Page 46 - Fall2011

A Dietitian’s Experience

in the nursing home
Part two: We must Change the Paradigm of health Care Delivery
By Kim rodriguez, ms, rD, LD

President Obama pushed preventive health • Proton pump inhibitor (antacid): 53.4 million
care with the passage of the 2009 healthcare law. prescriptions;
But the kind of “preventive care” that he and most • Hyperglycemic agents (diabetes): 48.3 million
health professionals talk about is not preventive prescriptions.
at all. These policy makers talk about Medicare
and Medicaid coverage for tests to discover The total cost of pharmaceuticals charged
disease in its early stages, to treat disease in its to Medicare Part D in 2010 was over eighty-two
later stages, and to fund pharmaceutical therapy billion dollars.
to ease symptoms of disease—not ways to bolster This drug benefit has also increased the
health and truly prevent disease from developing overall cost of medical care thanks to the related
in the first place. increases in physician visits, prescribing and
Currently, our healthcare system not only monitoring of medications (and the many ensu-
supports disease, it rewards it. Insurance re- ing adverse events), and treatment for medical
imbursement is higher for a healthcare facility complications and side effects caused by the use
if the patient presents with more diagnoses. of so many medications at one time. According to
Pharmaceutical medications are offered at no the Agency for Healthcare Research and Quality,
cost to the facility or physician and, in many Americans treated in hospitals for medication-
cases, a physician collects “perks” if even more related problems surged in 2006 to almost two
pharmaceuticals are prescribed. million.
In 2003 the Medicare Prescription Drug The Census Bureau reports that the number
Improvement and Modernization Act autho- of Americans sixty-five years old and older is
rized CMS (Center for Medicare Services) to expected to more than double to eighty-nine mil-
begin offering a comprehensive drug benefit for lion by 2050. We may be living longer, but we
its elderly in January 2006 (Medicare Part D). are living sicker, and becoming sicker younger.
The benefit was hugely expensive, adding more Nursing homes are already admitting patients
than nine hundred billion dollars to Medicare younger than sixty years of age. These are people
spending over the next ten years and represent- too ill to care for themselves and must apply for
ing an increase in total Medicare benefit outlays Medicare’s support.
of twenty percent according to the 2007 U.S.
Congressional Budget Office. A TREND THAT MUST END
According to the American Association of Great changes in healthcare legislation must
Retired Persons (AARP), here is how the Medi- take place in order for the system to sustain itself.
care drug benefit has bled the U.S. budget for I think these changes must include the reduction
2010: and/or elimination of unnecessary pharmaceuti-
Currently, our cal medications and their replacement by other,
healthcare • Pain medications: 131.2 million prescriptions; safer healing modalities. Most important, we
• Cholesterol lowering drugs: 94.1 million pre-
must recognize the importance of eating only
system not scriptions; whole, unadulterated foods to be and stay well.
only supports • Blood pressure medications: 87.5 million pre- I have worked in the healthcare system for
scriptions;
disease, it • Thyroid medications: 87.4 million prescrip- twenty-one years as a registered dietitian in over
fifty nursing homes throughout the country. I
rewards it. tions; am also well educated in integrative and holis-
46 Wise Traditions FALL 2011 FALL 2011 Wise Traditions

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