President Barack Obama

NEWS ANALYSIS

When it comes to healthcare reform and Medicare, long-term care operators tend to focus on the so-called small pieces. These include things such as therapy caps, Minimum Data Set payments and forced reimbursement reductions that Congressional inaction might put in place.

But the two men who want to be president for the next four years — incumbent Barack Obama and challenger Mitt Romney — tend to take a bigger-picture approach.

That helps explain why both are trying to redirect swing voters’ away from potentially damaging realities — and toward rhetoric likely to leave a more favorable impression.

For Obama, that means shifting the political discussion away from a stagnant economy that has failed to generate much in the way of jobs growth. For Romney, it means directing the debate away from his term as governor of Massachusetts, where he put a healthcare system in place that largely resembles the one he now promises to pulverize.

In a sense, healthcare and Medicare are pawns both candidates are playing with. But for long-term providers, this is hardly a game. As the field has learned all too well, operators will likely have to live with unpleasant consequences, regardless of the victor.