What They’re Saying
What They’re Saying
• A recent New York Times editorial said the "high cost of institutional care impoverishes families and strains federal and state healthcare budgets, and most people prefer to age where they live, at home." But, the editorial said, since Congress cut the amount of reimbursement agencies would get for Medicare services, the home care industry has suffered sharp losses. "If Congress does nothing, home healthcare payments will be automatically cut by an additional 15% next year," the editorial said. It further said, "the cut should be dropped and serious study given to what the payment system ought to be. Congress had reason to rein in ballooning Medicare costs in 1997. But the nation’s oldest and most fragile citizens should not have to suffer for good intentions that have gone awry."
• In a letter to the editor of the New York Times, Suzanne Mintz, president of the National Family Caregivers Association (Kensington, MD), wrote that "this country cannot legislate or regulate the home care assistance needed by frail and ill people, and yet that is what Medicare continues to do. Family caregivers, who provide 80% of home care services, know that flexibility of services is the only realistic approach to maintaining loved ones at home." Mintz further wrote that "Congress cannot replace the $196 billion of free service’ that family members provide . . . Perhaps now that the Congressional Budget Office has shown that slashing payments for home care hurts patients and doesn’t save money, Congress will begin to listen to family caregivers."
• In a recent letter to the editor of the New York Times, Uwe Reinhardt, a professor of economics at Princeton University, wrote that it is not evident that home healthcare is cheaper than inpatient care. "The national average hospital ratio is about 65%," Reinhardt wrote. "Having armies of home care workers traveling to geographically disparate locations to visit patients requires more resources than would be needed to care for the same patients if they were concentrated at half-empty hospitals. And quality of care can be more effectively assured in a hospital than in a home care setting, where health workers cannot easily be supervised." Reinhardt further wrote that "careful economic analysis is apt to show that the cost of home care typically exceeds that of inpatient care at half-empty hospitals. The added cost can be justified only if home care yields patient and family a commensurately higher quality of life," Reinhardt wrote.
• "I am writing because I am concerned about the In-Home Supportive Services program in Ventura County," said a recent letter to the editor of the Los Angeles Times. The letter said many of the workers are leaving to seek better-paying jobs."We need to support quality home care in our community. This is the program that will provide for us and our loved ones with the dignity of living in our own homes when we are unable to care for ourselves."
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