Michigan Disability Resistance

Some seniors think Medicare made a mistake.  Others are stunned when they find out that being in a hospital even for a couple of days doesn’t always mean they were actually admitted.

Instead, they received observation care, considered by Medicare to be an outpatient service. The observation designation means they can have higher out-of-pocket expenses and fewer Medicare benefits. Yet, a government investigation found that observation patients often have the same health problems as those who are admitted.

More Medicare beneficiaries are entering hospitals as observation patients every year. The number doubled since 2006 to nearly 1.9 million in 2014, according to figures from the Centers for Medicare & Medicaid Services. At the same time, enrollment in traditional Medicare grew by 5 percent.

By and large, Dale Kleber had a pretty straightforward trip up the economic ladder. He went to law school and worked his way up to general counsel of a major food distributor in Chicago and then chief executive of a dairy trade organization. He is putting his third and fourth kids through private college.

“Our generation was pretty spoiled,” says Kleber, 60. “We had it good. The economy was in a huge growth spurt. Some dips here and there, but nothing severe.”

But a couple of years ago, Kleber hit a roadblock. He’d left the dairy group and started looking for another job; he and his wife didn’t have quite enough saved to retire comfortably. He didn’t think he’d have trouble finding work.

Scores of applications later, with few callbacks and no offers, Kleber is close to admitting defeat — and admitting that age discrimination might be one of the biggest challenges his generation has faced.

Although a 2013 Pew Research Center study shows that 65 percent of Blacks are against assisted suicide, there are not many Blacks who are active in the anti-doctor assisted suicide movement. Here are three reasons that we Blacks must join this critical movement.

1. Our Healthcare System is inherently racist. Studies show that Blacks are treated differently than White patients and receive inferior care, particularly in the areas of cardiac, diabetes, and pain management. Blacks are more likely to die because doctors have overlooked something critical or will not listen to or believe what we have to say about our health and pain. This puts us at a greater risk for persuasion or coercion into assisted suicide should we acquire a terminal illness.

2. Black patients, particularly those of us with disabilities, are more likely to be poor and either not have access to or be aware of services, supports and financial assistance and accommodations, putting us at risk of doctors devaluing our lives and persuading or coercing us into assisted suicide, citing financial burdens on our families.

The American Bar Association has asked that a proposed Centers for Medicare & Medicaid rule authorizing mandatory, pre-dispute arbitration in long-term care admissions contracts not be implemented.

In a letter (PDF), sent Monday to administrator Seema Verma, the ABA advocated for CMS retaining its current rule, which prohibits long-term care facilities from entering into binding arbitration agreements with residents until after a dispute arises.

The Trump administration introduced the proposed rule change in June. That was in response to a 2016 Health and Human Services rule under the Obama administration that prohibited federal funding for nursing homes requiring residents to resolve disputes in arbitration. A motion filed by various nursing home groups to block enforcement of the rule was granted in November by a U.S. district court judge in Mississippi. The ruling was appealed, however, in June, the court granted a joint motion to stay (PDF) district court proceedings, pending completion of proposed rulemaking.

If implemented, the proposal would harm residents’ rights and interests, the ABA letter states, and the current rule fits the recent U.S Supreme Court interpretation of the Federal Arbitration Act. Some believe the high court’s May 17 opinion(PDF) in Kindred Nursing Centers v. Clark prohibits bans on pre-dispute binding arbitration in long-term care admissions contracts, but that view is “mistaken,” the ABA letter states. In the Kindred opinion, the court found that under the FAA, arbitration agreements may only be found invalid based on legal rules that would apply to any contract.

“While Kindred clearly prohibits singling out arbitration agreements for disfavored treatment, nothing in the court’s reasoning or under the terms of the Federal Arbitration Act require singling out arbitration agreements for favored treatment. Yet, that is exactly what CMS is doing by its proposed total embrace of mandatory pre-dispute arbitration provisions in admissions contract,” Thomas M. Susman, director of the ABA’s Governmental Affairs Office, wrote in the letter to Verma.