Michigan Disability Resistance

http://bit.ly/2NAFHHi

Study debunks notion that large chunks of Medicare go to futile end-of-life care.

Around 25 percent of Medicare spending in the U.S. occurs in the last year of people’s lives. This is sometimes discussed as a questionable use of resources: Is society throwing large amounts of medical treatment at some patients in a futile, if noble, effort to extend lives that are bound to end soon?

A new study co-authored by an MIT health care economist offers a resounding answer: No.

After examining millions of medical records, the study found that although Medicare spending is concentrated among people who die, there is very little Medicare spending on patients whose death within the year is highly likely. For example, the researchers discovered, less than 5 percent of Medicare spending is applied to the single highest-risk percentile of all individuals — and their predicted one-year mortality rate is still just 46 percent.

“What we discovered is, very little money is spent on people who we know with high probability are going to die in a short amount of time,” says Amy Finkelstein, a professor in MIT’s Department of Economics and co-author of a paper in the journal Science that details the study’s findings. To the extent that such cases exist, she adds, “they’re just not the drivers of spending” in bulk.

The study also illuminates the general circumstances of late-in-life mortality. Fewer than 10 percent of people who die in a given year have a predicted one-year mortality rate over 50 percent. As the researchers found, even when people are admitted to a hospital in what turns out to be their last year of life, fewer than 4 percent of those patients have a predicted one-year mortality rate of 80 percent or higher at the time of admission.

In a sense, the study shows, the apparent concentration of spending on last-year-in-life patients is a byproduct of the fact that even relatively low-mortality health scenarios for the elderly will include a certain number of deaths — not that the individual treatment decisions represent longshot cases.

http://bit.ly/2NySZ7c

In the second of five articles analysing public submissions on the proposed euthanasia law, Jeremy Rees examines worries about families coercing people to end their lives.

Would families pressure a loved one suffering a terminal disease into taking their lives if euthanasia becomes legal?

“I believe that this law change will be putting vulnerable patients at risk,” Auckland GP, Gisa George says.

“I am worried about the strain this would put on our elderly. Often the elderly feel isolated and vulnerable. Many of them feel that they might be a burden to their loved ones, especially when they need a lot of input and care. If assisted dying is legalised , there is a risk that our elderly might feel that they need to choose this option….”

The worst case of this I witnessed involved the hospital roomate of my maternal grandmother who spent a month dying from lung cancer at 87. At that time, visiting hours were the same for everyone, and the family of her roommate was in at the same time everyday. The roommate's daughter-in-law spent the visits telling her mother-in-law how the cost of the treatment was taking away the future of her grandchildren. Awful....

Youtube video...

http://bit.ly/2NARlC4

Experts have told us that they can discern within minutes whether any given long-term care environment is the type that truly supports self-determination and self-advocacy for residents. People in long-term care deserve privacy, freedom, respect, and every chance to pursue a fully engaged adult life. Here are some "Welcome Indicators" that can help you tell right-off-the-bat whether or not an environment is the kind that regards and facilitates its residents.

The first part of the article is a very thorough and complete narrative about all the ways that probate is used to exploit and steal the assets of old people. I didn't quote it because it is long and has an internal logic that can't be shortened. Read it..... 

http://bit.ly/2IYYtot

The completely legal, utterly grotesque system for undermining the rights of the elderly.

“In 2003 in Florida, there were 23 professional guardians,” he said. “Today, there are 670.”

According to Sugar, these guardians are sometimes no more than high-school graduates with little or no experience and are often untrained, uncertified and unlicensed. Yet they can make $85-per-hour-per-ward-per-day. An income potential of $100,000-per-year can be earned simply by opening the daily mail belonging to half-a-dozen wards.

“The stated occupation of one of the most prominent guardians in the State of Florida is ‘dog walker’,” Sugar said. “But she has control over the lives of elderly people and multi-million or billion-dollar estates.”

Speaking generally, and without addressing Munger or any other guardian, Sugar described what he said was a common pattern.

“The first thing the guardian does, within the first 30 days, is to collect every nickel the ward owns. It’s called ‘marshaling the assets’,” he explained. “Then they seize recurring revenue streams. If you’ve ever worked, been in the armed services or had a pension, you represent a tremendous amount of income because the guardian now controls your Medicare or Medicaid. They seize and divert social security payments or veteran’s benefits and change beneficiaries on life insurance policies.”

