For the first time since President Bush's ill-fated effort to privatize Social Security five years ago, the future of the nation's flagship retirement program is back on the policy agenda. For example, Social Security will almost certainly be an issue for President Obama's deficit reduction commission. Unfortunately, we may be headed for the same non-productive shouting match we had over the Bush [...]
The Senate Finance Committee has begun an investigation into four big home-health agencies that, it alleges, artificially inceased their home therapy visits to take advantage of higher Medicare billing rates. A May 12 letter from committee chairman Max Baucus (D-MT) and senior Republican Charles Grassley (R-IA) asked the four for-profit agencies--Amedisys, Almost Family Inc. Gentiva Health Services, and LHC Group-- for records and [...]
President Obama has signed health reform, including the CLASS Act, into law. Now, his administration needs to turn a law into an insurance product people will buy. It won't be easy. No other country has tried to create a voluntary public long-term care insurance program, which is what CLASS is. The challenge will be to design a policy that provides a respectable benefit at an [...]
The health reform bill passed by Congress last night includes big changes in the way we pay for long-term care, both at home and in nursing facilities. The reforms will give the elderly and disabled far more flexibility in the way they get care and, at the same time, begin turning long-term care from largely a welfare program to an insurance system. The biggest change [...]
Mike Vitez at the Philadelphia Inquirer has done a great story on palliative care at a community hospital. Mike weaves the deeply touching story of Mary Tole, a 74-year-old woman who spent two months in the suburban Philadelphia hospital with an undiagnosed illness. She spent much of that time in an intensive care bed in a coma. Mike describes how the hospital's palliative care team [...]
Republican Scott Brown's stunning victory in the Massachusetts Senate race has obviously turned the health reform debate on its head. Without a 60-vote majority in the Senate, Democrats are no longer assured of passing a major health bill. But what will this mean for long-term care reform? There are three key long-term supports and services issues at stake--expansion of Medicaid home and [...]
The politics of the CLASS Act, the proposed voluntary government long-term care insurance program, are getting nastier. Critics have taken to calling it a Ponzi scheme, comparing it to Bernie Madoff, and ripping it as a massive new unfunded government spending program. Senator Joe Lieberman (I-Conn) called it "a whole new entitlement program" which it certainly is not. I've raised concerns with CLASS [...]
It was a good day for supporters of the CLASS Act, the national long-term care insurance program that has been on the edges of the health reform debate. A version of the measure was included in the House Democratic reform bill introduced today by Speaker Nancy Pelosi. The decison all but assures the long-term care proposal will be included in the [...]
I spent yesterday morning at a Kaiser Family Foundation panel discussion on the CLASS Act, the national long-term care insurance program being considered as part of health reform. The panelists, who included Senate Health Committee aide Connie Garner and a number of advocates for long-term care reform, were upbeat about the possibility that CLASS will be included in a final health [...]
In a bit of surprising news, Senate Finance Committee Chair Max Baucus (D-Mont) added some key long-term care amendments to his health reform bill. The provisions, first proposed by senators John Kerry (D-Mass), Maria Cantwell (D-WA), and Chuck Schumer (D-N.Y.) would all make home and community based care more accessible under Medicaid. Currently, Medicaid is only required to provide long-term [...]