Chicken Little strikes again

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If you’ve been in this field long enough, you are accustomed to the threat of doomsday.

In the long-term care industry, the sky is falling. Constantly.

It’s easy to feel that way today as nursing homes are feeling the squeeze of inadequate Medicaid and Medicare reimbursements more than ever. One news report last week said that all 50 states are proposing cuts in healthcare benefits and health insurance for the elderly and other vulnerable groups in the face of soaring deficits.

But you have to wonder whether some fears are a bit overblown. Take the latest scare from the federal government. Trustees of the Social Security and Medicare programs said this week, as they did last year, that Social Security will become insolvent by 2041 as will Medicare’s hospital insurance trust fund in 2019.

Medicare Part A is projected to begin paying more in benefits than it collects from payroll taxes this year, trustees said. Medicare Part A, as we all know, funds therapy that has helped nursing homes pull in additional revenues.

Great. That’s all providers like you need to know. Add the end of entitlements to your growing list of concerns, including how you are going to pay for those much needed pressure-relief mattresses.

Pardon the sarcasm. But it’s hard not to be a little cynical. After all, if things are so bad, why don’t we fix them?

Patchwork solutions

One person keeps the hype in perspective. Diane Rowland, who has served as executive director of the Henry J. Kaiser Family Foundation’s Medicaid commission since 1991, knows about so-called crises and lawmakers' slow reactions to them.

“Somehow in our country, we manage to absorb these crises and go on with kind of marginal fixes or absorbing the crisis and saying we have to do something about it,” she told me recently.

She remembers when the number of uninsured Americans was deemed to be at nearly a "breaking point" early in her career.

“What I have learned is that we tend as a nation ... to reform things in an incremental way rather than in a wide, sweeping comprehensive way,” she said.

(By the way, you will read more about Rowland in a profile in the April issue of McKnight’s Long-Term Care News.)

The country needs to develop a blueprint for change instead of “throwing everything up in the air” and starting a brand new program at the federal level, she said.

Planning ahead …. What a novel concept.

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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.