"The minerals magnesium, potassium and silica are all converted inside the body to calcium" - unless there's some radioactivity going on how is this true? I only have a rudimentary understanding of chemistry but that statement made me question the whole document. This is just a minor point (and I'm feeling pretty nit-picky about it) but it leads to a bigger question. Is there a way of providing a quick fact-sheet like that without oversimplifying things or teaching everyone biology? It also makes me ask the question: since many people aren't scientists how do you establish trust between yourself and the aging population? On the flip side, how do you make sure older people don't trust bad information?
Question from the 3rd piece: "Political economy of aging" - the government sets up senior centers and bureaucracies to look after the aging population - should government define what these people need or should it allow aging individuals to decide what they need? (i.e. give money to local communities of elderly instead of telling everyone "you need a senior center").
Here's a bit of a canned question about this stuff: Health care is really expensive and it's clear that people who exercise regularly and take care of themselves cost the system less. Should there be an incentive system in government payouts to people who, through their actions, are at less risk than others?
"Inpatient hospital" is the largest percentage of the medicare pie - how can we reduce the amount of time people are in the hospital? What types of things are people hospitalized for?
As I'm reading the last reading about the different medicare plans I'm thinking "I don't understand all this." I'm lifting this from a book "Who killed health care?" but we have tax advisers and we have legal advisers who we retain. For complicated things we usually have a specialist who we can call day or night that knows our situation and is willing to help. How come this is not the case for the medical profession? It sounds like there's a ton of money out there for it and a huge need - why no solutions?
1.) Kaiser Foundation, Medicare at a Glance
Currently Medicare offers the same benefits to any beneficiary no matter their
accumulated retirement funds. Would a government program that matched the
funds provided by retirees help fund the rising cost of Medicare?
2.) Kaiser Foundation, Medicare at a Glance
In 2002, 9 million Medicare beneficiaries purchased supplemental coverage
through private policies. If this number of people are willing to pay out of
pocket expenses for their health care, why aren't more efforts focused on
enabling private policies to fund their entire coverage?
3.)JANE E. BRODY, To Avoid ?Boomeritis,? Exercise, Exercise, Exercise
Brody points out that by people's 40th birthday people have "weak links" and
are more susceptible to injury by pushing their frames to their physical limit
and are thus falling apart. This would seem to imply that people that haven't
been taking care of themselves through the years and suddenly decide to
exercise are at an increased risk of injury, even at the young age of 40. Does
this go contrary to what we've been hearing that exercising, even when started
in senior years, is more preventive of injury than causative?
* Why is it not economically viable for a doctor to be sent to someone's house? (As opposed to an emergency medical team and a visit to the ER.)
* What is the best way to pay for the medical expenses of retirees? Should it be spread among society at large, or should individuals pay into an insurance account while they work (like a medical 401k, or long-term care insurance)?
* Can incentives be given through Medicare (lower premiums, etc) to encourage healthy behavior (not smoking, proper exercise, etc)? Would this be an effective means of motivation?
Who is ELDR Media? I have a lot of issues with their handout. Not only does it not make sense to say that getting a bone density test prevents osteoporosis (as per the title), the advice on hormone replacement and supplements strike me as overly simplistic and even potentially harmful. Hormone replacement therapy is very controversial. And as for vitamins, lot depends on the type of supplement, doesn't it? I think there's a huge difference between naturally occurring and synthetic vitamins (although others might well disagree). And messing with vitamins can sometimes backfire, leading to a false sense of security. For example, I've been told that iron interferes with calcium absorption. So someone trying their best to take everything winds up with less.
Medicare is confusing. How do people get it figured out and get signed up for the right parts?
Posture seems like a little-noticed stepchild in the whole muscular-skeletal disarray. I appreciated seeing it listed in the Boomeritis article. Rather than being conscious of our posture as young people, we only notice it when we've messed ourselves up and call in the ergonomics specialists. How can we intervene sooner to form good habits early?
