What They’re Saying

• In a letter to the editor published in the St. Louis Post-Dispatch, a man responded to Sen. Christopher Bond’s view that Congress needs to restore provisions supporting care in the home. Medicare once paid for luxury expenses, such as private jets, under the previous system, Larry Simpson wrote. He said the system allowed an unlimited number of visits at an inflated reimbursement rate. "Although the recent Medicare reimbursement changes have resulted in reduced reimbursement for home healthcare providers and have been touted as causing hardship, this hardship is only in a reduction of corporate executive luxuries and unrealistic shareholder profits." The new method of reimbursement has eliminated those who abused the system. Simpson argued that home health agencies pay between $60 and $70 per visit to managed care organizations, but complain they cannot survive on $90 per visit, a figure he quoted from Bond, which they receive from Medicare. "I do agree with Bond that the system is definitely broke. Unlike him, I feel the way to fix the problem is to not return to overspending," Simpson wrote. "Instead, let the physician determine the number of home visits necessary, based on the patient’s medical condition, and allow the home healthcare provider to realize a reasonable reimbursement rate for the services provided."

An editorial published in the Dallas Morning News supports a bill in the House that would expand Medicare benefits to pay the costs of teaching independent living to the vision-impaired. About 20% of Americans between the age of 65 and 74 have some sort of vision impairment, according to Lighthouse International. These people receive costly in-home and nursing home benefits from Medicare. While the Congressional Budget Office is still tabulating how much the program to teach independent living would cost, experts seem to think it would be in the millions of dollars, instead of the billions spent on nursing home and other care for disabled Americans, the editorial stated. "The measure is worthy of consideration, especially if the costs are controllable and as modest as its advocates insist," the editorial said.

David Banks, the CEO of Beverly Enterprises (Fort Smith, AK), commended USA Today in a letter to the editor for its cover story on nursing homes facing cutbacks. Banks said the nation must be prepared to care for millions of elderly who will soon need skilled nursing home care over the next 20 years by defining quality care, determining the cost of it, and deciding whether the nation is willing to pay the cost. "With a huge demographic wave poised to crash upon us in the next five years, these issues must be addressed now," Banks wrote. "The longer we put off serious discussion, the harder these issues will be to resolve."