I apologize for the length of this article, started before Thanksgiving! I had no idea there were so many facets to this subject. I have done my best research and verification I could do. But, if any reader spots an error, please let me know. This is what is wrong with our health care system.

Managed Health Care
Does that give you a feeling of security? It shouldn’t. For the past three months I’ve been talking to people from four hospitals, as well as EMT’s and Home Health Care employees. I have listened to doctors, nurses, patients and families of patients. Insurance agents for their perspectives and people who have to code correctly for Medicare, Medicaid and insurance companies. It has been as comprehensive as I could manage. It is a fascinating subject. But the more I dug, the more I wondered how we would or even could change it.

We have gone from a world where doctors were in private care, in charge of all aspects of their business. If they turned out not to be good doctors, they endangered their own livelihood along with the patient. Most charged a reasonable fee that people could afford. But, if the person was truly destitute, they either wouldn’t charge them or ask them to pay what they could. In those days, a doctor might receive produce or eggs. Sounds like a good bargain to me.

Doctors of yester year treated the whole person, not one part or one organ. They took whatever time was needed. Not every patient was the same. The majority of doctors went into the medical field to help people, to heal them. Not to see how many drugs they could get them on so they could profit from drug company kickbacks. But, the Archons, who run this world, couldn’t have that. All these positive outcomes couldn’t be allowed to continue. There was no real money in that.

So, the next move was making sure that doctors would have to join in partnerships with other doctors. One person could ill afford those shiny new medical machines. Also, during my childhood, doctors in private practice would make house calls if people were too ill or had any kind of infectious disease. What? You mean you didn’t have to drag yourself out of bed to go sit in the doctor’s office, spreading germs to anyone there?

However, that was soon to change, as the goal became profit, for some doctors. It wasn’t just about caring for people anymore. It was to make as much money as the system allowed. But, as with all systems, any time you centralize power, you are asking for tyranny. This has created a paradox in this country. America has the best health care in the world-if you can afford it and if you can find it. The last of the home visiting doctors, at least in my area, was in the late sixties, as my mother’s health necessitated it. Strangely enough, her health returned once she had to make the trek to his office.

About this time, I began to notice another change in health care. The big insurance companies seemed to have more power than the doctors to determine your care. First with Blue Cross/Blue Shield, then Aetena, I found there was a third more powerful voice in whether I needed a test done or not. Being disgustingly healthy most of my life, I paid little attention to these changes. But, I was made aware of the change in one area. When you went to one doctor in a cluster of three or four in a practice, it was a roll of the dice which one you would get to see on any particular day. Even for just a general check-up. Inevitably, there was always one I didn’t like, and that is who I got most of the time.

Health care is not like commodities that can travel distances for a profit. It is always or it used to be local. When I had an infection of four serious bacteria in my bloodstream, I got to consult with what they called, a doc on a stick. The Infectious Disease Doctor who was in Texas, lived several states away. That was so cool. The doctor is using zoom or some such AP. However, in many situations you need to be able to see a real live doctor. I would say over the last thirty-forty years, we have seen one consolidation of doctors and hospitals, where most doctors operate out of. (pun intended) This isn’t always a good idea when you are talking about people’s health care.

For a time, at least in this area, doctors ran hospitals. Enter the insurance companies. Now you have people with little to no medical degrees or knowledge, deciding whether a patient could have a procedure or a drug. Then, insurance companies began hiring doctors, at more money than they could make ‘practicing’ medicine. I remember reading about one of those doctors, who finally quit because she just couldn’t take it anymore. Humana paid her a very good salary, but it was based, along with her bonuses, on how often she determined that the person didn’t need the procedure or medicine they wanted and needed. Her conscience finally surfaced.

Doctors with ethics, began to walk away from this way of ‘providing’ health care. If they were going to be able to care for people, they needed to hire people, or train those already working for them, to deal with the insurance paperwork. Payments relied heavily on coding eventually. Make a mistake and you wait even longer for payment. Medicare and Medicaid are notoriously slow to pay. Independent doctors, the few remaining and small hospitals couldn’t afford to wait months for their payment. Hospitals in larger cities weren’t hurting too badly yet. And hospitals run by churches were last to fall victim to these corporations. But, fall they did. Medical equipment is expensive. Doctors still in private practice, couldn’t afford, for instance a mammography machine, and many of the other services the hospitals provided. So, they had to somewhat stay in the good graces of those who owned those machines. Also, as newer and fancier machines came on the market, many hospitals bought more than they needed. So, doctors, who were tethered to that hospital, were ‘encouraged’ to suggest their patients needed that test just to be sure. My goodness, how did doctors ever manage to heal their patients before all the bells and whistles were available?

