Monthly Archives for July 2016

How the Election Impacts Social Security

Published in Woonsocket Call on July 24, 2016

On the final night of the Republican National Convention (RNC) an average of 32 million Americans tuned in to watch Donald J. Trump, a New York Real Estate Developer, author, television personality and now politician, formally accepted the GOP nomination for President of the United States.

After he delivered his July 21 speech, reporters, political commentators, and even postings trending on twitter called Trump’s hour and 15 minute speech (4,400 words) “dark” because of its stark tone and content. This GOP presidential candidate’s speech was even referred to as being the longest acceptance speech in history since 1972.

Before more than 2,400 delegates Trump, 70, pledged to be the nation’s law and order president who would crack down on crime and violence. America first would be Trump’s mantra during the negotiation of international trade deals and the existing NAFTA trade accord would be renegotiated.

Trump also called for defending the nation’s borders against illegal immigrants and giving parents more choice in choosing schools for their children. And to the forgotten men and woman across the country who were laid-off because of President Obama’s mishandling of the economy Trump promised to be their voice. Syrian refugees would be vetted and only those individuals who “will support our values and love our people” will be admitted, he said.

Trump Ignores Social Security in Speech

Aging advocates say that Trump’s acceptance speech was short on details when it can to domestic policy, specifically Social Security and Medicare. But, you won’t need tea leaves to read how a future Trump Administration will change the way the nation supports its retirees. .

According to Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), the choice of Governor Mike Pence as Trump’s running mate should send “a very clear message to America’s seniors that their priorities will hold little weight in a Trump administration.” While Trump has promised on the campaign trail that he won’t cut Social Security and Medicare.

During his 12 years serving as a U.S. Congressman, Pence consistently voted in favor of GOP legislative efforts to cut benefits in Social Security, Medicare and Medicaid, says Richtman, charging that Trump’s vice presidential running mate is one of a few Congressional lawmakers that has a strong “anti-seniors voting record.”

Richtman says that “Mike Pence was one of Congress’ biggest proponents of privatization. He supports cutting Social Security benefits by raising the retirement age, reducing the COLA, means-testing and turning Medicare into “CouponCare.” As he told CNN, ‘I’m an all of the above guy. I think we need to look at everything that’s on the menu,’ and the record shows he has done just that by supporting every form of Social Security, Medicare and Medicaid benefit cut proposed in the past decade.”

While Trump has promised not to cut Social Security benefits on his year-long campaign trail, he continues to surround himself with advisors who are “polar opposite” of his positions says Richtman. “They say actions speak louder than words — Donald Trump’s choice of Mike Pence as his Vice-Presidential running mate will speak volumes to American seniors,” he adds.

Political Experts Weigh in

Darrell M. West, Ph.D., Vice President and Director of Governance Studies at the Brookings Institution, says that “Trump is on record as saying he does not want to cut Social Security so that is considerably different from most Republican leaders, who support benefit reductions as a way to balance its books. This probably is the reason the [GOP] platform is vague on Social Security. The party could not reconcile Trump’s view on not cutting benefits with the party’s general view that cuts are needed. That left them with a reference to market solutions without explaining what that meant.”

“Party leaders have said they want to raise the retirement age for people under age 50. That issue certainly would be on the issue in a Trump presidency although it is not clear how he views that issue. But there would be significant support in a GOP-run Congress for doing that and cutting the benefits of future retirees,” adds West.

West believes that “Democrats have a very good chance of recapturing control of the Senate. If that happens, that will allow them to block benefit reductions or raising the retirement age, he says.

Wendy Schiller, professor and chair, Department of Political Science at Brown University, warns that talking about changing Social Security can be risky and this “involves a depth of knowledge about entitlement financing that eludes most political candidates especially those without any political experience.”

The Brown professor of politics does not see Trump tackling this issue in any meaningful way in the campaign and she does not believe it will be a priority for him or the GOP if he wins. “Recall George W. Bush tried to reform Social Security immediately after he won reelection in 2004 – by late January 2005 it was dead on arrival in Congress,” she says.

