Politics and Nursing Home/LTC Reform
Posted by Heather on September 1st, 2008 / 
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I know Patti has a rule about no political posting here, but I’m putting that aside for the time because a couple items have caught my attention.
1) Several weeks ago Kim posted about the LTC industry, and the people who work within this industry, have no trust in Barack Obama when it comes to reforming health care. Surprisingly no comments were left on that post.
2) Over at the PHI Blog they have made a big deal that the Democrats have mentioned direct care workers and fair wages and more training.
3) In fact, the Republicans have mentioned long term care and it’s problems in their past two platform drafts.
This isn’t reported by PHI though- who need to be fair and balanced. I lose respect for groups when I suspect they have a strong political agenda vs. a real desire to make things better for ALL. PHI have shown they favor Democrats a lot lately.
The fact that direct care workers are mentioned is all that matters to this advocacy group. The wishes and desires of the people being pushed into nursing homes and other LTC facilities is a moot point I guess. Older people for the very most, would prefer NOT be spend their last years in nursing homes, which are horribly expensive.
Those who are poor have few choices however.
FACT: Less than 5% of ALL people over 70 reside in nursing homes; they almost all depend upon Medicaid for paying. This is about 1.8 million people.
FACT: It costs the US over a billion dollars each year to fund the care of these 1.8 million people.
THINK: About how much it will cost the US when that percentage of older people increases to 10, 15, 20%…
Reform? We need reform. Because we’re never going to be able to keep up with the fiscal requirements of nursing home care. No other nation in the world keeps as many of it’s senior citizens locked up in nursing homes; it’s not a problem for these countries because their cultures and priorities are different from ours. We like to pretend we care for our elderly and disabled citizens yet we show this by making them leave their homes and enter institutions. And we complain that we don’t get paid enough when it is, after all is said and done, WE WHO PAY OURSELVES.
I want to mention a serious and plausible solution, that PHI and other so called advocates conveniently like to forget…that nursing homes are not the only way to go. That other ideas and programs are out there, being talked about, being tried out and have worked. All without the demand of government funds. While the wages of those who provide care will always be up for debate, the expectation that the government must somehow be more involved with this is crazy. Where is the money going to come from? You.
The Republicans are not perfect in this issue. But in their last platform in 2004, long term care and all the problems associated with it were mentioned. And now, in 2008, we see it again. Republicans want to further the agenda of Choices-real options for older people who wish to stay at home and therefore end the need for so many nursing homes- something we have written about dozens of times here. Will PHI report on this? I doubt it.
From McKinght’s LTC News:
The draft of the Republican party’s 2008 platform calls for new non-institutional long-term care options.
“We must develop new ways to support individuals, not just institutions, so that older Americans can have a real choice whether to stay in their homes,” according to the draft released this week. “This is true not only with regard to Medicaid, where we spend $100 billion annually on long term care, but also for those who do not qualify for that assistance.”
Instead of pushing for reform in places where it isn’t going to happen, how about focusing on some solutions? How about thinking outside the box? How about seeking ideas and feedback from those most effected- the soon to be older people who have the most to lose here?
I know it makes people uncomfortable. But we must be realistic and honest.
So much more money can be saved by avoiding nursing home admissions. The cost of a one year stay for one resident could cover the costs of a home care option for 2 or three elderly people.
THAT’S REAL REFORM. Not political pandering and other games. It doesn’t matter whether one is Democrat or Republican. When it comes to health care reform and all things that come under it’s umbrella, each of us should be independent enough to see through the foggy political forest and not get lost in it.
September 1st, 2008 at 7:32 am
Interesting post Heather, and I don’t think Patti will get all twisted over this.
For years people have been trying to make change in LTC- in every aspect of it. From the survey process to CNA wages and much more. Looking at it all we see very little has changed. I say- to many chiefs are among the indians.
Very few Democrats have been willing to enter the law making process that would have to occur in order for such major change: On the local level not federal. Why? Because any wage increases must come from the states. The federal government can make all the laws it wants, but it will always be up to each state to put them into force. When it comes to money, states can only draw upon it’s people, who large and small, Democrat and Republican- reject bills that ask for more funding. It’s as simple as that. These people say NO because it means a tax hike for them- usually in the form of property taxes.
Too many people live in a world where they believe the government can save us all from the things that seem unfair or unjust. It pisses me off to no end to know the chain nursing homes get away with paying the aides such pity wages as the owners make huge profit. BUT, this is a free country. The aides DON’T have to work for these places. They are not forced to do so.
Politicians like us to forget this untidy bit of fact. Democrats want the owners to share the fruits of the aides’ labor; Republicans want the investors to earn a good return on their money. Either end, it is all about money.
I think this is part of PHI’s advocacy: To raise awareness of the wage/benefit factor as being a matter of national interest. They want to see owners share more, which is fine with me…as you know…it’s the small town nursing homes owned by local families who will suffer. And the small town owners outnumber the chains 5:1.
My fear is we will be left with nothing but chain nursing homes under a Democratic enforced “reform”; the chains are AWFUL in so many areas we cannot allow that to happen. However, the chains would be allowed to get away with even more under a Republican leadership.
In all my years of doing this work, the only politician who is worth his weight in gold is Senator Grassley. Who has, time after time, stood up for aides, nurses, good care; who has stood up to poor care, chains, ineffective survey processes, all things nursing home.