I really appreciated DeNubile's term "fix-me-itis." It seems to embody a certain lack of responsibility for self-care that I've noted on occasion among my peers. But at the same time, it can be difficult to find the resources for prevention. Sometimes I think the medical establishment also has a "just fix it" attitude. For example, my mother was recently found to have high blood pressure. The cardiologist started writing a prescription without any inquiry as to the root of the problem. My mom doesn't care for drugs, so she asked to see a nutritionist. She was surprised to realize how much salt she was eating. Turns out most Americans are eating about 3x the RDA of salt. She has been able to lower her blood pressure by cooking more and eliminating added salt. Turns out, even children are also eating far more salt than they should. But if my mother hadn't pushed back, we all would have been eating salt without realizing it, and she would be taking unnecessary medications as well.
• there are several inaccuracies in the “how not to get osteoporosis” article. How do the authors expect people to follow their recommendations when quite a few things they say are inaccurate (i.e. Saying that potassium turns into calcium, etc.)?
• Why haven’t policy makers changed medicare to fix the gaps and make having complete coverage easier and more understandable?
• Would testing drugs in older people help with dosing of older adults, and avoid many of the related problems?
Chapter 14 from Social Forces and Aging suggests that home care is only less costly because some of the care is undertaken by family members. If health care policy assumed that family care was an important component of care for patients with long-term care needs, how could we make it easier and more financially viable for people to care for their family members? What are the limitations of the Family and Medical Leave Act in this regard?
The fact that HMO's are run for profit just doesn't make sense to me. Health care does not seem to be a for-profit venture. What is the historical reason HMO's are for profit?
Medicare by nature groups together people with high needs. Usually insurance works because risk is spread out amongst a large group, thereby reducing the group's overall risk level. How would the universal health care options being touted by the current Democratic candidates utilize this idea to reduce costs?
“Medicare At A Glance”:
• If individuals are 65 years or older and do not meet Social Security/payroll tax criteria, do they receive medical coverage at all?
• What types of services are included, and should be included, in Medicare’s “preventive health” coverage?
• How will proposed universal health care models intervene with Medicare operations?
“To Avoid ‘Boomeritis,’ Exercise, Exercise, Exercise”
• Since prevention seems to be the golden message of this article and many others, shouldn’t we (as designers and as a society) be targeting younger age groups with these all-encompassing exercise regimes?
1. “ ' The key to a good workout is customization,' based on a professional assessment of flexibility, cardiovascular endurance, strength and balance," reported the NYTimes in "To Avoid 'Boomerits,' Exercise, Exercise, Exercise." But not everyone has the means to have this sort of professional assessment done --- what do we recommend those who can't afford to have a customized workout designed?
2. In the health classes I've taken at Stanford, we've talked a lot about how the US healthcare system is completely broken. Really we should just scrap the entire thing and start over. But that's unlikely to happen: we're working in a country founded on the idea of the self-made man. As a society we're skeptical of anything that might resemble "socialism." So my question is a big one: WHAT DO WE DO? What's the answer? How can we gradually start making a change? Or not...
3. SFA explains that "effective long-term care in the community requires "case management," which involves looking at all of a person's needs and resources and developing a coordinated treatment plan that includes a variety of services, including health care." Who is responsible for making this comprehensive assessment?
4. SFA gives an anecdote about Mrs. C. to illustrate the flaws of the medical model, which recognizes only two types of people to treat: those who are seriously ill, need hospitalization AND those who are up and about, can go to doctor or clinic. I nearly cried after reading the hypothetical, but very real story of Mrs. C. This is a huge oversight. Are there organizations, laws, people (?) working on the problem? How can it be fixed?
1. The NYTimes article talks about how "cookbook recipes" for exercise are no good. But, if older adults are already not exercising, with these cookbook recipes widely available, doesn't it seem even less likely that they would go the whole nine yards to ask for a customized plan? In terms of design, could there be a website that asks detailed questions about an elderly person's health/problems and then produces a customized plan based on their responses? (Of course the efficacy of a website for older people is questionable as always...)
