Tag: Medicare

Raquel Welch, “Sex Goddess of the 1970s,” and my younger daughter Amelia

March 10, 2013, State College, PA., 7:40 PM. I was asked this afternoon why I nearly went crazy before each of my daughters was born. The lapse of judgment—mentioning Raquel Welch to my 22 year-old daughter this afternoon—is a good example of why I worried about becoming a father.

As anyone who is a parent knows, it does not matter what we say.

What matters is how we behave.

If I behave as a father should behave—instead of telling my daughters what to do and then provide an opposite example—then my poor behavior condemns my status as a Good Father.

Kansascitybomberposter

Hence, regard this confession of the error of my ways (and the circumstances surrounding it) when I made mention of the film Kansas City Bomber to my daughter this morning (over an often clear Skype connection). A movie review of sorts is contained within this plea for forgiveness. Mea culpa.

The stimulus for my poor behavior is the fact that Amelia, who is currently teaching English in rural Spain, is training to be a roller derby contestant.

My daughter Amelia in her Spanish roller derby You Tube debut

Sadly, this video is no longer available.

 You will clearly recognize Amelia at the end of the video. She is haming it up holding up a sign that reads “500″ and then getting knocked off her feet. Just goes to show what a fine woman I raised her to be.

I was directed to this Riedell Skates site this morning when Amelia showed me an impressive pair of Riedell Skates along with much of the impressive protective equipment required to prevent physical damage which can result from falling on concrete. See http://www.roller.riedellskates.com/ProductDetail.aspx?ProductName=SuzyHotrod

I had been reading Amelia’s postings in Spanish on Facebook—Spanish sadly being a language I do not yet speak nor read. The Bing translations are dreadful (compared to Microsoft’s competitors in this emerging software market. (Microsoft, which owns Bing and also owns and does an excellent job with Skype, appears to take little effort to improve; I have asked Bing).

The gist of one such posting was that Amelia complained that the only area of her body for which protection is unavailable is her ass—the idea of strapping a pillow to it had not yet occurred to her.

I had not realized until this morning that Amelia is in training to be a roller derby contestant. Until this morning, the only thing I knew about the subject was a dimly remembered fact that Raquel Welch had been in a roller derby movie widely publicized decades ago which I refused—at the time I was a film snob–to see.

So, the first trigger to the error in judgment was the desire, as a father, who when his daughter mentions a subject on which I am a complete and total ignoramus was to pretend I knew something.

The second trigger was the vivid memory that when I was her age, a graduate of college, on my way to presumably be adult and mature, I became obsessed with an oddball sport—different from Amelia’s, but given my upbringing distinctly unusual.

Unlike many of my friends and contemporaries, my memory of my past is vivid. At 65, I remember distinctly the follies I committed at 22 among them being the failure to wear a helmet while riding horses (for which I had no talent), the insistence I had in riding horses that I knew I could not control; and the frequency with which I fell—risking concussion in one instance. When, on the beach of the Pacific Ocean under an absolutely beautiful horse threatening to stomp me out of existence, I gave up being an equestrian forever (parenthetically, influencing my elder daughter Joanna to become a superb rider and trainer of horses).

It is not bad parenting to say, I neglected to take necessary precautions to prevent a concussion. Concussions are dangerous. The moral of my reminiscence Amelia not only appreciated but observed with wonder, “How did you ever survive to be 65?” [And presumably burden our country’s economic future by being both a social security recipient and a Medicare beneficiary—Social Security, Medicare, and housing for the disabled are discussed elsewhere and are indeed the theme of this site (a site one diligent reader observed is “scattershot”—connecting all postings in the site is a planned posting {once I figure out how to do it}; perhaps Raquel Welch is on Medicare and would appreciate a well-positioned grab bar].Raquel_welch_1millionyearsbc

Now for the movie review. The movie, Kansas City Bomber was released in August of 1972 at the same time a white horse stomped me into abandoning horseback riding permanently. The 1970s were a pathetic decade during which undergraduates were jealous of people like me who went to college in the tumultuous 1960s. Some reacted by pretending it was the 1960s still; others wore bell bottomed pants wide belts, ghastly ties or longer skirts; still others became Watergate junkies. By and large the 1970s was a very boring decade.

Raquel Welch was listed as the most desirable woman of the 1970s by Playboy readers. Wikipedia defines Raquel Welch’s profession as “actress and sex symbol.” She was not a good actress. Kansas City Bomber was part of a wave of films about offbeat sports. I had not heard of roller derbies until the movie was released (three months before Richard Nixon won re-election by carrying every state in the Union except Massachusetts).

Having made reference to Kansas City Bomber, I rented it this afternoon on Amazon and with great difficulty (washing many dishes and performing many chores while stopping and starting) reached the conclusion.

Kansas City Bomber is of one of the worst movies ever made. For aficionados of the movie review genre, I hereby make the declaration that if you are worried about my spoiling the plot for you (not that there is anything in the plot that can be ruined), stop reading now.

Clearly Raquel Welch is an attractive woman—far more attractive in still photographs then when she is actually moving. There is, to my point of view, nothing wrong with a father saying that sex between consenting adults can be pleasurable. But, I can never imagine making love to a woman who is chewing gum—which Raquel Welch does constantly throughout the movie and I suspect throughout life. (Now that she is 73, I wish her well, hope she does not have dentures, and hope she continues to enjoy chewing gum.)

The Riedell Skates Company would be advised not to mention the movie in any of its promotional literature. Kansas City Bomber depicts roller derbies as a sport in which the results are fixed, there is little skating and a great deal of fighting. The owner of the primary team for whom Raquel Welch (KC) plays encourages attractive women to fight each other. There is nothing at all erotic about the movie. KC and the owner have an affair, but there is no nudity and the kisses are bland. Bland kisses. At one point, KC is reproved for using the word “hell.” The minimal amount of profanity is so limited the film would probably receive a G rating today.

The most interesting (and shocking to me) scene is when KC, who has two adorable children, roller skates with her daughter during a transition period between beating up women on roller skates. The two skate beautifully on astonishingly smooth concrete given the distressed neighborhood she calls home. The shock, her daughter, age 8, is not wearing a helmet even though the danger of falling on her head is ever-present.

