Certain healthcare words are worth fighting for

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Elizabeth Newman
Elizabeth Newman

Last week, long-term care providers likely celebrated the slashing of regulations announced by the Trump administration. This week, they should be appalled by a move that may impact how they do their jobs.

That's because of the administration's new directive for multiple Health and Human Services agencies to avoid seven words. While much of the focus has been on the Centers for Disease Control and Prevention and words such as “evidence-based” or “fetus,” at least one other HHS agency also received guidance to stop using the words “entitlement,” “diversity” and “vulnerable,” according to the Washington Post. It's worth noting that some disagree about whether the words are “banned” or not, with an HHS spokesman saying a description of a ban is a “complete mischaracterization of discussions regarding the budget formulation process.”

But let's assume it's less of a “ban” and more “guidance” or “technique.” The message is still clear. 

Those last three words alone likely come up in many of your conversations, as in “How do long-term care providers take care of a vulnerable population, protect entitlement programs and handle diversity among an aging group of seniors?” While the second HHS agency wasn't mentioned specifically, sources told the Post that participants at that agency were also told to use “Obamacare” instead of the Affordable Care Act and to use “exchanges” instead of “marketplaces.”

Don't get me wrong: There are plenty of words tossed around in long-term care so often that they can be hijacked and lose meaning, such as selling an organization's “proactive approach to person-centered care,” or “‘X' product is the key to solving infection control.” But there's a big difference between marketing guidance and a federal agency strongly discouraging official documents or grants from using specific key words.

While long-term care providers rarely all have the same political opinions, most believe strongly in protecting vulnerable citizens. It's easy to dismiss the “guidance” from the Trump administration as “not my problem,” but Michael Adams, Chief Executive Officer of SAGE (an advocacy group for LGBT elders) makes the point that aging sector providers work hard to embrace and recognize the diversity of people we serve.

“Any efforts to erase that reality affects all of us,” he told me. “If we as a sector are committed to person-centered care and caring for every individual, I don't see any way around how this doesn't affect our work.”

With regard to transgender elders, “We will not make believe that they do not exist,” he said.

He and I agree that, rather than an arbitrary decision from faceless bureaucrats, this decision does not happen in a vacuum.

“Were it not for the past year, this could be treated as an aberration or a misunderstanding, but we know that's not the case,” Adams said. He noted SAGE has spent months fighting with the Trump administration over the issue of transgender elders.

The word ban “creates an environment in which we can't talk about the diversity of the people we work with. It's completely backward.”

Not to mention the exact opposite of what the Trump administration promised to do — make it easier to run a business. This decision merely creates one more obstacle for providers and government to speak the same language. It shouldn't be controversial to suggest those on the front lines, or even government employees in agencies such as HHS or the CDC, have a better sense of what words are needed than politicians looking to score points.

Follow Senior Editor Elizabeth Newman @TigerELN.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.