Health Care Breakthroughs

This March, the American Society on Aging and the National Council on Aging held their annual conference. Jim Firman, the CEO of the National Council, asked an audience of some 2,000 professionals to raise their hands if they favored the health care reform bill.

Almost all the people in the hall responded, indicating their strong support. When Firman asked for those opposed to the then-pending legislation, virtually no raised hands were to be seen.

Evidently, professionals in the field of aging—social workers, medical personnel, service agency administrators, academics, and others—were rooting for the bill to pass. But, at the same time, polls showed that a majority of older Americans wanted it to fail.

How could such a discrepancy have developed? Why the sharp division between the servers and the served?

I did not poll professionals and elders to find out the answer. However, I can guess some likely reasons for the split.

First, older Americans were subjected to fervent propaganda from many of the health care reform bill’s opponents. And much of the information provided was seriously misleading or downright false. Such, for example, were claims made by some Republican leaders and others that changes in Medicare would require so-called “death panels” to determine which elders would be allowed to live.

This focus on a supposed threat to their very lives presumably distracted elders from one of the parts of the bill most favorable to them. This is the closing of the so-called “doughnut hole.” In 2003, Republicans had led the way putting this truly oppressive requirement into the Medicare drug program.

If they fall into the doughnut hole by hitting the $2,250 mark in total expenses, elders must pay for prescriptions completely on their own. Relief does not come until their total expenses climb to $5,100.

Older people were unaware of at least two other major included in the legislation.

I do not recall the mainline media ever mentioning these two parts of the proposed bill.  You would never know about these benefits unless you were a policy wonk prepared to read countless pages of dense legislation written by lawyers.

The first of these surprises in the new law is the Elder Justice Act. This rates as another breakthrough by advocates for vulnerable elderly people.

It owes its existence to the determination of advocate Bob Blancato who, with the coalition he founded, has lobbied for it since 2003. A member of that coalition has called the Elder Justice Act “the most comprehensive federal legislation ever to combat elder abuse, neglect, and exploitation.”

This new benefit provides money for adult protective services, a long-term care ombudsman program, and criminal background checks on people seeking employment in nursing homes and other long-term care facilities.

A co-sponsor of this proposal when it was first introduced into the Senate was  Orrin Hatch, a Republican from Utah. Eventually it gained the support of many members of both parties.

Commenting on this breakthrough, Blancato says: “The Elder Justice Coalition is pleased that Congress has recognized and responded to the growing national problem of elder abuse with the passage of these bills. With estimates as high as 5 million cases and with victims of elder financial abuse losing 2.5 billion a year, it was long overdue to act.”

The second surprise benefit for elders in the health care bill is known as the CLASS Act. First introduced by Ted Kennedy, it provides federal money for a voluntary long-term care insurance program. It will pay “not less than 50 dollars a day for non-medical services and supports necessary to maintain community residence.”

For decades, there have been strenuous efforts made by advocates for people who need long-term care support. Seeing it included in the new law has to count as a breakthrough for older Americans everywhere.

Asked about the value of these two new programs, veteran Massachusetts Home Care advocate Al Norman expresses enthusiasm for the one concerned with abuse. He looks forward to Massachusetts receiving funds to make up for cuts made by the governor. Currently, some 15 reports of abuse in our state come in every day.

With the Class Act provision, however, Norman has some problems, in part because it will not kick in until several years from now. Many people will be ultimately encouraged, however, to see the federal government finally offering a plan, even an imperfect one for long-term care.

But the passion of the plan’s opponents seems to have overwhelmed appreciation of its many fine features. Whipped into fury by specious arguments, many older citizens convinced themselves they would be harmed if Congress passed the bill.

As an elder myself, I feel grateful for those parts of the new law that benefit my age peers and me. I hope that, in time, many more people will come to appreciate those features.

I also celebrate the achievement of reforming health care now, reversing the frustration of previous presidents, Republicans and Democrats, over so many decades.