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December 7, 2009

The sad story the Democrats would rather not tell

Carol Brown
As Senate Democrats hung together last week on a "test" vote on health care reform, their willingness to cut Medicare to fund their colossal plan revealed their willingness to abandon the most vulnerable among us - the frail and elderly. Many among the oldest of the old receive in-home care, something that is essential as it helps reduce hospital admissions or winding up in a nursing home. It also provides access to medical services for those with the added challenge of living in rural communities.

Home health care will be a casualty of the current bill as it is slated to absorb more than 10% of the Medicare cut. Ironically, proponents of health care reform brag about how the bill will reduce costly hospitalizations of elderly folks. But by slashing home health care, the effect will be the opposite of their stated intentions. More elderly patients will be hospitalized as a result, not less.

Of course the Democrats have rationalizations for everything. But their explanations are nothing more than double talk that appears to be founded on something akin to the credibility of climate change. Democrats in both houses of Congress have rationalized the cuts by claiming that care will not be compromised. The Senate Finance Committee as gone so far as to suggest that the proposed changes would "encourage home care workers to become more productive."

"Encourage home care workers to be more productive." What does that even mean?

As far as I can tell, the expectation of increased productivity suggests that home care workers are currently slacking off on the job. But if the nurses who work for Eastern Maine Home Care cited in this article are any example, they sure aren't slackers. These nurses see patients throughout rural parts of the state, traveling across fields and forests, using snowmobiles and cross country skis, doing whatever it takes to take care of their patients.

Perhaps the Democrats are counting on increased productivity in the form of home care workers increasing the length of their shift for no extra pay. Or, I suppose cutting corners could be another way to increase productivity.

Meanwhile, Congressional Democrats have stated that they are assuming this increased productivity will keep pace with the rest of the economy. "Assuming," indeed. Apparently this is nothing more than wishful thinking.

... Saundra Scott-Adams, executive vice president of Eastern Maine Home Care, said: "That's a joke for home health care. We provide one-on-one care."

Her doubts are shared by Richard S. Foster, chief actuary of the federal Centers for Medicare and Medicaid Services. Mr. Foster said the health care industry was "very labor-intensive" and could probably not match the productivity gains of the overall economy.

Needless to say, patients and home care workers are deeply concerned about proposed cuts.

"Our staff are scared," Ms. Harvey-McPherson said, "but it's our patients who will pay the price if Congress makes the cuts in home care."

Phillip H. Moran, a 65-year-old diabetic in Houlton, Me., lost his right leg several years ago. His kidneys are failing. Without regular visits from a home health nurse, Mr. Moran said, he would be in danger of losing his other leg because of complications from diabetes. As a double amputee, he would be more likely to go into a nursing home.

"The nurses' visits are really important," Mr. Moran said. "If they are cut, it could cost people their lives."

Republicans are holding the Democrat's feet to the fire on Medicare cuts, focusing on the devastating impact they will have on home health care. Nebraska Senator Mike Johanns has proposed an amendment that would protect Medicare payments to home health agencies.

Senator Kerry has now offered his own amendment that will presumably safeguard home health services.

As the debate rages on, the Democrats often cite AARP's support for the cuts, sticking to their claim that Medicare cuts will strengthen the program by reducing inefficiency and waste.

Now they're worried about inefficiency and waste?!

How convenient for them to pick and choose. In this case it is the elderly that are the population of choice they put at risk under the verbal umbrella of: Don't worry. Really. This will be good for you. It won't hurt a bit. We promise.

Who among us is willing to place our grandparent, our parent, or ourselves in the hands of a political party that appears bent on letting the elderly come up with the short straw every time?

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