Healthcare PSAs and BSAs

This is what was recommended to my MIL. Saved a hell of a lot of hassle when the time came, but like i said, i had no idea this was even a thing. Couldn’t be better designed to keep tje poor in their place, though. Take the only asset many of them have, and leave the next genetation starting over. :face_vomiting:

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Wait, what product are you describing right now?

Season 2 Freedom GIF by Nanalan'

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Extremely.

:woman_facepalming:

Bingo. Bounty hunters. Or repo men/wimmin. Etc.

Am I correct in understanding that this (from the ABC news article):

it was part of a routine process the federal government requires of every state: to recover money from the assets of dead people who, in their final years, relied on Medicaid, the taxpayer-funded health insurance for the poorest Americans.

is entirely different from lookback penalties, which are just how one qualifies for Medicaid in the first place?

NB: date of article is 2023

What Is the Medicaid 5-year Lookback?

The Medicaid 5-year lookback is a device used by the government to ensure that you haven’t given away your money or resources. It seeks to prevent a scheme where a senior has the government pay for their care instead of using their money or other assets.

When you apply to Medicaid for long-term care benefits, they will review recent financial transactions for disallowed transfers of money or property. The lookback period in 49 of the 50 states is five years and begins as of the date of the Medicaid application. However, in California, the lookback period is only 2.5 years (30 months). If Medicaid finds ineligible transactions, the applicant will be assessed a penalty.

I had to learn this term too, which is related the Medicaid application process, because if the person needing Medicaid is married, the total community assets are what Medicaid looks (and looks back) at:

With luck, outside that lookback window.
Luck favors the prepared etc.

Unreal (FTA):

There’s at least one person who acknowledges the rule isn’t working: the man who engineered it.

Many people don’t know about the decades-old mandate, which was intended to encourage people to save for long-term care — or risk losing the equity from their home, explained Stephen Moses, who now works for the conservative Paragon Health Institute.

“The plan here was to ensure that people who need long-term care can get it but that you plan ahead to be able to pay privately so you don’t end up on the public health care program,” Moses said.

As if many U.S.ians have extra money at the end of each month to “save.”

Source:

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With the caveats that this is not my area of expertise and that seminar was quite a long time ago: yes, I think the clawback/recovery is different than the look back. The look back is for determining eligibility. IIRC, a homestead (up to a certain value) isn’t part of the eligibility determination. Like how there are homestead exemptions for taxes. But I would be very surprised if the states don’t use the information gathered during a look back to determine if a person owned a home at death (or probably within a few years of death).

Medicaid is ridiculously complicated. It shouldn’t be. It should do more for more people. The relatives of deceased people shouldn’t be forced to pay back money because their loved one owned a home. It is, like the US healthcare industry, absolutely broken. Better than nothing most of the time, but awful, expensive, and unjust.

Anyone at retirement age should try to get a few consultations with financial advisors and an elder law attorney to get their finances in order and set for later life. As you mentioned, that look back is five years. Ideally, you’d want your most valuable assets in a trust well before you think you might need Medicaid.

This makes my blood boil. No one relies on Medicaid if they are wealthy enough to pay for their own care. But it takes true wealth! Even upper middle class cannot swing most elder care because it’s just too expensive. Not without impoverishing the entire family, including all adult children. It’s part and parcel of our broken for-profit medical system complete with venture capitalists squeezing nursing homes for every penny and damn anyone who actually has to live there.

I didn’t go into elder law because, like family law, it was just too heartbreaking for me.

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Thank you from the bottom of my heart: yours was a knowledgeable qualitative explanation.

As much as @docosc helps us understand very real issues medically, I can’t stress enough to all our peeps in the U.S. just how monumentally difficult it is to navigate later life legal and financial realities that absolutely connect to the state of one’s health.

Understood.

Yep.
And Medicaid (the office) lost my dad’s paperwork three times, forms that were filed during the first and second years of the :tangerine: :clown_face: administration. Surely a sheer coincidence.

My guess is, on this bbs, folks here skew somewhat older. Many have likely participated in some way in the care of an elderly family member. Our own time is coming. I know I am nowhere near financially ready by Stephen Moses’ standards, and I’ve been earning paychecks since age 16.

:100:
While one still has one’s brain cells in working order (more or less).
Presuming one can pay for such advice.

I wish I did not have very direct evidence and experience of all this. Among my IRL data points: some really odd “we know what we are doing is against the law but we did the math and we’d rather pay the legal fines” stuff that nursing homes do (at least the ones we dealt with) where there’s zero accountability. We did our math and saw that suing the nursing homes in assorted protracted legal battles was financially unworkable for us.

Any vulnerable captive population (elderly in care, children in care, incarcerated people, the list is long) that can be targeted and leveraged by venture/vulture capitalists is attractive plunder.

I hear you. Respect!

Big shimmering piles of gratitude. Thanks again.

