09:53 – Thanks to Rod Schaffter for his suggestion yesterday that I fill the chemical bottles using a wash bottle and weighing the bottle as I fill it. Talk about a brilliant idea. I’m using ACS reagent grade 98% sulfuric acid, which has a specific gravity of just under 1.85 g/mL. Since all three solutions are 99:1 w/v sulfuric acid:chemical, I can take the specific gravity as 1.85 g/mL. That means to fill a bottle to 5 mL, I just transfer 9.25+ g of solution to the bottle, and to fill it to 10 mL I just transfer 18.50+ g. This should be a quick and easy method. Thanks, Rod.
In fact, I may start using Rod’s method to fill some other chemical bottles, particularly the ones that emit strong fumes, including acetic acid, ammonia, and hydrochloric acid. All of those contain either 15 mL in a 15 mL bottle or 30 mL in a 30 mL bottle, so I won’t even have to weigh those; I can just eyeball the fill level.
I have only two or three wash bottles on hand, and I think they’re all 250 mL. I’m going to add a dozen or two 500 mL unitary wash bottles to my next purchase order. That way, I can just dedicate one or two wash bottles per chemical and store the chemicals in the wash bottles. They’re LDPE, for which the Thermo Scientific chemical resistance table lists 98% sulfuric acid at 50C as “Little or no damage after 30 days of constant exposure.”
The forensic science book is officially published tomorrow, but Amazon already has it in stock and is shipping it. We’re starting to get more queries about the FK01 forensic science kit, which we plan to start shipping by the end of this month.
Barbara and her sister, Frances, are visiting and evaluating independent-living and assisted-living homes for their parents. They’re going to narrow down the candidates to three or four and then take their parents to visit their short list of facilities and ask them to pick one. Barbara’s and Frances’s goal is to get their parents moved to a suitable place as soon as possible. Once they’ve moved their parents, they’ll worry about getting their parents’ home cleaned out and ready to go on the market. I think this is a good plan. Their parents really need to be at a retirement home sooner rather than later. Barbara and Frances could then stop worrying constantly about something happening to their parents, and the facilities provided by the home would also take a great deal of the burden off them for running errands, taking their parents to doctor visits, and so on. For the last couple months or more, Barbara and Frances have been busy almost daily with things they have to do with their parents. They both need a break, badly, and getting their parents into a good retirement home will give them that break.
My one suggestion for Barbara and Frances in their search for assisted living places. Make sure there is also a nursing home that is a part of the facility. That way if their health deteriorates to the point where her parents need full time care they can move without having to go through the search again. I suspect they’re already aware of this, just thought I’d mention it to be sure.
Yes, the various facilities here have different combinations of care level.
The one I’m kind of hoping they choose is very close to our home and Frances’ workplace. It’s relatively new and very nice. It’s independent-living only, although they do make provision for home health care nurses coming in as needed.
Many of the others they’ve looked at are either independent-living plus assisted-living, assisted-living plus skilled care, or all three. It’s pretty common to have 2- or 3-floor facilities, with each care level on a particular floor.
Like most old people, Barbara’s parents are afraid of nursing homes, because they think that’s where old people go to be abandoned and die. So Barbara and Frances are leaning toward a facility that has only independent-living or that plus assisted-living.
The other issue is cost. Her parents can afford the places they’re looking at, but her dad thinks that since their house is paid for it’s “free”. He’s not counting utilities, upkeep, taxes, paying a yard guy, their monthly food costs, and all the other stuff that’s included in the monthly rate at these facilities. Not to mention the very real costs, money and time, that Barbara and her sister incur running errands, taking them to the doctor and hair appointments, and so on. So he thinks the prices are a rip-off.
Their parents really need to be at a retirement home sooner rather than later.
Be prepared to suffer some wrath from the parents. No one likes going into a facility as that is a loss of independence and is not taken lightly. You just have to know that it is for their own benefit and safety.
Also, since Barbara’s father is a veteran immediately apply with the VA for assistance as soon as they are transferred. The VA will provide about $1K a month to help pay for the facility and will do so for any surviving spouse. I failed to know this when my aunt went in assisted living and lost out on three years of benefits.
It does not matter if the facility is a nursing home or assisted living. If Medicaid funds are being used the monthly amount drops to $90.00.
Regardless, apply with the VA once the transition is made.
Thanks. Barbara was aware that the VA paid part, but not how much or whether it would continue to pay for her mom if her dad died.
Geeze Ray. I can’t believe how much you learned suffering through your Aunt’s disability. I’m a vet and didn’t know about the VA providing help. Thanks for the information.
That barely scratches the surface MrAtoz of what I had to learn and deal with when I had to assume taking care of my aunt.
Social Security, Medicare, Medicaid, IRS, VA. They all have different rules and requirements. Particularly annoying was the benefits that were due from the VA.
When I found out my aunt may be eligible I applied for her. At the same time I inquired about benefits for myself. Sure enough I was entitled to benefits and had been for 30 years because of my broken back I received in the service.
I inquired when I got out of the service but was told since the injury did not happen while on duty I did not qualify. That was wrong. If the injury happens while you are in the service you are entitled to benefits regardless of whether you were working or goofing off (doing something stupid in my case). I lost out on a couple hundred dollars a month, tax free, for 25 years, about $60K. My aunt lost out on about $36K which would have paid for assisted living for one more year.
My biggest advice for veterans is go to the local state VA office and see what is available. If the vet has any health issues at all apply to the VA for benefits. You have nothing to lose and a lot to gain.
Benefits for spouses are also available. There are some rules about when the couple were married and length of time. Applying is the only way to know for sure.
Get a copy of the vets DD-214. If you don’t have a copy apply to the VA to get a copy. That paper is worth it’s weight in gold. Also get a copy of your medical and service records from the time in the service. Sometimes portions of the records have a habit of getting lost. Found that out when the records about my heart condition were surprisingly not in my medical files that the military maintained.
