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The Affordable Care Act (ACA), that dream that President Obama brought to fruition despite warnings from mindless Republicans that it should be flushed down the toilet, is going to make the Kochs and their like a lot richer. The GOP mindset is a wonderment.  "I want what's mine and I'll take yours too." The ACA offers endless opportunities for its adversaries to rake in hundreds of millions of dollars when the Care Giving industry begins booming...and it will.
     

There are several levels and options available when extended care becomes necessary.  Most are or will become acquainted with this industry while in recovery from an accident, illness or existing condition.  Long term care is essential but prohibitively expensive and, while some private insurance or Medicare may cover a large portion of the costs, they do not cover all of the costs..  Those not covered are the responsibility of the patient in the form of co-pays, which are high. The most typical agencies are those that offer extended patient care in skilled nursing facilities that provide 24/7 care for as long as necessary to meet "safe discharge" criteria.  Most of those are nationwide and carry familiar names. These serve primarily those of us who do not have long-term care insurance.  Strict State standards for these facilities are in place.

A second type of facility is the privately owned, usually in a home environment with private rooms or two person occupancy. These are selected by families whose relative has a condition, such as Alzheimer or Dementia, and demands constant supervision as well as care.  They are extraordinarily expensive and may be paid for by private insurance.

The third and the one with which some of us may become familiar are those that care in the client's home. The length of in-home care is determined by the client and can crange from 2 hours to  24/7.  In-home care is traditionally paid for by the patient with 24/7 costing from $275 to $450 per day. But that is not the entire cost. The client is also required to provide to the care giver 3 meals per day and to purchase all supplies necessary. Who wouldn't be interested in investing in a business with ridiculously low overhead?

As more people sign up for the ACA, the more need there will be for extended care facilities. This cannot be anything less than America's next booming industry. The likelihood of a "boomerang" diminishes with the musical sound of each "k aching."  

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Comment Preferences

  •  I read an amazing article (6+ / 0-)

    about a town in the Netherlands recently.  It is actually a facility for people with dementia that was built like a walled in town. It has shops and a theater and everyone from patients to care takers are dressed in regular clothes.

    The idea is to give people with dementia a way to have a "normal" life while still totally safe.

    Most of the people taking a hard line against us are firmly convinced that they are the last defenders of civilization... The last stronghold of mother, God, home and apple pie and they're full of shit! David Crosby, Journey Thru the Past.

    by Mike S on Sat Jun 21, 2014 at 02:17:16 PM PDT

    •  This is it: (6+ / 0-)
      Recommended by:
      DRo, cany, Pluto, Catte Nappe, thomask, David54
      In the Dutch municipality of Weesp, not far from Amsterdam, sits the village of Hogewey. At first glance, it looks like any other village, with shops, restaurants and a movie theater. Apartments surround a courtyard complete with rippling ponds, trickling fountains, vibrant seasonal flowers and benches perfect for enjoying a sunny afternoon.

      This village, however, is quite unusual. Hogewey, sometimes referred to as "Dementiaville," is an ongoing, 20-year-old experiment in cutting-edge dementia care. Home to 152 men and women living with severe dementia, the community has 23 residential units, each shared by 6 to 8 residents. Around-the-clock care is provided by 240 full- and part-time "villagers" who are actually trained geriatric nurses and caregivers dressed in street clothes. The staff takes care of everything from cooking meals and planning activities to assisting with bathing, personal care and medications. Even the individuals staffing the various village "businesses" are trained in dementia care.

      Most of the people taking a hard line against us are firmly convinced that they are the last defenders of civilization... The last stronghold of mother, God, home and apple pie and they're full of shit! David Crosby, Journey Thru the Past.

      by Mike S on Sat Jun 21, 2014 at 02:25:25 PM PDT

      [ Parent ]

      •  Thank you Mike for a wonderful story! (1+ / 0-)
        Recommended by:
        Mike S

        Mike,

        I cannot tell you how much I appreciate your replying to the article I wrote and for sending the text of the Netherlands experiment.  What an incredible concept. One of my roommates in hospital was a 75 year old woman who had been diagnosed 11 years earlier with Alzheimer. I have been fascinated by the human brain for years and knew that there was light inside of the darkness. I watched a conversation that her family had with the psychiatrist treating her and could not believe how they conversed, using pronouns rather than her name.

        I wrote my article using my own experience in skilled nursing facilities following an accident in December 2014. I was sent by the hospital to a facility where I remained until late April. I am now home and am paying the unbelievable price of $2,100 per week and it's bankrupting me - literally. Something has to change in the follow-up care; staying in a skilled nursing facility is enough to drive anyone into dementia...

        When I was posting on Huffington Post, I communicated with two friends from the Netherlands. This was when gun violence erupted (Newtown; Aurora, et al) and to learn how the Dutch view of our country is changng. It's important for us to be aware of this and to take it seriously. We are not losing our standing as a power but we are rapidly losing respect.

        I enjoyed reading your comment and hope we stay in touch.

        Pat

        •  Don't think too poorly of the doctors and family (0+ / 0-)

          members you just wrote about. My step father suffered from Alzheimer's for many years until he passed away last year and my mother is in the middle stages of it. Other than his disposition my step father was replaced completely by someone else. Coping with that was extremely difficult. Realizing that I will be going through it again is even harder.  People have to deal with it in their own ways so I don't think there is a "correct" way to do it.

          Thanks for your kind words and best of luck with your recovery.

