HealthBridge's In-Home Care Blog

Pre-seniors.  Trans-Boomers.  Octogenarians-in-waiting.  

Yes, I know there are other people on this earth besides seniors. 

But, hey, I'm a senior care guy.  That's why I wrote about the six ways health care reform will impact seniors on Tuesday.  

A few readers reminded me of something that I overlooked:  Health care reform will affect every single American.  

For the answer, I looked to Stanford health economist and professor of medicine Dr. Jay Bhattacharya.  He gets straight to the point in this interview with Stanford's news service, wherein he explains the implications of health care reform.  

To summarize, Dr. Bhattacharya says Health Care Reform will:

1. Require everyone to buy insurance
2. Create an exchange to facilitate the purchase of insurance
3. Require employers to offer insurance
4. Require insurers to meet certain standards, e.g. they can't exclude people with pre-existing conditions
5. Increase the number of people with insurance
6. Raise taxes
7. Cut Medicare

It will not:

1. Force a government take over of health care
2. Reduce the cost of care
3. Create so called death panels
   

What do you think?  How do you see health care reform affecting senior care givers like you and me?  

PS:  We think providing great care to seniors is politically neutral and we don't wade into political waters that often.  So, if you agree or disagree with Dr. Bhattacharya's interview points, please let me know in the comments. 

If you're like most senior caregivers, the health reform bill gave you butterflies from the start. Not because of your political opinion of the bill, but because you remembered something that many people had forgotten: American seniors already have government health insurance.

You knew that regardless of the bill's impact on the Joe the Plumber, it would have a material impact on your senior loved ones.

Like all political animals, the bill is neither as grand nor as sinister as our Representatives would have us believe.

But, it will affect senior citizens in 6 key ways. Here's how:

1. Medicare. The dreaded Medicare Prescription Drug doughnut hole is set to shrink. Seniors who reach the prescription drug coverage gap in 2010 will receive a $250 rebate. Starting in 2011, drug companies will offer a 50% discount on their brand name medicines that are purchased in the doughnut hole.
2. New Taxes. Medicare payroll taxes are set to increase by 0.9% to 2.35% and investment income will rise to 3.8% for taxpayers earning more than $200,000/single $250,000/joint.
3. Medical Tax Deductions. Beginning in 2013, the threshold for itemized medical deductions rises to 10% of adjusted gross income from 7.5%, as it is today. Seniors over 65 will be exempt from this rise until 2016.
4. Advantage Plans. Medicare Advantage plans are now required to spend 85% of their revenue on patient care. Also, federal payments to Medicare Advantage plans are frozen at 2010 levels.
5. Retiree Health Plans. Some seniors have enjoyed retirement health benefits from their former employers. The new law will reimburse employers for claims between $15,000 and $90,000. These payments will be used to lower the costs for the people enrolled in the employer plan. This program will end in 2014 and will not apply to retirees who are eligible for Medicare.
6. Long Term Care. Beginning in 2011, workers can enroll in a national long term care insurance program called the Community Living Assistance Services and Supports (CLASS) program. Workers will use voluntary payroll deductions to finance the program and, after a five year vesting period, can use the benefits to pay for non-medical home care and assistance.

The most hotly contested part of the health care reform bill will have no direct impact on seniors.  Since seniors have access to Medicare, they're excluded from the mandate that all (excuse me, most) Americans buy health insurance.  And, they're insulated from the impact of the state insurance exchanges.  

Now as for their caregivers like you and me, that's a different story.  

How do you see health care reform affecting seniors?

Do your trips to the doctor or hospital encapsulate all of your health care events?  Do they represent all of your health care spending?

What about your vitamins, your gym membership, and the hours of senior care you provide?  How about your job, house and education?

Politicians and talking heads often declare that America spends more and gets less for our health care dollars.  They point to infographics like this one to illustrate their point. 

The implied solution to the problem is simply to spend less on health care.  Reduce the cost of care.  Problem solved. 

But, is it possible that the system of care delivery - the care of sickness and emergency - is fundamentally flawed? 

The Blue Ridge Academic Health Group has published a report entitled, The Role of Academic Health Centers in Addressing the Social Determinants of Health.

Its statistics are stunning.

 
The report summarizes the situation as follow:

Our current health care system is costly and ineffective to an increasing degree each year because it has too limited a focus – sick care delivery – and pays inadequate attention to health promotion.

Moreover, the health promotion programs that are in place rarely focus on social determinants of health such as jobs, housing, education, etc. Instead, the focus largely remains on the health problems and concerns of individuals, rather than on the problems endemic to a population...

As a senior caregiver, you can relate.  Senior care is largely unfunded by health insurance and other entitlement programs.  The role of the caregiver as a contributor to the overall health care system, too, is often unrecognized.

If this study included the contributions of the family caregivers, I'm certain the results would be even more dramatic.

Do we need to reduce health care costs in the US?  Yes.  Should we work to improve health for people of all ages?  Definitely.

Is insurance reform the way to accomplish this?  It's just a start.

Special thanks to Paul Levy, CEO of Beth Israel Deaconess Medical Center.  He has written many articles that have inspired my thinking on healthcare leadership, executive transparency and healthcare reform.  He also wrote the article that inspired this one. 

Subscribe today and get the Dallas In-Home Care Guide free!

Subscribe to HealthBridge and get this free 15 page ebook.

The Dallas In Home Care Guide gives you a solid overview of the different types of senior care and who pays for what.  

Click here to subscribe and get the ebook today.

Caregivers care about results. 

"Don't give the me the recipe, let me taste the pie," a client once told me.  

That's why, on this blog, we refrain from covering the back and forth volley of health care politics.  

But, from time to time, we'll dive into an issue that surprised us or has our clients all atwitter.

Earlier this week, President Obama released his Fiscal Year 2011 Budget to Congress.  In it is something called the Caregiver Initiative.  Since this piece of the budget isn't getting much press, we wanted to share it with you here. 

Here's what it includes:

• $50 million more for the National Family Caregiver Support Program, which through area agencies on aging, provides families support, information, counseling and respite help.
  
  
• $2.5 million more for Lifespan Respite Care program, which doubles its financing.  This program, which is available to caregivers of disabled family members no matter their age, provides for brief periods of home care or facility stays to allow the caregivers a break to recharge and regroup.    
  
  
• An additional $50 million for the Home and Community Based Services program, which uses area agencies on aging to provide adult day programs, home care and transportation services.  

Some senior care advocates love the measures.  As Elinor Ginzler or AARP says, "Approximately 65 million Americans provide care to a loved one, giving more than $375 billion worth of unpaid care each year—often at their own financial and emotional expense.  Increasing support to these invaluable individuals would be an important step to help those who do so much to help others."

Howard Gleckman, Senior Research Associate at the Urban Institute disagrees.  "President Barack Obama wants to increase funding for a government program intended to make it easier for family caregivers to get respite care. These hard-pressed families desperately need the helping hand. But the White House initiative is a symptom of all that is wrong with long-term-care policy in the U.S."

What do you think?

To stay current, subscribe today.   You'll also get the Dallas In-Home Care Guide free!

Subscribe to HealthBridge and get this free 15 page ebook.

The Dallas In Home Care Guide gives you a solid overview of the different types of senior care and who pays for what.  

Click here to subscribe and get the ebook today.