home and community based services

Tomorrow, we are joining numerous organizations in calling members of Congress to tell them that the time is now to pass meaningful health care reform. For AAHSA members, elders, people with disabilities and their families, that means:

• Community Living Assistance and Supportive Services (CLASS) provisions.
• Medicare payment update for nursing homes and home health.
• Improvements in Medicaid for nursing homes and home and community-based services.
• Improvements in prescription medication coverage.

Please  call (800) 828-0498 from 8:30 a.m. to 6 p.m. Eastern and express your support. Our Web site features a sample script and ideas for spreading the message.

Since the Massachusetts election, Washington has been in a frenzy. From “woe is me” to euphoria, depending on your point of view. The talk-show pundits are in ideological argument heaven! The swing of one Senate vote, though important in the chemistry of the Senate on some important matters, misses two important points:

1. The needs that health reform is supposed to meet are still critical and urgent.
2. Congress’ mission is to advance policy legislation, not just to get reelected.

As to the needs:

• There are still millions of uninsured people (some of your family and friends are among them).
• We are all still vulnerable to loss of insurance coverage.
• There are still only three options to pay for long-term services and supports: pay out of pocket with no help, private long-term care insurance if you qualify and can afford it, and Medicaid if you deplete your assets and choose legal self-imposed poverty.
• Caregiving responsibilities for post-acute care are still a problem for 35 million people every day — most are women who also work.
• Medicaid is still inadequate and unsustainable, is biased toward institutional care and rations home and community-based services.
• Paradoxically, nursing homes are still under-reimbursed and over-regulated.
• There are still seniors who choose between food and medicine because of the doughnut hole problem.
• America still pays more for health care than any country in the world and has lower quality outcomes than many.

I understand that political ideology is involved — right and left. Rigidity all around. It freezes conversation and sometimes makes enemies of friends. So, let me tell you about Linda and her dad, Bob (situation disguised for confidentiality reasons). Bob is a long-time friend. We grew up together — were part of the same religious groups and participated in the same Bible studies, support groups and mission projects. Linda and my son are contemporaries.

Our friends in the same group are all over the political map. One is an elected official from one party, another a major fund raiser for another party. Politics was a topic for jocular jousting most of our lives — nothing more. What unites us is faith, our struggles with family issues, death of loved ones, commitment to common causes and the good times we’ve had. We all love each other. Politics has never intruded on that basic dynamic.

The health care reform debate tested those bonds recently. The canned rhetoric from both sides was rampant — too much of it either wrong or intentionally distorted on both sides of the political aisle.

In conversation with Bob, I found myself in the “Yeah, but…” mode and he responded in kind, with each of us with sharing some facts and figures to support of position. A microcosm for the stalemate we see in the media every day.

Though I feared starting an argument, I asked Bob about his daughter Linda’s health care insurance coverage. Linda has had a chronic illness since a young age, but her job provides health insurance. I asked Bob if he worried about Linda’s insurance. “Yes, I do,” he said. “She has coverage now, but her company is small and her condition is not likely to be cured anytime soon.”

I asked him if Linda had any coverage for long-term services and supports in the (God forbid) event she became partially disabled — not uncommon for a person with her condition. “No, I haven’t really thought about that, but she has no coverage.” I shared with him my own concern about my loved ones who have no coverage or are vulnerable to the lack of it.

The conversation changed, as did the tone of it. We both agreed that, regardless of ideology, health care in America is not adequate until Bob and I have coverage for our families. We both agreed to write our senators — his are in one party, mine in the other — with this message: “Until health care covers real people situations, Congress and the White House have a responsibility to fix this major national problem now!” Real people are at risk, which is secondary to anyone’s re-election in my book.

It is time for urgent, courageous leadership. History lampoons political ditherers and do-nothings. It elevates leaders. Great political leaders in my lifetime from Truman to Reagan, from Bush to Obama, all had courage in the heat of ideological battles to take stands on vital issues. That strength of leadership is what we admire most about them.

Too many people are vulnerable, including your family, Bob’s family and my family. Health care needs to be reformed now, most especially to address the needs of our growing population of elderly and people with disabilities. Our country cannot afford to do otherwise, morally or financially. So do your part. Make the call tomorrow. Encourage others to do the same. Be a leader.