          Most of the people taking a hard line against us are firmly convinced that they are the last defenders of civilization... The last stronghold of mother, God, home and apple pie and they're full of shit! David Crosby, Journey Thru the Past.

          by Mike S on Sun Jun 22, 2014 at 09:59:26 AM PDT

          [ Parent ]

          •  home health (1+ / 0-)
            Recommended by:
            Mike S

            Mike S,

            Thank you once again for responding.  There is no greater teacher than experience, and you have had your share.  We in my family have had the good fortune to have avoided witnessing those we care about go through the declining mind.  Our enemy has been cancer, which took my father at a young age (pancreatic), my sister (colon and liver), and 3 brothers (lung - years of smoking).

            Pat

  •  Which is why the Harris case is so important. (3+ / 0-)
    Recommended by:
    DaNang65, Catte Nappe, David54

    It's about the unionization of home health care workers.

    "Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity." --M. L. King "You can't fix stupid" --Ron White -6.00, -5.18

    by zenbassoon on Sat Jun 21, 2014 at 02:23:42 PM PDT

    •  health care facilities (0+ / 0-)

      zenbassoon

      Thank you for replying to the article. I love the Dr. King quote - "conscientious stupidity" - how vividly he describes what has been happening in our country.

      Unions are vitally important in most industries. While Medicare     and private insurance pays about $300 per day per patient in skilled nursing (at least those in California where I live), the care givers earn about $11 to $12 an hour - and they do the hard work.

      We have a long way to go to reach equity in all fields of work. I was in skilled nursing for several months and learned more than I want about how they operate.  Their employees work 12 hour shifts; have 3 breaks; one-hour for lunch and dinner, and must supply their own food, not that the food even resembles fine dining.

      Excellent quotes - thanks again.

      Pat

  •  Can you explain please (2+ / 0-)
    Recommended by:
    Susan from 29, Catte Nappe

    why:

    As more people sign up for the ACA, the more need there will be for extended care facilities.
    Will the ACA make more people sick?
    •  Just a guess on my part but the more (2+ / 0-)
      Recommended by:
      AR2, David54

      care people get the longer they will live.

      Most of the people taking a hard line against us are firmly convinced that they are the last defenders of civilization... The last stronghold of mother, God, home and apple pie and they're full of shit! David Crosby, Journey Thru the Past.

      by Mike S on Sat Jun 21, 2014 at 03:25:11 PM PDT

      [ Parent ]

    •  Health Care boom (0+ / 0-)

      I like Bill Clinton's simple answer to most of life's mysteries: "Arithmetic."  

      My personal guess is that there will be three forces that drive the increase in health care facilities: population growth, greed and need. As the ACA membership increases, the need for more skilled nursing facilities will increase. People who have not had health insurance would most likely not have been able to afford the care that is available - few of us actually can. Hospital stays are shorter (I was transferred to a facility on the 4th day following my surgery) and this can impede recovery. Facilities that once provided physical and occupational therapy now treat illness and injuries.

      I see that you are from California. I live in the capitol city and there is an explosion of new hospital construction and modernization/enlargement of existing hospitals. Kaiser has at least 6 in the region with more under construction; Mercy (now known as Dignity Health) has just modernized 3 of its largest hospitals and built an acute care facility with more on the way. The University of California Davis facility doubled in size and offers care for most who do not have health insurance yet. It also houses the UC Davis Medical School and is the northern California triage center.

      I never expected to become so interested in the health business, but the opportunity for greed and wealth are in place.

      Pat

  •  Aging Services are the Boom Time Industries. (2+ / 0-)
    Recommended by:
    David54, TheDuckManCometh

    You provide a good outline of the principal services that will now be funded in ways that were undreamed of 5 year ago.

    Provider Magazines 2013 Top 50 is a who's who of companies making a fortune on seniors housing and care, long term care, long term and post-acute care, or aging services.

    http://www.providermagazine.com/...

    Genesis
    ManorCare
    Life Care Centers
    Golden Living
    Kindred Healthcare
    SavaSeniorCare
    Consulate Health Care
    Extendicare
    Evangelical Lutheran Good Samaritan Society
    Preferred Care Partners
    Creative Solutions
    Saber Health Care

    Here is an interview by a expert in the  field of for profit nursing home care- it was done in 1997 and forecasts the future- a future that most of these companies counted on.

    For-profits have come to dominate the U.S. nursing home sector. Why? And what effect does this reality have on quality of care? More broadly, what can we learn from this industry about the roles of nonprofit and for-profit firms competing in the social service marketplace? Fuqua Professor Will Mitchell discusses his research team’s answers to these questions derived from their analysis of several thousand nursing homes over seven years.

    http://www.caseatduke.org/...

    "It is better to light one candle than curse the darkness." (Adlai Stevenson in praise of Eleanor Roosevelt) (Glowing Candle Avatar Adopted in 1986)

    by murphthesurf3 on Sat Jun 21, 2014 at 08:21:36 PM PDT

    •  Health Care (0+ / 0-)

      As usual, I write the ending and you supply the academia.

      Thanks for the links; I'll check them out.

      P

      •  I find the numbers in the info provided (0+ / 0-)

        compelling in supporting your case. The old, the sick, the infirmed are cash crops in a system where the state guarantees payments....so your thesis is one that is, on its face, both logical and likely.

        "It is better to light one candle than curse the darkness." (Adlai Stevenson in praise of Eleanor Roosevelt) (Glowing Candle Avatar Adopted in 1986)

        by murphthesurf3 on Mon Jun 23, 2014 at 09:51:08 AM PDT

        [ Parent ]

  •  This is exactly why the ACA was just the beginning (0+ / 0-)

    of a process that must continue at the federal level and at the state level .
    Personally I believe that process of driving the profiteering out of health care will end with single payer health care which squeezes the most bang out of every buck spent on health care.

    You can't make this stuff up.

    by David54 on Sun Jun 22, 2014 at 06:37:07 AM PDT

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