cost. But, overall, what happens to the terminally-ill patient is of little concern to them.
This disparity between Medicare and private health insurers is due to demographics. Medicare is an entity whose enrollees are, overall, much older, and their illnesses tend to be more serious and complex than those affecting younger people (below age 60), and the age- and lifestyle-related deterioration in their physiologic systems cause more negative reactions to treatment. Because Medicare is a congressionally-mandated program which ostensibly offers the same coverage to all, and because the vast majority of enrollees requires advanced (read as expensive) care, it is essential that Medicare exercise some creativity in finding ways to reduce their costs while providing mandated care for patients. Enter hospice care.
Private insurers are under no such obligation. They’ve winnowed out as much of the risk as possible by refusing to enroll at-risk people (including those with at-risk spouses and children), creating a very favorable risk pool. On the rare occasions that one of the enrollees develops metastatic cancer, or a heart condition, or an autoimmune disorder, the focus is not on finding cost-effective ways of providing health care for that patient, but on not paying for care at all. From the moment that diagnosis code is entered in their system, the patient is subjected to special attention from their insurer: receiving letters questioning their eligibility (even though they’ve been paying premiums for 20 years, without using benefits), denial of coverage for myriad reasons, and, often, termination of their coverage. Even in cases where the insurer is legally obligated to provide contracted services, they will often refuse to do so, attempting to delay such time as they have to part with money. They are hoping to hit the jackpot, and often do: the patient is too sick, and their families are too inexperienced or too busy to maneuver thru the morass, and they simply give up fighting.
I believe this is the reason for much of the public’s aversion to health reform: circumstances in their lives have been such that they have not experienced a need for major health care services. As such, they cannot be expected to know that, not only is the deck stacked against them if they should become ill, but that the current “system” is unsustainable in the wake of the health care tsunami headed our way in another few years when half the Boomer population is over 70. Spurred on by opportunistic politicians, corporate executives, and media talking heads, they’ve been worked up a ill-informed lather that will work against their interests and those of their families in the future.
September 25, 2010 at 9:43 AM in reply to: OT: Anyone hear the NPR interview about the person getting dependant care coverage from parents #610018Participant[quote=bearishgurl][quote=SK in CV][quote=bearishgurl]SK in CV, I don’t know how 60 minutes came to that conclusion, then. IMO, insurance companies and Medicare should be willing to pay for hospice up to six months or about $50K. Acc. to 60 minutes, that’s roughly five days in the ICU.[/quote]
Not sure, I’ll take a look at the video later. But the date on the article is 11/22/09. The bill underwent hundreds, maybe thousands of changes before it passed 4 months later.
Medicare does pay for hospice. As does most private medical insurance (in addition to Medi-Cal and TRICARE). For those uninsured or covered by private insurance that doesn’t include hospice care, hospice care is still available at little or no cost for those that can’t afford it.[/quote]
This is very good to know. Thank you, SK in CV![/quote]
Actually, I heard quite a bit of discussion about hospice/end-of-life options from some of the politicians who were proponents of the health reform bill. It’s not surprising that it didn’t make it into the forefront of media coverage at that time. After all, calm and reasoned discourse about a humane and relatively inexpensive way to care for terminally-ill patients can never hope to trump visions of death panels by politicians and attendees alike at Jerry Springer-like town hall meetings when a news show producer is selecting footage.
Medicare has been quite good about encouraging and covering hospice care for some time now. Again, most Americans, including our esteemed lawmakers, are woefully uneducated about the health care delivery system in which they are seeking to make profound change. Most know absolutely nothing about the hospice option, since they, or members of their family, have not been in a position to require it. However, Medicare policymakers have recognized both the economic and sociological advantages.
This happens in situations where the legal obligation to provide across-the-board services exists. Private health insurance companies are well aware of the cost advantages of hospice over hospitalization. However, no end-of-life care is far cheaper than hospice, and private insurers have that option.
When physicians stop cure-centered treatment of a patient, either because none exists or because the patient/family has requested it, the patient enters the realm of palliative care. Most private health insurance carriers will not provide coverage of palliative care-related hospitalization. The hospital alerts the family that there will be no further third-party payments, and the family then has the options of moving the patient to an assisted-care facility, to a hospice provider, or to their home where they will have to provide the patient’s care themselves (they also have the option of leaving the patient in the hospital and paying the entire bill themselves).
