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    Aging Aggressively:: How to Avoid the Us Health-Care Crisis
    Aging Aggressively:: How to Avoid the Us Health-Care Crisis
    Aging Aggressively:: How to Avoid the Us Health-Care Crisis
    Ebook174 pages2 hours

    Aging Aggressively:: How to Avoid the Us Health-Care Crisis

    By Betsy M. Chalfin M.Ed, John Cotton MS and Thomas Jones MD

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    About this ebook

    Take charge of your health! If you are an aging individual in the United States, its crucial to understand present health-care policies and doctorpatient relations so you can aggressively demand the best care. Once you know the ins and outs, youll feel secure and enjoy the aging process.
    The first step is to acknowledge two important facts:
    1. As a member of the elderly population in the United States, you are part of a significant numerical force in society.
    2. You canand shouldbe certain that your voice is heard in every aspect of social and medical planning.
    Aging Aggressively also offers advice on personal health practices, including valuable resources to help you successfully manage your health.
    Youre not dead yet! Take the bull by the horns and demand the best care for yourself so that you can liveand agewell.
    LanguageEnglish
    PublisherBalboa Press
    Release dateNov 18, 2013
    ISBN9781452586618
    Aging Aggressively:: How to Avoid the Us Health-Care Crisis
    Author

    Betsy M. Chalfin M.Ed

    Thomas C. Jones, MD, is an emeritus adjunct professor of medicine and public health at Weill-Cornell Medical College in New York. He has had an extensive career in medicine, both in practice and education. He is a highly respected research physician trained in infectious diseases, international medicine, and public health. John F. Cotton, MS, has extensive experience in planning and development positions for state, local, corporate, and educational functions. He has played an important role in originating and administering the details of health care–related federal programs and policies.

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      Book preview

      Aging Aggressively: - Betsy M. Chalfin M.Ed

      Copyright © 2013 Thomas C. Jones MD.

      All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the publisher except in the case of brief quotations embodied in critical articles and reviews.

      Balboa Press books may be ordered through booksellers or by contacting:

      Balboa Press

      A Division of Hay House

      1663 Liberty Drive

      Bloomington, IN 47403

      www.balboapress.com

      1 (877) 407-4847

      Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

      The author of this book does not dispense medical advice or prescribe the use of any technique as a form of treatment for physical, emotional, or medical problems without the advice of a physician, either directly or indirectly. The intent of the author is only to offer information of a general nature to help you in your quest for emotional and spiritual well-being. In the event you use any of the information in this book for yourself, which is your constitutional right, the author and the publisher assume no responsibility for your actions.

      Any people depicted in stock imagery provided by Thinkstock are models, and such images are being used for illustrative purposes only.

      Certain stock imagery © Thinkstock.

      ISBN: 978-1-4525-8660-1 (sc)

      ISBN: 978-1-4525-8662-5 (hc)

      ISBN: 978-1-4525-8661-8 (e)

      Library of Congress Control Number: 2013920067

      Balboa Press rev. date: 11/11/2013

      Contents

      1.   Take Charge of Your Health

      2.   A Social Perspective

      What We Need to Do As Individuals

      3.   Frequent Minor Problems of Elders

      4.   Maintaining an Active and Fulfilling Lifestyle

      5.   Obtaining Appropriate Physical and Mental Support, Health Advice and Nursing Care

      6.   Educating Your Physician About Quality of Life Care

      7.   When Medications, Diagnostic Tests and Procedures Are Needed and When They Are Not

      Issues Regarding Public Policy of Health Care

      8.   The Politics of Your Health Care

      9.   Examples of Health Care Insurance Plans and Government Health Care Taxation Approaches

      10.   Medicare and Medicaid Health Plans—Designed to Fail?

      11.   Recent Proposals to Reform Medicare

      Personal Things to Remember

      12.   The Importance of Humor, Domestic Pets, Music and Interpersonal Relationships

      13.   Memories are an important part of aging—Both the Good and the Bad

      Conclusion

      Aging is A Wonderful Process But It Must Be Done Aggressively

      Afterword

      Appendices

      Appendix A. Confusing Language is a Major Problem in Understanding Medication for Young and Old

      Appendix B. A Conceptual Societal Health

      Program for Elders

      References

      About the Authors

      1

      Take Charge of Your Health

      This book is about growing older, about taking charge of your health, about understanding present health care policies, and about feeling secure and enjoying the process. It is also a clarion call to those of us who are older adults to take advantage of two important facts: we are a significant numerical force in society, and we can and should be certain that our voices are heard in every aspect of social and medical planning. This book was stimulated by, and is a follow up of, the book Taking Charge of Your Health by John Burton and William Hall. That book sets the stage, we hope this one fills in some of the details.

      The book is divided into three sections. The first (chapters 1–7) describes what we face each day of our aging lives and what we can do to interact with our health care providers in a positive but assertive way. The second (chapters 8–11 and the appendices) is a primer on current health care policy in the United States and internationally, so that we can better understand decisions politicians and physicians are making thus enabling us to make relevant contributions to the process. The third (chapters 12 and 13) offers nuts and bolts suggestions and some personal insight about maintaining a sense of humor, achieving self-fulfillment, and reflecting on our memories while facing the important issues of health, medical care, and end-of-life decisions.