“Overall I am not sure the GOP leadership in the Congress has fully processed what a Trump presidency would look like in terms of policy or what his priorities might be. It is unclear to me that they will align closely and getting anything through Congress these days is nearly impossible, no matter who sits in the Oval Office,” she adds.

Stark Differences in Platforms to Fix Social Security

On Friday, the released Democratic Platform released reveal a stark difference as how to the Democratic and Republican parties will fix the ailing Social Security program. The GOP platform. Although current retirees and those close to retirement will receive their benefits, changes are looming with a Trump administration and a Republican-controlled Congress. For younger generations all benefit cut options to be put on the table, opposing the lifting of the payroll tax cap and sees privatization of Social Security as a way for older American’s to create wealth for use in retirement. On the other hand, the Democratic Party platform calls for a strengthening and expansion of the existing Social Security program. The Democrats oppose any attempts to “cut, privatize or weaken” Social Security, and calls for lifting the payroll tax and exploring a new COLA formula.

NCPSSM’s Richtman notes “ It’s also very telling that while the GOP buried their cuts and privatization plans for Social Security under the Platform’s Government Reform heading, the Democrats addressed Social Security, as they should, as part of their plan to restore economic security for average Americans. That’s been Social Security’s fundamental role for more than 80 years — providing an economic lifeline impacting the lives of virtually every American family.”

As AARP’s John Hishta noted in his July 22 blog, even though the “political spotlight was not on Social Security” at the RNC in Cleveland, delegates, rank-and-file politicians and even political operatives that he talked with clearly understand the programs importance to retirees and younger generations.

“If political leaders fail to act, future retirees could lose up to $10,000 a year. All beneficiaries could face a nearly 25 percent cut in their benefit,” warns Hishta. .

Hishta tells his blog readers that “AARP’s Take a Stand campaign left the RNC with renewed determination to make updating Social Security a bigger part of the presidential debate.” He pledges to continue pushing for strengthening and expanding the nation’s Social Security program at next week’s Democratic National Convention in Philadelphia and until the November presidential elections.

To keep informed about Social Security discussion during this presidential campaign go to http://takeastand.aarp.org/,

Revelations Bring Together Heaven, Earth

Published in Woonsocket Call on July 17, 2016

Approaching their twilight years, aging baby boomers might occasionally think about their impending mortality, even contemplating what happens after their last breath is taken, wondering what lies beyond the veil. But a growing number of people who have reported Near Death Experiences (NDE) may just shed some light to this age old question.

Although some people, diagnosed clinically dead, come back to life after being revived with no conscious memory of this experience, others experiencing a NDE report vivid, personal memories of their out-of-body trip across the veil. During this spiritual experience the person may meet dead family, friends and even their spiritual teacher, see a white light or travel through a tunnel.

Critics of NDE may try to explain away this experience as being the result of psychological and physiological causes, but those who come back with their direct knowledge of the afterlife don’t buy these explanations.

Dozens of books have been published, many being listed on the New York Times best sellers list, detailing the author’s clinical death and NDE, they strongly believe as evidence of an afterlife.

One book, published by Rodale Books in 2015, details what Tommy Rosa, a Bronx-born plumber learned in 1999 about health and healing during his NDE and coming back to life. Rosa’s chance meeting at a conference with Dr. Stephen Sinatra, an integrative cardiologist and psychotherapist, seen on “Dr. Oz” and “The Doctors,” would lead to the publishing of a 247 page book, Health Revelations from Heaven and Earth.

One such book, published by Rodale Books in 2015, details what Tommy Rosa, a Bronx-born plumber learned in 1999 about health and healing during his NDE and coming back to life. Rosa’s chance meeting at a conference with Dr. Stephen Sinatra, an integrative cardiologist and psychotherapist, seen on “Dr. Oz” and “The Doctors,” would lead to the publishing of a 247 page book, Health Revelations from Heaven and Earth.