At some point, the private equity investors took over, not the actual patient care, but what doctors were allowed to do. We still have doctors to provide care, of course, but there is a thin line that they follow in that care. Most doctors limit their time with a patient to 15 minutes. So if you’ve ever felt like you were getting the bum’s rush, you probably were. I began to discover that, in some hospitals, doctors were ‘encouraged’ to take a patient’s age into consideration. Did they really need that kidney transplant? Wouldn’t weekly dialysis do for the remainder of their life? Had age always been a factor and I just hadn’t been aware of it? Was a form of National Health Care a better choice? If so, why did wealthy Canadians come to the United States for most of their care? What about Western European countries? Did they offer better care? I decided to find out.

I had heard for years how far superior the Western European form of medical care was. When it comes to integrative medicine, yes. But, their population is aging like ours is. This brings on long term care. I found they were suffering from the same conditions. administrators/investors, not doctors decided such things as consolidations, cuts in services. Hiring people, not always vetted properly. Background checks were either non existent or sloppy. And then, COVID hit. In the U.S., many health care workers refused to treat people with an experimental drug, not approved by the FDA. Many refused to take any of the jabs themselves and were either fired or quit in protest. As more and more people refused not only the COVID shots, but other vaccines as well, fearing that anything in a syringe could be one of the COVID jabs, a crisis in health care has been the result. Referred to in some places as a medical desert. I was to find out that people who were turned down because they were told there was no room, later found out there were beds, but the hospital or nursing home was running on a serious worker shortage. That just confirmed my suspicion early on, that things experienced here were being experienced world wide. This wasn’t an accident. It had all been planned for a long time.

I learned from a person in administration, who asked to be kept anonymous, that private equity firms are moving quickly to buy into the American health care system, and have been for some time. This is mostly, hospitals, nursing homes, home health agencies and senior apartment complexes. It appears that we old farts are worth some money. Investments have increased substantially since this person took their job, over twenty years ago. They also said that investments have increased at least 20 fold from around 2000 to 2018. And have continued to accelerate since that time.

Their story made me think of sharks circling around helpless victims as financially distressed rural hospitals became targets. These investments aren’t about improving services to the patient. Instead, the investors put profit before patient health nearly always. This makes vulnerable communities sitting ducks for the investors to take advantage of the situation. When COVID first hit in 2020, my daughter worked at a nursing home in another city. The shark spokesman showed up in sandals and pajama bottoms for the introduction as the new owners. They took everyone’s seniority away and limited care for the residents in order to save money. Several people walked off the job and their seniority was finally restored. But, not everyone came back. Nevertheless, they weren’t replaced. As COVID made it’s way through the community, the agency allowed a local hospital to dump COVID positive people into the general population. Fifteen people died, including a nurse and office staff person. There is a massive class action lawsuit in progress.

Another home health agency was bought up by these same investors. Same story, different place. The care of the elderly dropped significantly. Wages and salaries were frozen until the agency started showing a profit. And, once more, they lost quite a few nurses, CNA’s, kitchen staff and other employees. How is this benefiting people? Does anyone remember when doctor’s in California went on strike, I think in 77? I remember the number of people dying, dropped precipitously. How interesting. So, in many areas of the country, these vulture investors began to look around for stressed rural hospitals that just didn’t have the capital to keep running. The rural hospital, of course, was happy to partner with an investor that had money to keep them serving their communities. I wonder if they read the fine print on that contract?

Consolidation has had mixed results for these rural hospitals. Sometimes the investors allowed the hospital to continue to run and serve the community. Often, the hospital found that they were being limited in the services they could provide. Quite often the hospital discovered that the larger hospital would take the money generated by the rural hospital and invest it in other hospitals they ‘owned’.This forced the smaller hospital to eventually close their doors, leaving a community adrift and having to drive a ridiculous number of miles to receive the care they used to get locally. Working in a local hospital’s home health department, I got to see this deterioration of care up close.