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Forgive me, Amelia, for ever mentioning Kansas City Bomber. Please do not watch it. Continue to watch Bunuel instead.

Dear reader, I will now attempt to make this site less scattered by focusing on the housing problems of disabled and elderly individual (primarily, Baby Boomers like me, whose karmic future may be decided by whether they voted for Raquel Welch as the most desirable woman in the 1970s).

Note: The photographs here are of Raquel Welch and I assume they are in the public domain. If not they will be removed.

For photos of Amelia see: https://joelsolkoff.com/digressions/countdown-to-amelias-graduation/

—Joel Solkoff, mea culpa

Dental Updates and Movies

Tooth 18 Extracted

Family, friends, loved ones, and casual acquaintances have been asking about my tooth extraction on Tuesday.

My left rear bottom molar—tooth 18—is extracted. My father Isadore’s birthday was yesterday—from whom I inherited many of my stubborn genes [not to mention the stubborn genes on my mother’s side]—and Isadore (who would have been 113 born in Odessa while it was still Russia but is now the Ukraine) is almost certainly responsible for the fact that my molar root refused to let go in my kindly dentist’s chair a week ago Tuesday.

lower_dentalarch

This figure is correct in being lower, but my side was the left and not the right. So imagine this illustration being on the left; it was the last molar that was removed—called by everyone involved as tooth number 18, but when I looked up dental notation…Trust me; ask a dentist about which dental notation system they use here in Pennsylvania and why (if you care).

The Big Sleep

Clearly, the thing to do after you wait for the pain to go away (with pills that make your tummy hurt) is  watch movies.

Then after the Novocaine wears off and I am good for nothing because of the penicillin, it does not matter what I watch as long as there is something distracting on Netflix, Amazon, or the DVD collection from the library around the corner.

TheBigSleepPoster

There are times, during dental adventures, when it does not matter how many times I watch the same movie. Take The Big Sleep, for example, based on the wonderfully romantic novel by Raymond Chandler, which I have read three times, turned into a brilliant film by Howard Hawks, starring Humphrey Bogart and Lauren Bacall. “What wrong with you?” Bogart asks Bacall in a memorable conclusion which is in no way a spoiler, “Nothing you can’t fix.” As the credits roll the screen shows two partially smoked cigarettes neatly paired next to each other in an otherwise empty ashtray.

What’s next? 

Well in dentistry, quite a lot.

The big question is can I save my teeth? I have good teeth. Unlike my parents, who entered their respective nursing homes with their teeth in a glass, if things go well false teeth are not inevitable. Whether things will go well is an open question.

First, there is the radiation treatment. Yes, I am grateful to be alive and not die at age 28 as would have been my fate without radiation treatment to cure me of Hodgkin’s disease, a cancer once immediately and invariably fatal.

One consequence of the radiation treatment is that it burned my spine and turned me into a paraplegic unable to walk, run, or even stand without holding onto something. I would prefer being able to walk but c’est la vie as Don Marquis’ cockroach Archie would have put it, “C’es la vie.”

220px-First_drawing_of_Archy

Another consequence of radiation treatment is that it dried up my salivary glands and that not only prevents me from competing in spitting contests, it means that for decades saliva, which is good for my teeth, was not plentiful and dry-mouth Solkoff’s teeth rotted as a consequence.

Are my teeth salvageable? Probably. If I hurry. If I find the money to pay for them. If I hurry.

[Consider this your place for updates to Joel’s teeth. Stop by often and I will give you a tooth by tooth breakdown.]

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As for movies,

I recommend, Jackie Brown.

JackieBrown2

Pam Grier plays Jackie Brown whose skill at driving Robert De Niro and Samuel Jackson totally and completely crazy caused one magazine to list the film as one of The 500 Greatest Movies of All Time and rightly so.

More on this film, others, and my observation about how difficult it is to become an actor and similar cinematic musings as my dental adventure continues.

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Also, I will not neglect the politics of dentistry: the President’s unwillingness to include dental care in the Affordable Care Act, the absence of dental care in Medicare, the pathetic attempt to provide it in Medicaid, and the absence of sufficient philanthropic dental care.

Does the President really not have a government provided dental plan? Do the 535 members of the House and Senate really have to dip into their own pockets to get their teeth cleaned?

[Please, readers, provide me with statistics on the cost to our society of neglected teeth—the cost to the gross national product of lost productivity due to unnecessary dental pain. I want charts. I want statistics.]

This site is about to launch a Dental Crusade.

crusade

 

I write in praise of Paul Ryan

My political perspective is different from Paul Ryan‘s.

I will be voting for Obama despite disappointment ObamaCare did not seek to cover ALL Americans for fear that non-documented workers might get health treatment.

Universal coverage critics appear unable to understand that communicable diseases can be stopped at the source saving lots of things–remember the Bubonic plague? Also, read Rat, Lice, and History.

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I am a paraplegic who has been on Medicare for 7 out of the past 18 years I have been a recipient of Social Security Disability Insurance [SSDI]. I have been trying to obtain work–REAL WORK– get off Social Security by the time I am 65, but obstacles to getting off the public dole are considerable.

[I believe the greatest tax imposed on the disabled and elderly poor is requiring us over and over to prove we do not work, obtain outside income, and show (beyond a shadow of a doubt) we are not hiding huge quantities of stock.]

Back to Paul Ryan.

Yes, he gave a dreadful speech at the Republican National Convention.

Perhaps, I might be a bad yardstick, but if I had been able to spend time at the Universe Outside of Time Republican Convention in Tampa, I would have gone stark raving mad–a convention of bored Romney delegates none of whom had bothered to wear t-shirts supporting their candidate.

In the passion of the movement, a young man for the job (remember Teddy Roosevelt?) Ryan freaked out.

Who wouldn’t?

He was chosen to be a vice presidential candidate because of the impressive contribution he has made to the current substantive debate on economic policy. He may be young, but he is the only presidential and vice presidential candidate to have compiled an impressive analysis of the budget problems America faces. AND he has proposed detailed solutions.

