A Step By Step Plan To Conquer Debt

Recently I encountered a doctors office that had billed me twice for his services.  The first time was two years ago, and at that time I sent his "office manager" a copy of my cancelled check.  Again I was billed after two years for the same amount.  There was now a "new office manager", and according to her they were not paid.  This is what prompted me to write this letter to them.  I am sure it will be useful to many of you, and can be adapted in many ways.  I left off the names for obvious reasons.  Unfortunately these incidents occur more often then not, and most people can be bullied into paying for something they don't owe.

Contact me using my help line, and I will give you letters from my book to help you keep creditors at arms length for at least 90 days.  There will be no charge for these letters.

This blog will address heart disease pertaining to both men and women.  It has been proven that women present much differently than men do when in distress, and are having a heart attack.

As a friend of mine pointed out to me recently never ever have someone drive you to the hospital.  Anything can, and usually does happen on the way there.  An ambulance is a much better choice preferably an ALS unit if avalable to you.  They have both the expertise, and equipment to keep you alive until you reach the hospital.  Always ask to go to a trauma center if one is close by.

I went to see a new pulmonologist today, and he has a partner in his group that only does sleep studies.  Immediately after he saw me he ordered a O2 saturation test done overnight at home.  The other shoe will drop, and I'm sure he will order a sleep study to be done, and that is not necessay since I do very well at night with O2.  The problem is that these days doctors drop you from their practice like crazy, and in a very small community your options are very limited.  You have to play nice, and pretend that you are hanging on their every word. As most everyone knows most large practices are nothing more than money making machines.  If you want to remain in control of what they do just put them off for as long as possible.

Homecare Patients Worry About Medicare Cuts

CARIBOU, Me. — Dozing in a big lift chair, propped up by pillows in the living room of her modest home here, Bertha G. Milliard greeted the nurse who had come to check her condition and review the medications she takes for chronic pain, heart failure, stroke and dementia.

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A Threat to Home Health Services Ms. Milliard, 94, said those visits had been highly effective in keeping her out of the hospital. But the home care she receives could be altered under legislation passed by the House and pending on the Senate floor as Congress returned to work this week.

As they are across the nation, Medicare patients and nurses in this town in northern Maine are anxiously following the Congressional debate because its outcome could affect Medicare’s popular home health benefit in a big way. The legislation would reduce Medicare spending on home health services, a lifeline for homebound Medicare beneficiaries, which keeps them out of hospitals and nursing homes.

Under the bills, more than 30 million Americans would gain health coverage. The cost would be offset by new taxes and fees and by cutbacks in Medicare payments to health care providers.

Home care shows, in microcosm, a conundrum at the heart of the health care debate. Lawmakers have decided that most of the money to cover the uninsured should come from the health care system itself. This raises the question: Can health care providers reduce costs without slashing services?

Under the legislation, home care would absorb a disproportionate share of the cuts. It currently accounts for 3.7 percent of the Medicare budget, but would absorb 10.2 percent of the savings squeezed from Medicare by the House bill and 9.4 percent of savings in the Senate bill, the Congressional Budget Office says.

The House bill would slice $55 billion over 10 years from projected Medicare spending on home health services, while the Senate bill would take $43 billion.

Democratic leaders in the Senate and the House justify the proposed cuts in almost identical terms. “These payment reductions will not adversely affect access to care,” but will bring payments in line with costs, the House Ways and Means Committee said. The Senate Finance Committee said the changes would encourage home care workers to become more productive.

The proposed cuts appear to be at odds with other provisions of the giant health care bills. A major goal of those bills is to reduce the readmission of Medicare patients to hospitals. Medicare patients say that is exactly what home care does.

“It helps me be independent,” said Mildred A. Carkin, 77, of Patten, Me., as a visiting nurse changed the dressing on a gaping wound in her right leg, a complication of knee replacement surgery. “It’s cheaper to care for us at home than to stick us in a nursing home or even a hospital.”

Delmer A. Wilcox, 89, of Caribou, lives alone, is losing his vision, uses a walker and has chronic diseases of the lungs, heart and kidneys. He said his condition would deteriorate quickly without the regular visits he received from Visiting Nurses of Aroostook, a unit of Eastern Maine Home Care.

The Aroostook County home care agency, which lost $190,000 on total revenues of $1.9 million in the year that ended Sept. 30, estimates that it would lose an additional $313,000 in the first year of the House bill and $237,000 under the Senate bill.

The prospect of such cuts has alarmed patients and home care workers.