While there are some private carriers who do assist in paying for some or all of these options, many do not. There’s no financial incentive for them to do so. They know that the patient’s family will continue to pay the premiums until the patient’s death, so they’re not concerned about loss of income. They realize that the patient’s family will probably provide the care if forced into it by cost. But, overall, what happens to the terminally-ill patient is of little concern to them.
This disparity between Medicare and private health insurers is due to demographics. Medicare is an entity whose enrollees are, overall, much older, and their illnesses tend to be more serious and complex than those affecting younger people (below age 60), and the age- and lifestyle-related deterioration in their physiologic systems cause more negative reactions to treatment. Because Medicare is a congressionally-mandated program which ostensibly offers the same coverage to all, and because the vast majority of enrollees requires advanced (read as expensive) care, it is essential that Medicare exercise some creativity in finding ways to reduce their costs while providing mandated care for patients. Enter hospice care.
Private insurers are under no such obligation. They’ve winnowed out as much of the risk as possible by refusing to enroll at-risk people (including those with at-risk spouses and children), creating a very favorable risk pool. On the rare occasions that one of the enrollees develops metastatic cancer, or a heart condition, or an autoimmune disorder, the focus is not on finding cost-effective ways of providing health care for that patient, but on not paying for care at all. From the moment that diagnosis code is entered in their system, the patient is subjected to special attention from their insurer: receiving letters questioning their eligibility (even though they’ve been paying premiums for 20 years, without using benefits), denial of coverage for myriad reasons, and, often, termination of their coverage. Even in cases where the insurer is legally obligated to provide contracted services, they will often refuse to do so, attempting to delay such time as they have to part with money. They are hoping to hit the jackpot, and often do: the patient is too sick, and their families are too inexperienced or too busy to maneuver thru the morass, and they simply give up fighting.
I believe this is the reason for much of the public’s aversion to health reform: circumstances in their lives have been such that they have not experienced a need for major health care services. As such, they cannot be expected to know that, not only is the deck stacked against them if they should become ill, but that the current “system” is unsustainable in the wake of the health care tsunami headed our way in another few years when half the Boomer population is over 70. Spurred on by opportunistic politicians, corporate executives, and media talking heads, they’ve been worked up a ill-informed lather that will work against their interests and those of their families in the future.
September 25, 2010 at 9:43 AM in reply to: OT: Anyone hear the NPR interview about the person getting dependant care coverage from parents #610331Participant[quote=bearishgurl][quote=SK in CV][quote=bearishgurl]SK in CV, I don’t know how 60 minutes came to that conclusion, then. IMO, insurance companies and Medicare should be willing to pay for hospice up to six months or about $50K. Acc. to 60 minutes, that’s roughly five days in the ICU.[/quote]
Not sure, I’ll take a look at the video later. But the date on the article is 11/22/09. The bill underwent hundreds, maybe thousands of changes before it passed 4 months later.
Medicare does pay for hospice. As does most private medical insurance (in addition to Medi-Cal and TRICARE). For those uninsured or covered by private insurance that doesn’t include hospice care, hospice care is still available at little or no cost for those that can’t afford it.[/quote]
This is very good to know. Thank you, SK in CV![/quote]
Actually, I heard quite a bit of discussion about hospice/end-of-life options from some of the politicians who were proponents of the health reform bill. It’s not surprising that it didn’t make it into the forefront of media coverage at that time. After all, calm and reasoned discourse about a humane and relatively inexpensive way to care for terminally-ill patients can never hope to trump visions of death panels by politicians and attendees alike at Jerry Springer-like town hall meetings when a news show producer is selecting footage.
Medicare has been quite good about encouraging and covering hospice care for some time now. Again, most Americans, including our esteemed lawmakers, are woefully uneducated about the health care delivery system in which they are seeking to make profound change. Most know absolutely nothing about the hospice option, since they, or members of their family, have not been in a position to require it. However, Medicare policymakers have recognized both the economic and sociological advantages.
This happens in situations where the legal obligation to provide across-the-board services exists. Private health insurance companies are well aware of the cost advantages of hospice over hospitalization. However, no end-of-life care is far cheaper than hospice, and private insurers have that option.
When physicians stop cure-centered treatment of a patient, either because none exists or because the patient/family has requested it, the patient enters the realm of palliative care. Most private health insurance carriers will not provide coverage of palliative care-related hospitalization. The hospital alerts the family that there will be no further third-party payments, and the family then has the options of moving the patient to an assisted-care facility, to a hospice provider, or to their home where they will have to provide the patient’s care themselves (they also have the option of leaving the patient in the hospital and paying the entire bill themselves).