I do not agree with the philosophy behind his analysis. Nor, do I agree with his proposals. But, he has the intelligence to realize that trying to understand the current baffling economy in which we are in is worth serious attention. [How many legislators do you know willing to devote time to thinking and learning and trying to solve problems worth solving regardless of their political views?]

Watching Paul Ryan with attention when he appeared last year and early this year on Meet the Press and other Sunday network television programs, he presents himself as a serious man intent on helping the U.S. economy. He has stated repeatedly that his plan is not the ONLY plan worthy of consideration. He says that he wants to be presented with other plans, hear other people’s ideas regardless of their views.

What is wrong with that?

Ryan has been accorded considerable respect among Wahington-insiders who know him.

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I lived in Washington, D.C. for 17 years.

This is a view of the Capitol focused primarily on the Senate side. For 17 years, I lived six blocks away.

Those living in the beltway know how things really get done in Washington. When I lived in DC, I was:

  • Senate-confirmed political appointee to the President of the United States serving as special assistant to the deputy secretary of labor
  • Consultant to Congress’ General Accounting Office and to the Office of Technology Assessment
  • Consultant to Democratic and Republican Chairmen of the Securities and Exchange Commission
  • Author of a book on the politics of food  [Let me tell you in detail about the Sugar Act of 1948 (as amended)]
  • Free-lance writer for The New York Times, The New Republic, and Newsday

The two legislators I admired most were: Tom Foley, liberal Democrat from Washington State and Bob Dole, especially in his role as Chair of the Senate Finance Committee.

Former Speaker of the House Thomas A. Foley (D-WA)

Foley became Chair of the House Committee on Agriculture as a result of a revolt by the left-wing of the House who opposed the dictatorial policies of powerful chairmen (yes, men) who refused to allow freshmen members of the Committee to speak at all during hearings).When Foley became Speaker of the House, I was in heaven. At last, a legislator I respect is Speaker of the House. I felt as if I were the Elijah of a New Era where at last serious decisions about serious subjects would be handled by an individual I greatly respect.

Robert Dole (R-KA) former Chairman of the Senate Finance Committee

Bob Dole became a different Bob Dole when he ran as a vice and presidential-candidate coming across as a mean, incoherent, humorless fellow. The reality of Bob Dole as a senate leader is startlingly different. Those of us who lunched with him at the National Press Club were presented with a delightfully funny astonishingly competent senator. Bob Dole was the guy who rescued the farm bill from Senate Chair Jesse Helms’ venomous posturing on non-agriculture related issues.

There are 435 members of the House and 100 members of the Senate. For decades, I have been studying them. In any given Congress, fewer than twenty Senators and Representatives give a damn about solving the country’s problems–not furthering political objectives, but solving problems. Tom Foley and Bob Dole were the exceptions in their time.

Present exceptions include:

The skillful Senate Majority Leader Harry Reid (D-NV)

The fixer Sen. Barbara Boxer (D-CA)

 

 

The brilliant Sen. Charles Schumer (D_NY)

 

AND yes, Paul Ryan.

Do not underestimate Paul Ryan.

Saving Medicare billions: Trying too hard can get in the way

Ambulance parked in front of my bedroom window waiting to pick up a neighbor
Ambulance parked in front of my bedroom window waiting to pick up a neighbor

Today is Sunday, February 26, 2012.  I took the photograph above last week. My apartment is within an eight-story building housing 90 low-income elderly and disabled individuals, an ambulance parks outside my window at least once a week. Sometimes my neighbors and I return. Sometimes, not. The cost for Medicare, Medicaid, and other services to go on the gurney ride to the hospital and beyond is many times higher than the cost of preventing and treating.

The following article appeared in the October, 2011 issue of  HME News and it still reflects an ongoing concern. Following the article, I will provide a memorial note on one of the residents who did not return.

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The money saved as a consequence of concentrating on what is right will astonish the body politic

” I have saved up enough pills to kill myself,” a neighbor told me, “if I ever have to go to Centre Crest.”

