Hospital At Home A Flawed Model

There has been a movement over the past few years to energize the concept of providing some degree of hospital level care at home. Medicare has been modifying its rules to pay for projects that move in this direction and some policymakers are touting this concept as a welcome addition to the health care system.

The Hospital at Home program is quite simply a bad idea. Why would we want to beef up the hospital system of care when it is clear that we should be putting the majority of our health care dollars into prevention, not into patching things up after they go bad?

Hospital care should be the care of last resort. When things break and diseases take hold hospitals do a good job of fixing things. But hospital type care should not be a model for how a health care system moves forward into the future.


Healthcare Resource Info Hours

In Dec. 2022, Congress voted to eliminate the extra federal funding and requirement that states keep people on Medicaid. States will be able to start Medicaid redeterminations on April 1. According to the Urban Institute’s projections, up to 29,000 Vermont Medicaid recipients could be affected.

The Vermont Workers’ Center is hosting two drop-in informational sessions in the Community Room at the Brooks Memorial Library in Brattleboro. The sessions will be on Jan. 25 and Feb. 8, between 2 p.m. and 4 p.m. Members of the public are welcome to stop in to find out whether they will be affected, what their rights are in this process, and how to be sure that they aren’t cut off for bureaucratic reasons. People who are not on Medicaid and have questions about health care access are also welcome, as there will be other health care resources available. For more information, email windham@workerscenter.org.


The Politics of Insulin

A reasonable person might think that if a disease affects the lives of 38 million Americans, or 11 percent of the population, that measures would be in place to make life a little more bearable for them. Don’t hold your breath. Diabetes is a difficult disease to manage under the best of circumstances, but when people with the disease don’t have enough political power their needs take a back seat to the profits of the pharmaceutical industry.

This is not a revelation. What I am mostly talking about is the obscenely high price of insulin. People with Type I diabetes require daily insulin and they make up five to ten percent of all diabetics. About 30% of type 2 diabetics require insulin.

About eight million Americans rely on insulin to stay alive. Not a critical mass for politicians to get worked up enough, especially when you consider that lower income people and people of color represent a higher number of insulin-dependent diabetics.


A Weak Effort At Medicare Dental Coverage

It may be a case where we should be thankful that there is at least a recognition that the mouth needs insurance coverage as much as the rest of the body. According to a recent article in Health Affairs, “Medicare Parts A and B will begin coverage of dental treatment to eliminate oral infection prior to solid organ transplant and select cardiac procedures in 2023, and prior to head and neck cancer treatment in 2024. CMS will also generate an annual review process for coverage of other medically necessary dental treatment.”

This is extremely narrow coverage that will not affect a lot of people but it is a start. In 2019 and 2021 the U.S. House passed a Medicare dental benefit bill but the U.S. Senate did not adopt it. The Build Back Better Act originally included Medicare dental coverage but that was removed because of lobbying by the American Dental Association.


Prescription Drug Access Seminar

Richard Davis RN, long-time health care advocate, will be offering an information seminar for Windham County residents who are looking to find out the best way to buy prescription medications at the lowest price.

With the closing of Hotel Pharmacy and Brattleboro Pharmacy people are facing confusing and difficult choices finding out how to continue getting their prescriptions filled.

This seminar is for people who do not have insurance for medications. If you have Medicare D or are enrolled in a prescription drug insurance program this seminar is not for you.


Medicare Threat Is Escalating

Seniors continue to flock to enroll in Medicare Advantage plans. Most don’t know that they are helping to convert the program into just another private insurance plan. The insurance companies have been able to lure people in with low cost or no premiums and enticements that seem to good to be true.

There is a reason that the insurance industry advertising blitz has been so pervasive and relentless this year. Insurance companies are reaping higher profits from Medicare Advantage and, even though there is a high level of fraud and abuse, the companies committing these crimes simply pay fines and make it part of “just doing business”.

The Physicians for a National Health Program (PNHP) has been one of the few activist organizations working hard to educate the public about the threat to Medicare and to provide factual information about what is going on. They have launched a new effort to get the word out and I am extracting some of the more important points.


Brattleboro and VT COVID-19 Regional Dashboard Summary – January 2023

Here’s the January 2023 dashboard summary. We continue semi-regular COVID-19 dashboard numbers from the Vermont Department of Health, and MA and NH counties that surround Brattleboro, as long as they continue providing them.  Scroll down the new comments for the latest.

Vermont and MA have very limited looks at what are going on these days, with weekly snapshots. NH attempts daily updates but doesn’t always give new totals. We continue to try…. : )


Brattleboro and VT COVID-19 Regional Dashboard Summary – December 2022

Here’s the December 2022 dashboard summary. We continue semi-regular COVID-19 dashboard numbers from the Vermont Department of Health, and MA and NH counties that surround Brattleboro, as long as they continue providing them.  Scroll down the new comments for the latest.

Vermont and MA have very limited looks at what are going on these days, with weekly snapshots. NH attempt daily updates but doesn’t always give new totals. We continue to try…. : )


The Flu Still Needs To Be Respected

We have reached a point where vaccine fatigue and disregard for the seriousness of COVID and seasonal influenza have taken hold. They are diseases that will never go away and we still need to take measures to protect ourselves against the morbidity and mortality they can cause.

