With many Republicans forecasting the end of Medicare for those under 55 and few members of my own Democratic Party willing to propose sweeping reforms to preserve it, several Washington insiders speculate that serious Medicare reform will remain a third rail of American politics.
Yet based on my experience, common ground on Medicare is possible and, in the short term, policymakers have an immediate and time-sensitive opportunity to prevent and manage costly chronic illnesses such as cancer, diabetes and hypertension through a coordinated approach to treating patients led by home health care. By strengthening options that let people get much-needed care at home, policymakers can save money, give older Americans what they want and address the chronic disease epidemic facing our nation.
Consider the following: Nearly three quarters of those who live to 85 will eventually need health assistance ranging from simple help around the house to 24-hour skilled nursing care. According to the Department of Health and Human Services, a week in a private nursing home room costs about $1,500 while a week of home health care costs considerably less.
If Congress accelerates already planned cuts in home health care (currently under consideration) or raises fees on seniors even more, it will encourage many to enter costly nursing homes and, eventually, increasing the overall cost of the Medicare program. This defies fiscal and political logic.
Moreover, policies that force seniors into nursing homes through cuts to home health spending will directly impact our efforts to prevent and manage chronic disease. The cuts reduce the capacity to provide health care services to chronically ill patients at home. Patients with chronic disease account for 75 percent of U.S. health spending and the numbers are higher in entitlement programs. Eighty-three percent of every dollar in Medicaid is spent on chronic disease and 99 percent in Medicare.
The best chance America has to alleviate this burden is by creating a coordinated team-based approach to health care in which doctors, nurses, nurse practitioners, home health aides and patients are all working together to treat and get in front of chronic conditions. While some individuals have needs that require care only institutional settings can provide, few should leave friends, family, and familiar places simply because they need extra help.
Home health aides spend much more "face time" with seniors and disabled persons than doctors and nurses. Our medical system must take advantage of this. With better information technology -- interoperable electronic medical records in particular -- and improved integration between health providers of all sorts, home health workers can serve as a "front door" to a better-coordinated medical system. Improved coordination of care, in turn, can save money (it's almost always cheaper to treat problems early), reduce medical errors, and improve quality of life for Americans on Medicare.
Such home and community-based solutions should appeal to both ends of the political spectrum. Republicans intent on cutting the budget should know that they'll save money by reducing the need for institutional care. Democrats who want to raise the quality of public services should be secure in the knowledge that home health care spending will do just that. Providing opportunities for patients to receive their health care services at home rather than at more expensive institutional settings is a common sense solution.
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Steven East, CEO and President
Caring People Home Healthcare Agency Servicing New York, New Jersey and Florida
http://www.caringpeopleinc.com
Thanks for dedicating time to this critical topic!
Laura Mitchell from GrandCare Systems!
But with our present Congress , if there aren't any serious corporate profits , or lobbying money , built in a recommendation Congress will be totally blind and deaf to it .
Almost all recent new laws have been designed to enhance corporate profit while gouging the American public and Congress does not seem to want to break out of that syndrome .
Included in those new laws are American job exportations , which is and indication of what Congress really thinks of the people the elected them . And their desire to kill the Seniors Medical Health Insurance Program lets us all know what Congress thinks of seniors .
Privately insuring this cost-will save the state and federal governments hundreds of billions of dollars.
The provided incentive should be so strong-
that you actually receive a full income tax DEDUCTION-
on your policy's annual premium.
Yeah, those EVEL private sector insurance companies-
sure would be EXTREMELY helpful in this scenario.
And those in their 40's? Tons of easy money to invest.
Where do you send those who can't afford to pay for a doctor?
To the Emergency room of the local hospital, arguably the most expensive treatment facility available, with doctors not trained for, nor eager to work on the routine illnesses of the indigent.
For the elderly it's even worse.
"A fate worse than death"? That's my opinion of most nursing homes I have seen. Yet the Federal government will pay to haul grandma off to the nursing home, (in a very expensive ambulance), but they won't pay for someone to help her keep her independence (as much as is possible) and stay at the home she's lived in for decades.
Our entire health care system makes no sense.......................but it sure makes lots of dollars, for the select few who know how to "play the game", and the politicians in their pockets.
#2 -inadequate support for in-home services, especially minor support needs, shopping & cleaning, for example, for residents in unsubsidized housing & for short periods, such as minor illnesses, emergencies, etc.