While there are some private carriers who do assist in paying for some or all of these options, many do not. There’s no financial incentive for them to do so. They know that the patient’s family will continue to pay the premiums until the patient’s death, so they’re not concerned about loss of income. They realize that the patient’s family will probably provide the care if forced into it by cost. But, overall, what happens to the terminally-ill patient is of little concern to them.
This disparity between Medicare and private health insurers is due to demographics. Medicare is an entity whose enrollees are, overall, much older, and their illnesses tend to be more serious and complex than those affecting younger people (below age 60), and the age- and lifestyle-related deterioration in their physiologic systems cause more negative reactions to treatment. Because Medicare is a congressionally-mandated program which ostensibly offers the same coverage to all, and because the vast majority of enrollees requires advanced (read as expensive) care, it is essential that Medicare exercise some creativity in finding ways to reduce their costs while providing mandated care for patients. Enter hospice care.
Private insurers are under no such obligation. They’ve winnowed out as much of the risk as possible by refusing to enroll at-risk people (including those with at-risk spouses and children), creating a very favorable risk pool. On the rare occasions that one of the enrollees develops metastatic cancer, or a heart condition, or an autoimmune disorder, the focus is not on finding cost-effective ways of providing health care for that patient, but on not paying for care at all. From the moment that diagnosis code is entered in their system, the patient is subjected to special attention from their insurer: receiving letters questioning their eligibility (even though they’ve been paying premiums for 20 years, without using benefits), denial of coverage for myriad reasons, and, often, termination of their coverage. Even in cases where the insurer is legally obligated to provide contracted services, they will often refuse to do so, attempting to delay such time as they have to part with money. They are hoping to hit the jackpot, and often do: the patient is too sick, and their families are too inexperienced or too busy to maneuver thru the morass, and they simply give up fighting.
I believe this is the reason for much of the public’s aversion to health reform: circumstances in their lives have been such that they have not experienced a need for major health care services. As such, they cannot be expected to know that, not only is the deck stacked against them if they should become ill, but that the current “system” is unsustainable in the wake of the health care tsunami headed our way in another few years when half the Boomer population is over 70. Spurred on by opportunistic politicians, corporate executives, and media talking heads, they’ve been worked up a ill-informed lather that will work against their interests and those of their families in the future.
Participant[quote=bearishgurl] eavesdropper, I have that exact same light in my circa 1993 kitchen today, lol! [/quote]
BG, I knew you were a woman of taste and refinement!
I had one of those in my last house also. Contractor choice in my husband’s house (built in 1997), and he could never understand why I hated the thing (I think that guys just have a love thing going with fluorescent lights, period.) Ours was about 60 inches long, and it always reminded me of a lid to a casket. Naturally, I lived with it for years, and didn’t get around to replacing it until we put our house on the market in early ’08.
[quote=bearishgurl] Lol, UCGal, my mom chose the “farm scene” wallpaper and I had to do the papering. Had to make sure each corner of her “farm-sized” 11’x22′ kitchen was properly plumb-bobbed, or the cows’ udders, chicken heads and rooster craws would run north, straight up the wall! I did the bottom half of her kitchen wall in coordinating stripes to match her 7 pc. vinyl dinette set! [/quote]
BG, you have only yourself to blame for that day of hell! Haven’t you ever heard of “proper prior preparation”?
Whenever I agreed to do a wallpapering job for my mother, I made sure that I made a big plate of double chocolate hash brownies the night before. That way I didn’t have to worry about any of that plumb-line b.s. Halfway into the second brownie, Mom would channel Salvador Dali, and the wallpapering was done in a flash. I’d always see her looking at it, with a puzzled expression, but somewhere in the deep recesses of her brain, she knew that she shared responsibility for the mismatched cows’ udders, perpendicular stripes, etc., etc.
Participant[quote=bearishgurl] eavesdropper, I have that exact same light in my circa 1993 kitchen today, lol! [/quote]
BG, I knew you were a woman of taste and refinement!
I had one of those in my last house also. Contractor choice in my husband’s house (built in 1997), and he could never understand why I hated the thing (I think that guys just have a love thing going with fluorescent lights, period.) Ours was about 60 inches long, and it always reminded me of a lid to a casket. Naturally, I lived with it for years, and didn’t get around to replacing it until we put our house on the market in early ’08.