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OK, so I finally did get to this one. (Sorry, busy weekend.) This seems to be the major area of limitation:

This study also has some limitations. We could not identify gender in our administrative data sets, only biological sex at birth. We also did not explore race or ethnicity as a confounder of the association between teen pregnancy and premature mortality for several reasons. First, we did not possess a data source that accurately identifies race and ethnicity, especially among Canadian-born women. Second, we were unaware of the reasons why race and ethnicity would be associated with teen pregnancy or premature mortality beyond the known higher rates of economic disadvantage and structural racism experienced by certain racial and ethnic groups[20](Teen Pregnancy and Risk of Premature Mortality) and the ensuing health risks to an affected family,21 including a higher likelihood of ACEs22 and intergenerational teen pregnancies.1

Now, Canada (where the study was done) is not the US, and I cannot say that minority teens there would suffer as much due to systemic racism as those here do, but this seems a disingenuous statement. Intersectionality is not so much additive, as multiplicative or even exponential as a risk effect. That said, the use of teen pregnancy as an indicator of ACE’s seems to be pretty obvious, and those are known to increase risk of suicide, homicide and deaths due to misadventure, these being the biggest killers of teens in general. The fact that they took this study beyond the teen years to show the risk persists into the 20’s and 30’s is what is fairly new, and scary, to me. It does make sense, but I’ve not seen evidence showing this previously. Interesting, and if I am being honest, depressing, study. Damn, we suck as a society when it comes to our kids… :cry:

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These points are why I advise people to watch the movie I Care a Lot. They never stop the quest to find new and horrible ways to get blood from a turnip. That includes casting a wide net when they run out of rutabagas:

This is why I avoid offers for caregiver jobs. After three times with family, I’ve seen enough/too much to ever do it again. :cry: My plan is to avoid institutions altogether and advocate for the law/government to allow people more choice at that point, too.

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Oh fer Pete’s sake, are they serious?

Those of us who still retain full custody of our humanity will keep doing what we can, from wherever we are, in whatever ways we can, as much as we can. Every kindness is a significant act, and kids know it, even if they can’t articulate it.

Compassion is the radical act of our time.
Thank you, all you radicals here now.

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Sheesh I just read the plot on wikipedia and it’s one of the most cynical things I have read in long time. :nauseated_face: I think I’ll pass. Real life is hard enough for me right now.

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As Ars has reported previously, measles is among the most contagious viruses known and can linger in airspace for up to two hours. Up to 90 percent of unvaccinated people exposed will contract it. Symptoms can include high fever, runny nose, red and watery eyes, and a cough, as well as the hallmark rash. About 1 in 5 unvaccinated people with measles are hospitalized, while 1 in 20 infected children develop pneumonia, and up to 3 in 1,000 children die of the infection. Brain swelling (encephalitis) can occur in 1 in 1,000 children, which can lead to hearing loss and intellectual disabilities. The virus can also destroy immune responses to previous infections—a phenomenon known as “immune amnesia”—which can leave children vulnerable to various other infections for years afterward.

This morning, prior to reading this article, I had a Russian mom ask if I knew how she could get her kids exposed to pertussis! “This is how we do it. You know, so we don’t get shots.” I just cannot, some days, I cannot…

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That is the point of the shots! Safe exposure to the disease or important parts of the disease!

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Sadly, there have been far too many IRL cases of so-called Silver Collar Crime like this, so I watched it as more of a cautionary tale while considering ways to avoid becoming a victim. :woman_shrugging:t4:

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“Beyong the ragingly obvious reasons that we’re ignoring, we can’t think of any other obvious reasons”

But this is really a weakness in interpretation.

It is the data set and the outcome that I find vastly upsetting. We’ve been working on training our bedside staff to ID currently or recently pregnent women (because our EMR can’t do it!) and trying to get them resources for post partum depression.

But now, looking at this data, there’s such a scary long tail effect to Teen pregnancy, that I’m getting together some staff to discuss how this paper should change our current practice.

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Yeah, that is exactly my takeaway as well. It’s not just the postpartum and infancy period, it drags on for what looks to be the duration of their study. It’s almost like being a parent never ends. Or, to cite one of my favorite parenting documentaries:

“It goes on forever and it’s just as scary.” My oldest is 39. I still worry over her. It never ends. And when you are barely (or not) able to take care of yourself, that added pressure can be absolutely fatal.

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Hell Yeah Damages GIF

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I love morels, and have tried growing them a couple times, with no success of note. But never should they be eaten raw. This applies to pretty much all mushrooms. Cooking them is pretty much mandatory. (Steps off soap box.)

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Often hyperaccumulators, as mentioned in the article.

https://www.sciencedirect.com/science/article/abs/pii/S0065229616301227

https://www.sciencedirect.com/science/article/abs/pii/S0048969719325070

(Plants. Fungi. Even algae. Heads up.)

And though not really applicable to this poisoning case specifically, cooking will not reduce the heavy metals problem. Know your sources!

I’d be really careful about where some stuff is grown including inside the U.S. A friend wanted to harvest prickly pears until I explained to her they are growing right by a very busy highway. Hard pass. Opuntia spp are well-known hyperaccumulators. So many edible things are.

Caveat “eater”!

ETA, ETA2: second and third links added

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Yup. Hence the fairly recent changes to recommendations for baby cereal.

Arsenic in brown rice: do the benefits outweigh the risks? - PMC.

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In a medical triumph, the US Food and Drug Administration on Monday approved a gene therapy that appears to trounce a rare, tragic disease that progressively steals children’s ability to talk, move, and think, leading to a vegetative state and death. For those who begin to slip away in infancy, many die by age 5. But, with the new therapy, 37 children in an initial trial were all still alive at age 6. Most could still talk, walk on their own, and perform normally on IQ tests, which was unseen in untreated children. Some of the earliest children treated have now been followed for up to 12 years—and they continue to do well.

$4.25 mill. Holy shit. It’s a one-time, curative infusion. But who can afford that? I’ve only seen this once, and it was brief and bad. I have a kid with Hunter-Scheie syndrome who is currently the first in the world to receive what sounds like a similar therapy and it is amazingly effective for him, actually undoing some of the damage already done. But what will the price of that one be? “We have a cure, but not for you” is a truly nauseating and evil thing to say to a child.

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