What They’re Saying

• Steve Keener, president/CEO of Medical Depot (Englewood, CO), a medical equipment retailer, recently made a statement regarding the HME industry in Colorado. In his statement, Keener said, "In 1999, the Colorado home medical equipment industry will save the state’s taxpayers millions of dollars, millions that Medicare and other agencies would have paid to physicians, nurses, and hospitals to provide care within the four walls of a hospital. Technology is now such that much of what has in the past been done in the hospital can now be provided at home at a great saving to whoever is paying the bill." In the same way, Keener said, "the home healthcare industry also saves money for those of us who have private medical insurance. The lower costs to an HMO, PPO, or other health insurance organization, the lower the premium for its policy holders." Keener further said that despite such savings, the federal government has targeted the home care industry for huge cuts that threaten the integrity of the industry as a whole. He said the reason the government does this is "because those who make a living from the ill and infirm are easy to malign. Paying big money for an expensive piece of equipment, or having to forgo the best technology because an HMO doesn’t want to pay for it, creates a certain negative image in the consumer’s mind." Keener stated that, when asked who’s to blame, he says, "For most consumers it’s the supplier".

A recent Los Angeles Times editorial calls President Clinton’s recent announcement that the biggest domestic item in his budget this year will be $5.5 billion set aside to provide a $1,000 yearly tax credit for people with severe disabilities and relatives who take care of them a "spark of good news" among fast-rising costs of caring for disabled elderly in their homes. "This is not the first time Washington has recognized the problem," the editorial stated. "In the late 1980s, noting that home care is more economical and humane that institutionalization, the government allowed Medicare dollars to be used for the first time for nursing visits to people’s homes. Because of the change, federal payments for home healthcare costs have mushroomed tenfold in the last decade, far more than necessary."

Pete du Pont, policy chairman of the National Center for Policy Analysis and former governor of Delaware, recently wrote in a letter to the editor of The Washington Times that President Clinton’s recent long term care proposal for patients and their families "sounds like a helpful way to defray the costs of chronic and nursing home care." In fact, he wrote, the proposal, if passed, "would take us in the wrong direction by encouraging people to wait until a loved one needs long term care rather than insuring against the problem beforehand. While there is a need to help families meet the exploding costs of long term care, there is a better way to do it." He further wrote that with families more scattered and with seniors living longer than they used to, making the decision to take in an elderly relative is more of a commitment than it used to be. As a result, he wrote, many Americans turn to nursing homes or assisted living residences for help. But this costs a lot of money, he wrote, and many middle class Americans cannot afford this type of care. He said, further, that most families go on welfare to be able to afford it. "President Clinton’s proposal would offset some of the costs of long term care by making available a $1,000 tax credit to be used against long term care expenses," he wrote. "But his plan would only exacerbate current policy that encourages people to go unprepared for nursing home expenses and then turn to the government for help from Medicaid when the crisis arrives. If we are going to use the tax system for healthcare needs, let’s use it to encourage people to purchase health insurance before they are faced with the catastrophic medical costs."

A recent editorial in The San Francisco Chronicle said some aspects of President Clinton’s long term care package are patterned after the successful Caregiver Resource Centers in California, which provide information, education, and support to caregivers of adults with brain disorders. "Although the $6.2 billion proposal is the largest new domestic initiative in what will be Clinton’s 1999-2000 budget plan, the amount is modest compared to need," the editorial said. "The average cost of staying in a nursing home is now $47,000 a year. And hiring in-home aides quickly adds up." The editorial further states that the proposal is still significant for focusing attention on what could be a national catastrophe if ignored and for recognizing the necessity of federal help for the elderly and those who care for them.