Health Care Reform

DECEMBER 13, 1993 VOLUME 1, NUMBER 4

Much discussion has been heard about health care reform proposals. The administration’s plan, the “single payor” proposal, and the alternative plans of the Republican leadership, a bipartisan group of Senators and Congressmen, and Republican Nancy Kassebaum of Kansas have all been widely discussed.

Long Term Care

Most of the proposals deal with acute care, doctor and hospital visits and, in some cases, medications. Little attention has been paid to the long-term care component of our national health care costs.

Now two national coalitions of long-term care advocates have spoken up about the treatment of nursing care costs and services under each of the various proposals. The Long Term Care Campaign, consisting of 138 groups, and the Leadership Council of Aging Organizations, consisting of 35 groups, have given “passing” grades to only two of the proposals. According to the two advocacy groups, only Clinton’s health care plan and the “single payor” proposal of Rep. Jim McDermott (Dem.-Wash.) and Sen. Paul Wellstone (Dem.-Minn.) deal with the long-term care issue at all.

Alternative Proposals

According to the two coalitions, of the remaining proposals, only Sen. Kassebaum’s even addresses long-term care. That proposal would establish a commission to decide which long-term care costs would be covered in its basic benefits package. The bipartisan plan of Sen. John Breaux (Dem.-La.) and Rep. Jim Cooper (Dem.-Tenn.) was rated as a step backward because it would eliminate Medicaid, phase out long-term care funding altogether, and force states to pay for long-term care.

Of Interest

Curtailing Miss Daisy

(From Cooking Light, Nov/Dec 1993):

“Asking aging parents to give up their car keys is not easy, but it is a problem more sons and daughters will face as the population grows.

Statistics show that motor vehicle accidents cause the most injury-related deaths among 65 to 74 year olds and are second only to falls after age 75. Although people over age 75 drive less, their accident rates equal or surpass those of teenagers.

But allowing aging drivers to keep their independence is important, says Dave Carr, M.D., a geriatrician at St. John’s Mercy Medical Center in St. Louis. He advises adult children not to take lightly any attempt to restrict or eliminate a parent’s driving privilege. For one thing, elderly drivers often know their limits and restrict themselves by not driving at night, on highways, during rush hour, or in bad weather.

‘When older drivers fail to give up the road despite decreasing skills, it’s usually because their judgment is impaired,’ says Carr.”

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