Turns out the diagnosis from the military was incorrect. That was discovered when I had my radioactive stress test and sonar stress test and no issues were found.
And if the folks have income from investment with a total above that on which no tax is imposed and the assisted living has an RN on duty, the cost is deductible as a medical expense.
Congrats on the potential move! Here in Texas most of the independent living facilities are in cottages surrounding the main assisted living building. Most, not all. The cottages typically have their own parking, utilities, etc and are nice places to live.
Seeing all these US government benefit programs, I am continuously amazed at the dollars involved. I think that the TEA party people are idiots in that we can roll the federal government back to it’s listed constitutional duties only. That is so not going to happen without a major upheaval. I keep on telling everyone that 40% of Medicaid (not Medicare, Medicaid!) is paying for little old ladies and men in nursing homes here in Texas. Most everyone has a destitute grandma, grandad, aunt or uncle living off one of these programs. We have apparently 50 years of people now expecting all these benefits, changing this will just about require a civil war.
I hadn’t considered that. I will simply note that one of my great uncles and his wife lived in an assisted living place until one of them required more care and had to move to the nursing home side of the same facility.
My only input is from when it looked like my mom was going to need more care than we could provide. What my research uncovered, was that of the places around me, if we chose one that was only independent living, and she later needed assisted or a high level of nursing care, there was a terrific financial penalty to change homes.
The one we ultimately picked had all levels of care and moving from one section to the other was easy to accomplish. Later found out that a good high school friend had parents who chose the exact same home about 10 years earlier. Both of his parents had to move up the chain to more intensive care as time went on.
I might also mention that it was a home run by the Methodists. There are 2 of those in Indiana.
Sadly, they’re right. My grandmother spend her last few years in a nursing home. Relatives have good intentions, but interacting with an Alzheimer’s patient is difficult, and it’s easy to put it off a day, or a week, or…gee, when did we last visit grandma?
Then the nursing homes themselves are often a problem. At the one my grandmother was in, there was constant turnover of personnel, and constant penny-pinching by the management. It was otherwise a nice facility, but the turnover in personnel meant that the patients were effectively surrounded by strangers, which has got to be unpleasant.
On a more pleasant note, my copy of the Illustrated Guide to Home Forensic Science Experiments just arrived and at first glance it looks very interesting. Hopefully I’ll find some time to take a deeper look at it and post an Amazon review soon.
but the turnover in personnel meant that the patients were effectively surrounded by strangers, which has got to be unpleasant.
I thought that was what happened with everyone that an Alzheimers victim encountered.
We used to visit my aunt a couple of times a week in assisted living. Took her to a couple of plays, took her out on the boat, wife took her to lunch once a week. But eventually that had to stop because it upset her too much. My wife and I had become strangers.
When she ran out of money we had to put her on Medicaid and thus a nursing home as Medicaid will not pay for assisted living. My wife and I had now become total strangers. Visits from my wife were relegated to once a month, me about once every three months. The visits were just too upsetting for my aunt and we were advised to reduce our visits.
My wife would go once a month to check on her care. Unannounced of course and never on the same day of the month or week. Different hours too. Never had a problem with the facility.
Dementia (which covers Alzheimers) totally robs the mind. But an expert said the victims really don’t know after they get past a certain level of forgetting things. It just becomes normal. Changing their routine, as in family visits, is actually not good as it makes the victim angry because they cannot remember. That certainly was the case with my aunt.
To echo Ray Thompson’s comment, a good friend’s mother had to go to an assisted living facility, and the amount of venom that she directed towards her son was simply amazing. A Rockwell-esque quiet church going lady, who had had a terrible car wreck & some oxygen deprivation resulting in minor brain damage, suddenly started talking about how much she hated her son and how much he obviously hated her for moving her from her home of 50+ years. After six months or so she adapted, became part of the society in the home, and all was good. When she died there must have been two dozen residents who took the shuttle bus to her funeral; a great tribute IMHO.
A friend of mine evaluated Alzheimer’s homes for her mother by one criteria: whether or not she could smell urine when she walked in the front door. About 3/4 of them failed her nose.
I believe that the federal government prohibits segregating Alzheimer’s patients in facilities that accept direct or indirect federal funding. That makes it miserable for the residents who don’t have Alzheimer’s.
And dangerous. A friend’s mother was raped by an Alzheimer patient that they could not separate from the people who still had all their marbles.
I believe that the federal government prohibits segregating Alzheimer’s patients in facilities that accept direct or indirect federal funding. That makes it miserable for the residents who don’t have Alzheimer’s.
Is that another example of stupid federalism? Alzheimer patients require a lock-down facility. That is much more dangerous (locked fire exits!) and more supervision is required.
My friend had a great deal of trouble finding a nursing home that accepted Medicaid that had empty beds and met her no urine smell criteria. She finally found a facility in central Texas about 100 miles north of here. The charge is about $6,000 per month which is first paid by her Social Security ($1,200/month) and then the balance is paid by Medicaid. Her mother has not remembered her in about a decade so when they moved her from Colorado to Texas, it was a big deal and traumatic for the both of them. My friend had to assume guardianship over her mother from her oldest brother since he took all their Mom’s assets to build himself a new home.
Our Governor, Rick Perry, and Lt. Governor have specifically talked about this problem as a serious issue in the Legislature next Jan. Since Medicaid in Texas is paid 50/50 by the Feds and State, this is a serious state funding issue. Medicaid in Texas is about $20 billion this year and is about 20% of the Texas state budget.
http://www.chron.com/news/article/Medicaid-spending-growing-faster-than-Texas-taxes-3539136.php
Medicaid is a serious issue but what is the solution?
