Attention please Medicare Acting Administrator Andy Slavitt, correct violations of Medicare regulations and the essence of Medicare
Dear Administrator Slavitt
Steven E. Brown, CEO and President of State College PA’s excellent hospital...
ultimately is responsible for ensuring the admission practices at his hospital are not merely legal but proper. For a variety of reasons, admitting me to the hospital is more expensive than for most patients. Hence, after waiting to be admitted last Friday night, I was presented with a paper to sign. The paper said that I understood that I was being admitted on “observation status.”
Politely, I demurred. “You don’t mind if I do not sign this?” I asked the excellent physician who presented it to me. He said that signing it was not obligatory. He then gave me a copy of the form with the notation that I had not signed it.
I was then admitted to the hospital and enjoyed the benefits of an excellent hospital room, superb food, sensitive nurses, and an understanding physician. When I was expelled from the hospital against my will, my case manager explained that I had no recourse to file an appeal with Medicare because technically I had not been formally admitted as a patient.
I am not an attorney. Given the nature of Medicare regulations and the understandable concern of hospital administrators that costs be kept to a minimum, whoever is responsible for this flimflam may get away with it. However, this slight of hand is not only a sin, it is foolish. Forcing a patient out of the hospital before he has been properly treated (against the wishes of his physician) has negative short-term and long-term consequences.
Nine years ago, when I was a graduate student at Penn State, I had a series of problems relating to the fact that:
I am a paraplegic
I was experiencing considerable pain in my right shoulder which I had dislocated following a serious fall.
I was/am in my 60s having problems maintaining energy required for my work.
The fact that I had survived cancer (Hodgkin’s disease after receiving high doses of radiation.
I was having trouble sleeping.
Dr. Jeffrey Jackson, a State College psychologist, decided to concentrate to the importance of establishing a sensible sleep schedule. He said it is a myth that as one gets older one requires less sleep. Indeed, sleep deprivation for the elderly is a serious health problem.
Dr. Jackson, who is a behavioral psychologist, made the following suggestions:
Sleep in a room that is separate from the one in which I work.
Confine my activities in bed exclusively to sleep and making love.
Establish a sleep regime and ritual.
Reduce coffee consumption.
For nine years, I have failed to follow his excellent advice. My current health problems  require I make the reforms he suggested.
Establish a sleep ritual
Put on pajamas to indicate it is time for bed. Hitherto, I have been sleeping in my clothes. Or throwing on a t-shirt. A formal garment meant to indicate: This is what one traditionally wears when sleeping as opposed to: These are the clothes I wear when awake.
2. Establish a prayer schedule to differentiate night from day
a) This is the prayer I say when I awake. This is my favorite Hebrew prayer.
As a child my beautiful mother Miriam recited Hebrew prayers with me.
My mother when she was 20.--shortly before she became pregnant with me. When in June of 1947, she graduated from Hunter College, under Mother's undergraduate robes, I was noticing cooking inside her womb. Hunter was famous for Margorie Morningstar, the then City College of New York school for women. Natalie Wood played Margorie Morningstar in the popular film baseed on Leon Uris 'bestselling novel. Mother said frequently, "I attended Hunter College with Margorie Morningstar." In the same month that Mother received her bacheloor's degree in Arts from Hunter, Mother also received a bachelor's degree in Hebrew from a Hebrew college. My maternal grandmother complained frequently that Mother's dual bachelor's degrees while pregnant with me was "overdoing it."
The Hebrew prayer I said with my mother each night from the time I was 3 until I was 10 was the Shema.
“The first verse encapsulates the monotheistic essence of Judaism: “Hear, O Israel: the LORD our God, the LORD is one” (Hebrew: שְׁמַע יִשְׂרָאֵל ה’ אֱלֹהֵינוּ ה’ אֶחָד), found in Deuteronomy 6:4, sometimes alternatively translated as “The LORD is our God, the LORD alone.” Observant Jews consider the Shema to be the most important part of the prayer service in Judaism, and its twice-daily recitation as a mitzvah (religious commandment).
“It is traditional for Jews to say the Shema as their last words, and for parents to teach their children to say it before they go to sleep at night.”
When it comes to prayer, my background is so intense I cannot imagine praying to God in any language but Hebrew. When I was 3 I was able to say the first two words of the Shema. I quickly memorized the three lengthy Hebrew paragraphs that represent a complete recitation of the Shema.
Here is a definitive sentence from the Book of Numbers from which portions of the Shema are taken. [See also Deutoronomy 6:4.]
Notice the vowels under and within the Hebrew letters. This is how this sentence looks without vowels. [Except for poetry, Hebrew books, magazine articles, and written language in Israel (and indeed in the Torah) are not reproduced with vowels.
“The earliest examples of written Paleo-Hebrew date from the 10th century BCE. ” –Wikipedia
אני יהוה אלהכם אשר הוזתי אתכם מארץ מזרים להיות לאלהים אני יהוה אלהכם
“When I was just a little girl I asked my mother what will I be Will I be pretty will I be rich Here’s what she said to me/
“Que Sera Sera Whatever will be will be The future’s not ours to see Que Sera Sera What will be will be/”
Current impediments to remaining faithful to this critical sleep schedule
I am currently recovering from a dangerous MERSA infection. This is the third time I have had this infection. The first two times I was hospitalized . Once this summer. Once in October. The infection currently takes the form of manifesting itself in the form of truly disgusting boils. The boils are painful.
The summer’s boil appeared under my right arm. I was hospitalized at Mt. Nittany Medical Center. My physician lanced the boil. I was also given massive doses of antibiotics. At first the antibiotic Clindamycin was administered intravenously. Then, after the wound had healed and I was released from the hospital I was proscribed 300 MG every six hours. During the period I religious took the medication, I felt massive exhaustion. For over a week, I felt as if every waking moment was an exercise in swing under water with bricks tied to my feet.