In recent weeks, we've heard end-of-life counseling compared to government run "death boards." This rhetoric is beyond irresponsible, but it lays bare a very important problem--too many of us have no idea what living wills and other advance directives do, or how they work. So, a brief primer: In short, these legal documents allow you to tell doctors and hospitals [...]
The most bizarre episode so far in Washington's health care debate is the persistent rumor that the House version of reform would force Medicare patients to participate in counseling sessions where they would "learn how to end their life sooner." This is a lie. The House bill would do no such thing. Yet the myth persists, thanks to constant repetition by conservative radio talk show hosts such [...]
The House Energy & Commerce Committee has added Senator Ted Kennedy's national long-term care insurance proposal (the CLASS Act) to its version of health reform legislation. This is another remarkable step forward for the measure although, as I've noted before, the fate of this and other long-term care provisions won't be decided until Congress writes a final health care bill sometime this [...]
For those interested in long-term care, the House Democrats' consensus health reform bill is pretty disappointing. Unlike the Senate Health, Education, Labor, and Pensions Committee version, it includes no proposal for national long-term care insurance. And it largely ignores efforts to expand access to home care for those on Medicaid, who now often can only get care in nursing facilities, or to better coordinate care [...]
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 [...]
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 [...]
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 [...]