I live in an independent housing apartment building in downtown State College, Pa. The nearly 100 residents of Addison Court are disabled or elderly. Most of us are poor–the more affluent are on Social Security or Social Security Disability and Medicare.
At least once a week, the ambulance stops by my window and a resident goes off to the hospital. The lucky return. The not-so-lucky move on to Centre Crest, the default public nursing home about 11 miles away, where assisted living means expensive round-the-clock care, diaper changes, attachment to machines that keep the biological aspects of life going, medical personnel who make sure medications are taken correctly, and a world view that echoes Dante’s inscription over Hell: “Abandon hope, ye who enter here.”
Last year, Pennsylvania’s Department of Aging estimated it costs Medicare $40,000 extra each year for a resident to move from an independent living to an assistive living facility. The loss of dignity to the individual is incalculable.
The French philosopher Jean Paul Sartre observed that when one tries especially hard to listen, often the trying gets in the way of hearing. Medicare is trying too hard to do the wrong thing. Medicare‘s purpose is not to save money, but to provide health care in a way that concentrates on improving the quality of life. Recent evidence on the brain’s adaptive capacity provides hope that not only can individuals resume physical capacity from the devastation of a variety of afflictions that affect us at Addison Court, but also we can regain our talents to improve this society, not simply take from it.
“The Brain that Changes Itself, Stories of Personal Triumph from the Frontiers of Brain Science,” by Columbia University’s Norman Doidge, M.D., points to the brain’s ability to recover from strokes and other disorders with rehabilitation and concern.
“Traditional rehabilitation,” Doidge writes, “typically ended after a few weeks when a patient stopped improving, or ‘plateaued.’ And doctors lost the motivation to continue.  But…these learning plateaus were temporary…Though there was no apparent progress in the consolidation stage, biological changes were happening internally, as new skills became more automatic and refined.”
The Obama administration’s penny-wise-and-pound-foolish cutbacks on availability to durable medical equipment, rehabilitation services, and home health care are forcing residents of independent living facilities into the Centre Crests of this country. For example, the narrow focus is apparent in Medicare‘s frequent citations of the Congressional Budget Office‘s competitive bidding estimates of relatively insignificant savings for Medicare Part B ignoring the astronomical costs that will result to Part A when disabled individuals like me can no longer pick up the phone and call my local medical equipment provider. Instead, I must wait for a competitive bidding winner (several have unsavory reputations and some are based out-of-state) to provide a battery. Delays could easily force me into Centre Crest as a result of falls, problems getting to the bathroom, etc. Delays would rob me of the ability to work as an adviser on virtual reality models for construction of future aging in place housing–construction which will result in significant Medicare savings.
Medicare is discouraging the necessary alliance between rehabilitation therapists and medical suppliers. This alliance will help restore the ability of my fellow residents to function and contribute to society.
“Individuals with disabilities remain one of our nation’s greatest untapped resources,” said Rep Jim Langevin, D-R.I., the only quadriplegic in Congress. To release the untapped resources of the elderly and disabled, Medicare must stop thinking about saving money and start thinking about improving health. The money saved as a consequence of concentrating on what is right will astonish the body politic. Providers of durable medical equipment require the support of consumers like me. Providers and rehabilitation therapists have been slow to recognize that in unity there is strength. Together they must spread the word that when an individual becomes old or disabled, science is rapidly increasing the ability to regain talent and good health.
–Joel Solkoff is the author of “Learning to Live Again, My Triumph over Cancer” and is adjunct research assistant at Penn State’s Department of Architectural Engineering.
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Memorial Note: Tonight, November 14, 2011, Jack Seidner aged 93, my neighbor and friend at Addison Court, State College. PA, died while talking to his son who had called from Israel. He died at Centre Crest, an assistive care facility in Bellefonte, PA, 11 miles from Addison Court.
Jack was a veteran of World War II and was a monthly calendar boy on the Jewish War Veterans calendar last year  He will be buried beside his wife in Harrisburg at a private funeral.
Jack was a wonderful man. He was basically an intellectual although he hid it as much as possible. When I wrote a story about home medical oxygen, oxygen which he received to stay alive, he refused to be photographed saying, “I have been studied enough.”
His sense of humor was ever-present, sometimes to the point of reciting bawdy limericks to the residents of Addison Court. I will miss him. He died at Centre Crest. The article below, originally published in HME News on September 27, 2011, is dedicated to his memory. In these days of turmoil at Penn State University, the need to care for the real needs of this community should be apparent.

My first scooter: Originally published as a Valentine to the Durable Medical Equipment Industry

 [The following was originally published in the February, 2011 edition of HME News as a Valentine to the Durable Medical Equipment industry. The love continues.]

I was so angry, wild with fatigue, that I lifted my ugly drug store cane intending to destroy my employer’s computer printer. This was in California’s Silicon Valley. The printer was networked to nine computers. After a late night writing a portion of a manual on silicon wafer inspection, I commanded the computer to print.

After I weaved my way to the printer (seemingly miles away from the computer), there was no document. Five trips back and forth (nothing each time) and my level of frustration caught up to my level of exhaustion. My control was at the breaking point.

Six months previously, I had lost my ability to walk. The concepts I was writing about were hard to understand even when I had been healthy and well-rested. My ability to physically support my body was shaky. I fell several times a day. My right arm had been badly dislocated in a fall. What I needed was a fore-arm crutch with properly fitted prosthetics or a scooter. My doctors focused on understanding how I lost the ability to walk and little on how I could live without walking.

Mortgage payments were due. Home was North Carolina where a wife and two elementary-school-aged children waited. The local economy determined technical writers were not currently needed. At the same time (1996), California needed my skills as of yesterday and I was promptly hired for KLA-Tencor, a company paying large sums to do fascinating work.

I did not break the printer. I drove to my apartment, slept and thumbed the yellow pages praying for relief. I did not know what I was looking for. After a while, I left a voice mail with a dealer in wheelchairs and scooters (not knowing then what a scooter was). That is how I purchased my first mobility device.

Scott returned my call and listened to my situation. We talked price. He recommended a used front-wheel drive scooter. I was skeptical. “Let me show you how it works,” he said, crossed town quickly and lifted a scooter from his truck. I sat down and drove circles around the empty street. My able-bodied college friend David Phillips, in whose house I had an apartment, was fascinated. Keeping David from driving my scooter was hard.

I had discovered three important things about mobility devices:

    • They are fun.
    • They take away the drudgery of not being able to walk.
    • They remove the image that I am someone to be pitied.

I arrived at KLA-Tencor, having:

    • Given Scott a down payment (the beginning of many, mostly personal, expenditures, on equipment, including rear-wheel  drive scooters, power chairs, wheelchair lifts and ramps)
    • Taken the scooter apart myself and shakily inserted the parts into the trunk
    • Slid sidewise hugging the Pontiac’s body
    • Reversed the process

My colleagues applauded. I had solved a physical problem with a technical solution and in the Silicon Valley that was worthy of commendation.

As I look back on the past 14 years, especially worthy of commendation are you, the suppliers of DMEPOS. My time with you here is almost up. Traditionally a column is about 750 words. I have used most of them. A 750-word column can express effectively only one major idea. That idea is that you, the medical suppliers, and people like me, your customers, are a family.

We are a family surviving in a world where David Stockman, Ronald Reagan’s former budget director, said in November on ABC News that the United States can no longer afford to provide its disabled citizens with “scooters.” As competitive bidding illustrates, clearly a bipartisan effort is underway to make it difficult for the disabled to receive mobility and other DMEPOS devices and for you, our local medical suppliers, to get paid for them or even to stay in business.

The pain is especially felt by indigent consumers and small suppliers. In this month where every day is Valentine’s Day, it is helpful to remember the words of Benjamin Franklin (an amorous man if ever there was one) on the signing of the Declaration of Independence: “We must all hang together or assuredly we shall all hang separately.”

