Long-Term Care Reform Proposal #2

Many lawmakers and congressmen are opposed to even confronting long-term care issues.¹ They are making a serious mistake by failing to acknowledge that the chronically ill need a continuum of care that does not come to an end at hospital discharge or when they leave their physician’s office. At the present time, Medicaid is responsible for providing long-term care only to nursing home residents. Furthermore, in 2004, Medicare covered only 13.9% of the cost of care in nonhospital nursing homes². Due to the fact that states are under no legal obligation to provide home care, this assistance is often limited and poorly funded.¹

Congress continues to tackle health care reform, and we believe that any new plan needs to involve a strong long-term care component. Even though many people may be opposed to this idea because our elderly population is still very healthy and independent, there is still an immense need for long-term health care reform. Because of the aging population and the rising cost of health care, states need to search for different ways to increase quality and access while decreasing cost for the older adults and elderly. The primary goals should be higher quality, cost efficiency, and consumer satisfaction.³

Due to the large aging population, the need for long-term care will increase dramatically within the next few decades. For this reason, access to long-term care needs to become more available while remaining cost efficient. Because the elderly population is so large today and their demands are so diverse, we propose that there needs to be a large increase in a variety of institutions in the country. For example, there may be a 65 year old that just needs help getting out of his or her bed in the morning; or there may be a 65 year old with end stage lung cancer that needs to be placed in a hospice care facility. Furthermore, every day we undeniably can see how poor quality increases cost.⁴ For instance, an elderly person does not receive the proper care in his or her nursing home, which leads to skin irritation and a pressure ulcer that eventually sends this person to the hospital. Therefore, each state’s budget needs to take into account the needs of their elderly population and assess this need in order to develop more facilities that provide specific care. An emphasis needs to be placed especially on home health care.

Because our aging population is fairly healthy, many elderly adults want to remain in their home as along as possible to maintain their independence and a high quality of life. The utilization of home health care has declined due to the Balanced Budget Act of 1997, which inflicted restrictions on home health coverage for Medicare beneficiaries.² This act may have controlled costs, but it did not increase quality or access for the elderly. Moreover, home health care is much cheaper than nursing home care.⁵ However, millions of Americans who need long-term care but cannot afford to pay for even home health care, end up spending most of their assets in order to qualify for Medicaid and then move to nursing homes, which are covered by the program. This is incredibly expensive for the government because they pay about 60% of long-term care costs in the United States. Obviously this situation does not benefit anyone because the elderly have to give up their assets in order to obtain health care, which many may not even need to be in a nursing home, and the government ends up spending way more on long-term care.

As a large part of our reform, we propose that both the federal government and each state’s government work with one another in order to incorporate a change in their budget so that both Medicare and Medicaid are distributed better. If the budgets can allow for this type of change, Medicaid and Medicare could allow more money to be put into home health care rather than nursing homes. Consequently, the elderly population would be more apt to paying for home health care because they would receive some money from these programs. Therefore, these changes would decrease cost for both the elderly population and the government, increase access by allowing more people to receive care at home, and increase quality by providing one-on-one care in an individual’s home.

-Kayla Schuster

Sources-

1. Gleckman H. Will Long-Term Care be Included in Health Care Reform? Kaiser Health News. 2009. Available at: http://www.kaiserhealthnews.org/Columns/2009/September/091409Gleckman.aspx. Accessed March 10, 2010.

2. Shi L, Singh D. Delivering Health Care in America: A Systems Approach. Boston: Jones and Bartlett Publishers; 2008.

3. Folkemor D. A Guide to Long-Term Care for Policy Makers: The State of Long-Term Care. National Conference of State Legislators. 2010. Available at: http://www.ncsl.org/Default.aspx?TabId=14491. Accessed March 10, 2010.

4. Smith D. The Role of Long-Term Care in Health Reform. The Heritage Foundation. 2009. Available at: http://www.heritage.org/research/healthcare/tst032509c.cfm. Accessed March 10, 2010.

5. Pickert K. Should Long-Term-Care Insurance Be Part of Health Reform? TIME. 2009. Available at: http://www.time.com/time/politics/article/0,8599,1946431,00.html. Accessed March 10, 2010.