RFK Jr. - Danger to Health; Migraine News; Filial Responsibility Laws
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Migraine News
New research describes for the first time how a spreading wave of disruption and the flow of fluid in the brain triggers headaches, detailing the connection between the neurological symptoms associated with aura (colors I see) and the migraine that follows. The study also identifies new proteins that could be responsible for headaches and may serve as foundation for new migraine drugs. (Univ. Of Rochester)
t is estimated that one out of 10 people experience migraines and in about a quarter of these cases the headache is preceded by an aura, a sensory disturbance that can includes light flashes, blind spots, double vision, and tingling sensations or limb numbness. These symptoms typically appear five to 60 minutes prior to the headache.
The cause of the aura is a phenomenon called cortical spreading depression, a temporary depolarization of neurons and other cells caused by diffusion of glutamate and potassium that radiates like a wave across the brain, reducing oxygen levels and impairing blood flow. Most frequently, the depolarization event is located in the visual processing center of the brain cortex, hence the visual symptoms that first herald a coming headache.
While migraines auras arise in the brain, the organ itself cannot sense pain. These signals must instead be transmitted from the central nervous system—the brain and spinal cord—to the peripheral nervous system, the communication network that transmits information between brain with the rest of the body and includes sensory nerves responsible for sending information such as touch and pain. The process of communication between the brain and peripheral sensory nerves in migraines has largely remained a mystery.
The most widely accepted theory is that nerve endings resting on the outer surface of the membranes that enclose the brain are responsible for the headaches that follow an aura. The new study, which was conducted in mice, describes a different route and identifies proteins, many of which are potential new drug targets, that may be responsible for activating the nerves and causing pain. The researchers also observed that the transport of proteins released in one side of the brain reaches mostly the nerves in the trigeminal ganglion on the same side, potentially explaining why pain occurs on one side of the head during most migraines.
I am hopeful that safe new medicines will be the result.
RFK Jr. IS A Danger to the U.S.
Scott Gottlieb, who served as commissioner of the Food and Drug Administration (FDA) during President-elect Trump’s first term, expressed concerns with the pick of Robert F. Kennedy Jr. to lead the Department of Health and Human Services (HHS) due to his anti-vaccine advocacy.
“I think if RFK follows through on his intentions, and I believe he will, and I believe he can, it will cost lives in this country,” he said during a Friday appearance on CNBC’s “Squawk Box.”
“You’re going to see measles, mumps and rubella vaccination rates go down, and like I said, if we lose another 5 percent [of vaccinations], which could happen in the next year or two, we will see large measles outbreaks,” he continued. (The Hill)
I am so ashamed of the names being proffered to lead government agencies. This one in particular is especially dangerous. The paradox is that we have had high vaccination rates for these many childhood illnesses for so long that people have forgotten that these illnesses can result in a crippled life and death. And so they assert the luxury of “You Can’t Tell Me What To Do” instead of recognizing the disastrous consequences they foist on their own children and on the public at large.
ACTION
Text SIGN PBXONF to 50409 to tell your Senator to demand NO SENATE RECESS. All Trump appointees must get a hearing. And a NO vote for RFK Jr. who is a danger to public health. Here is the message you’ll send. You can use . Or via Apple Messages / MESSENGER]
“I am your constituent and I don’t want measles, mumps, rubella, diphtheria or any other preventable illness anywhere in the US. These diseases are dangerous and deadly. RFK Jr. will make it easy to not vaccinate and then children and adults will die needlessly. I know you want every child to have a fair shot - give them that fair shot and reject RFK Jr. AND BY THE WAY - Make sure the Senate does not recess so you get to review EVERY SINGLE TRUMP APPOINTEE. Thanks. I am counting on you.”
Filial Responsibility & Finance
Baby boomers are the generation born after World War II between 1946 and 1964, during the post-World War II baby boom period. They are now between 60 and 78. Some retired and some getting ready to retire. In 2020, 3.2 million of them went into retirement in the United States, way more than in prior years.
How are they doing financially?
