Democratic and Republican Platforms Back Home-Based Care For Older Adults

For the first time, both major political parties have explicitly recognized in their platforms the need for community-based long-term care. While the Democratic and Republican platforms included few specific recommendations, the fact that they acknowledged the importance of personal assistance and social supports for older adults (and in the Democrats’ case, for younger people with disabilities) is a significant step towards future policy change.

The Democratic platform is far more expansive, addressing the importance of strong home-based services and supports for both paid aides and family caregivers. It also calls for expanded family leave, which could help some working people caring for parents or spouses. Here are the two key sections from the Democratic platform.

Doctors Die Like The Rest of Us

In recent years, it has become conventional wisdom that physicians avoid the end-of-life mistakes that many of the rest of us make.  The story: They die at home rather than in hospital intensive care units. And they rely on comfort care such as hospice or palliative care rather than often-futile high tech medicine.

That conventional wisdom, it turns out, is a myth—at least according to a new study by Daniel Matlock and colleagues published in the Journal of the American Geriatrics Society.  Docs, despite their better understanding of the nature of terminal illness, their knowledge of the limitations of medical treatment at the end of life, and even their ability to talk as peers to their own physicians, die pretty much like the rest of us.

A New Vision For Medicare: Breaking Down Barriers Between Medical Treatment And Personal Care

Since July 1 was the 50th anniversary of Medicare first enrolling (and paying benefits for) seniors, it’s a good time to think about modernizing the half-century old program.

A couple of weeks ago I tried to make the case for why we should improve Medicare. Now, let’s think about how.

Should Drugmakers Be Allowed To Avoid Taxes On Their Profits From An Alzheimer’s Drug?

In one of the worst ideas I’ve heard in a long time, two congressmen have introduced a bill to make profits from the sale of certain anti-Alzheimer’s drugs tax free for seven years.  The measure, sponsored by representatives Patrick Murphy (D-FL) and Mike Fitzpatrick (R-PA), may be well-intentioned, but it would provide a multi-billion dollar windfall to pharmaceutical companies. There is no evidence it would improve the nation’s overall health and it could very well harm it.

Happy 50th Birthday Medicare. Now, Let’s Think About How to Update It.

On Friday, July 1, it will be 50 years since Medicare first began paying health benefits for older adults. It is an anniversary worth celebrating—and easy to forget that prior to Medicare half of all seniors had no insurance. But much has changed in a half century—and Medicare has not kept up. It is time to rethink the program—both the benefits it offers and how it is financed.

Many advocates are opposed to redesigning the program. They fear, not without reason, that some politicians see modernizing Medicare is just another opportunity to cut the program.  But they need to recognize a reality: A rapidly growing population of chronically ill older adults is not being well-served by the traditional Medicare program.

What Paul Ryan’s Latest Health Proposal Would Mean For Seniors

House Speaker Paul Ryan’s proposed blueprint for health reform would make major changes in medical care for seniors, raising out-of-pocket costs for some and shifting others from traditional Medicare coverage to commercial insurance.

His plan, called A Better Way, would slowly raise the age of eligibility for Medicare and cap federal spending for the program, increasing subsidies for low-income seniors but raising out-of-pocket costs for higher-income retirees. It would make Medicare Advantage managed care plans more attractive. And, in a significant omission, it barely acknowledges the importance of long-term supports and services for older adults and younger people with disabilities and suggests few ways to improve such care.

A Key Senate Committee Kills A Program That Advises Seniors on Medicare

Do you understand Medicare? Of course you don’t. Neither does anybody else. So why would Congress abolish a modest federal program that pays for actual human beings who can explain it to confused consumers?

Last week, the Senate Appropriations Committee essentially voted to abolish the State Health Insurance Assistance Program (SHIP) by quietly eliminating the entire $52.1 million in federal funding that keeps the service going. In 2014, about 15,000 counselors in 3,300 state and local programs provided direct personal assistance to about 3.5 million older adults and younger people with disabilities. More than half of the counselors are unpaid volunteers. SHIP does not subsidize Medicare. It only provides advice.

How much is family caregiving worth?

What are family caregivers worth? As the credit card commercial says, they are priceless. But they also have a financial value. And calculating that value is important as we consider ways to help them. For example, before Congress creates new government supports for family members who help aging parents or other relatives with disabilities, it will want to know if that assistance could reduce other government spending.

Why Encouraging Older Adults to Stay In their Homes Isn’t Always Smart

Most of us, most of the time, want to age at home. But the reality is not everyone can, or should. Sometimes staying in your own home as you become increasingly frail is a poor choice. It can be lonely and even dangerous. It can burn out family caregivers. And it even can be more costly than other options, especially for people with very heavy care needs.

To Stay in their Communities, Seniors First Need A Place To Live

Sometimes, you just have to say what is crashingly obvious. And when it comes to older adults aging at home, here it is: If seniors are going to avoid a nursing home, they need a safe, affordable alternative. Without one, they may die prematurely. And even if they live, they will almost surely need institutional care, which may be a bad alternative for them and, if they are poor, will cost the government a small fortune.  In short, you can’t age in place without a “place.”