Daily Editors' Notes

This pilot long-term care program might require actual pilots

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John O'Connor
John O'Connor
The Centers for Medicare & Medicaid Services often backs pilot programs that might help improve long-term care services. In recent years, the agency has funded efforts to do things such as update employee background checks, reduce pressure ulcers, improve e-prescribing, and foster at-home independence.

The jury's still out on how well many of these and other efforts are actually playing out. But you have to at least commend the government for trying. Especially when one considers the long-term care tsunami that will be arriving before many of us reach our dotage. The looming challenges include federal and state governments going deeper in hock, increasing demand for chronic and rehab services, Medicare and Social Security heading toward bankruptcy — and millions of soon to be long-term care recipients living off what's left of their 401ks. It's not a pretty forecast.

So maybe it's time to start a pilot program that might actually require pilots: Export long-term care residents to Mexico.

And before you deride me as clueless (as others have occasionally been known to do), please hear me out. The idea is not completely original: I was struck by the notion after reading an article about a similar practice that's beginning to take place in Germany.

There, seniors are being sent to care homes in Eastern Europe and Asia. The move is part of an austerity program, as Germany's economic prospects and demographics are not so different from our own.

The Guardian reported that an estimated 7,000 German seniors were living in Hungarian retirement facilities in 2011. An additional 3,000 were moved to facilities in the Czech Republic, and 600 more were exported to Slovakia. There are also unknown numbers in Spain, Greece and Ukraine. Thailand and the Philippines are also attracting increasing numbers.

As you might imagine, critics are calling the practice inhumane. And I can see their point. After all, who wants to spend their final years as a stranger in a strange land?

So here's my proposal: make it an attractive option. The U.S. could contract leading long-term care operators to build state-of-the-art facilities with ocean views. Staffing requirements would be 50% higher (remember, the cost of living in Mexico is much lower), U.S. oversight regulations would apply, and each resident would get four round trip tickets to/from the U.S. each year — which could be transferred to loved ones. Also, up to four family members would have one free all-inclusive stay for a week in a nearby four-star resort, which would also be a part of the deal.

Best of all, this could all be done for a fraction of what a stay in the United States would cost. Yes, it's a bit unorthodox. But it might be worth a try. And it's not like the government hasn't thrown away a lot more money on dubious priorities.  Or did I miss the memo on how well the wars in Iraq and Afghanistan have turned out?

So let's quickly review: In a bold move, CMS backs a pilot project that could improve care, cut costs and perhaps make life a lot more pleasant for our nation's seniors. Right — it will never happen.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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