Nannies and Healthcare Reform Part IV

The Elderly and Death Panels
By Polly Sci

We have been discussing healthcare reform. Changes in Medicare could alter how seniors use healthcare services, at least as outlined in House versions of the bill.

Current proposals attempt to promote preventive services and medical screenings by eliminating co-payments for those services. The purpose of this approach is to lower program costs and improve wellness by catching and treating chronic illnesses before they evolve into serious disease.

The House bills also try to control cost increases by increasing payments to providers of primary care services while decreasing payments for certain specialists.

A committee will also be formed that scrutinizes the scientific evidence of the efficacy of various treatment protocol. These types of science review committees are formed by every insurer constantly and continuously. The object is to provide the best care available and to discourage unproven and ineffective treatments. We can find no proposal to force any change in the doctor-patient relationship. The choice of treatment will still be left to the best judgment of the doctor and the patient.

If there is “rationing” of any sort we envision that it will be in the selection of healthcare providers. We expect that there will be a shortage of primary care physicians. We think that shortage will lead to levels of medical providers who are trained to diagnose, treat, and prescribe for minor and common health issues. No proposal exists that promotes this approach. This is merely a change that we anticipate will be implemented out of necessity.

Somehow, a clear, simple, and prudent proposal to allow patients to confer with their doctor about end-of-life planning once every five-years has morphed into “death panels” and “pulling the plug on grandma.”

We find no evidence of any such intent in any proposal. In fact, it is prudent for every family to memorialize end-of-life decisions. The purpose of such declarations are to be certain that the wishes of the patient are followed and that those decisions are known and legally enforceable and not arbitrary. The reality is that a for-profit corporate hospital is content to care for a vegetative state patient as long as Medicare pays for the care, regardless of the chance for recovery or the quality of life.

The elderly should be alert to healthcare changes but we see no reason for them to be apprehensive.

As we end our current discussion of healthcare changes, we urge you to consider whether healthcare should be a right available to all citizens or whether healthcare is a privilege available only to those who can afford it.

If you work as a nanny please take our survey about health insurance so your input can be included in our October 2009 issue of Be the Best Nanny Newsletter, by clicking here.
Please note the opinions of the author may not match the opinion of Be the Best Nanny Newsletter. The article is published to encourage a mature and respectful debate.
What are your concerns about healthcare reform?


  1. In general, Nannies have some of the lowest wages in the country. If they have health insurance it is typically through their husbands. For me and my nanny friends at least that has been the discussion. No one has to end their private insurance if they do not want to.Thank you for posting this important series.Felicia H.Jersey City NJ

  2. What bothers me is that I started this conversation with my boss because a dear nanny friend is very ill and had to ask for a leave of absence and is out of money to pay for cancer treatment. My boss mom was almost flippant saying the nanny should have bought health insurance. I immediately thought "are you kidding me? Making $13 an hour how can she afford health insurance?" I did not say it but want to.Reality check: nannies can't afford to buy their own health insurance!Jody, Nanny with 45 years experienceCape Cod Mass.

  3. We all need to legalize our end of life plans. Good advice whether healthcare is reformed or not!Lari Z, Nanny of 3Providence RI

  4. Excellent that you are the only nanny group I know of willing to cover controversial topics like this, but most important topics like this too.

  5. Excellent that you are the only nanny group I know of willing to cover controversial topics like this, but most important topics like this too.Anyone who has had a loved one on life support has been on a "death panel." The reason nannies who oppose health reform are very vocal on yahoo groups and facebook but not here is that this is the first intelligent discussion by nannies on the topic I have heard, read, or seen. No one can oppose your truth and easy to understand description of the topic.Thanks as always!

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