I once wondered why so many people who can’t pay their bills somehow manage to afford tattoos, lottery tickets, cigarettes and other seemingly dubious expenditures.
Then it hit me: We spend money on things that deliver some kind of reward. That insight into the human condition also helps explain why our long-term care system finds itself in such a precarious position these days.
Advocates for reform insist care must get better, much better. Operators counter they can’t make payroll as it is. It’s no secret what the answer is: more money. More money for training, salaries, supplies, equipment and other outlays a well-run facility requires.
The problem, however, is finding that money. Let’s face it, taxpayers are in no mood to spend more on long-term care services these days. Where’s the reward in that? As for any lawmaker foolish enough to suggest higher taxes for that purpose? Let’s just say he or she had best keep an up-to-date resume.
But you know what the public — and more importantly from a funding perspective, lawmakers — eagerly support? More money for defense.
Both seem to go Coo Coo for Cocoa Puffs when defense spending is mentioned. In fact, it’s the one budget area where suggested amounts are routinely dwarfed by final allotments. Almost universally, generous funding here is viewed as not just warranted, but essential. The general sentiment amounts to this: We’ve got to support the men and women in uniform. Plus the payoff — demonstrated patriotism — is more than a little rewarding.
So here’s a suggestion: Let’s morph the Department of Health and Human Services into the Department of Defense. Attitudes about funding support would shift overnight.
Suddenly, we would have lawmakers fighting to devote more of the Treasury to Medicare, Medicaid and other programs that aid the elderly. Operators and vendors would see unprecedented support. And by the way, care would improve dramatically.
Look, I realize such a transformation has a snowball’s chance. Perhaps merely suggesting the shift is a bit ridiculous.
But is it any more ridiculous than MedPAC reports that routinely call for reduced funding support? Or CMS trying to claw back Medicare dollars at the end of a back-breaking pandemic? Or a White House alleging opaque ownership structures when such information is available in the public record? Or scapegoating skilled care settings for COVID-19 deaths, when those are among the best examples of where heroic caregiver deeds were performed?
Clearly, we already have silliness in abundance. Why pile on?
John O’Connor is editorial director for McKnight’s.
Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.