In my aunt’s case she paid for 5+ years of care in an assisted living facility. How much further can a person plan for their care? 300+K dollars is a lot of money and most people don’t have that amount. Do we just turn the old out into the street? Is the family responsible for caring for the elderly? In my aunt’s case she had no family except a sister and a nephew (me). I certainly could not afford $4500.00 a month as that is more than my paycheck. I certainly should not be forced to sell my home and all my assets to pay for care for a relative. Then what happens when I no longer have any money left?
Medicaid is a significant drain on all states budgets but I don’t know of any solution.
he took all their Mom’s assets to build himself a new home.
That surprises me as medicaid can look back five years to find assets that were distributed. Give $10,000 to a charity and 4.5 years later apply for Medicaid and that charity has to give the money back. Same with giving money to family members. If the person has a house a lien is placed on the house by the state. Life insurance policies without beneficiaries (goes to the estate) are claimed by the state.
That is why you why you need to change beneficiaries on all policies at least 5 years before applying for Medicaid. Anything within the five years and Medicaid will put a claim on the funds.
The only expenditures that are allowed are for prepaid funeral expenses, clothing, medical, food and some personal items. I was audited by the state for those 5 years and had to provide records.
I believe that the federal government prohibits segregating Alzheimer’s patients in facilities that accept direct or indirect federal funding.
That is indeed true. Assisted living facilities can do the segregation because they are receiving no federal dollars. When my aunt went into the nursing we asked about seperation and was told that was not allowed. She was placed in a room with a fairly normal person, just physically challenged. My aunt hated the lady and accused the lady of stealing my aunt’s husband (been dead for 20 years). They had to change rooms on my aunt 3 or 4 times because of problems.
whether or not she could smell urine when she walked in the front door.
I guess I was lucky as the home that I found did not smell like that. More of a barf covered up by disinfectant.
When my aunt was in the assisted living facility she had her dog. She would let the dog out and there was a wooded area by the facility. The dog got into a skunk and my aunt brought the dog into the building. Her clothes and room were saturated. When we got called we entered the facility and immediately smelled skunk masked by disinfectant. We expected a large bill from the facility. But in a couple of days they had everything back to normal. They must use some strong stuff. We had to destroy her mattress and all her clothes.
the amount of venom that she directed towards her son was simply amazing.
Yep, been there, received that. A scathing letter full of hate. Screaming at me, attempts at violence. But after about a year it sort of settled down as her condition got worse. She would have moments of clarity and strike out. You just endure it.
I did find a flight reservation on her bed with a taxi cab confirmation. She had made arrangements to fly home. I asked the facility to stop her leaving. The assisted living facility said they could not because that would be considered kidnapping. I called the airline and asked them to cancel the reservation.
The airline smugly told me I was not Della and would not provide me with any information or cancel the reservation. I said fine. Della has dementia and once she gets on your plane she is your problem not mine. You can change her diaper. The airline quickly provided me the information and then canceled the reservation.
That is my point, I do not know what is the solution for Medicaid. Social Security and Medicare are essentially funded out of people’s paychecks. In fact, the Medicare taxes are going up on Jan 1, 2013? 2014? for people with unearned income more than 200K per year. Medicaid is paid for out of the general funds from the Feds and States.
In Texas, the legislature is talking about the possibility of Medicaid growing larger than the state school funding (40% of state budget) in the next 10 years. If we take the Obamacare deal then Medicaid funding will jump from 20% to 30% of the state budget next year. But the Feds don’t have any real money…
I know that my friend and her siblings tried to charge their oldest brother with elder fraud. The Colorado DA would not take the case as the brother “invested” their mothers money in a couple of oil wells that went dry. Meanwhile he built a new house. Their mother did not get into the Medicaid system until they brought her to Texas. I wonder if Texas even does Medicaid audits? I know that you cannot get into Medicaid in Texas unless you have less than $3,000 in assets.
We are having problems with massive Medicare fraud in Texas. There are doctors and hucksters being charged with Medicare fraud each day in the paper. It gives one the sense that the Medicare / Medicaid bureaucracy is totally overwhelmed here.
I don’t advocate throwing anyone into the street. But at some point the musical chairs are going to remove a critical chair and something bad will happen. Maybe collapse of the USA financial system. Maybe a civil war.
Illustrated Guide to Home Forensic Science Experiments just delivered from Amazon.
Bob, I was wondering if a link is available to download a preview of the Forensics book?
How to care for the elderly is a really hard problem, especially for people with dementia. In the “good ole days”, with multiple generations living in the same home, the family provided the care. Or lack of care, depending. That’s just not how our society is set up any more.
The one thing that seems clear: this shouldn’t be dealt with at the federal level. Let states and local communities work out the solutions that they need; there’s likely to be a difference between the needs of New York, New York and Podunkville, Iowa. Return the federal tax dollars to people’s pockets; let the money be used locally.
As expensive as health care is, the bigger limitations seems to be personnel. Here, at least, there is a massive shortage of people who are willing to spend their days caring for the elderly. Swiss salaries being high, we are currently able to import staff from outside the country, but then you have people who may not speak the local language very well – really great for the patients. Also, this just passes our problem off to the countries we are stealing staff from.
Switzerland isn’t stealing staff from anyone. With unemployment as it is (25% in Spain) those countries should be glad to get rid of people, who will probably send remittances home anyway.
My mum’s situation isn’t so good. She had three falls in less than a week a few weeks back, the last one put her in hospital for a week and they gave her morphine for the pain. She seems pretty depressed at the moment, but her aged care facility – a really good one – has various levels of care so she should be okay to stay there. She’s been fairly overweight for 20-30 years but in the last two or three she’s lost quite a lot of it, she looks pretty scrawny now. She’ll be 89 in December, I just hope she makes it that far.
