A gerontologist’s take on what is needed to reform Medicare.
Lazris (The Blue Gene War, 2004, etc.) finds fault with Medicare’s payment rules and believes the system may undermine the health and well-being of elderly patients. The author notes that Medicare reforms in the Affordable Care Act failed to provide safer, affordable alternatives to frequent hospitalizations for treating the elderly. Lazris, a primary care geriatric physician and medical director at facilities for the frail elderly, advocates a minimalist approach to medical interventions for many chronic health problems of advanced age, including dementia. He argues that Medicare’s outdated payment rules and assumptions about life expectancy are financing “an interminable search for eternal life” instead of ensuring that Medicare pays for long-term “palliative” care, ideally at home. “[W]ith age comes a decline that no amount of dollars will curtail,” Lazris writes, although the elderly and their families often think otherwise. One of his female patients petulantly “fired” him, labeling the good doctor a “nincompoop” for taking her off a statin drug that he believed was doing her more harm than good. Lazris devotes the final part of his book to proposing Medicare policy changes to reduce “excessive use” of expensive medical tests and medications for treating the inevitable losses of aging. The author concedes that changing Medicare will be difficult. Some obstacles to reform may be too entrenched, but Lazris presents a convincing case for introducing modest financial “disincentives” into the Medicare payment system, which might include $50 copays for appointments with certain types of medical specialists, $100 copays for procedures such as MRIs and $200 copays for every trip to a hospital emergency room—all paid for out of pocket. With an insider’s view, the author does an excellent job of diagnosing pervasive problems in the Medicare system.
Privately published by Strunk of Cornell in 1918 and revised by his student E. B. White in 1959, that "little book" is back again with more White updatings.
Stricter than, say, Bergen Evans or W3 ("disinterested" means impartial — period), Strunk is in the last analysis (whoops — "A bankrupt expression") a unique guide (which means "without like or equal").
This early reader is an excellent introduction to the March on Washington in 1963 and the important role in the march played by Martin Luther King Jr. Ruffin gives the book a good, dramatic start: “August 28, 1963. It is a hot summer day in Washington, D.C. More than 250,00 people are pouring into the city.” They have come to protest the treatment of African-Americans here in the US. With stirring original artwork mixed with photographs of the events (and the segregationist policies in the South, such as separate drinking fountains and entrances to public buildings), Ruffin writes of how an end to slavery didn’t mark true equality and that these rights had to be fought for—through marches and sit-ins and words, particularly those of Dr. King, and particularly on that fateful day in Washington. Within a year the Civil Rights Act of 1964 had been passed: “It does not change everything. But it is a beginning.” Lots of visual cues will help new readers through the fairly simple text, but it is the power of the story that will keep them turning the pages. (Easy reader. 6-8)