[quote=bearishgurl] Lol, UCGal, my mom chose the “farm scene” wallpaper and I had to do the papering. Had to make sure each corner of her “farm-sized” 11’x22′ kitchen was properly plumb-bobbed, or the cows’ udders, chicken heads and rooster craws would run north, straight up the wall! I did the bottom half of her kitchen wall in coordinating stripes to match her 7 pc. vinyl dinette set! [/quote]
BG, you have only yourself to blame for that day of hell! Haven’t you ever heard of “proper prior preparation”?
Whenever I agreed to do a wallpapering job for my mother, I made sure that I made a big plate of double chocolate hash brownies the night before. That way I didn’t have to worry about any of that plumb-line b.s. Halfway into the second brownie, Mom would channel Salvador Dali, and the wallpapering was done in a flash. I’d always see her looking at it, with a puzzled expression, but somewhere in the deep recesses of her brain, she knew that she shared responsibility for the mismatched cows’ udders, perpendicular stripes, etc., etc.
Participant[quote=bearishgurl] eavesdropper, I have that exact same light in my circa 1993 kitchen today, lol! [/quote]
BG, I knew you were a woman of taste and refinement!
I had one of those in my last house also. Contractor choice in my husband’s house (built in 1997), and he could never understand why I hated the thing (I think that guys just have a love thing going with fluorescent lights, period.) Ours was about 60 inches long, and it always reminded me of a lid to a casket. Naturally, I lived with it for years, and didn’t get around to replacing it until we put our house on the market in early ’08.
[quote=bearishgurl] Lol, UCGal, my mom chose the “farm scene” wallpaper and I had to do the papering. Had to make sure each corner of her “farm-sized” 11’x22′ kitchen was properly plumb-bobbed, or the cows’ udders, chicken heads and rooster craws would run north, straight up the wall! I did the bottom half of her kitchen wall in coordinating stripes to match her 7 pc. vinyl dinette set! [/quote]
BG, you have only yourself to blame for that day of hell! Haven’t you ever heard of “proper prior preparation”?
Whenever I agreed to do a wallpapering job for my mother, I made sure that I made a big plate of double chocolate hash brownies the night before. That way I didn’t have to worry about any of that plumb-line b.s. Halfway into the second brownie, Mom would channel Salvador Dali, and the wallpapering was done in a flash. I’d always see her looking at it, with a puzzled expression, but somewhere in the deep recesses of her brain, she knew that she shared responsibility for the mismatched cows’ udders, perpendicular stripes, etc., etc.
Participant[quote=bearishgurl] eavesdropper, I have that exact same light in my circa 1993 kitchen today, lol! [/quote]
BG, I knew you were a woman of taste and refinement!
I had one of those in my last house also. Contractor choice in my husband’s house (built in 1997), and he could never understand why I hated the thing (I think that guys just have a love thing going with fluorescent lights, period.) Ours was about 60 inches long, and it always reminded me of a lid to a casket. Naturally, I lived with it for years, and didn’t get around to replacing it until we put our house on the market in early ’08.
[quote=bearishgurl] Lol, UCGal, my mom chose the “farm scene” wallpaper and I had to do the papering. Had to make sure each corner of her “farm-sized” 11’x22′ kitchen was properly plumb-bobbed, or the cows’ udders, chicken heads and rooster craws would run north, straight up the wall! I did the bottom half of her kitchen wall in coordinating stripes to match her 7 pc. vinyl dinette set! [/quote]
BG, you have only yourself to blame for that day of hell! Haven’t you ever heard of “proper prior preparation”?
Whenever I agreed to do a wallpapering job for my mother, I made sure that I made a big plate of double chocolate hash brownies the night before. That way I didn’t have to worry about any of that plumb-line b.s. Halfway into the second brownie, Mom would channel Salvador Dali, and the wallpapering was done in a flash. I’d always see her looking at it, with a puzzled expression, but somewhere in the deep recesses of her brain, she knew that she shared responsibility for the mismatched cows’ udders, perpendicular stripes, etc., etc.
Participant[quote=bearishgurl] eavesdropper, I have that exact same light in my circa 1993 kitchen today, lol! [/quote]
BG, I knew you were a woman of taste and refinement!