As a patient advocate, I was able to keep the patients and their families well informed on over prescribing both medicine and procedures, like mammograms. The decision was always the patient’s and the families, but at least it was an informed decision. I nearly had a heart attack myself when I went over a new patient’s med list, to see that her doctor was prescribing a heart medicine that didn’t play well with her diabetes medicine. It was causing heart attacks and was eventually taken off the market. When I called her doctor to ask if he was aware of this, he said, “Oh, no. I didn’t know that. I will change her medicine and please take those that she has back to the pharmacy.” This was not an isolated incident. And, strangely, he seems to be the doctor of choice for the elderly at home or in nursing facilities. I smell money filling pockets. I also realized, over time, that as my clients aged and entered a nursing home, this same doctor soon had them back on three pages of pharmaceuticals instead of the few necessary ones. I don’t suppose this doctor got any kickbacks from the drug companies?

And then we get to deal with Medicare and Medicaid. Many doctors refused to take anyone on Medicaid. Either agency took so long to reimburse money for the service, that many hospitals and nursing home agencies were forced to assign a full time person just to deal with, not only insurances, but both of those programs. Medicaid is a federal agency, yes but it is managed by the state. In the case of our state, we were losing so much money on that program, that our governor was thrilled to turn that behemoth over to three insurance companies. We had a meeting in our library with the mouth pieces from the three companies. I said, “You guys are going to lose your ass. Do you think the governor wanted to get rid of this program because it was such a money maker for the state?” I got three pair of deer in the headlights looks

In less than three months, one of the companies was gone. In another six months the second company bailed. The third company managed to hang on doing just what I had predicted they would have to do to remain solvent. I and others, had tried to tell them there was no way they could provide the same level of service the recipients were used to, and pay for our wages. They would have to make some serious cuts somewhere. They would have to cut the time allowed for a service, or eliminate some of the services entirely, or pay us workers a lot less. Which would cause a serious drain of people in health care. You have to cover every person who qualifies. Whether or not they played fast and loose with what it took to qualify, I don’t know, but we had several patients dropped.

This proved to be ‘managed’ health care on steroids. As I had expected, services were sharply curtailed. A bath allotted an hour, originally, went to 20 minutes. That usually entails assisting a patient to the bathroom. Helping them to undress and step into the tub or shower stall. Soaping and rinsing them. Shampooing and conditioning the hair. Drying them off, and applying a lotion to their skin. Then helping them dress again and escorting them back to their recliner or lift chair. Then, you have to clean up the mess you made in the bathroom. I don’t know about other CNA’s. I’m fast, but there is no way I can move an elderly patient that fast to accomplish all of that in twenty minutes. I refused to comply. When the director tried to intimidate me, she found out what a mistake that was. I said, “Don’t Medicare and Medicaid pay you for an hour bath? She said yes, and I said, “That is fraud. And, I will give those people the hour they have coming or I will turn you in to the Medicare/Medicaid hot line for fraud.” I was the only one ‘allowed’ to take an hour with a patient. Everyone else had to do baths in twenty minutes. So, I called in to the Medicare/Medicaid hot line and turned her in. Whoever the agency had doing investigations in our area must have been a buddy of hers. They called her to let her know when they would be there so she would have time to make sure all her ducks were in order.

That wasn’t unexpected, I was in the process of finding a different job and eventually started working for myself and turned my paperwork directly in to the state for payment. Double what the hospital paid. Then the three insurance companies took over and it was a disaster for all of us. They made it nearly impossible to take patients to other towns for specialty treatments. When we had done this service under the state, we only needed the doctor’s signature on the patient’s printout and we were paid for the trip and mileage as well. After the three insurance companies took over, they made it nearly impossible to be reimbursed for a road trip. Most of us refused to take patients out of town then, causing a burden to the patients and their families who had to take a day off work to take them to their appointments.