–Joel Solkoff is a monthly columnist on disability and elderly related issues for Voices in State College, Pa. He is the author of three books, including The Politics of Food and Learning to Live Again: My Triumph Over Cancer. He served in the Carter Administration as Special Assistant to the Under Secretary of Labor. He has a bipartisan loathing of anyone trying to keep assistive technology from individuals with disabilities—a loathing he is trying to turn into corrective love.

Marilyn Tavenner Confirmation Watch June 19th Update: Who cares if anyone runs Medicare?

Senator Max Baucus, Chairman of the Senate Finance Committee, who helped write the original Medicare legislation that President Johnson signed into law.

June 19, 2012 update on Marilyn Tavenner’s confirmation (don’t hold your breath) hearings:

“So what did Sen. Max Baucus (D-Mont.) say when HHS Secretary Kathleen Sebelius asked him to hold a confirmation hearing for Marilyn Tavenner, acting administrator of CMS?

“’It’s going to be difficult to proceed with the Republican opposition,’ said Baucus, chairman of the powerful Finance Committee, when I asked him about the conversation.'”

http://www.modernhealthcare.com/article/20120618/BLOGS04/306189981/max-baucus-fire-non-starter:

You call the enthusiastic endorsement of Tavenner by Rep.Eric Cantor, House Republican Majority Leader,  “Republican opposition.” Give me a break Senator Baucus.

Senator Max Baucus, Chairman of the Senate Finance Committee, who helped write the original Medicare legislation that President Johnson signed into law.

Here is what I told Katrina vanden Heuvel , the editor and publisher of the Nation Magazine [who appeared this Sunday as a refreshingly articulate advocate for abandoning the current foolish policy of austerity above all else on This Week with George Stephanopoulos ] when she asked me to give my younger daughter a gift subscription as a college graduation present:

“Katrina:

“I am shocked by The Nation’s failure to report on the deterioration of the current Medicare system which as a recipient and a left-of-center Democrat, I can report on what is actually going on (despite the Nation’s unexamined rhetoric). Indeed, I have suggested that I write about it for you to no avail. Hence, no subscription for my daughter Amelia: https://joelsolkoff.com/blueroof-reality/countdown-to-amelias-graduation/”

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In response to the report from the Wall Street Journal below:
11:52 pm May 21, 2012
Joel Solkoff wrote :

The failure of Max Baucus and the 12 Democratic members of the Senate Finance Committee, many of whom are liberals whose rhetoric on saving Medicare is voluminous, to hold hearings on Marilyn Tavenner to be head of Medicare and Medicaid is a disgrace. As a paraplegic who has experienced the deterioration of Medicare as it currently exists under President Obama, the fact that his Administration has not had a confirmed Administrator reveals the sharp disparity between a President who lauds Medicare while cutting its budget by half a trillion dollars as part of the cynical price paid to ensure passage of Obamacare. Eric Cantor’s support of Tavenner would have forced Senate Republicans to think twice about voting against her. As one who enthusiastically supported the President four years ago, my unenthusiastic vote for his re-election is indicative of the lukewarm support that could cost him the election. The Nation, The Progressive, and other presumed defenders of Medicare have failed to be critical of the President’s penny-wise, pound foolish administration of a program which he is currently destroying while speaking eloquently about preserving its future. A genuine confirmation hearing for an Administrator whose budget is larger than the Pentagon’s is long overdue. Failure to hold hearings undermines the Democratic pretense that Medicare is worth saving and makes me ashamed to admit that I am a Democrat. What happened to the party of Adlai Stevenson and Eleanor Roosevelt? The best way for Obama to prove his credibility is to push for the support of his nominee and to indicate his commitment to what used to be Democratic values.

http://blogs.wsj.com/washwire/2012/05/21/no-confirmation-hearing-planned-for-marilyn-tavenner/

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Every day I:

1. Log onto the Senate Finance Committee website. http://finance.senate.gov/

2. Click http://finance.senate.gov/nominations/

3. Then, scroll down to here:

12/01/11

Marilyn B. Tavenner, of Virginia, to be Administrator of the Centers for Medicare and Medicaid Services, vice Donald M. Berwick, resigned

4.   Click

  Check Status

5.  Watch paint dry as I go to this site http://www.thomas.gov/cgi-bin/thomas which reads:

Presidential Nominations
112th Congress (2011 – 2012)
PN1165-112

 

Nomination: PN1165-112
Date Received: December 01, 2011 (112th Congress)
Nominee: Marilyn B. Tavenner, of Virginia, to be Administrator of the Centers for Medicare and Medicaid Services, vice Donald M. Berwick, resigned.
Referred to: Senate Finance

Legislative Actions
Floor Action: December 01, 2011 – Received in the Senate and referred to the Committee on Finance.

Organization: Department of Health and Human Services

Control Number: 112PN0116500

__________________________________________________________

Now for some background information. In December, I published the following article in HME News, the publication for the home medical equipment industry which may help you understand the circumstances behind the nomination of Marilyn Tavenner to head the half trillion-dollar agency which significantly affects the life and health of all Medicare and Medicaid recipients.

Who is in charge of Medicare?