I had one of those in my last house also. Contractor choice in my husband’s house (built in 1997), and he could never understand why I hated the thing (I think that guys just have a love thing going with fluorescent lights, period.) Ours was about 60 inches long, and it always reminded me of a lid to a casket. Naturally, I lived with it for years, and didn’t get around to replacing it until we put our house on the market in early ’08.
[quote=bearishgurl] Lol, UCGal, my mom chose the “farm scene” wallpaper and I had to do the papering. Had to make sure each corner of her “farm-sized” 11’x22′ kitchen was properly plumb-bobbed, or the cows’ udders, chicken heads and rooster craws would run north, straight up the wall! I did the bottom half of her kitchen wall in coordinating stripes to match her 7 pc. vinyl dinette set! [/quote]
BG, you have only yourself to blame for that day of hell! Haven’t you ever heard of “proper prior preparation”?
Whenever I agreed to do a wallpapering job for my mother, I made sure that I made a big plate of double chocolate hash brownies the night before. That way I didn’t have to worry about any of that plumb-line b.s. Halfway into the second brownie, Mom would channel Salvador Dali, and the wallpapering was done in a flash. I’d always see her looking at it, with a puzzled expression, but somewhere in the deep recesses of her brain, she knew that she shared responsibility for the mismatched cows’ udders, perpendicular stripes, etc., etc.
Participant[quote=CA renter] Yep, that’s an awesome house.
Wish we had more houses down here like that to choose from instead of one tacky, two-story, McStucco box after another.
Lord, please, please, please make these big developers/builders die off and allow people to buy their own lots and build their own custom homes again! Amen.[/quote]
CAR, wish I had your faith, but I fear that if most of the citizenry started to design their own houses, it would be worse than what most of the big developers are doing.
They’d have to start a new magazine: “Architectural InDIGESTion” (yeah, I know…that’s really bad. But it’s late in the day here in the east).
Call me a snob. But trust me on this one. If you want to get an idea of what happens when people have a construction loan, a yen to be a “designer”, and a little time on their hands, click on the link: http://homesoftherich.net/2009/06/inside-teresa-giudices-new-jersey-mansion.html
*Don’t miss the video house tour halfway down the page. See something you just gotta have? Link to the catalog for the October 3 bankruptcy auction:
http://www.ajwillnerauctions.com/index.cfm?AuctionID=559&fuseaction=home.auctionDetails
Participant[quote=CA renter] Yep, that’s an awesome house.
Wish we had more houses down here like that to choose from instead of one tacky, two-story, McStucco box after another.
Lord, please, please, please make these big developers/builders die off and allow people to buy their own lots and build their own custom homes again! Amen.[/quote]
CAR, wish I had your faith, but I fear that if most of the citizenry started to design their own houses, it would be worse than what most of the big developers are doing.
They’d have to start a new magazine: “Architectural InDIGESTion” (yeah, I know…that’s really bad. But it’s late in the day here in the east).
Call me a snob. But trust me on this one. If you want to get an idea of what happens when people have a construction loan, a yen to be a “designer”, and a little time on their hands, click on the link: http://homesoftherich.net/2009/06/inside-teresa-giudices-new-jersey-mansion.html
*Don’t miss the video house tour halfway down the page. See something you just gotta have? Link to the catalog for the October 3 bankruptcy auction:
http://www.ajwillnerauctions.com/index.cfm?AuctionID=559&fuseaction=home.auctionDetails
Participant[quote=CA renter] Yep, that’s an awesome house.
Wish we had more houses down here like that to choose from instead of one tacky, two-story, McStucco box after another.
Lord, please, please, please make these big developers/builders die off and allow people to buy their own lots and build their own custom homes again! Amen.[/quote]
CAR, wish I had your faith, but I fear that if most of the citizenry started to design their own houses, it would be worse than what most of the big developers are doing.
They’d have to start a new magazine: “Architectural InDIGESTion” (yeah, I know…that’s really bad. But it’s late in the day here in the east).
Call me a snob. But trust me on this one. If you want to get an idea of what happens when people have a construction loan, a yen to be a “designer”, and a little time on their hands, click on the link: http://homesoftherich.net/2009/06/inside-teresa-giudices-new-jersey-mansion.html
*Don’t miss the video house tour halfway down the page. See something you just gotta have? Link to the catalog for the October 3 bankruptcy auction:
http://www.ajwillnerauctions.com/index.cfm?AuctionID=559&fuseaction=home.auctionDetails
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