Health Care Reform and LTC: Part II
Issues of long-term care have dominated public concern since President Clinton proposed his health care reform plan in 1993. Efforts towards a universal long-term care policy address priority areas of aging and disability in various ways such as the use of Medicaid waivers. Problems of long-term care, such as the nature of entitlement programs, are now the major concerns of the Administration on Aging and the Department of Health and Human Services. Long-term care policies at state and local levels are necessary to meet the compelling needs of an aging population.
As the White House and Congress debate ways to cut costs and improve quality in the nation's health care system, it is essential that those in the industry keep a close eye on the details and ensure that vulnerable citizens are not marginalized in the process. Significant cuts in Medicare nursing home funding would be catastrophic. Hundreds of key frontline care jobs would be eliminated, quality improvement programs would lose vital funding and, ultimately, important long-term care facilities that are already struggling due to chronic underfunding would have to close.
According to the Census Bureau, the world's 65-and-older population is projected to triple by 2050, growing from 516 million today to 1.53 billion. During the same time span, the 85-and-older population is projected to increase more than fivefold, from 40 million to 219 million.
With these projected numbers, it is not difficult to see why those looking for ways to cut health care spending would like to consider cuts to long-term care. Health care spending increases after the age of 50 and continues to accelerate. The financial per capita burden at age 85 and older is nearly six times as high as the burden at ages 50 through 54. Costs of care for people during their last two years of life account for 40 percent of all Medicare health expenses.
Adequate, stable Medicare funding and patient outcomes go hand in hand, and our ability to maintain sufficient work force levels, to sustain comprehensive quality improvement programs and to continue caring for our patients and residents now and in the future is at stake.