I read the other day that 65 million Americans are on Medicaid. Add to that, in 2022 there were 63 million people on Medicare. Hospitals know when Medicare/Medicaid people show up, they are going to lose money. So, some inflate the cost to be covered. Medicare, for instance, will decide how much will be allowed for that service. Then they will pay 80% of what is allowed. In my case, still holding on to an F plan, my insurance pays the balance. Others may be left with the remainder of the bill. I began to notice service prices being exaggerated, so the final pay could come close to or exceed what a procedure or service truly costs.

Who determines the cost of an MRI or CT Scan? One source I talked to said that hospitals charge anywhere from 300-1,200% of what they know Medicare/Medicaid will pay. So, what is the true cost? And, where does that money come from? People who are still working and paying taxes, of course. Do corporations or insurance companies have to invest any money in this black hole? Either way, insurance rates go up.

Then we come to 2021, 2022 and beyond. Hospitals, receiving government money, were mandated to be in 100% COVID compliance as far as vaccines, masking and social distancing. But not all followed these mandates to the letter. That was just the excuse many fell back on. This meant if you wanted to be employed there, you went along with the program. I’m not quite sure how you could be compliant, wearing masks that don’t work or how you could care for someone from a distance, but that was the loony orders coming down from on high. A good many hospitals lost people in every department, radiology, lab techs, emergency care, doctors, nurses and CNA’s.

My daughter was the first nurse fired for refusing to take the jab. And she took many others, including all of maintenance, out with her to walk the picket line. Try running a big hospital without maintenance. Union steward training and walking a picket line with me, as a child, taught her well. Many chose to stay and took the jab for financial reasons. That is all she was striking for, CHOICE NOT MANDATES! Even with the COVID money from the government, it was still stressful to lose people well trained on the job. And, that only worked until May 11, 2023 when the COVID spigot was turned off.

Because of my usual curiosity during a short stay in two different hospitals, I asked several employees how the shortages were working out. I discovered that one way was to bring in RN’s, LPN’s, CNA’s and other workers to take the place of those who were fired for non-compliance or who had just walked off the job because they refused to be coerced to take an experimental drug jabbed in their arm. One after another of these employees said they had answered advertisements to work as traveling employees. The majority I talked to said, for instance that the RN’s were paid $264.00 AN HOUR, plus room and board and travel time paid for. Plus, wait for it, they weren’t required to be vaxxed. WTH?
That is how your tax dollars were being squandered-er paid out. Wouldn’t it have been simpler and cheaper to make getting the jab a choice instead of a mandate?

As for the smaller hospitals in our area, and no doubt, nationwide, the venture capitalists were taking money generated from their care and reinvesting it in larger hospitals elsewhere. I watched this happen to a city just south of us. First, their hospital struggled to stay in business. Soon a larger hospital in a bigger city south of there bought them out. Everything looked great for a while. Repairs were made to the structure, people were hired for specific positions. Then 2-3 years after that, the doors were closed. Shock rippled through the community as jobs were lost and services were 20-30 miles away. Before too much longer the larger hospital set up a care center on Main Street to cater to Medicare/Medicaid cash cows, like podiatry, eye/ears/nose and throat doctors. And, while we were still waiting for that service to settle in, we saw notice of their closure, 1-2 years after opening. I received a letter, dripping with sorrow that they had to close this center. We could choose to go to their other centers, 10, miles away, 45, or 40 miles further. I think I will go back to soaking my feet, then clipping my own toenails...or make my husband an offer he can’t refuse! I was instantly suspicious as the factory I had worked at for 28 years, was bought out by a giant privately owned company, but the CEO was refusing to let me order small parts that would allow me to fill a 100,000 dollar Saudi order. When I threw a fit to the head of Accounting. He laughed and said, “A failing company is a wonderful tax write off. And after five years, he will close the doors.” Which is exactly what he did. Hmm.

The other medium sized hospitals in the area consolidated. Unfortunately, they also consolidated names with no indication by city which one they were. It took a while, and many complaints from patients and hospital personnel before they found a way to identify which hospital to send orders to. I’m pretty sure the people making these decisions have reached their level of incompetence. The ambulance service didn’t escape this stupidity either. I have watched as the ambulance service was first run privately, then by the hospital, then by the county. It looks right now, like it has been sandwiched in with the fire department. It is difficult to see why this backbreaking job pays so little, but explains why the turnover is so great. When your life is in the hands of an EMT, you want them to be well-trained and motivated to do the job as best they can.