      Thomas C. Jones has been a highly respected research physician trained in infectious diseases, international medicine, and public health. He is emeritus professor of medicine at Weill-Cornell School of Medicine, where he did his own internship and residency, and later was one of the most popular professors of parasitology and infectious diseases. He has cared for patients in private practice, on hospital wards, in an army hospital in the Philippines during the Vietnam War, and in the refugee camps of Thailand and along the Pakistan-Afghanistan border. He has published over 200 scientific articles, chapters in the most important medical textbooks, and his own book titled Medical Care of Refugees (Oxford University Press, 1986). He was the first editor of the Brazilian Journal of Infectious Diseases—the first English-language medical journal ever published in South America. His research on toxoplasmosis provided ground-breaking insight into that disease process, and his collaboration with physicians and researchers in Brazil and Haiti brought him international respect among his peers and created a rich environment for study for the medical students, residents, and researchers who worked abroad with funding from his grants. Dr. Jones is in a unique position to address the issues of our faltering health care system and recommend a solution—specifically, what we can do to obtain the care we need and head off a potential health crisis, for our own lives and for our society. Now that he is retired from professional medicine and outside of the mainstream, Dr. Jones’s somewhat irreverent view is precisely what makes his opinions relevant today.

      As contributing author, John F. Cotton has contributed two chapters (2 and 11) and Appendix B to this book. His views are pertinent based on his many years of experience in state government, originating and administering the details of health care-related federal programs and policies. In addition, his views on how those programs affect quality of life for elders and our real social obligations make his contribution especially valuable.

      The editor, Betsy Chalfin, adds another dimension based on her years as a copyeditor for Thomas C. Jones at Cornell University Medical College and at the Brazilian Journal of Infectious Diseases, and from her years of experience as a program coordinator in international refugee relief and as a hospital administrator.

      There are a number of familiar quotations that suggest how we should think about aging and we have selected two in particular to set the tone for this book. Dylan Thomas wrote, Do not go gentle into that good night… The second is a quote from the character Old Lodge Skins in the movie Little Big Man based on the book by Thomas Berger. Old Lodge Skins thought it was his time to go to the Happy Hunting Ground so he climbed up into the mountains and waited for Nature to take its course. After waiting awhile, he realized he was still alive and concluded, Sometimes the magic just does not work!

      Our primary focus here is health care for elders—what is wrong with it and what we can do to make it suit our needs. You will learn that health care is not just about medicine but it is also a complex mix of social attitudes and personal and political will.

      There are many examples of special and often discriminatory treatment of elders in our society—like forced retirement regardless of productivity; periodic medical reports required to engage in active sports despite the fact that they are in good health; exclusion from certain social events that are planned for a younger population; or participation in a musical group or chorus that prefers a more youthful public relations image. There is often a lot of fun and peace of mind associated with getting older, but for the situations that fail to meet our needs or expectations, we advocate an aggressive approach to challenge and change them.

      When one considers the issue of health care and what can be done to improve it, especially the care directed specifically toward the aging population, we find a number of powerful influences in play. We find that lawyers enthusiastic about generating class-action legal challenges for their own financial gain, regulatory agencies influenced by numerous lobbyists anxious to direct the purchasing power of elders, and politicians elected or removed by the increasingly elder demographic are the powerful sources of potential change of the system—not physicians.

      As participants in the health care bureaucracy, the authors learned that physicians alone are unable or unwilling to define the life-enhancing support systems needed for their patients and translate them into appropriate delivery of health care. Ever increasing pressures on health care providers makes this so. These pressures include administrative guidelines and insurance reimbursement requirements that impose time limits allotted for a physician to spend with each patient even though the physician believes more time is necessary for adequate evaluation and care; constant advertising that suggests nearly miraculous effects of a specific prescription medication that misleads patients and prompts them to question their physician’s recommendations; and finally, intellectual and financial rewards that drive young physicians toward medical specialization rather than general medicine—each of these pressure tactics work against a physician’s need and desire to focus on the overall health status and life quality needs of his or her patient.

      There are a number of hidden features affecting the social welfare of elders that must be explored. The plethora of medications prescribed for the aging population is a vivid example. In their book, Burton and Hill quoted the famous physician, writer, and social critic Oliver Wendell Holmes. To paraphrase that quote, . . . almost all medications prescribed to patients would do better to be thrown into the sea—a good move for humanity although probably not so good for the fish. The multitude of prescribed medications are supposed to allow a patient to reach old age but the clinical studies, the statistical analyses of these studies, and information on how they apply to special sub-groups are often not available. So, a 75-year-old patient is instructed to take a certain medication to improve his or her chance of survival even though the drug studies were done on specific at-risk groups between 30 and 60 years old. The logical question here is, Why not focus a study on those over age 70 whom the drug is usually prescribed for? The answer is almost always that the subgroup analysis of the targeted population would alter the power of the statistical result—in other words, the pharmaceutical companies could not exaggerate the beneficial power of their drug. Up to now, the elder population has had little power to insist on more accurate information—we believe the time has come to change the paradigm. We will discuss specific examples, like the use of statins, in chapter 3. These examples are among the issues the aging population must think about and understand if they are to appropriately manage their health care. Inappropriate

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