Yes. We’re releasing the book under a Creative Commons license, but we had to wait until the book was officially published, which it is as of today.
http://www.thehomescientist.com/forensics/Illustrated_Guide_to_Home_Forensic_Science_Experiments.pdf
I don’t advocate throwing anyone into the street. But at some point the musical chairs are going to remove a critical chair and something bad will happen. Maybe collapse of the USA financial system. Maybe a civil war.
I too wonder when the system is going to collapse. The cost to my aunt in to the state was $150.00 a day in the nursing home. The asset limit was $2200 to qualify for medicaid.
When I knew my aunt was running out of money I applied a couple of months before. She still had about $5,000 in funds. Two months in the assisted living would take $7,000 of those funds but she would get another $5,000 in income during that time ($500 retirement, $970 from the VA, $900 from social security) leaving her with about $2700. That was over the medicaid limit of $2200.
I was told that I could buy her a prepaid funeral policy but I had to make the funeral home the beneficiary and provide the state with a copy of the policy. I also was not allowed to cash in the policy except upon her death by state law. This kept people from buying a $15,000 policy, getting the relative on medicaid, then cashing in the policy. In my aunt’s case I paid $1100 for a simple cremation with no funeral or services, bare minimum. That brought her funds down to $1600.00 which was within the medicaid limits.
However, because she was getting $970 a month from the VA and $596 a month from retirement, this put her over the limit of $1400 a month for receiving medicaid. But the nursing home was going to be $4500 a month. That created a significant dilemma. Not enough to pay for a nursing home but too much for medicaid.
So I had to open a Miller Trust (probably state specific). I had to have her retirement direct deposited into the Miller Trust. By law her VA money could only go to a guardianship account that currently existed. Once she went on medicaid her VA money would drop to $90 a month. That would take about three months. It would also take a couple of months for the direct deposit of the social security direct deposit to be changed to the Miller Trust.
So I made the changes. I tried to get the nursing home (and state) to allow me to pay from two separate accounts but was told that was against the law. All fees to the nursing home had to be paid from the Miller Trust. Failure to do so would result in denial of benefits. Since the nursing home by state law had to be paid out of the Miller Trust I would transfer the money from the guardianship account to the Miller Trust and the pay her portion of the nursing home bill. I did this for three months until the VA money dropped to $90 and the SS direct deposit was changed.
Then when I had my annual audit by the VA I had to explain why I was transferring the VA money to another account rather than direct paying the nursing home. I explained the state rules. Did not matter. I was told that transferring the money from the guardianship account to another account was a violation of federal laws and I could be fined $250,000 and spend 10 years in jail.
So there was a significant conflict. If I did not transfer the money and pay from the Miller Trust I would be violating state law and my aunt would not receive benefits. By doing the transfer I was violating federal law. No matter which way I did the funds I was breaking a law. Totally stupid.
I explained to the VA auditor why I had made the transfer and had to provide statements from the Miller Trust showing the deposit and the payment to the nursing home. The auditor said that in this case they understood and would not charge me with a crime but made a point to tell me that I really should be charged.
Then when her VA money dropped to $90 a month the state wanted those funds. VA rules state explicitly that the $90 cannot be used for her care and must be used for personal items not covered in the nursing home care. I had to argue with the state and finally had to have the VA talk with the state.
When the dust settled my aunt was getting $596 in retirement and $980 from SS. Out of that I paid $1526 to the nursing home and transferred the $50 she was allowed to keep to her guardianship account. The state was billed the rest for her nursing home care which was about $3,000 a month.
How people without someone of some reasonable intelligence can navigate this mess is beyond me. Even I was confused at times. I would get statements from medicare, her private insurance and from medicaid over medical bills. After about six months of trying to make sense of the stuff I just starting throwing the envelopes away unopened. Let the agencies battle it out.
My mother understood all of it, but she was a very intelligent woman and had to devote significant time and effort to keeping up with everything. I didn’t even bother to try to learn all the ins and outs. I just trusted what she said.
How to care for the elderly is a really hard problem, especially for people with dementia. In the “good ole days”, with multiple generations living in the same home, the family provided the care. Or lack of care, depending. That’s just not how our society is set up any more.
Demographic changes are key – longer life spans and smaller families.
Back in the 1950’s my grandmother was living with my family and suffering from dementia. Actually the entire family was suffering from her dementia. One day when my parents were out my older sister got scared and took all the knives and scissors upstairs to keep them away from grandma; grandma couldn’t climb the stairs. My parents tried to talk to the family doctor about it but got the old “you young people these days” response. Then grandma had to go to the doctor for some reason. The doctor came back to my parents, “That woman is crazy, if you don’t commit her I will!” No kidding! So grandma spent the rest of her life – a few years – as a ward of the state in what amounted to a storage facility for crazy folks, complaining that they made her live in a garage. Terrible for her, very tough on dad, but what else was there?
Thanks for that. I was a bit surprised that the forensics book PDF was only 1/3 the size (18 MB) of the Biology book (56 MB) for a similar page count.
Me, too. I’m not sure what they do, but I suspect there’s a lot of metadata in earlier drafts that gets removed from the final. The last pre-final version of the biology book PDF was 149 MB, which got crunched down to about 56 MB. I think the last pre-final draft of the forensics book PDF was close to 100 MB. I’m not sure how they crunched that down to 18 MB, but it looks fine to me.
My mother understood all of it, but she was a very intelligent woman and had to devote significant time and effort to keeping up with everything.
No doubt. I just gave up wanting to spend the time and effort to figure it all out. It was the nursing home, medicare, primary insurance and medicaid’s task to sort it all out. I just gave up.
And just yesterday I got another statement from medicare in the mail for my aunt. She died March 23 of this year. The statement was for services rendered on the 23rd of March so perhaps it will be the last.
There was a dental company that would come to the nursing home and do dental work. In my aunt’s case about $2.5K worth over the course of her last year. She could not (or did not remember how to) chew so all her food was basically mush. But the company did X-rays, cleanings and all manner of service. All effectively paid for by medicaid. Everything up to the medicaid allowance.