Between low pay and mandated jabs, our county has lost roughly 33% of those employed previous to 2021. How can you fully run a hospital if you don’t have enough well-trained and well paid people to take care of your patient load? If you can’t afford to pay them what a larger hospital in a big city would pay them, you’re going to lose some of your staff. With rural hospitals taking in less money, more people on the government dole and fewer people who have employee subsidized insurance, it’s a no-brainer that the smaller, rural hospitals would be closing their doors. That means, if you have a heart attack for instance, or are in a major car wreck, you will have to travel farther to a hospital. And, as my RN, Cath-lab trained daughter says, “Time is tissue”, especially when it comes to a heart attack.
When rural hospitals close their doors, it affects more than just their patients. That hospital also provides usually, well paying jobs, in most circumstances.

Universal Health Care is just about inevitable. Will UHC take care of the doctor/nurse/EMT shortage? It remains to be seen. And, what about the rural areas? We need transparency at all levels. Do we really need to have dozens of prices for the same procedure? Current payments are set by Congress for Medicare and Medicaid. On top of that, there are swarms of lobbyists hovering around every Congress person. That is why payments are set below what it costs to provide the care, which means they will be underpaid. There has to be some way to change how services are paid. Perhaps that is one reason why people sixty-five and older receive less quality care than the young. Every death reduces yet one more person carried by the system. I hate to think that is the case. Yet, nearly every time someone tells that their loved one received shoddy care or in some cases, no care at all, my first question is, “How old are they?” Inevitably, that person was 65 or older. And lately, even 60. Or they were handicapped in some way.

Just like Social Security, once kept afloat by a younger work force paying into the program, so too do these younger workers pay into Medicare. And, those of us who have paid into the system all our working lives are still paying into Medicare, by a chunk coming out of an already meager social security check. The problem is a scant younger work force to pay for the Baby Boomers who have been retiring for some time. A good number of the Boomers have taken better care of themselves than their parents did. Never smoking. Or have stopped years ago. More reliance on natural substances to replace Big Pharma side effect laden drugs. And, much more interest in healthier eating and exercising. All of this has led to statistically fewer trips to the doctor’s, which is good. But we aren’t exiting as fast as the previous generation did. So, the Deep State has been looking for ways to help us along, I believe. This Plandemic has just been the latest and best planned tool in their bag of tricks. Add in the fact that even the fewer youngsters we have, unbelievably, have picked up the smoking/chewing/drugging habits of their more clueless parents. On top of this, with their living on the edge junk food habit, there will be even fewer people who will make it to retirement. Apparently, it still isn’t enough.

What I am finding out about the care or lack of care in the local hospitals, nursing homes, and senior living centers that I have been finding, tells me that this so-called pandemic was very definitely planned a long time ago.

That is the only thing that could account for the negligence and outright murder I have uncovered of many seniors. I would recommend that younger family members accompany their seniors to doctor appointments, scheduled surgeries and ER visits. Ask questions. Don’t be put off by what I call educated arrogance. Your loved ones deserve the best care, just as everyone else does. We lost a wonderful chiropractor, not long into COVID. He was scared to death he was going to get it. He begged his best friend, an MD. at the local hospital for a script of Ivermectin. The doctor refused. The Chiropractor caught COVID, and having a couple of comorbidities, he was really ill. He was transported to the ER, sent by helicopter to a larger hospital, begging loved ones not to let them vent him. Which they did, along with Remdesivir and he died. I don’t want to say what I would have done to his wife and his so-called friend in case they turn up in a farm field or hog lot somewhere.

You may also have to go toe to toe with an insurance company or a medical employee. At the very least, I would ask that person what treatment they would want for their loved one or for themselves. Make it personal. Don’t be afraid to try alternative health care and natural substances. Just be smart about it and do your research first. Our seniors are valuable members of society. In the past, most cultures honored their seniors and were smart enough to benefit from their knowledge and experience. Don’t let those Bottom Line advocates dictate when our seniors should depart.

Remember, one day you will be in their shoes and hope that your children and grandchildren will treat you as a valued member of the family.