Updated 6/21/11 and 10/17/08
The President of the United States and his successors must address the challenge of trimming Medicare and Medicaid costs. The vast baby boom generation has just begun to need services. Young and old citizens alike are succumbing to chronic diseases that can require years of expensive treatments. Many enter the system years ahead of schedule because of partial or total disability.
As a person living with and caring for someone with chronic illnesses, I want to share the following strategies that could greatly decrease the costs associated with these and related programs.
Redistribute a large part of the funds now set aside for nursing home care into agencies that offer home care, day care, and respite services. The current regulations are absurd. Many caregivers provide full-time care for their loved ones because they can’t afford to send them to nursing homes or because most nursing homes have such bad reputations. The stress of attending to someone around the clock can lead to disability, premature death, or an illness that requires nursing home admission for both the caregiver and patient, in spite of the caregiver’s heroic efforts.
In addition to the in-home medical care and health education now provided, caregivers need help with bathing their patients two to three times a week and cleaning their homes once a week. Sitters and overnight respite care also are necessary. If based on personal family circumstances and guided by practical regulations, these services could help to cut the number and length of nursing home admissions and create new jobs.
Require certification of non-medical home care agencies and training for their staff. The pay is often so low that many of the workers don’t take their jobs seriously. Requiring certification and training would justify higher fees and wages and attract more responsible workers into these positions.
Simplify paperwork for medical professionals. The amount of required documentation increases the cost of medical care and frustrates providers. The number of providers who will accept new Medicare patients in my city shrinks almost every month.
Reimburse non-traditional services provided by practitioners of functional medicine (FM) and other natural disciplines. Unlike mainstream or allopathic medicine, natural medicine addresses the causes of disease. Natural practitioners focus on prevention as well as treatment of chronic diseases.
Give enough in food stamps to cover the cost of nutritious meals. Malnutrition leads to disease. Most people I know who are on food stamps run out of food long before the end of each month. A disabled friend of mine receives $10 a month. That won’t buy enough food to keep a cat healthy.
Ask recipients and providers how to improve these programs. Participants understand the weaknesses and strengths of the system.
For more on elder care issues, read my next three posts, “Elder Law Can Interfere with Good Care,” “Never Assume Anyone Thinks Like You,” and “Blog Offers Thanks for Spotlight on Elder Abuse.”
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