The wide-ranging debate over Medicare, a major factor in the presidential election next year, primarily focuses on whether future generations will benefit in the same way that the current 46 million recipients like me benefit. Politicians, critics and would-be-recipients express the illusion that the health care I receive from Medicare represents the ideal. I believe that the only way to save Medicare is to dramatically improve the way it is run today so that it remains a program worth saving.
The primary audience for this commentary is the men and women who provide DME other equipment necessary to sustain and maintain the quality of life. Recently, 87-year-old Lilian Hutchinson, who gets around on an unstable walker, fell and broke her elbow in an independent living facility for 90 elderly and disabled residents where I live in State College, Pa. I believe that if Lillian had access to a scooter or a power chair in her apartment, she would not have fallen. The tales of needless suffering you could tell resulting from a Medicare bureaucracy that increasingly limits access to mobility equipment and medical oxygen seem beside the point.
Durable medical equipment represents only a small fraction of the Medicare budget. The whole system for providing medical care for the elderly, disabled and poor is not working efficiently in large part because of the absence of leadership at CMS, an agency of the U.S. Department of Health and Human Services. My intention here is to answer the question: Who runs Medicare? In theory, Dr. Donald Berwick, a distinguished Harvard physician with an outstanding reputation as an advocate for efficient health care, runs CMS.
Last year, President Obama named Dr. Berwick to be administrator of CMS, a position one senator described as the nation’s health czar since the job also includes putting in place much of the legislation passed last year, which, by one estimate, will extend health care to 32 million Americans who do not have coverage.
Sadly, the president had failed to appoint an administrator early on in his administration, when Senate confirmation would not have been a problem and when an adviser with the expertise and gravitas Dr. Berwick has in the medical community would have proven useful. The major flaw in the president’s landmark legislation was how he intended to pay for it. He decided against raising taxes, which might have doomed passage.
Instead, half the estimated trillion dollars required to extend healthcare coverage was targeted to come from savings to the Medicare budget as a result of achieving cost savings, reducing fraud and abuse, and increasing efficiency. Anyone who has ever made a New Year’s resolution to save money can tell you it is imprudent to spend it before the money is actually saved.
By the time Dr. Berwick arrived at Medicare, he was in the impossible situation of being required to save $500 billion, a requirement for which he had not been consulted and in a situation where the president had given him neither the time nor the authority to implement.
The political comedian Mark Russell observed, in a similar context, that exercising leadership without the necessary authority is equivalent to sending a eunuch to an orgy. Fearful of Republican reaction to Dr. Berwick’s appointment and unsure of the allegiance of Democrats on the Senate Finance Committee, the president refused to fight for Berwick’s confirmation or to find a replacement who would achieve bipartisan support.
Using the recess appointment mechanism, which allows a president to appoint an official on a temporary basis while Congress is not in session, Berwick currently serves as acting administrator and will be replaced next year by his deputy Marilyn Tavenner. Tavenner, while respected for her organizational skill, her background as a nurse and a hospital and state health care administer, does not have the stature required to lead what is in effect a cabinet level position.
Although CMS has a larger annual budget than the Pentagon, as I write this, there has not been a confirmed head of Medicare since 2006. For the purposes of comparison, if the Defense Department did not have a confirmed secretary for five years, there would be a national outcry.
–Joel Solkoff was a political appointee in the Carter Administration, serving as special assistant to the Under Secretary of Labor. He believes a bipartisan solution to the problems of Medicare is achievable.

On February 3, I sent the following letter to Senator Max Baucus (D Montana), chairman of the Senate Finance Committee which has oversight over Medicare and has the power to conduct confirmation hearings on President Obama’s nominee to run Meadicare:

The Honorable Max Baucus

Chairman

Committee on Finance

United States Senate

219 Dirksen Senate Office Building

Washington, D.C. 20510

Dear Senator Baucus

I am writing to request an invitation to testify at the confirmation hearing of Marilyn Tavenner to be Administrator of the Centers for Medicare and Medicaid Services.

I am a paraplegic who is a Medicare recipient. While I am generally supportive of Acting Administrator Tavenner’s appointment, especially since it has been so long that CMS has had a confirmed Administrator; I have considerable concerns about durable medical equipment. As a user of mobility devices and as one who has researched other equipment in the durable category, especially medical oxygen, I think it important that my concerns be discussed.

Specifically, I am concerned about the cumbersome procedures involved in obtaining medical equipment. The current competitive bidding program, the absence of assurances that award winners will provide batteries, other necessary equipment, and maintenance are among the issues on which I would like assurance—both from Acting Administrator Tavenner and from the Senate Finance Committee with its oversight responsibilities.

I realize that no hearings have been scheduled as of this writing. However, given the importance of Medicare and Medicaid I would appreciate my voice being heard, especially on the subject of indigent disabled individuals who have suffered most from current and proposed CMS practices.

I write frequently on disability issues for Voices of Central Pennsylvania, HME News, the monthly publication of the home medical care industry, and for a variety of other publications. I am the author of three books including Learning to Live Again My Triumph over Cancer. My disability writing can be accessed easily by keyboarding my name into Google.

Thank you.

Sincerely,

Joel Solkoff

_________________________

Of course I cannot testify unless there are hearings.

For a number of reasons, it seems likely that Marilyn Tavenner is not a controversial nominee and the committee and the Senate would vote to confirm her.

It is hard to run something when you do not have the necessary authority.

Politicians are using this election season to talk about the important of Medicare and Medicaid. If they really believe what they say they would hold confirmation hearings.

There has not been a confirmed had of Medicare since the Bush Administration. 

 

 

Suggested stories:

 

Rep. Glenn (GT) Thompson representing Penn State plus

Rep. Glenn Thompson discusses his nearly 30-year long career as a manager of rehabilitation therapists, as a rehabilitation therapist, and as a health worker, which included changing bed pans at Centre Crest, an assistive living facility near State College, PA.

You can listen to this interview below.

https://drive.google.com/file/d/0B6JAIMWh-_zIeFMyVUtXbjZWUkU/view?pref=2&pli=1

I interviewed the Congressman on February 6, 2010. Rep. Thompson called me at State College from Tuscon, AR where he was visiting his son who had been wounded during military service. He was unable to return to Washington, DC because the DC area which had received two feet of snow closing airports and requiring Congress to readjust its voting schedules.

At the time, I was a columnist for Voices of Central Pennsylvania, a publication that has been extremely kind to me. My monthly column, entitled From Where I Sit, ran for over a year and concentrated exclusively on disability-related issues. This voice interview, published on the web page of the publication, was an adjunct to the following March, 2010 printed column:

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Strangers, snow and rehabilitation

Thanks to a failure to act in January, the Obama administration has made a serious mistake in allowing competitive bidding for durable medical equipment such as oxygen canisters, wheelchairs, power chairs and other devices.
I believe that if President Obama had a Medicare adviser of stature to explain the
consequences, Obama would not have made this mistake that will continue to hurt people with disabilities—including me.