“We would have to consider shrinking the area we serve or discontinuing some services,” said Lisa Harvey-McPherson, who supervises the Aroostook agency as president of Eastern Maine Home Care.

“Our staff are scared,” Ms. Harvey-McPherson said, “but it’s our patients who will pay the price if Congress makes the cuts in home care.”

The four agencies under the umbrella of Eastern Maine Home Care cover a huge geographic area. Its nurses aim to see five patients a day, and they drive an average of 25 miles between patients, traversing potato fields and forests of spruce, birch and maple trees — and a few bear, moose and lynx. In winter, they may need a snowmobile, or even cross-country skis, to reach patients in remote areas.

President Obama has said that the savings in Medicare would be achieved by eliminating “waste and inefficiency” and that “nobody is talking about reducing Medicare benefits.” Moreover, he said, health care providers stand to benefit because they would gain tens of millions of new paying customers.

Home care executives question the arithmetic.

“No family or individual should ever go without health care coverage,” Ms. Harvey-McPherson said, as she drove up to a patient’s home here. “But an increase in the number of people with insurance would not necessarily help our agency because we depend so heavily on caring for seniors, with 80 to 90 percent of our home care revenue coming from Medicare.”

The impact on Medicare is a major concern for Maine’s senators, Susan Collins and Olympia J. Snowe, both Republicans being courted by the White House. Ms. Collins, a longtime champion of home care, has indicated she will resist the proposed cuts.

“Deep cuts to home health care would be completely counterproductive to our efforts to control overall health care costs,” Ms. Collins said. “Home care and hospice have consistently proven to be cost-effective and compassionate alternatives to institutional care.”

In trying to slow the growth of Medicare, Democrats in Congress assume that health care providers can increase their productivity at the same pace as the overall economy.

But Saundra Scott-Adams, executive vice president of Eastern Maine Home Care, said: “That’s a joke for home health care. We provide one-on-one care.”

Her doubts are shared by Richard S. Foster, chief actuary of the federal Centers for Medicare and Medicaid Services. Mr. Foster said the health care industry was “very labor-intensive” and could probably not match the productivity gains of the overall economy.

While nurses can monitor some patients with electronic telecommunications devices, they said they still needed to provide hands-on care to many.

Phillip H. Moran, a 65-year-old diabetic in Houlton, Me., lost his right leg several years ago. His kidneys are failing. Without regular visits from a home health nurse, Mr. Moran said, he would be in danger of losing his other leg because of complications from diabetes. As a double amputee, he would be more likely to go into a nursing home.

“The nurses’ visits are really important,” Mr. Moran said. “If they are cut, it could cost people their lives.”

For the past month my dialysis provider has seen to provide only one Tech for every 8-9 patients.   A formula for disaster in the clinical environment.  This weekend a "trainee Tech" will be the only Tech available to us.  This does not show very good judgement on the head nurses part.  If more than one patient happens to get into distress at one time it could become tragic.  A fatality in the making.

"MIRIAM'S WEBSURFING FIND: I must give credit where credit is due, Barry Kiker found this helpful website and blog and wrote about it in his blog, Dialysis and Me.

Michael W. Newman's site is entitled What You Can Do to Conquer Your Credit and Debt Problems, also the title of his book, now in its second edition and available at his site and Amazon.com. The book is full of helpful information and sample letters to use when dealing with debt collectors and credit card companies. He gives gives concrete applicable suggestions and explains the laws that can help you get out of trouble. With the economy in the state that it's in many people are struggling with financial issues, especially people with CKD5 and other chronic illnesses. Michael hopes to help with his website and book.

Along with his extensive business background, Michael is also on in-center hemodialysis. He shares some of his experiences in his blog and forum which can be found on the site. One of his recent forum posts has good ideas on how to protect yourself while at dialysis."

Today was a first for me.  I actulally had the supervisory nurse wanting me to take myself off of dialysis when she knows that my hands are too painful to do that.

I think she could be classified as a potential moron!!!

Screaming at me while I was in severe pain didn't help much either.

The day before at this same clinic in Pensacola another nurse gave me an entire litre of saline, and then blamed it on me telling his boss that I told him to do it.

I then had so much fluid on I had to stay for another hour to get the fluid overload off.

Then there was the time I was screaming in pain from cramping.  There was a tech not more than four feet from me entering information on the computer.  He refused to come over to help.  Later he told his boss that he was in the process of pulling needles out of a patients arm.  A total fabrication on his part.

This is a very dangerous clinic to be doing dialysis in.

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http://conquerdebt.wordpress.com/2009/02/27/hello-world/