I once wondered why so many people who can’t pay their bills somehow manage to afford tattoos, lottery tickets, cigarettes and other seemingly dubious expenditures.
Then it hit me: We spend money on things that deliver some kind of reward. That insight into the human condition helps explain why our long-term care system finds itself in a precarious position these days.
Advocates for reform insist care must get better, much better. Operators counter they can’t make payroll as it is. It’s no secret what the answer is: more money. More money for training, salaries, supplies, equipment and other outlays a well-run facility requires.
The problem is finding that money. Let’s face it, taxpayers are in no mood to spend more on long-term care services. Where’s the reward in that?
But you know what the public and lawmakers eagerly support? More money for defense. Both seem to go Coo-Coo for Cocoa Puffs when defense spending is mentioned. It’s the one budget area where suggested amounts are routinely dwarfed by final allotments. Almost universally, generous funding here is viewed as not just warranted, but essential. The general sentiment amounts to this: We’ve got to support the men and women in uniform. Plus there’s the payoff of demonstrated patriotism.
So here’s a suggestion: Let’s morph the Department of Health and Human Services into the Department of Defense. Attitudes about funding support would shift overnight. Suddenly, we would have lawmakers fighting to devote more of the Treasury to Medicare, Medicaid and other programs for the elderly. Operators and vendors would see unprecedented support. And care would improve.
Look, I realize such a transformation has a snowball’s chance. Perhaps merely suggesting the shift is a bit ridiculous.
But is it any more ridiculous than MedPAC reports that routinely call for reduced funding? Or CMS trying to claw back Medicare dollars at the end of a pandemic? Or a White House alleging opaque ownership structures when such information is publicly available? Or scapegoating skilled care settings for COVID-19 deaths?
We already have silliness in abundance. Why pile on?
From the July/August 2022 Issue of McKnight's Long-Term Care News