I tried to stop them but was told since the state was paying for the service it was not my choice. The last service by the dental company was on March 15 of this year in the amount of $444.00. Medicaid always adjusted the amount I paid on Della’s behalf to the nursing home for each service and I have to then pay the dental company. For March the final bill to the nursing home was indeed reduced by the $444.00. I held the money in reserve until last month. I have not received a bill from the dental company and suspect I never will.
And I finally closed the Miller Trust. There was $12.38 left in the account. I just took the money. If the state of TN wants to come after me for $12.38 I will give the state the money. But I doubt it is worth their effort.
The final task is to file the final tax return in January of 2013.
Hi Ray, it is sounding like you went the final mile with your aunt and five miles more. I never dreamed how much stuff that is required to take care of an elderly person with dementia. And doing it through the social services sounds like even more paperwork and conflicting rules. I liked the opportunity to go jail when Peter doesn’t like the way that you paid Paul. Thank you for seeing that through.
Yup, the dental sounds like a mild scam in your case. Just multiply that by the 100,000,000 people on Medicaid in the USA and the entire system is suspect.
If you look at corruption worldwide—which is ultra-massive—then look at the corruption that has been uncovered in the US, it is truly hard to imagine that the corruption not uncovered in the US is not genuinely massive.
And frankly, unlike most people here, I believe the corruption in the US government sector—outside of the legislative and judicial system—is minimal compared to that in private enterprise. IMO, there are massive numbers of businesses that purposely, intentionally, and knowingly break laws. I agree there is too much government, but it is government that is catching the criminals, not the private sector. Private sector covers it up.
Take daycare. Anybody who lived in Boston during the ’80’s and ’90’s got a heart-wrenching view of the worst that daycare could be. In Germany, all daycare (Kindergarten) is government-run by law. There are no pedophile scams going on there.
If you’re talking about the Fels Acre Daycare Center, I would suggest you read the wikipedia article I linked. It’s probably one of the worst cases of prosecutorial abuse in my lifetime.
I am fully aware of Fels Acre (lived there while it was going on), but it was not the only one under question, and yes, that case is one I, too, regard as clear corruption in the justice system, so I was not really referring to it. There were more than a half-dozen others involved in scandals, some of which elicited guilty pleas by the parties involved. The issues were not only pedophiles, but also mistreatment of children—especially those diagnosed with disabilities. In some cases, the daycare’s were nothing more than day-prisons for children handicapped in one way or another.
I ferried our 5 grandchildren to and from Kindergartens in the 2 areas of Berlin where we lived, and they were marvels of competently organized activities that the kids all loved, unlike the all-day free-for-all playtime that I saw most everywhere when we were looking for daycare for our own kids in the US. In fact, the daycare centers that we liked the most, did not offer the option of daily care–only accepting a student a couple days a week, so more kids could attend.
I have talked before about the certification programs that Germany requires for many jobs. Kindergarten care-giver is one. That program is 2 years, and when one is finished, the graduate knows how to perform every task that goes on in a Kindergarten, as they are all essentially the same. There are shorter programs for things like sales clerk. The programs are created by consortia of business and education people who put together the training of skills that businesses say they require. When someone finishes the Kaufmann program, they know exactly how to run a cash register, how to tag items in inventory and stock shelves, how to run the back-end storage of inventory, how to use all the computer programs used in retail—every facet of the daily activities of a sales clerk. When a business hires somebody with certification of a Kaufmann, they are assured that the person can be given a task and require no on-the-job training. Far cry from the gal who removed the IV from my arm the other day, when I was in for some tests. You would not see that level of complete and utter ignorance of what to do, by staff in any hospital in Germany—even on somebody’s first day at work.
And while I am complaining about US medical care, let me extend it to sticking me with that IV. In Germany, that is the doctor’s work, NOT a nurse’s. Nurses do paperwork and inventory stocking in Germany, they are not substitute doctors. They do not even take temperatures or blood pressure readings. There, doctors assist other doctors, NOT mere nurses. I had enough needle and IV sticks in Berlin to know that they put in needles quickly and painlessly—every single time. In the US, I have had only 1 nurse (with 30 years of experience) stick me without pain. The other day, the nurse missed getting the IV up the vein. TWICE gawddammit, she retracted it and started over, causing bleeding under the skin in the process, and hurting like hell.
Not only is the cost of medical care extraordinarily extravagant in the US, it is incompetent compared to what I experienced in Europe. But, of course, people who have not lived anywhere outside the US have no idea about that, and are not at all inclined to believe me.
Ray Thompson says:
22 August 2012 at 09:07
> Lynn McGuire says:
> 21 August 2012 at 20:58
> I don’t advocate throwing anyone into the street. But
> at some point the musical chairs are going to remove a
> critical chair and something bad will happen. Maybe
> collapse of the USA financial system. Maybe a civil war.
I too wonder when the system is going to collapse.
I’ll tell you when the proverbial sh*t will hit the fan: when US GDP goes negative for several quarters in a row with no sign of change. Every spending policy of the Federal Government hinges on eternal positive GDP—most outlooks requiring positive growth at a minimum factor of 3% or better.
Nothing goes up forever. Nothing! China has a long enough history to have found this out once already in ancient times. Britain found it out and it ended the Empire. As GDP starts contracting, the cards will collapse. And we may almost be there.
http://www.bbc.co.uk/news/world-us-canada-19349587
Every time I am in front of people watching a TV with news of Romney/Nobama or political ads of any kind, I publicly announce that I am not voting for either of them, but voting straight Libertarian. That has happened 3 times in the last couple weeks. You know what somebody in every group has said to me? “I’m not planning on voting this time.” That is when I start in and encourage them to vote Libertarian for some true change. Happened again tonight when I was with friends who were watching the news after supper. After the “I’m not going to vote,” line, I got my sales pitch in. Try it on your end. It just might start to make a difference. A LOT of people are turned off by this particular election. If Libertarians would only start a national ad campaign capitalizing on that discontent, we might see some change.