If you want to have the most accurate information about influenza then you should look to the CDC web site. They are the experts and they keep meticulous statistics as well as providing consumers with relevant and useful information.

Here is a useful list from their web site:


Brattleboro and VT COVID-19 Regional Dashboard Summary – November 2022

It is time for the November 2022 dashboard summary. We continue semi-regular COVID-19 dashboard numbers from the Vermont Department of Health, and MA and NH counties that surround Brattleboro, as long as they continue providing them.  Scroll down the new comments for the latest.

Vermont and MA have very limited looks at what are going on these days, with weekly snapshots. NH attempt daily updates but doesn’t always give new totals. We continue to try…. : )


The Yearly Medicare Advertising Blitz

It’s bad enough that we are being subjected to a barrage of political ads as the mid-term election approaches. Those of us in the Medicare eligibility pool are also experiencing the yearly lust to enroll by private insurance companies hoping you will switch to a Medicare Advantage plan. Medicare pays them extremely well when people sign up for Advantage plans.

My simple advice is that if you are enrolled in traditional Medicare stay there. Consider switching back to traditional Medicare if you are in an Advantage plan. From October 15 until January 15, 2023 Medicare beneficiaries can switch Medicare plans.

Understanding all of the implications of types of Medicare plans can be difficult. If you look at some of the most important issues, such as cost, then decisions can be easier. Medicare Part A has no cost for most people. In 2023 the standard monthly premium for Medicare Part B will be $164.90 and the annual deductible will be $226.


Brattleboro and VT COVID-19 Regional Dashboard Summary – October 2022

It is time for the October 2022 dashboard summary. We continue semi-regular COVID-19 dashboard numbers from the Vermont Department of Health, and MA and NH counties that surround Brattleboro, as long as they continue providing them.  Scroll down the new comments for the latest.

Vermont and MA have very limited looks at what are going on these days, with weekly snapshots. NH attempt daily updates but doesn’t always give new totals. We try…. : )


The Pandemic is Not Over

The pandemic is not over. Sorry to burst your bubble, but if you think that COVID is not still in the air and infecting and killing people you are not accepting reality. According to the CDC there 49,808 new cases a day, 353 deaths every day and 3737 hospitalizations every day.

Nearly 96 million Americans (an underestimate) have been infected with COVID, 1,051,389 Americans have died and there are currently 20,033 people now being treated in U.S. hospitals for severe cases of COVID. Those numbers have slowed over recent months but the disease is still very much with us and will most likely become something we have to deal with for a long time.

My wife and I have been extremely careful about respecting the power of COVID and up until two weeks ago we thought we would be able to avoid becoming infected. We have had two boosters and also the Omicron protective (third) booster. We wear masks in all indoor public places and try to avoid crowds.


Where Are The Dental Therapists?

It was about 10 years ago when a group of Vermont health care activists started working on the creation of a new level of dental practitioner to fill in gaps in the provision of dental care. Bills passed the Vermont Senate in 2015 and the House in 2016 and S.20 was signed into law by Governor Peter Shumlin in June 2016.

An April 2016 story in VTDigger provides a description of what the bill does. “The profession would require more education than a dental hygienist but less education than a dentist.
A dental therapist would have a bachelor’s degree and be allowed to perform eight procedures more than a dental hygienist. The person would need to work under a contract with a supervising dentist, who has a doctorate. However, the dentist would not need to practice in the same building as the dental therapist.’

“The Vermont Technical College in Randolph has outlined sample curriculum for a four-year program to train dental therapists should S.20 become law. The person would learn the same three years’ worth of curriculum as a dental hygienist but spend an additional year in training.”


Brattleboro and VT COVID-19 Regional Dashboard Summary – September 2022

It is time for the September 2022 dashboard summary. We continue semi-regular COVID-19 dashboard numbers from the Vermont Department of Health, and MA and NH counties that surround Brattleboro, as long as they continue providing them.  Scroll down the new comments for the latest.

Vermont and MA have very limited looks at what are going on these days, with weekly snapshots. NH attempt daily updates but doesn’t always give new totals. We try…. : )


Monkeypox Education and Vigilance Can Protect Us

Should Americans, and the rest of the world, worry about the current outbreak of Monkeypox? It doesn’t look like it will cause the same level of morbidity and mortality that COVID has caused, but it does have the potential to infect a lot of people.

It’s worth knowing the history of this disease. As reported in the Smithsonian magazine, “Since it was first identified in a colony of monkeys in Copenhagen in 1958, monkeypox has been largely overlooked by the Western world. An infectious poxvirus that causes fever, chills and rashes, the disease is endemic, or consistently regionally present, in ten African countries. Until recently, however, it was rarely found in Europe and the Americas—a trend that has, historically, led Western public health officials to disregard its spread elsewhere.”


Brattleboro and VT COVID-19 Regional Dashboard Summary – July 2022

It is time for the July 2022 dashboard summary. We continue, despite almost no one paying attention or wearing masks despite new variants that vaccines don’t protect against,  regular COVID-19 dashboard numbers from the Vermont Department of Health, and MA and NH counties that surround Brattleboro, as long as they continue providing them.  Scroll down the new comments for the latest.