A reading of this book reveals two very different approaches at looking at health, one gleaned from a spiritual experience and the other by scientific training, but both lead to the same set of conclusions. The tome offers eight health revelations (being connected with others, faithfulness, your vital force, grounding, being positive, self-love, seeing your body as a temple, and life’s purpose) geared to helping you live your best, healthiest life, revitalize yourself and embrace a new found sense of purpose and spiritual balance — gleaned from Rosa’s experience and fully corroborated by four decades of medical expertise and other scientific evidence by Dr. Sinatra, who practices in St. Petersburg, Florida, Manchester, Connecticut.

Rosa believes experiences described in his book are different from other NDE books published. His eight revelations can be applicable in the reader’s daily life.

To date, Rosa has promoted his book and his heavenly revelations in newspapers, radio and television. Over 20,000 copies of his book have been sold.

Peeking Over the Veil

Eighteen years ago, Rosa was walking across the street to a local convenience store to buy bread and he was hit by a car and became clinically dead for several minutes. Right after he was hit, Rosa felt a tug whisking him off into a tunnel of light [a common NDE]. The 58-year-old was rushed to the hospital and resuscitated, but left in a coma for weeks. During his NDE Rosa found himself in “Heaven,” where he met a spiritual Teacher and was taught the fundamentals about health and healing.

Ultimately, Rosa remembers that he would emerge from his coma not only grateful to be alive, but with a new found sense of intuition, increased empathy and more awareness of the connection to Heaven and Earth.

Rosa, a founder of the Stuart, Florida-based Unicorn Foundation whose mission is to bring spiritual awareness and education to everyday people, says that the most important revelation of his NDE was that all living things are connected. “No one’s actions are isolated to that specific person, but that every action has a ripple effect throughout the energy of our fellow,” he says. In this book. Dr. Sinatra confirms the importance of this revelation, noting how the need for human connection lies at the very heart of human existence. He describes how the practitioner’s ability to empathize with his patients is what truly facilitates the healing process, and also touches upon how one’s emotions can influence their health and overall well being.

His perspective of religion and living life has changed, too. Although he was raised a strict Catholic, the diversity of beliefs serves “Heaven” leading a person to a higher divine plane of consciousness. “I know now that everything is a dream and that you don’t sweat the small stuff,” he says.

Synchronicity Births a Book

At the time of Rosa’s NDE, Dr. Stephen Sinatra was dismantling the prevailing ideas of preventive pharmacology with his holistic approach to treatment. When Rosa met the Florida-based cardiologist, he got an intuitive feeling that the physician had an infection in his hip. This insight confirmed Dr. Sinatra’s own similar thoughts of infection, and he was later diagnosed with a staph infection. When Rosa shared with Dr. Sinatra the divine revelations of healing that he had learned in his celestial travels, the cardiologist was shocked–the keys to solving the imbalance of energy that he had identified as the cause of most chronic illness were the same as those Tommy was relating. Until this point, Dr. Sinatra hadn’t thought about how they were all connected and now it all made sense.

A dinner conversation would propel Rosa and Dr. Sinatra to write Health Revelations from Heaven and Earth, a book covering spiritual revelations from Rosa’s NDE and putting a medical slant to it. “I was prepped for this incredible conversation as I had many NDEs in my own cardiac practice,” remembers Dr. Sinatra. Once Rosa had discussed how he learned not only the importance of “grounding,” during his NDE but other health topics Dr. Sinatra was espousing in his medical practice and at lectures, it was clear to both that a book project must begin. And it did.

Millions Experience NDE

Over the years, Jeffrey Long, M.D., a leading NDE researcher, has documented over 3,000 NDEs, posted on the http://www.nderf.org website. The practicing radiation oncologist says that this data base is by far the largest collection of NDEs, available in 22 languages, that is publicly accessible. Readers from over 100 different foreign countries access Dr. Long’s web site monthly. Over 300,000 pages are read from this website every month.