This stuff is one of the reasons I’m very glad I didn’t go into teaching. In Year 11 I was seriously contemplating training to be a high school maths, physics and history teacher, but fortunately by the time I got to uni I’d become fascinated by computer science, and became a programmer instead. My sister has said a number of times that I’m not cut out to be a teacher, personality wise, and I think I have to agree with her. She also thought I’d hate the parent-teacher nights and bureaucratic wars that are part of teaching. In principle, I’d still like to have been a high school teacher, in an ideal world.
She’s had parents complain about her because she’s given a very light one finger tap on the forehead to emphasise to a child that they should stop misbehaving.
There was a case in Queensland where a male teacher had accusations made against him, the case went to trial, it quickly became apparent that the kids’ accusations were untruthful and malicious and he was acquitted. He didn’t get his job back and last I heard was washing cars for a living in a city 200 km away.
There was also this “scandal” in California, mentioned on Jerry Pournelle’s site:
http://en.wikipedia.org/wiki/McMartin_preschool_trial
I have no objections to nurses taking blood samples and inserting needles into me. Sometimes I feel literally nothing, other times there’s a little bit of discomfort. I have practically no complaints about needles since about 1976.
Until recently we had an extreme shortage of doctors here, many had “closed their books” (stopped accepting new patients). Now our med schools are crowded so we’ll probably have enough to replace the old codgers who are reaching retirement age. Meanwhile, the government has set up “nurse led” clinics for mild ailments to take the pressure off hospital “casualty departments” (=the ER in US parlance) and busy medical practices. A few years ago I remember going to a private no-appointment clinic to see a doctor, waited 2.5 hours and didn’t get to the head of the queue by closing time. All I got was priority the next day.
Last month, I needed to see my doctor for some pain I was experiencing. Called on a Wednesday, got an appointment for the following Monday afternoon, just before closing. That kind of delay, combined with doctor salaries that are more than 10 times what they are in the rest of the world, means there is a severe shortage of doctors. My pain peaked on Saturday, but was gone by Monday. He had no idea what it was. Great. And that kind of crap is what forces people needlessly into emergency rooms, instead of a doctor’s office. If I felt it was out-of-hand, that is where I would have gone. Great—just what an ER needs: a patient the doctor won’t see in time..
The internal medicine guy I saw in Strausberg, just down the street from our house, would see me anytime I dropped in. Never had to wait more than an hour when I did that. He was not open on Fridays, which is common in Germany; hardly any office is open every day, nor are the opening hours consistent from day to day. You adjust to that. A woman here in Tiny Town, who has worked in the same bank for almost 40 years, says it does not make any difference when they close: more people come in during the 5 minutes before closing than the whole rest of the day—whether that was 2:00pm back in the ’70’s, or the 6:00pm now.
I protest the replacement of doctors with nurses. Strongly! I have seen a competent system, and nurses are secretaries in that system. As it should be.
A girl I fancied back in the Eighties was *really* smart, she did a medical technology degree instead of medicine proper. A course adviser asked her why, with her good marks, she wasn’t studying medicine.
Anyway, she got her degree, which qualified her to work in a lab but not directly with patients. Couldn’t get a job in her field despite trying for a year or more. Last I heard she was a doctor’s receptionist, despite being smart enough to be the doctor herself. It’s that sort of waste of talent that annoys me.
How well a person does their job is more important to me that the letters on their qualification. I don’t recall a doctor using a needle on me in 30 years, but innumerable nurses have. I’m fine with that.
When a nurse cannot do it painlessly and correctly, first time, every time, I have big problems with that.
Doctors used to do that here when they all had their own private practices, but don’t anymore. Nowadays, they have corporate groups and want to do as little work in as short a period of time as possible and get paid as obscenely much money as possible. Why people in this country are okay with that is beyond me. I guess they are afraid of doctors.
My daughter in-law worked 10 hour days as a doctor, and when I left, got paid less than her husband, who was a civil servant. He only had to work 8 hours a day. My doctor comes in at 09:00 and leaves at 16:00—and NEVER works weekends,—unlike daughter in-law who worked varying shifts and rotated weekends with others in her group.
Heh, I remember being sick enough once in the early Eighties to persuade my doctor to make a house call. I still can’t believe I talked him into visiting me at home. That happened fairly routinely in the Sixties when I was a kid.
Which reminds me about one of the ways the world has changed: It used to be that doctors made house calls and pizza shops didn’t. Now pizza shops do house calls and doctors don’t.
Anyway, if a person, nurse, doctor or junkie does enough injections they usually get got at it. That’s why I don’t object to nurses sticking needles into me.
Yeah, I can’t believe how expensive stuff like education and medicine is in the US. A young woman I know from the US is paying about $7000 pa in fees here to go to a first rank university here. She said it would be at least 5 times more in the US for the same quality school.
*got. good
Part of that is because nobody pays full price for either medical care or education here.
My daughter had surgery and spent six days in the hospital earlier this year. Total bill for everything was $165,000. Our insurance paid about half that and negotiated with the hospital to write off most of the rest. My wife and I were left to pay about $3500.
I’m sure we paid (or our insurance paid) a ridiculous amount for a few pieces of plastic.
I wouldn’t be surprised if it was in the thousands of dollars for a few plates and screws.
If you consider the requirements of the plastic thought it doesn’t sound as unreasonable:
1. It has to be sterile.
2. It has to be strong enough you can make plates and screws out of it.
3. It has to very slowly dissolve in the human body.
That’s still way way way too much.