According to a recent GOBankingRates survey, the largest proportion of younger boomers (ages 60 to 64) and older boomers (ages 65 to 78) have $100 or less in their savings account, with 41% and 33%, respectively, reporting low balances. (Yahoo Finance)
Baby Boomers have an estimated median retirement savings of $194,000 as of late 2023, according to the TransAmerica Center for Retirement Studies. The survey found that 26% had less than $50,000 in retirement savings accounts and 10% had nothing saved. (Investopedia)
Access to Services and Care
The reason we are discussing this is that there is a move afoot in the government to start reducing social security or increasing the retirement age. Project 2025 talks about reducing food subsidies, like SNAP and Women Infants and Children (WIC). There is active discussion of moving seniors to Medicare Advantage programs or Networks of care instead of offering the public insurance trust Traditional Medicare and there is talk of restricting Medicaid. That may dramatically increase costs and reduce access to care.
If you are a woman, a child, or a senior and food is a problem, you have cause for concern. If Medicaid or Medicaid is your health insurance, you have cause for concern.
If you are the child or grandchild of someone who may have financial difficulties, trouble getting sufficient food or paying for their healthcare in the face of these upcoming changes then you also have cause for concern. Here’s why.
Filial Responsibility
Filial responsibility refers to an adult child’s (and in some states grandchild’s) legal duty to support his or her parents/grandparents. Thirty U.S. states currently have filial responsibility laws that obligate adult children to support parents if they can’t do it themselves. Filial laws require children to provide for parents’ basic needs such as food, housing, and medical care. The extent of filial responsibility varies by state, along with conditions that make it enforceable including the parent’s age and the adult child’s financial situation. (Ref)
The medical care requirements of filial responsibility can be controversial. Funding copayments for your parents’ doctor visits is one thing, but absorbing a $100,000 bill for a nursing home stay is an entirely different level of support. Unfortunately, filial responsibility laws may not differentiate much between the two. If you live in a filial state and your parents start accumulating healthcare bills they cannot pay, the healthcare provider may be within its rights to sue you, and win.
Filial laws haven’t been uniformly enforced in the past, but experts predict a rise in enforcement going forward. Filial responsibility court claims are one way healthcare providers can recoup their costs when five- and six-figure medical bills go unpaid.
in some states, filial responsibility laws can apply to grandparents, meaning that depending on the specific legislation, grandchildren may be legally obligated to provide support to their grandparents in certain situations, although this is less common than the responsibility applying to parents and children directly; a few states even extend the duty to siblings or other relatives depending on the circumstances.
States With Filial Responsibility Laws
In 2024, there are 30 U.S. states with filial responsibility laws. Here is a link you can use to look up the law in each of those 30 states.
Filial responsibility laws can be very different from state to state. Georgia’s statute, for example, simply states that a child who’s able must support an impoverished parent. The Arkansas law requires an adult child to provide specifically for a parent’s mental health needs, but only when that child has the means to pay and the services are not covered by insurance. In Virginia, you and your siblings are financially responsible for medical bills including long-term care — but you are no longer responsible for that long-term care bill after your parent has been institutionalized for 60 months or more.
When are Filial Responsibility Laws Enforced?
Although filial laws in each state may differ, there are some commonalities when it comes to enforcement. You’re most likely to be deemed legally liable for a parent’s medical bills when:
Your parent does not qualify for Medicaid
Your parent is impoverished.
Your parent has medical bills and cannot pay for them.
You do have the ability to pay, or your parents fraudulently transferred assets to you.
If you live in a state with filial responsibility laws and these conditions apply, you may be legally obligated to support them. If a healthcare provider were to sue a parent for an unpaid medical bill, the court may declare that filial responsibility falls on the child.
4 Implications of Filial Laws
If you have elderly parents and you live in a filial state, filial laws should be a consideration in all major financial decisions, both for you and your folks. Overlooking these laws and your responsibility under them can lead to some fairly tricky situations. (Fenelli Legal)
1. You can be sued for your parents’ long-term care bills
Your mom’s family doctor isn’t going to sue you to recover a $25 copay. But when the debt figure is high, say $50,000 or more, the healthcare provider will be more motivated to take you to court. That’s why filial responsibility cases tend to involve long-term care bills. Even a short stay in a custodial care facility can be very expensive, and patients without Medicaid or long-term care insurance must pay these expenses out of pocket.
