It’s a pretty rare week when this sector’s funding woes don’t reveal themselves in some ugly way.
Sometimes it’s in the form of a fight between providers and states over Medicaid outlays. Sometimes it’s an operator getting caught cutting corners to trim costs. Sometimes it’s a national association berating a wholly inadequate funding proposal. The list goes on. And on.
One could argue that these unfortunate developments are inevitable, considering how the game is played.
The long-term care sector relies on the mercies of Medicaid and Medicare to pay most bills. Given this reality, operators (or their representatives) must regularly go hat-in-hand to state or federal lawmakers — and essentially plead for their share of very limited funds.
It is in many ways a demeaning and demoralizing exercise. Still, it must be done, lest the resulting payments be more sparse. And things soon might get more difficult: Medicare is scheduled to go belly up by 2026, while an overdue economic decline could do serious damage to states’ Medicaid coffers. Care to guess how those developments might affect funding availability?
Yet there is one area where tax dollars are doled out as if money were no object: military spending. Now before you accuse me of being weak on defense, please know this: I agree that providing for our nation’s defense is one of the most important functions of government.
But here’s the deal: Not only are a lot of defense dollars spent on dubious projects, the numbers themselves keep rising — and there is apparently no end in sight.
It’s worth noting that the Department of Defense’s base budget rose from $384 billion to $502 billion between fiscal years 2000 and 2014 in inflation-adjusted dollars — an increase of 31%. President Trump’s 2020 budget continues the funding flattery. It would give the department about $718 billion.
So how do providers snap off a piece of this action? Simple: Make long-term care a part of the Department of Defense.
We could even create a name that matches, like the Department of Senior Security. And maybe we could dream up some cool-sounding multibillion dollar projects for good measure, like the F-35 Dementia Defeater, the EELV Antipsychotic Fighter, or the Amraam Staff Improvement Launcher, just to name a few.
You say these notions doesn’t make sense? Perhaps not.
But you know what makes a lot less sense? Counting on a welfare program — Medicaid — to provide the lion’s share of long-term care funding. And that kooky notion has been in place for more than half a century. Maybe it’s time to fight for a better option.
John O’Connor is McKnight’s Editorial Director.