Insurance companies and particularly individuals (those who can afford to pay) end up paying hugely more than the cost of the service to subsidize the cost of treating people who cannot afford to pay. Hospitals have no choice but to dramatically overcharge anyone who can afford to pay, directly or via insurance, because they’re required by law to treat people who can’t or won’t pay. That’s why you or your insurance company ends up being billed $20 for a $0.01 aspirin tablet.
That’s why I’ve been arguing for decades that hospitals need to be allowed to treat only those who can pay. For those who can’t, I suppose we must provide an alternative. That alternative should be local clinics, run as cheaply as possible, and protected absolutely against any lawsuits. It would cost 10% or less of what it costs to treat indigents in a hospital in one of these clinics. The clinics should be able to handle nearly all of the problems themselves. For situations they can’t handle, they can have 911 transport the patient to a real hospital.
But we absolutely need to stop the hospital emergency rooms from being flooded with indigent patients. Many hospitals have actually closed their emergency rooms because they can’t deal with the flood, or pay for it. When a valuable good or service is available for free, there’s an unlimited demand for it. That’s what we see 24 hours a day in hospital emergency rooms.
Sure, I’d agree with no treatment for no payment. Here in Oz hospitals and surgeons in the Fifties and Sixties would treat poorer people very cheaply or for free. I’d like to see a large swing back to charity, where no one is obliged to help you, but they do so if they judge you worthy of help.
But I’ve heard stories of people who can’t pay not being treated. Women giving birth in cars outside hospitals because they can’t afford to be admitted. Admittedly those anecdotes are 20 years old…
I’m quite willing to share with indigent people who are making an effort. If they just expect charity as a right then they can starve as far as I’m concerned. Same if they won’t give up booze, ciggs, drugs whatever.
Keep in mind it was for a surgical procedure that required two skilled surgeons and it was about six hours from when they took her to surgery until she was in the recovery room. Should it cost less? It’s very easy to say yes, but it’s something where quality really matters. How much can you cut the cost without cutting quality? I’m reluctant to take that risk when the surgery it to correct a prematurely fused metopic suture.
I am contemplating having heart surgery next month. The cost is of no matter to me as I cannot affect that whatsoever. I will probably pay $3,000 of the $50,000 ??? bill (I have no idea of the cost). The place and the surgeon are of great importance to me though.
“In Germany, all daycare (Kindergarten) is government-run by law. There are no pedophile scams going on there.”
I am not sure what those two sentences have to do with each other. There’s nothing about being government run that would prevent abuses. Being run privately doesn’t promote them. Government certification (see next paragraph) sure, government run? Why?
Requiring some certification and training makes sense, though. You are, after all, teaching and raising kids, some of whom come from difficult backgrounds. Having some training in hand makes a lot of sense. Right now, my older son is doing exactly this: he has just started a 3-year school/apprenticeship program that leads to a qualification as a child-care specialist. This is a trade just like being a carpenter or a plumber, requiring an apprenticeship and corresponding schooling.
So far, the “male predator” insanity has not really been a problem here. A few child-care centers do not allow men to change diapers (for which the men are thankful…but seriously, it’s a bit stupid), otherwise, it’s not yet an issue. Hopefully, the insanity will down before it does hit here. Guys interact with kids differently, which can only be good for the kids. Especially for the (far too many) kids being raised by single mothers, who are otherwise lacking male role models in their lives.
On the subject of health-care, there’s a blog I enjoy reading: Crasspollination. This is an ER nurse in an urban ER, who details the kinds of patients they see. Lots and lots and lots of people faking symptoms in hopes of getting free narcotics. Some doctors who see through it, others who enable it. A hospital administration unwilling to tell the people to “go away”.
The latter is one I really don’t understand. EMTALA is really stupid legislation, but it still allows an ER to say: “you do not have a life-threatening problem, how would you like to pay for your treatment”. Apparently, the hospitals are too worried about lawsuits (probably not medical, but discrimination)?
brad says:
“In Germany, all daycare (Kindergarten) is government-run by law. There are no pedophile scams going on there.”
I am not sure what those two sentences have to do with each other. There’s nothing about being government run that would prevent abuses. Being run privately doesn’t promote them. Government certification (see next paragraph) sure, government run? Why?
I thought my point was pretty well developed, that I think it is clear that business and private enterprise are at the point of being quite willing to repeatedly cross the line into illegality. With prosecutions of private daycare centers in the US having increased in recent decades, safety of children is not a high priority with the outfits that run them.
Unlike many here, I categorically oppose the thinking that government is evil and cannot do anything right. Government is absolutely necessary. And in the United States, it is my opinion that wrongdoing in government operations (excepting law enforcement) is a LOT less prevalent than in private enterprise. Some things are better run by government. Repeatedly, we see privatization failing to provide the service government previously offered—both in satisfactory product delivery, future planning, and safety. Nowhere is that more evident than in the privatization of British Rail. Decay of the rail infrastructure when in private hands caused massive accident after accident, resulting in extraordinary death tolls. I recently noted the scandal with Duke Energy, who has bought out many of the Indiana local power companies. Aside from alleged executive wrong-doing including alleged illegal executive collusion and alleged illegal disposition of revenues, which the state is prosecuting, there is the fact that repair crews have been reduced so power interruptions have increased in length, and questions are being raised about the ability for the local grid to handle future expectations. When I get bad service now, complaining to my legislator once would affect the situation—but not now. Duke does not give one whit about what I think of their cost-cutting employee reductions, while at the same time increasing my rates, and sending portions of my payments to DC Congressmen’s election campaigns as part of their lobbying efforts.
Yes, there is today, every reason to trust government-run daycare over its private-run alternative. This isn’t the USSR or Bulgaria; crime and illegality in government is not a significant factor (except in law enforcement). But it sure is in private enterprise—all over the place. That tired old mantra that unrestrained capitalism and private enterprise always delivers the best, is just plain false in this day and age, thanks to ever-growing corporate conglomerates and their greedy bosses who are quite willing to step over the line at all levels, time and time again.
