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Monday, January 28, 2013

Are The Elderly A Burden To Society?

This moron Taro Aso (pronounced "as-hohl"), who happens to be Japan's finance minister, thinks so:


"Why should I have to pay for people who just eat and drink and make no effort? I walk every day and do other things, but I'm paying more in taxes"  {via The Guardian}.
Oh my.  I'm glad As-hol is a healthy 72 year old and not in need of assistance or medical care. And let me be clear: I do believe there are situations where prolonging life that lacks quality can be burdensome, not just financially, but from a humane perspective as well.  Aso's comments, however, are sadly reflective of notions of deservedness which run rampant in Western society as well.

Who defines what "quality of life" means?  And more importantly, who decides who deserves health care and who should just "hurry up and die"?  Believe me, I get that in the U.S. a lot of government spending in health care (in the form of Medicare and/or Medicaid) is distributed to our older population.  I'm not sure what long term care looks like in Japan, but when we in the U.S. talk about "exploring innovative ways to finance services for the elderly", and the never-ending chatter about cutting back programs like Medicare and Medicaid, it seems like we're shooting ourselves in the foot.

Image via: http://www.nyspltc.org/rates.htm
Do people realize how difficult it is for elderly people living at home to receive home health aide services?  Medicare (in NY anyway) will only pay for *maybe* 8 hours of aide service per week. And home health aides and visiting nurses are spread thin enough as it is...its pretty hard to attract people to these professions when pay is typically so poor. Yet, some elderly people would benefit greatly from having access to more home health services, which if they could receive, would keep them home longer. And guess what? Medicare and Medicaid would actually save money for covering home health services vs paying for long term care for seniors. In NY state alone, the average monthly cost for a skilled nursing home resident is between $8000-$9000 per MONTH. The government doesn't even start to cover costs of long term care until the resident has exhausted all of their personal resources. At $9000 a month, that doesn't take very long.

Instead of threatening to cut Medicare and/or Medicaid benefits to the elderly (because let's face it, with the expense of long term care, the government allocates a good chunk in Medicaid benefits for the aging population), why not expand home health care benefits?   Programs like Meals on Wheels and Adult Day Care Centers are much more doable financially and do heighten quality of life for many elderly people committed to remaining at home as long as they can. Home health care including ongoing physical therapy, social services and daily aide services would undoubtedly make a difference in whether a person could stay home (and save money/not need to tap into government aid so hard) vs moving into skilled nursing where the care costs are exorbitant.

Of course, people like me would be out of a job if the elderly stayed home and never moved to a nursing home. I realize what I propose affects the bottom line of for-profit long term care.  Still, who but a small percentage of business owners benefit from the current system in which we care for our elderly?  Why shouldn't options for how we spend our later years be wider in scope? After all, aging is the great equalizer.  


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