As a result of this competitive bidding process, T&B Medical and Dick’s Homecare—the only two companies providing power chairs, scooters and other equipment in State College—are in danger of losing to outside competitors, including competitors outside the state. What they are at greatest risk of losing are contracts to provide Medicare recipients such as myself with equipment and maintenance reimbursements.

Maintenance is the issue I worry about most. Some legislators have put together a plan, supported by a sizeable non-partisan group in the House, that would end the bidding process.

One of the authors of the legislation is Rep. Glenn (“GT”) Thompson, who represents Pennsylvania’s Fifth Congressional district, of which Centre County (his home) is one of 17 counties in a huge, 11,000 square mile district.

I asked Tina Kreisher, Thompson’s press secretary, for a 20-minute exclusive telephone interview because I thought we could cover the details on Thompson’s health care background so readers can see the link between what our congressman knows and the unsolved problems he is equipped to solve.
Thompson and I spoke by telephone for over an hour on Tuesday, Feb. 9 at 6 p.m. I did not realize the degree of detail we would get involved in, especially since Thompson is himself the father of a disabled Iraqi war veteran. Thompson does not make a practice of talking in public about 22-year-old Logan, who was wounded when shrapnel and explosives caught him by surprise.

Thompson called me from Tucson, Ariz. where he was attending Logan’s graduation from Army intelligence training, an experience that filled him with the special gratitude we in the disability community feel when someone we love makes progress toward independence. The two feet of snow in Washington had left him stranded in Tucson and he observed, “There are worse places to be stranded.”

Thompson’s advancement in health care followed two tracks. Academically, he received a bachelor’ degree from Penn State in Therapeutic Rehabilitation, a master’s degree from Temple for Health Science Recreation and a certification from M a r y w o o d University in Nursing Home Administration.
M e a n w h i l e , Th o m p s o n ’s career involved working in central Pennsylvania as a residential services aid, a recreation therapist and a rehabilitation services manager at Susquehanna Health Services in Williamsport.

Thompson was at one time an orderly at Centre Crest Nursing Home, and for three years cleaned out bed pans, changed patients out of soiled clothes and changed bedding. He worked with his wife Penny, who did similar work as a nursing assistant. At the same time, Thompson’s mother was a patient at Centre Crest’s Alzheimer’s facility.

Glenn Thompson [everyone calls him (“GT”)] developed a reputation for good work and excellent managerial abilities, including people skills. When GT visited State College on Labor Day weekend, his charm was evident. He talked about health care in the social hall and bingo parlor (across the hallway from where I am keyboarding this column) of Addison Court, which is an apartment house for senior citizens and those with disabilities. The Congressman arrived for the 8 a.m event just as the Webster’s coffee and goodies arrived. (It helps turnout for these events when food is present and Elaine Madder-Wilgus has been most obliging in providing the coffee Thompson was so grateful to drink.) The 10 additional members of the audience were mostly men and women in their 70s, 80s and 90s.

GT charmed everybody—83-year-old Lilian Hutchison, put her hand on my shoulder and said, “I like that fellow” and Lilian is very influential at Addison Court. Win Lilian Hutchison and you have won votes at Addison Court. Lilian is a registered Republican who voted for Obama.

In my interview with Thompson, I asked about each portion of his 31-year career, which ended when he was supervising 25 rehabilitation specialists and coming up
with strategies for improving ongoing rehabilitation.

For me, sitting in a power chair right now, Thompson is the guy to know. I am at a point where I can now go back to rehabilitation to Dr. Colin McCaul, a brilliant rehabilitation physician at Healthcare South, because I recently passed a cardiac stress test. Since I cannot walk, cannot stand without holding on to something and can dislocate my shoulder if I throw my right arm straight in the air, I need a specialist to adapt special exercising tools so I can get the cardiovascular exercise I need. In my considerable experience with physical rehabilitation in three states, the people who do the hands-on work, the people who touch my body to show me how to do special exercises, when touching is appropriate (a pat on the back is always useful)—these people are uniformly kind and helpful.

I am impressed by the kind of work Glenn Thompson did and taught other rehabilitation specialists how to do. Based on his experience, his testimonials, his conversation and his education, I feel sufficiently trusting to put my exercise program in his hands if he has time.

Obama, the president I helped elect, is doing some truly bad things to Medicare that will have severely negative effects on the disabled. They have potentially disastrous effects on me. I use my power chair frequently; I require battery replacements every six months. What if the competitive bidding process the Obama administration is implementing results in requiring me to get batteries from an out-of-area supplier and I have to wait too long?

Right now, Travis would be right over with the batteries. With competitive bidding, I have to depend on some anonymous supplier. During that wait, if my batteries won’t take a charge and I soil my bed repeatedly, I might have to move to CentreCrest, which would severely limit my opportunities.

The failure of the Obama administration to reach across the aisle, as it promised to do, is shocking when Glenn Thompson’s special knowledge is going to waste. At the time of my interview with Rep. Thompson on Feb. 6, the President had yet to announce an Administrator for Medicare and Medicaid. Medicare is the largest health insurance company in the United States. Medicare needs an administrator who can be confirmed by the Senate. Thompson would be confirmed by the Senate.

Or, President Obama, please find him a better job. Or wake up the Republican House Leadership and have him put on the Ways and Means Committee where he will have oversight over Medicare. Given the overwhelming Republican composition of the Fifth Congressional District, Thompson will eventually gain the seniority he needs.

I don’t want to wait. I want Thompson‘s special skills available to me now because I believe he can assure me a more secure future.

—Joel Solkoff

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Lady Gaga: When you became disabled in “Paparazzi,” you needed cooler equipment

Living in Central Pennsylvania has isolated me from the world’s realities. Until last month, I was unaware of Lady Gaga. [This posting originally appeared on October 10, 2010 at the web site of Voices of Central Pennsylvania, my home away from home.  http://voicesweb.org/invitation-lady-gaga-perform-bingo-parlor-addison-court-plus-disability-suggestions-paparazzi .]

This Lady shattered my consciousness. Not paying much attention to the fact that Lady Gaga was on the cover of September’s Vanity Fair, I bought the issue anyway. I buy Vanity Fair for the political reporting and because it is one of the best paying magazines for writers. I figure buying and reading a copy is like buying a lottery ticket. You can’t win if you don’t play.

