Another penny-wise, pound-foolish health care cut
Don’t these people ever learn?
There’s a heartbreaking piece in today’s New York Times that chronicles how at least half of these United States, grappling with underfunded budgets, are cutting back on home-care services for the elderly and disabled. First — and second, and third — of all, that’s unconscionably cruel. But fourth of all, it’s fiscally irresponsible.
As the article lays out, it costs one heck of a lot less to care for someone in their home than to maintain them in a nursing or assisted living facility. And it certainly costs less than to care for them in a hospital, after they fell, or became malnourished, or didn’t take their meds. In Oregon — once an exemplar of how to effectively care for people at home, now one of the state’s cutting back — nursing homes cost an average of $5,900 a month. Home and community based services cost $1,500 — about 25%!
The problem, as usual, is boneheaded law. States are required to provide nursing home care to receive federal Medicaid money. They aren’t required to provide home care. So, home care is the only place they can conceivably cut back with impunity.
The piece’s kicker grafs say it better than I ever could:
For states, having to cut the Medicaid programs is a double loss, because they come with matching dollars from the federal government. This creates state jobs and much-needed revenue.
Without these, said James A. Davis, a gerontologist at Marylhurst University and executive director of United Seniors of Oregon, “it really is a death spiral.”
“So often the programs to go are the early interventions that save money and keep people healthy,” Professor Davis said. “That comes back to bite you.”
The timing on this, of course, is pathetically ironic. I mean, part of Obamacare — which I still heartily endorse — calls for removing copayments for preventive medicine, things like well-baby checkups and such. Everyone knows the cost of that will be way less than the cost of caring for people who ignored their health. The economic principles behind providing home care are the same. What’s wrong with these people???!!!
On a different (you’ll see the connection) but more heartening note, the Times has an editorial applauding the growing number of states who are recognizing the stupidity of barring ex-cons from municipal jobs. Some progressive cities — the Times cites Boston, Chicago and San Francisco — long ago abandoned that rule. And now, Connecticut, New Mexico and Minnesota have passed laws protecting the employment rights of former offenders.
The Times suggests other states follow. I heartily concur. If you don’t do it on humane grounds, then do it on economic ones — if these folks can’t get jobs, the chances they’ll go back to crime are huge. And the crimes themselves will be a cost to society — as, of course, will be the cost of incarcerating them yet again.
Noone is suggesting that we put convicted pedophiles in day care centers, or burglars as home care attendants. But there are plenty of “safe” jobs to offer these folks. I’ll give the Times the final word:
Confining people with criminal convictions to the very margins of society is unfair and self-defeating. These sensible new laws recognize that.


















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