Quick, Grandma has a cheeseburger!
Kenyote speaker Andrew Carle
The rationale put forth for the regulation by Rep. Jim Abeler (R), Chairman of the House Health and Human Services Committee, is that an incorrect choice of long-term care services may eventually cost the state more in healthcare expenses. The irony of a bill mandating government counseling for long term care being put forth by a Republican aside, there are numerous issues with this rationale.
First, private pay assisted living and related senior housing communities almost certainly save both State Medicaid and Federal Medicare programs billions of dollars in healthcare costs each year. There is evidence to suggest residents in such communities experience improved quality of life in nearly every area, including reductions in falls/injuries, medication errors and depression, along with improvement in nutrition, activities, and overall social well-being.
Assisted living communities offering Alzheimer's care can additionally reduce incidents of elopement from the home that often lead to injury or even death. Overall, residence within a private pay assisted living or related senior housing community can lead to delayed entry into the very Medicaid and Medicare funded skilled nursing facilities the state appears to be worried about.
There is not a single study indicating such communities reduce overall quality of life for those living in them. Which brings us to issue number two …
If the state is seeking to mandate how private citizens spend their money on the theory it will save healthcare costs, private pay senior housing may well be the last place to begin. Under such an assumption, Minnesota needs to immediately mandate nutrition counseling for anyone standing in line at a fast food restaurant — for which there is overwhelming evidence of contribution to obesity and numerous healthcare issues.
But let's not stop there. How about consultation for anyone wishing to purchase cigarettes? Potato Chips? Cupcakes? How about for anyone taking an elevator for fewer than three floors? Each day private citizens make choices on how to spend their money and live their lives in ways that have been documented to cost the healthcare system. It's called free will.
In reality, mandated counseling for assisted living and related senior housing is being proposed not under the assumption such counseling will save costs, but that the elderly involved, and perhaps their adult children, are incapable of making the right decision.
It is the perpetuation of the idea that anyone of a certain age must need decisions made for them, despite all they have accomplished to get there. This, by the way, is the same government attitude that resulted in the over regulated nursing homes most seniors are attempting to avoid.
The state has an arguable right to ensure anyone accessing government-funded healthcare is properly screened and provided the right service, at the right price. But they should not be in the business of telling private citizens what they can or cannot do with their own money.
That includes allowing grandmothers to live where they want to live, or to even enjoy a burger and fries.
Andrew Carle is the founding director of the Program in Senior Housing Administration at George Mason University in Fairfax, VA. The program offers the first academic curricula in the nation for the field.