First presidential debate leaves long-term care operators with many questions, few answers

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John O'Connor, editorial director, McKnight's Long-Term Care News
John O'Connor, editorial director, McKnight's Long-Term Care News
If you're wondering what Wednesday night's presidential debate means for long-term care, you have plenty of company.

By the time both men wrapped up, it seemed that there were far more unanswered questions than answers. Will Medicaid become a block grant program? Will vouchers be a part of Medicare? Will funding to nursing homes be gutted? Will Big Bird have to leave Sesame Street if he falls and breaks a hip? Does Big Bird even have a hip? At this point, who knows?

The general consensus is that an energized Mitt Romney took it to a seemingly disinterested and occasionally perturbed Barack Obama. Whether this performance will continue in subsequent debates — and whether it will be enough to let Romney overcome Obama's lead in key swing states — remains to be seen.

It's obvious both men are intelligent, gifted orators. Each clearly wants to make the United States a better place to live. Yes, they have different ideas about what a fundamentally sound nation should look like. But I don't take issue with their philosophies or priorities.

What I do take issue with is the fact that both men seem to have forgotten how the levers in Washington actually work.

They apparently need to be reminded that we have this thing in the nation's capital called a Congress. It has 435 House members and 100 Senators. And oh, by the way, their job is to make laws and determine how tax dollars are spent. I realize these may be trifling points. But these 535 proverbial elephants in the room usually determine whether talking points ever advance beyond the good intentions phase.

That's worth keeping in mind as you hear each man describe how he alone can make things better over the next four years. In fact, neither is likely to get very far if Congress doesn't share a similar vision.

The bottom line is that unless the president we elect also has his own party in both Congressional chambers (including at least 60 supporters in the Senate), he cannot do much more than the rest of us.

Our Congress has its flaws and seems to be unusually dysfunctional these days. Few of its members can debate as well as the two men that more than 50 million of us watched Wednesday night. 

But here's the thing: When it comes to the big-ticket items before our nation, Congress always gets the last word.



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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.