The cover story on Lady Gaga says, “She is, without question, the world’s biggest pop star—with 12 million sales worldwide of her 2008 debut album (The Fame and bonus disc The Fame Monster). She had six No.1 hits on the Billboard charts: Just Dance, Poker Face, Love Game, Paparazzi, Bad Romance, andTelephone. She has had close to 800 million viewers of her videos on YouTube. She recently broke the record on Facebook with more than 12 million fans—surpassing those of President Obama.”

Then, Lady Gaga became a political activist.Lady  Gaga has close ties to the gay community. Indeed, there have been rumors that Lady Gaga is a man in women’s clothing—a rumor effectively quashed in a startlingly revealing scene in the brilliantly made video Telephone in which two prison guards strip her to determine that she is a woman. “Pity,” one guard says to the other guard.

Telephone is about a telephone call that takes place in a woman’s prison in which the astoundingly beautiful Beyoncé plays a featured role. I do not know whether Lady Gaga is beautiful or whether her songs are great music because she is basically a magician and I love her with a love that is more than a love.

At the end of September Lady Gaga engaged in one of the most bizarre forms of lobbying I have ever experienced. Groups such as the Service Members Legal Defence Network asked Lady Gaga to ask senators primarily REPUBLICANS to repeal the “Don’t ask; don’t tell policy” established during the Clinton Administration in which gays can serve in the military as long as they do not reveal their homosexual proclivities.

News 24 Entertainment Celebrity News reported: “In a black-and-white video posted on her website, the singer is dressed in a modest suit and tie, with a US flag as a backdrop, and looks somberly into the camera as she describes how ‘gay soldiers have become targets’ under the 1993 rule that has seen 14.000 Americans discharged from military service, ‘regardless of how honorable or how valuable they may have been to their units.’”

This story of a lobbying effort that began as a Twitter tweet was covered extensively. For another version as well as the tie in to the meat dress (at the Google prompt type in “Lady Gaga’s meat dress”); first, though, key in, “Lady Gaga lobbies Republican senators.”

The reason REPUBLICANS were targeted primarily has to do with the way the U.S. Senate conducts its business, a discussion that is too long for now. There were not enough Democrats willing to vote for gay rights and there were enough moderate Republicans who could have made the difference. Lady Gaga personally lobbied Senator Sue Collins of Maine, who said on the floor that she was in favor of abolishing Don’t ask; don’t tell. If she had voted then and there to follow her own convictions, then her vote would have made the difference. Instead, she chose not to vote for “procedural reasons” which the panel of Washington Week in Review said meant that in this election year, Senator Collins did not want to give the Democrats a win.

The following is Lady Gaga’s lobbying YouTube video. When she’s old enough (minimum age is 30), can you picture Lady Gaga in the U.S. senate? I can.

Lady Gaga says in the video that she is against all kinds of discrimination. I would like to enlist Lady Gaga’s help in helping solve ongoing problems here in State College regarding our disabled and elderly residents.

Lady Gaga is especially equipped to be helpful in this regard given her sensational video Paparazzi. Her lover throws her off a balcony and she emerges in a wheel chair, holding on to forearmed crutches (such as the ones I have in my closet): While she uses the crutches to get up, she is wearing a silver bodice, tight and revealing, singing:

“I’m your biggest fan/ I’ll follow you until you love me/ Papa-Paparazzi/ Baby there’s no other superstar/ You know that I’ll be/ Your Papa-Paparazzi./”

As she sings she wears a neck brace studded with jewels.

[Fashion note: Suggestion to Lady Gaga. You might want to consider wearing a better class of brace when doing future versions. The forearm crutch comes in a number of variations. The top of the line is the Lofstrand forearm crutch (also known as the Canadian crutch) in wood. I saw a Mexican soap opera star who wore forearm crutches in oak which was polished to gleam and made him look very sexy. I have spent more time than I care to admit looking for a Lofstrand crutch in wood. Wooden versions of the crutch were commonly available 10 years ago, but comfort (aluminum and other materials are lighter) has given way to beauty. If, oh Lady, you decided to go with gleaming oak, I will find you a sexy crutch. As for a wheelchair, what you need is a scooter. Suggested manufacturers include Amigo, made in the USA. and Pride, designed in Scranton, PA. The movement where your sycophants carry you effortlessly up a stair, she be redone to make it clear that you and the chair are heavy.]

What I want you, oh dear Lady Gaga, as a disability and elderly rights advocate here in State College, Centre County, Pennsylvania to do is:

  1. Sing for us at noon at the bingo parlor at Addison Court, 120 East Beaver Avenue, State College. Addison Court is an independent residence for the elderly and disabled. There are 90 of us. Several of us could use cheering up. We do not get to hear a lot of live music. Dazzle us.
  2. Advocate for us. After Florida, Pennsylvania has more elderly residents than any other state in the union. Centre County is attracting large numbers of elderly residents who retire here. Yet the music venues in Downtown State College are closed to us because Downtown businessmen do not think it is worth their while to provide access so people using canes, wheelchairs, walkers, scooters, and power chairs can listen to live music.
  3. Meanwhile, you could do a lot to increase opportunities for elderly and disabled residents of my town.
  4. Come on by. Use your wealth to buy a front-wheel drive
  • or an Amigo real wheel drive
  • or a Pride Power Chair

See Amigo and Pride webpages for more details:

http://www.myamigo.com/

http://www.pridemobility.com/

Here in State College you can purchase these and similar products at T and B Medical

http://www.tandbmedical.com/

  • or Dick’s Homecare

http://www.dickshomecare.com/content/state-college-pa

Then drive around town and tell Marilyn Tavenner, (as of December 2011, not yet confirmed), Acting Administrator of the Center for Medicare and Medicaid Services what it feels like to use mobility equipment to get around and then to get stuck.

“I’m your biggest fan/ I’ll follow you until you love me/”

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Note: Here at Addison Court, we still have a candle lit to guide Lady Gaga to our bingo parlor.