Meanwhile, Dr. Long’s website, notes that although most people who come near death do not remember anything, around 18% [like Rosa] later report that “something happened.” That “something” is often a near-death experience NDE, says Long. He notes a 1993 Gallop Poll estimated that 12 to 15 million Americans personally experienced a NDE. As of 2001, almost 600 adults per day across the nation experience an NDE.

In this book Rosa pokes a hole in the veil between the living and dead. He tells it like it is. Because of his NDE he does not fear death. “Death is only a new beginning,” he says

During his 40 years in medical practice Dr. Sinatra had been at the bedside of many of his dying patients. “Some I saved. Some I lost,” he said, acknowledging that being with his dying patients often frightened him.” Rosa’s spiritual journey and the lessons learned have brought peace to Dr. Sinatra, his co-author. “In a heartbeat he literally saved me from my own fear of death,” he says.

To purchase a copy of Health Revelations from Heaven and Earth, go to http://www.healthrevelationsbook.com.

Whitehouse Pushes for Medicare to Pay for Person-Centered Care

Published on July 11, 2016 in Pawtucket Times

At a June hearing of the U.S. Senate Special Committee on Aging, Senator Sheldon Whitehouse calls for improving care for over 90 million Americans with advanced illnesses like Alzheimer’s disease, cancer, and heart disease. On the day of this Aging panel hearing, the Rhode Island Senator unveiled his legislative proposal, “Removing Barriers to Person-Centered Care Act,” at this panel hearing that would promote better coordination between health care providers, and place greater emphasis on the care preferences of Medicare beneficiaries with advanced illnesses.

The hearing, titled “The Right Care at the Right Time: Ensuring Person-Centered Care for Individuals with Serious Illness,” explored ways to improve the quality and availability of care and examined care models that are helping people with serious illness and their families.

Having Important Life Conversations

The June 23 hearing pulled together witnesses who called for “about the need for families and health care providers to prioritize these important life conversations, so that individuals’ wishes are known and person-centered care is prioritized,” noted U.S. Senator Susan Collins, who chairs the Senate Special Committee on Aging. In her opening statement the Maine Senator called for federal policies to “support efforts to relieve suffering, respect personal choice, provide opportunities for people to find meaning and comfort during serious illness, and – most important – remain in control of their own care.”

Advance care planning conversations to a patients’ physical, emotional, social and spiritual well-being are important in the care of a patient, says Collins. However, studies reveal that less than one-third of physicians have reported that their practice or health care system has a formal program in place to assess patients’ goals or preferences, she notes.

Collins also shared a personal story of a close friend who benefited from the person-centered care she received while she was a patient at the Gosnell Memorial Hospice House in Scarborough, Maine. “Despite her serious illness, because of hospice care her days were filled with visits from friends and families and many joyful moments, and she was surrounded by her family when she died peacefully,” she said.

“I’ve heard from Rhode Islanders about how difficult it can be for patients battling serious, advanced illnesses to get the care and respect they want,” said Whitehouse.

Whitehouse noted that “We can do better by these patients. Because so many of the rules and incentives in our health care system are tied to the payment structure, we should design payment systems that support models of coordinated care that focuses on the full person. Payment systems should reward providers for honoring patients’ own preferences for their care.

As Dr. Atul Gawande, surgeon and author of the New York Times best-selling book, “Being Mortal, mentioned in his testimony, “people with serious, potentially life-limiting illnesses face substantial and increasing suffering, particularly during the last year of life. Medical care today typically exacerbates this suffering, often without any benefit of lengthened life. We have an opportunity to change this.”

“The goal is not a good death. Instead, the goal is to have as good a life as possible all the way to the very end,” say Dr. Gawande.

In her testimony, Amy Berman, a nurse and senior program officer at the John A. Hartford Foundation, who is living with stage IV inflammatory breast cancer stand stressed the importance of palliative care, which is designed to improve the quality of life for patients with serious illness.