Sugar added that the power guardians are given concerning a ward’s home or estate can result in “Strawman Sales.”

In a Strawman Sale, a guardian will appraise a home for a low amount for which he will secure court approval to sell. After ransacking it and taking whatever is of value, the guardian will then use a colleague, friend or associate to purchase the home at the court-approved rate. The court will then be sold at its full value allowing the guardian to keep profits never reported to the court.

“There are an endless number of ways for a guardian who is a layer to profit particularly from one ward,” he said.

Meanwhile, the family members who fight in Probate Courts to have their loved ones restored to them are systematically drained both emotionally and financially; punished for daring to oppose a system which is completely out of control and has all but been left unchecked, except by those few who have run afoul of it and fought back through ceaseless activism.

*     *     *

For eight years, Sugar has made it a life mission to raise awareness about guardianship abuse.

The son of two survivors of Auschwitz and Bergen-Belsen, who met in a Swedish refugee camp after liberation, Sugar arrived in the United States with his parents in 1949 and settled in Chicago. After a successful practice in internal medicine and a directorship of medical services at a North Chicago hospital, Sugar retired with his wife to Florida proud to leave the work of continuing the family legacy to their four children and eleven grandchildren.

Prior to eight years ago, Sugar was like many Americans. He was, he said, unaware of a nationwide industry that, in his opinion, was created around hijacking seniors and plundering every last item of value from them.

Sugar’s own family became involved in a legal matter involving guardianship—one he still cannot discuss today because, like the family courts who dispense judgment on the future of minors, those charged with rendering decisions on the elderly routinely issue the same non-disclosure gag orders which, under the auspices of privacy, also serve to shield court employees from accountability from the media or from legislators.

One thing Sugar can talk about was the effect the case had on him.

“It seemed to me that this was a system unbelievable for it to be occurring in the United States,” he said. “It was so off the charts, so unexpected and cruel that I decided to get educated. I had thought we were the only ones but, very quickly, I ran into people who had the exact same thing happen to them.”

http://bit.ly/2NuH3DF

Nuplazid, a drug for hallucinations and delusions associated with Parkinson's disease, failed two clinical trials. In a third trial, under a revised standard for measuring its effect, it showed minimal benefit. Overall, more patients died or had serious side effects on Nuplazid than after receiving no treatment.

Patients on Uloric, a gout drug, suffered more heart attacks, strokes, and heart failure in two out of three trials than did their counterparts on standard or no medication.

Nevertheless, the FDA approved both of these drugs -- with a deadly aftermath. Uloric's manufacturer reported last November that patients on the drug were 34% more likely to die from heart disease than people taking an alternative gout medication. And since the FDA fast-tracked approval of Nuplazid and it went on the market in 2016 at a price of $24,000 a year, there have been 6,800 reports of adverse events for patients on the drug, including 887 deaths as of this past March 31.

The FDA is increasingly green-lighting expensive drugs despite dangerous or little-known side effects and inconclusive evidence that they curb or cure disease. Once widely assailed for moving slowly, today the FDA reviews and approves drugs faster than any other regulatory agency in the world. Between 2011 and 2015, the FDA reviewed new drug applications more than 60 days faster on average than did the European Medicines Agency.

Europe has also rejected drugs for which the FDA accelerated approval, such as Folotyn, which treats a rare form of blood cancer. European authorities cited "insufficient" evidence of health gains from Folotyn, which shrinks some tumors but hasn't been shown to extend lives. It costs more than $92,000 for a 7-week course of treatment, according to research firm SSR Health.

As patients (or their insurers) shell out tens or hundreds of thousands of dollars for unproven drugs, manufacturers reap a windfall. For them, expedited approval can mean not only sped-up sales but also -- if the drug is intended to treat a rare disease or serve a neglected population -- FDA incentives worth hundreds of millions of dollars.

"Instead of a regulator and a regulated industry, we now have a partnership," said Michael Carome, MD, director of the health research group for the nonprofit advocacy organization Public Citizen, and a former U.S. Department of Health and Human Services official. "That relationship has tilted the agency away from a public health perspective to an industry friendly perspective."