Archive for September 24th, 2010

US Healthcare Issues

Friday, September 24th, 2010

Mom did not move today. Her insurance company is still balking at covering an intensive physical therapy facility; which she clearly needs. So, she’s probably going back to the nursing rehab facility either today or Monday.  It’s not definite yet that she’ll ultimately be denied the rigorous exercise program.  But it’s a distinct possibility.  Given my experiences caring for Mom within our current healthcare system over the past five years or so: Sometimes, when someone says that the US has the best health care in the world, I catch myself choking on chuckles, and then, covering my mouth to hide my tonsils and mute the full-blown bah ha has.

Since caring for Mom, I’ve observed numerous gaping problems in our system.  Here are some of them:

  • Poor communication between hospitals.  When Mom transfers from one hospital to another, her complete records have not always followed her immediately.
  • Lots of unnecessarily repetitious work.  So far, every time she transfers to another facility, we must resubmit our power-of-attorney papers, even if we had supplied them at her last visit to a particular hospital.
  • All facilities I’ve observed over the past few years with Mom’s many hospital visits, are way understaffed and way overworked.
  • Lacking coordination among the doctors caring for Mom.  So often, we’ve gotten one story when talking to a particular doctor, and then quite another when talking to a different doctor.  Doctor teams should meet more often and “get their stories straight” before talking to patients.
  • Unavailability of doctors to update family on patient status.  Frequently, we’ve had to wait days to meet with a doctor to tell us how Mom is doing and get a prognosis.
  • Hospitals are “dirty” places with all sorts of viruses and bacteria running around in great amounts.  Thus, I fear for my own safety should I ever require hospitalization.  Sometimes, it’s true that the cure is worse than the illness.
  • Health insurance policies are quite difficult to understand.  In fact, there are those who make careers out of understanding them and then explaining them to customers.  What’s up with that?
  • Health insurance companies are too picky about who they cover; denying insurance to anyone with pre-existing medical problems.  Fortunately, the health care reforms enacted this year attempt to address this issue; particularly with children’s coverage.   But unfortunately, the big insurance companies have found loopholes in the law to exploit already.  This year’s health care reforms were supposed to eliminate the pre-existing conditions criterion from consideration by insurance companies. They’re not supposed to any longer deny children coverage based on pre-existing illnesses. However, some of these insurers, to get around this new law, are canceling their coverage of children altogether.  See, this is JUST the sort of thing that a single-payer (a.k.a. public) healthcare option would have prevented. But people didn’t want it. *sigh* So now, many children may have to go without coverage.
  • Blood sugar levels not controlled very well for diabetics.  They typically only read the blood sugar and dispense insulin twice per day (we do it four to six times per day at home).  So, readings typically run high, in the low to mid 200′s, which is significantly higher than recommended levels.  This can retard patient healing, which would seem to interfere with the hospital’s key mission; to heal patients.  Plus, they serve a lot of “non diabetic” food to diabetics such as white flour, starchy courses, and sugary desserts. Frequently absent from menus are green vegetables, lean meats, whole grains, beans, seeds, fresh fruits, and nuts.  One would think that they’d know better in a hospital setting and that they’d give higher priority to better glucose management.

I’ll add more items to the above list as they occur.

Tom Hesley

Related Posts

Posted in Gripes, Politics | 5 Comments »

Tankless Vs. Tanked Water Heaters

Friday, September 24th, 2010
Be careful about buying a tankless water heater. While tankless units definitely offer the convenience of “endless” hot water, and do save you significantly on your fuel bill, they are more costly to install as you point out. Not only do you pay over twice as much initially… for them, but they’re higher maintenance than traditional units. Plus, they have a heat exchanger that must be replaced every few years (more or less depending on the condition of your water), and that can run a couple to several hundred dollars. So unless your need for endless hot water balances these draw-backs of the tankless models, I’d avoid them until their price comes down a little more.
I’ve read claims of as much a fifty percent fuel savings with tankless. If that’s true, it COULD be worth it over time; especially in communities with well-conditioned (soft) water, where the exchangers would tend to last longer.
They say it can take as long as 22 years to make back the money. That would amount to a savings of the cost of replacing two or three traditional tanks. Tankless is looking better and better.

Yes, that “pause” does not disappear with tankless. I solved that problem here however, by i…nstalling a circulating pump (instant hot water) that continuously keeps the hot water moving in the pipes. Before this, it would take as long as a minute for the cold water to be flushed out. But now, you get hot water no matter where you are in the house, in less than three seconds after turning on the faucet. Nice!=

Yes, when you don’t use much water, keeping tens of gallons of it in reserve and incurring the cost of repeatedly re heating the same water, as is what happens in a traditional tank-based heater, costs significant money. So you’d save that… money if you went tankless.

However, in places where there’s a near-constant draw of hot water (like where women reside (   :-)    )), the advantage of tankless would seem to be less pronounced, as you would actually be using the hot water before having to reheat it too many times. Hmmmm. I don’t know. I guess we’ll have to wait until more people have experience with this new technology and see how it pans out.

We heat our water with gas here.  But I’ll not be buying tankless any time soon. In fact, I hope I won’t be buying ANY type of water heater any time soon. :-)
Tom Hesley

Related Posts About Heating

Posted in Advice | 1 Comment »