“Palliative care is the best friend of the seriously ill,” said Berman, “Studies have shown that when palliative care is added at the beginning of a serious illness that people feel better and live longer.”

Finally, Dr. Kate Lally, Chief of palliative care for the Providence-based Care New England Health System, Medical Director of the Integra Accountable Care Organization, and Assistant Professor of Medicine at Alpert Medical School of Brown University, urged Congress to consider legislation that would improve the quality, not just the quantity, of life of the seriously ill. “I feel blessed to do this work, and to be able to reflect with my patients on the life they have lived, their joys and regrets,” she said. “I feel I am able to share some of the most sacred moments of their life, and be at their side as they consider what is most important to them in their limited time.”

“The healthcare system as a whole, as well as Medicare and Medicaid, need to face growing expectations about how people with serious or terminal illnesses are treated,” said AARP Rhode Island State Director Kathleen Connell. “We are investing in prevention and early treatment and getting better results. Ultimately, however, people will still face serious illness and palliative care. Person-centered care is the proper prescription, and we must strive to make sure that it’s available. We need to be vigilant when it comes to supporting a healthcare environment in which patients with serious illness feel they are well informed and can remain properly in control of their options. And while families still tend to avoid these discussions in advance, when the time is right proper guidance makes a world of difference.

“People form especially strong opinions about decisions made that may prolong their existence, but add little to the quality of lives and, in fact, can prolong suffering,” Connell added. “Conversations on this phase of life are critical and we applaud Senators Collins and Whitehouse for their contribution to this dialogue.”

Legislation to Support New Models of Coordinated Care

The thrust of Whitehouse’s legislative proposal is to promote better coordination between health care providers, and place greater emphasis on the care preferences of Medicare beneficiaries with advanced illnesses.

“Too many Rhode Island Medicare patients battling difficult illnesses are struggling to get the right care at the right time,” said Whitehouse. “We need to break down the barriers between patients and the care they need. Because so many of the rules and incentives in our health care system are tied to the payment structure, we should design payment systems that support new models of coordinated care that are focused on human beings and not some rule or regulation.”

Whitehouse’s legislation would establish a pilot program administered by the Centers for Medicare and Medicaid Services (CMS) made up of twenty “advanced care collaboratives” of affiliated health care providers and community-based social service organizations. Collaboratives would receive a planning grant to assess the needs of the population of patients it would serve; to purchase or upgrade health information technology to facilitate better coordination of care between providers; and to support education and training on documenting and communicating beneficiary treatment preferences and goals.

Once planning is complete, collaboratives would enter a three-year payment agreement with Medicare to provide coordinated, high-quality care for their target patient population. Under the terms of the pilot program, CMS would waive regulations to promote innovative care for patients with advanced illness.

Waivers would be granted to allow Medicare patients to receive hospice care and curative treatment at the same time. Currently CMS’s regulations force patients to choose one or the other for their terminal illness. Patients would be able to also receive Medicare coverage in a skilled nursing home without a consecutive three-day inpatient hospital stay. Under current Medicare rules, patients are often charged for skilled nursing care after they leave an inpatient hospital stay because they were hospitalized for observation rather than admitted to the hospital.

Whitehouse’s legislative proposal would also allow Medicare patients to receive home health services without the requirement that they be homebound. Under current rules, a patient’s condition must have progressed such that there “exists a normal inability to leave home,” denying these services to those who are seriously ill but still mobile. Finally, it would also allow nurse practitioners to sign home health and hospice care plans and certify patients for the hospice benefit. Right now, only doctors can do so, even though nurse practitioners are often the ones administering home health and hospice care. This forms another barrier for patients seeking these services, especially in underserved and rural areas.

According to Tom Koutsoumpas, Co-Chair of the Coalition to Transform Advanced Care’s (C-TAC) Board of Directors, Whitehouse’s legislative proposal is “a critical step forward to achieving high-quality, coordinated care for those with advanced illness. This legislation allows for important innovations in care delivery and removes obstacles to support patients throughout the care continuum.”