Health Reform Neglecting Senior Needs

The forgotten segment of health care in the national health reform debate is long-term care.

For those who aren’t sure what long-term care is, it is the numerous services that are arrayed to help maintain individuals with chronic conditions and disabilities that limit, sometimes severely, the ability to take care of oneself.

Long-term care can be intensive, such as skilled nursing and medical care delivered in a nursing home, and it can be temporary, such as the period of rehabilitation from either a surgical intervention or an event triggered by a medical condition, such as a stroke.  Besides nursing homes, long-term care services include home health care and home care, assisted living, adult day health care and short-term rehabilitation, among others.

When you drill down into long-term care, you also find specialty services, such as those for Alzheimer’s’ disease and dementia, and Parkinson’s.

What you don’t find is a rational, national way to pay for it.

And, you won’t find that in any health care reform proposal either, at least not to any great extent.

Oddly enough, what you will find, though, are suggestions that there should be cuts to Medicare, with the savings being used to help finance overall health care reform.  Medicare, ironically, is the one major federal government program that directs resources toward the health needs of those 65 and older, as well as certain persons with disabilities.  Even Medicare, though, has little to offer to cover the costs of long-term care.

With Congress adjourned until after Labor Day, there is an opportunity right now to contact our elected federal representatives to urge them to protect Medicare and to engage in efforts to address our long-term care needs.

August is a critical period.  During the time Congress is in recess, Senate and House members will be hearing from many constituencies about health reform.  If you are concerned about the needs of long-term care, and about providers such as Village Care of New York, which has served the downtown and West Side community with important senior care services for more than 30 years, now is the time to make sure you are heard.

There is a huge gap between the public’s expectations about how long-term care needs will be addressed in health reform and what’s in the various legislative proposals under consideration.

Surveys have shown that as much as 85 percent of Americans believe long-term care should be part of reform, and 58 percent oppose cutting Medicare to pay for reform.  Yet the various reform proposal before Congress at best make only modest advances in addressing the needs of long-term care, and at worst look to cut Medicare rates to help pay for the overall cost of reform.

President Obama recently met with AARP members where he got an earful about the need to protect Medicare, and he told the organization that “nobody’s talking about reducing Medicare benefits.”  Nonetheless, he didn’t back away from the concept of “cost-containment” saying that he wants to get rid of “waste” and that he has also targeted the higher payments that insurance companies get for Medicare Advantage plans over original Medicare.

The devil is in the details too, and other proposals that are being bandied about include taking final authority about Medicare payment matters out of the hands of Congress and giving it to a government “commission.”

While no one may be “talking about” Medicare benefit cuts, the consequences of some aspects of the proposals before Congress raise the real prospect that cuts to this important program for older adults could occur in a forum where neither the public nor Congress have a say.

If we are to make sure that health care reform offers real help and relief for individuals who need long-term care, and for their families, now is the time.  Moreover, health reform must not come at the expense of frail seniors through damaging cuts to Medicare that would undermine nursing home care and home care services, which millions of Americans rely on.

If you want to help, we’ve set up an easy way for you to do that at Village Care of New York’s website where you can find information to send to your House representative and to Senators Charles Schumer and Kirsten Gillibrand.  Go to www.vcny.org and click on the link under “Contact Congress on Health Reform” and you’ll be taken to a page that will help you write to our members of Congress by email.