The Congressional Budget Office estimates that premiums for the national long-term care insurance system proposed by Senator Ted Kennedy (D-MA) may be significantly higher than the $65 per month Kennedy aimed for. CBO figures that for the insurance system to be self-sustaining, premiums would have to be in the range of $100 to $110 per month. A key question for the Kennedy [...]
Nobody wants to see chronically-ill elderly patients making repeated trips to the emergency room. These visits are obviously bad for the patients themselves, who often suffer stress, disorientation, and high risks of infection. They are no good for Medicare, which has to pay the bill: The estimated cost of these readmissions is $17 billion annually. And, despite the common perception, they may not be good for hospitals, which are [...]
I participated in an interesting panel discussion on long-term care this afternoon at The Urban Institute . My fellow panelists were an impressive group of policy experts, all of whom have designed their own reform plans. They included Bill Galston from the Brookings Institution, Rich Johnson from The Urban Institute, and Anne Tumlinson from the consulting firm Avalere Health. While each approaches the problem from a [...]
The Democrats on the Senate Health, Education, Labor, and Pensions Committee have, as I expected, included three key long-term care services proposals in their massive 615-page health reform bill. The measure would require states to offer the same access to home and community care as they currently provide for skilled nursing facilities under Medicaid. It would provide new incentives for training both paid [...]
I've just started a column for Kaiser Health News, a brand new independent news service. I'll be writing twice a month on long-term care issues, looking at policy, new research, and on-the-ground community ideas for improving long-term supports and services. My first piece, published this morning, looks at Senate HELP Committee Chairman Ted Kennedy's CLASS Act. While the measure, which would create national long-term [...]
USA Today published my op-ed column today on the need to include long-term care services and supports in health reform. It is nice to see that USA Today is so interested in this all important subject. All of us who are caring for our parents know why Congress should not miss this opportunity to address the needs of those receiving care as well as their families. [...]
If you are impoverished and unable to care for yourself, Medicaid is required by law to provide long-term services--in a nursing home. Although the frail elderly and younger people with disabilities overwhelmingly prefer to stay at home, states are under no obligation to offer care in the community. So here is an idea: Why doesn't Medicaid make home care the default option for assistance? [...]
Senate Health Committee Chair Ted Kennedy (D-MA) will include a major restructuring of long-term care services in his version of health reform, due out in late May. But getting those changes through Congress "is like pushing a rock uphill," says Connie Garner, Kennedy's top staffer on aging and disabilities issues. Garner spoke yesterday at a terrific conference sponsored by Health Affairs and [...]
In the debate over health reform, there has been an increasingly emotional argument over whether controlling medical cost growth will require rationing of care. The answer is: Of course it will. We ration care today, but do it in a profoundly irrational way. Reformers hope that health reform will allow us to do it in a more sensible manner, based on medical [...]
I heard a great presentation this morning by Shawn Bloom of the National PACE Association on how goverment tries to coordinate care for those elderly who are both frail and very poor--among the most at-risk people in the country. PACE is an innovative program that is geared to seniors still living at home. It combines adult day services with medical care and other [...]