It’s hard to comment on the Commission on Long-Term Care’s just-submitted report without getting hacked off. Really, really hacked off.
To call it a fool’s errand would be to insult misdirected dimwits.
To say it’s a waste of time and resources would be to affront bureaucratic bungling gone wild.
To call it one of the more cynical political maneuvers we’ve seen from Washington in a while would be, well, pretty accurate.
Nothing in this report would surprise any reasonably well-informed long-term care professional. That is, unless you’re unfamiliar with concepts such as eliminating Medicare’s three-night hospital inpatient requirement to qualify for post-acute coverage. Or that it might be a good thing for people to receive care in the most appropriate setting available. Or that applying new technology options could prove useful.
Let’s face it: This report is at best a nice term-paper. Any self-respecting grad student with Google access and a long weekend could have crafted something just as coherent, and equally frivolous.
Many people have suspected from the beginning that this would turn out to be another Washington-style kabuki dance. But the final nail in the proverbial coffin arrived last week. That’s when it was revealed that the commission could not agree on how to address the long-term care’s central challenge: paying for care.
That’s like designing a car for the future without determining how the engine will work. So rather than a blueprint, we were handed optional checklists with supporting commentary.
In retrospect, perhaps we shouldn’t be surprised that things turned out so poorly. Congress finally got around to establishing this committee in January, as part of a larger fiscal cliff deal. Then it took our president and Congressional leaders three month to finalize its members.
So the commission basically had 100 days on a tight budget to identify and fix the nation’s long-term care woes, in a report that Congress was not required to take action on.
This year’s group turned out to be a poor man’s version of the Pepper Commission, which released a landmark report covering the same ground — only in a much better way — in 1990.
Unlike this most recent smash-and-grab effort, the Pepper Commission took a serious look at long-term care’s problems and possible solutions. The group held hearings in Washington and across the nation. Members heard testimony from as many experts as possible. Among the interested parties that weighed in: providers, consumers, employers, workers and insurers, to name a few. Then its members met in multiple follow-up sessions to develop well-founded recommendations. The 2013 version? Not so much.
But in the end, both efforts were consigned a similar fate: Each commission submitted reports that turned out to be little more than carefully crafted doorstops.
Better luck next time. If there is a next time.
John O’Connor is McKnight’s Editorial Director.