Chuck, I agree with you to this extent: Government is the logical choice to run infrastructure activities that are de facto monopolies.
Your example of British rail fits this category, because whoever owns and manages the rails between, say, Oxford and London has a monopoly. The British example is even sillier, because the people who owned the rail (“Railtrack” iirc) had nothing to do with trains. They didn’t particularly care if the ride was comfortable – they just wanted to save on maintenance costs so that they could make a profit. The whole setup was doomed from the beginning.
However, I think you underestimate the biggest problem with government-run activities: because there is no profit incentive, there is no incentive towards efficiency. Bureaucracies take root at grow, and empire-building become more important that whatever the organization is really supposed to be doing. In areas here free market competition makes sense (i.e., wherever there is no natural monopoly), government-run organizations are likely to be a poor choice.
What about power companies? They, or at least their delivery infrastructure, is the same kind of problem as rail service: there is a natural monopoly. Maintenance by the government would be an option. However, I submit that it is also possible to do things right with private enterprise: the power company needs a financial incentive to provide good service over cutting costs. This could be achieved, for example, by charging a financial penalty for every power outage, and paying a bonus for long stretches of uninterrupted service.
However, when we get into the area of child care centers, you lose me. There are hundreds or thousands of child-care providers in any city; next to these are all of the inofficial providers such as neighbors, friends and grandparents. Competition is huge; parents can choose – and change – child-care centers easily. I don’t see any chance of government-run centers being (on average) better than privately-run centers. Be careful of comparing centers in Germany to ones in the US: there are huge cultural and societal differences as well. Two of these are particularly important: Germany does not have the huge underclass found in large US cities, and Germany does require child-care workers to have a trade-specific education.
I suppose the bottom line is where we stand on this: You write “I think it is clear that business and private enterprise are at the point of being quite willing to repeatedly cross the line into illegality.”
Sure, there are bad eggs. However, a quick Google on the specific subject of “daycare center prosecutions” turns up cases like these:
– North Carolina daycare centers operating without licenses. Perhaps a problem, but equally likely a state bureaucracy that makes licensing unnecessarily difficult. For example, the safety regulations. I found the Michigan regulations for outside play areas: now imagine trying to comply with them…
– Entries about the well-known unfounded sex-scare cases.
– Michigan moms accused of running illegal child-care centers when they take care of their friends’ kids, e.g., “Allowing her friends to drop off their kids at her house, so they didn’t have to wait outside at the bus stop, amounted to an unlicensed daycare, even though she wasn’t paid for her kindness.”
– A shooting that happened – entirely coincidentally – in the parking lot of a preschool.
Really, most of the real daycare prosecutions are for running unlicensed facilities. While I think licensing and personnel training are important, many of these cases are stupid (like the woman letting her friends’ kids wait for the school bus), or are the result of overly difficult regulations (like the play-equipment). In the first couple of pages of Google results, I found not one single instance of prosecution due to any sort of actual mistreatement of children.
Well, I do not agree on several counts. First, during the nearly 20 years I lived in Boston, it was a several times a year scandal that some daycare was charged with wrongdoing in a way that significantly compromised child safety. It was not always related to pedophilia, but sometimes was. I remember my wife and I commenting: how can this keep going on? how can there be so MANY places putting people’s children in jeopardy? I am not sure just googling would turn up all the instances prior to 2000, before the Internet became an archive for information. The lawyers I work with say they still have to go to the books to get older historical case information. But in Boston during the ‘80’s, there were other cases of pedophilia in day care operations that—unlike the problematic Fels case—were admitted to by the perpetrators.
Yes, there are many areas where government does not belong, but in the US, where safety of children is concerned there is no question in my mind that experience with private daycare shows children in the care of government-run daycare would be safer than those in private situations. Private enterprise is NOT the be-all and end-all of life. In the US it is a race to have the biggest conglomerate with the highest-paid executives, super-high debt ratios, almost total unconcern for product quality, and constantly pushing standards ever lower. The problems and fights I have in life in the US, are not with government entities, it is with the private ones—including private banks. This happens over and over again. I will admit that in Germany, it was just the opposite; although I suspect my status as an immigrant had a lot to do with that.
Daycare is one of those areas that is needed by what contemporary society has become—regardless of whether one agrees both parents should work or not. In the majority of cases, they do. We do not need profit added into the delivery of services essential to society, such as communication, transportation, utility delivery,—and daycare.
And this mantra about everything related to government always growing out-of-control is rubbish. The water company in Tiny Town has 5 people working in the billing/payment office and another 20 guys who maintain the pipes and run the wells, treatment plant, and pumping station. Essentially the same number of employees as when I was a grade school child here.
Yeah, the new Tiny Town mayor is spending more on trash collection than the old one did, but we are all aware that Democrats are patronage oriented, so elect them and you can rest assured more people will be working for government than in Republican administrations in the same jurisdiction. Happens every time. But the people around here complained about the Republican mayor’s cuts (just because in a tiny town, it hit people’s friends and family members), and the Democrat restored them—even though the city is bankrupt.
The only cultural difference between the US and Germany is that the Germans think and plan, while Americans don’t look past their noses on anything. Progress in America is essentially by serendipitous accident, not by thinking and planning. And by government-run, I do NOT mean free daycare. If the inner-city poor cannot come up with the money for daycare, then their kids do not get in—just like in Germany. Daycare is expensive in Germany, but nearly everyone with kids uses it. With 5 kids, our family paid the most to our local daycare than any other family with kids enrolled. The policies there to promote a society into having more children, do give Germans subsidies for each child in daycare, which we do not have here in the US.
IMO (and I work almost daily in the legal field), the wrong-doing exposed in free enterprise business, is only the tip of the iceberg to what is really going on. Government in the US, on the other hand, whether you think it is too big or not, is relatively free of corruption, and quickly discovered when it happens.