2. Just as we talked about how the elderly today are not treadmill enthusiasts, I wonder if the nutritional tips offered today are also rather foreign to them (for example, eat meat only once a day). What are good ways to persuade the elderly to alter their eating habits, esp. in a way that integrates their current eating preferences?
3. Why do minority groups have more health care problems and health care problems at an earlier age than others? Would this problem be alleviated if caregiving by family members was better compensated?
How might we provide better health care for elderly people who are in general healthy and active but require occasional
24 hours care? If cost is an issue, I would think in the long term, better health care for the active but occasionally sick, will help them stay active and require less health care in the long run.
Seems like a lot of the problem in financing health care comes from the large rate of inflation in health related services, compared to the general inflation rate. What is the source of this? Is this coming mainly from the raise of sales price by drug company, and is there something we can do about this?
How can we enable the elderly and immediate family members to be able to "self-help" with more accurate information?
1.) What is the most important policy agenda for older adults in the twenty-first century? What is the existing policy/institution most pertinent to older adults today? Describe these two policies and describe what needs to be done in order to implement/reform it.
2.) What are the specific issues that Medicare addresses, and why is it insufficient at addressing these issues? What health-specific problems are significantly ignored by Medicare?
3.) What are the significant gaps in the financing of health care in the US (specifically with regards to Medicare/Medicaid)? How is long-term care addressed by our current model of service and how is the quality and cost of health care regulated?
1. How do rich people exercise? How do poor people exercise? What do those differences mean about how we can get poorer people to take preventive measures by increasing exercise earlier in life?
2. Medicare disbursement is complicated. Varying it by 50 states is far more complicated. Does it ever make sense for federal programs to be administered federally? What is the advantage of state administration?
3. If seniors represent such a large part of medical cost and hospital utilization, does every hospital have a Geriatric practice that can look at the Mrs. C’s before they go to an emergency room? Should we triage based on age/disability for most cost effective and relevant treatment?
-On hormone replacement and osteoporosis: What are the side effects of hormone replacement? It seems that interfering with naturally occurring hormone levels would have potential negatives.
-If Medicare/Caid/Social Security do run out of funds, is there any safety net at all for elderly and poor healthcare?
-Is there a definitive list of what supplements to take at what age? Whenever I go into the drug store, I am intimidated by all the different supplement types and there is never good information on what has been medically proven to work in what amounts.
I was struck as I read the reading on osteoporosis. While these quick references for health seem very helpful an informative, if we are using them for the sake of prevention, does such information just add to our constant feelings of fear of being at risk for just about everything?
How can we attempt to ensure that the products/technologies/ideas that we develop in this class do not feed into the political economy of aging or do not become one more part of the aging enterprise that separates older adults and younger adults and makes older adults appear in need of a special service center?
I found it interesting in the readings about the health care system that there is both a great deal of overutilization of health care services (specifically of certain types of services and/or by certain groups of people) and also a great deal of underutilization of health care services (of other types of services and/or by other groups). It seems the depending on whether one believes the overutilization or the underutilization is a bigger problem, they will frame the policy issues and solutions in a very different way. How might we get a clearer picture of the actual use of services based on need, including the true costs of preventative services over time, and how might this information be used to change the way Medicare chooses what it will and will not cover?
1. I don?t agree with Brody?s assessment that ?A 30-minute walk on most days is just not enough.? She discusses how alternative exercises such as flexibility and posture are just as important?not better or worse. So what should we focus on first, flexibility and posture or the strenuous activity?
2. I thought Kaiser?s assessment of the preventative approaches were interesting. I just wonder, based on our last class, how do you translate these findings into elderly-friendly advertisements?
3. Is it more important that the elderly work on their own personal physical fitness or their own personal socioemotonal well-being? I know both are important, but if someone is asking about which is more beneficial, which would it be?