He is a Republican.
September 1st, 2008 at 7:56 am
As for the lack of comments on the Obama post I think it shows a level of boredom with politics overall. The people who work as aides don’t have the time or inkling to get involved; nor the money and other resources. They just want decent pay and benefits and to them political game has never gotten results. For too long, we’ve been promised things that never came through for us. Call it a loss of faith. Doesn’t matter what party. They just don’t have the will to do the right thing; more importantly it’s the people in our own states who don’t have the will.
September 1st, 2008 at 9:38 am
I for one, am a registered Democrat. I often wonder how anyone who works in health care can be anything but.
Democrats have been fighting for reform for years! They are stonewalled by the Republicans every time. Democrats have been trying to increase wages, benefit mandates and nursing home reform for as long as I can remember. It makes no sense to not do this: Yes, other options should be there, but for the most part older people do not have the means to pay for their own care once they become disabled. Any assets they have must be signed over to nursing homes as a form a pay back- this isn’t fair. These people have worked hard all their lives and don’t deserve this fate.
If the government were to end the war, focus inward and roll back tax cuts, there would be enough money to pay us decent rates, as well as increase funding for more aides, more nurses, better care and better benefits. If this happens, there wouldn’t be a shortage of nurses. Aides would stay in their jobs much longer. A well paying job gets respect from others. The work will never change, but it’s status sure can. Democrats fight for this. Republicans do not.
A national health care mandate would make life better for all. The promise and guarantee of health insurance would take a HUGE load of millions and millions and millions of people. Older people would benefit a lot from this. As would working class people who earn little.
Obama promises a national health care plan which makes sense. It would demand all businesses offer health care insurance without strings attached; no waiting periods and no denials based upon pre existing conditions. Money would be pooled from other less needed programs and, money from the war and it’s waste would pay for it. Taxes would only go up for the very wealthy who wouldn’t even notice the loss! Your average worker would not see a tax hike.
I respect the views of Republicans too- who don’t believe a nation should be responsible for the health care coverage of it’s people. But I totally disagree with this view. Without health care insurance, we’re all vulnerable to death which need not happen.
I would support mandates that require those who chose to do risky things be forced to pay more; smokers for example; overweight for example. Even gay lifestyles. But no one should have to go without health care because they have no insurance. Not CNA’s or anyone else.
September 1st, 2008 at 9:40 am
I just read the Obama post and all I can say is this: People who participated in that poll were industry insiders- nursing home managers and owners and investors. Not aides. Not nurses. No way.
September 3rd, 2008 at 11:44 pm
I have no problem with posts like this Heather. It’s fine.
I do feel bad for those who place too much value in politics to get things done. It’s never worked and a lot of people have been playing with the political end of this for years. I have met Senators Grassley, Kennedy and sat before them to speak of the problems with staffing, wages, benefits and poor supervision, yada yada. Not a thing changed. Many others have done the same thing.
I believe wholeheartedly that as a whole society needs to respect it’s elders more…once that happens those who care for them will be seen in a different light. Old people are useless according to many; and old is defined by the movers and pushers as anyone over 60…I’ve read alot lately about how the new age thing works: 50 is yesterdays 60 and so on. I think it’s true. But still older people get little respect.
As for Democrats, Republican- haven’t they all promised to make it all better? Yes they have. But no party, no Congress and certainly no President can make all these changes. Nope. The political will isn’t there- because the cost will be astronomical and Americans will- by and large- reject it. I don’t care what anyone says. NO ONE IS GOING to allow themselves to be taxed in one way or many ways- over half their income. NO ONE. And that’s what is will cost based on estimates NOW…we all know how the government is woefully incorrect at estimates! The actual costs is often three to four times as much.
Politicians tell people what they want to hear. Businesses and groups pander and kiss up to those polcats who they believe will help push their agendas and ideas. Not a one of them seek to make change happen in a real way- through the people, by the people and for the people. As Heather said, it is a VERY tiny segment of our population who require nursing home care paid for by the fed; not at all enough to justify the huge increase in costs it will take to make everyone happy. Even with the baby boomers coming, it’s not going to happen.
PHI is a great group. I do see the slant towards Democrats though and it bothers me. They should be seeking their goals with WHOEVER is in office- and not push party and political views upon those who stand to win or lose in this LTC long list of problems. Same with unions. When they do that, it pushes me away and I want nothing to do with them. The truth can be brutal but it needs to be said.
The Democrats have always failed us. So have the Republicans. This tells me politics isn’t the way to go. Steer clear of it; getting hopes up will only result in bitterness.
September 6th, 2008 at 7:23 pm
I have a problem with groups who claim to pull all interested parties, and all who have a stake in an issue, together to solve the problem or issue.
PHI is not doing this. They are promoting the view of the Democrats only, just as the unions do. Go to SEIU and see it everywhere: Obama, Obama.
I expect that up next at PHI.
Political action is good. Activism is a huge part of democracy- even though the US is not a democracy it’s a Republic. Similar styles of government though and both allow people to be active.
I say: Check the platforms and read the candidates own web sites for details. I think we’ll all find that both lack anything substantial and meaningful. Because there isn’t anything there that would make any of us jump for joy…
And vote. Vote on your beliefs and values and what’s important to you. For most people health care is an important issue these days. Long tern care of elderly however, is not. Patti is right when she says no one has any interest.