America is killing off its elderly women, says Salt Lake gerontologist Victor Kassell.
But nobody is complaining on the evening news or even addressing the problem at women's conferences, he complains."I sit around listening to NOW (the National Organization for Women) and the rest of the women's groups messing around with abortion, when the percentage of women affected by that is minuscule compared to women affected by Medicare," he says.
Increasingly restrictive regulations governing Medicare insurance for people over 65 are hurting America's elderly, Kassell says. The regulations "make it impossible for older people to get quality care."
Most of these older people are women. The average woman, he notes, can expect to outlive her husband by five years or more.
"Consciously or unconsciously, the political leadership in the country is deliberately doing in elderly women." If the statistics were reversed - if men lived longer than women - "would it be the same? I doubt it," he says.
Kassell, a medical gadfly whose favorite hat bears the motto "Age and treachery will beat youth and skill," is Utah's only privately practicing geriatrician. The average age of his patients is somewhere between 70 and 75. Eighty percent of his patients are women.
Kassell accuses the Health Care Financing Administration, which oversees Medicare, of using its policies and regulations to commit "gerocide" and "active euthanasia."
"Doctors no longer want to take care of Medicare patients," he says. "More and more doctors are turning them down. They don't want the hassle, and they don't get paid enough."
The hassle, according to Kassell, is the increased paperwork - hundreds of forms and codes, plus all the letters that must be written in response to rejected claims. "I spend all day Wednesdays going to nursing homes and all day Saturdays doing the paperwork for the people I see on Wednesdays."
Reductions in the amount of money paid by the government for Medicare patients, he adds, means that most doctors can't afford to treat the elderly or at least to treat them well.
Kassell, 71, says that he can afford to treat his patients because he receives Social Security and is not dependent on patient fees to make a living.
For a routine office visit, he says, he spends 30 to 45 minutes with each patient. Medicare reimburses him $20 to $25. Elderly patients, says Kassell, require more time than other patients - because they move so slowly, have more ailments and ask more questions. They also tend to call doctors more to clear up questions about medications.
Medicare's refusal to pay for house calls also discriminates against the elderly, Kassell says, as does Medicare's inadequate reimbursement for nursing home visits. According to Kassell, 97 percent of physicians refuse to go to nursing homes - where two-thirds of the patients are women.
Refusal to pay for hospitalization unless the patient is critically ill or needs surgery also hurts the elderly, he says.
The elderly don't get ill in the same way younger people do, he says. "They don't respond as acutely. Their indications are more subtle."
Kassell says two of his patients - who were not admitted to the hospital soon enough - died as a result of the Medicare policy, a situation he sums up by saying: "The patient did not know how to be sick according to the rules and regulations required by HCFA."
Kassell says he doesn't understand why women's groups aren't "up in arms about this lousy care." He also doesn't understand why the head of HCFA - a woman - has not done anything.
"Elderly women are bearing the brunt of the prejudice. Younger women are inflicting it. And the rest of the women are more concerned about abortion than they are about the aged.
"I'm upset with the people in the community here who will allow this to happen and not intervene."