The best-known example of a filial law case is Health Care & Retirement Corporation of America v. Pittas of 2012. At issue was a $93,000 nursing home bill that an elderly patient did not pay. Upon her release from the home, the woman left the country. The nursing home then sued her son who was still in the U.S. The courts ruled that the son was financially able and therefore responsible for paying the bill.
2. You may face civil or criminal penalties
If a court of law declares you responsible for a parent’s medical bills, you are subject to the usual debt remedies, including wage garnishment, bank account seizure, and liens. You may also face jailtime for neglecting filial responsibility. According to North Carolina law, for example, the refusal to support your parents is a Class 2 misdemeanor. That can earn you a 60- or 120-day jail sentence.
3. Financial transactions between you and your parents could be scrutinized
The court may investigate your recent financial transactions to check for any suspicious or fraudulent activity that could indicate you’re trying to get out of your filial responsibility to a parent. Property transfers are likely to be scrutinized, as those transactions might be deemed “fraudulent conveyance,” which is a property transfer that’s intended to defraud creditors.
For example, if you own an extra home that contributes to your net worth, transferring it to a friend for free may reduce your net worth to a level that would make you appear less capable of financially supporting a parent. However, going through with the transfer to avoid filial responsibility is a form of fraud that’s illegal. You might also risk violating Medicaid asset transfer rules, which would make your parents ineligible for Medicaid. Expect any transfers in recent history to be scrutinized by Medicaid, by any unpaid healthcare provider and, later, by the court if you are sued.
4. You may have to sue siblings or your parent’s spouse to recover funds
The law isn’t clear-cut with respect to how siblings and spouses should share responsibility for the family member’s medical debt. In the Pittas case, the Pennsylvania Superior Court ruled that the nursing home could pursue a judgment against Pittas alone, even if other relatives in the state were also financially responsible under the filial statutes.
Even if you have siblings who should share in the filial responsibility, the healthcare provider can come after you alone. If a judgment is rendered against you, it would be up to you to sue your siblings and recover their share of the debt.
PLAN, PLAN, PLAN
1. Start the conversation with your parents/grandparents
As awkward as it might be, you’ll have to ask your parents about their finances and, in particular, any plans they’ve made for long-term care. If your parents are wealthy, you’re not really at risk of being sued for their bills; unpaid healthcare providers would go after your parents’ assets before going after yours. The danger zone for you is when your parents are too wealthy to qualify for Medicaid, but not wealthy enough to cover hefty medical or long-term care bills.
In you’re in that danger zone, find out what plans your parents have made for long-term care. Common strategies include:
Life insurance with long-term care benefits
Permanent life insurance that can be cashed out or sold through a life settlement
Home equity that can be cashed out in a reverse mortgage or home sale to raise funds
2. Collaborate with other family members
If your parents/grandparents haven’t made plans for long-term care, that’s your cue to round up your siblings and have a planning conversation.
3. Consult with an elder care attorney
Whether your siblings want to participate or not, you should consult with an elder care attorney. Elder care attorneys specialize in issues involving long-term care and Medicaid qualification.
4. Help them qualify for Medicaid
If your parents/grandparents can legitimately qualify for Medicaid, that dramatically lowers your risk of absorbing their medical debt. There are legal ways to lower their income and assets enough for them to be eligible for Medicaid, should they need long-term care. These strategies are called Medicaid spend-down. You would need the expertise of an elder care attorney or financial advisor to devise and implement a spend-down strategy.
This doesn’t cover everything but it is a start.
RESOURCES
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Important Healthcare Resources
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Organizations to Contact
National Nurses United Medicare4All, Physicians for a National Health Program, One Payer States, Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision, Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Library of Advice, Specific Advice
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
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The section on filial responsibility was eye opening. I do not want my children saddled with costs of my care, but have little in savings due to later in life divorce. The threat to them is concerning.
Thank you for the information. I have suffered from migraines for decades. The information you presented was informative and anticipatory of forthcoming moves by the incoming president’s people. What implications those moves will have on others who didn’t think they were going to be negatively affected by the proposed policy changes.