Some Americans with long-term disabilities and chronic illnesses have found they didn’t pass muster with Medicare in terms of getting coverage for home health care, stays in skilled nursing homes and outpatient therapy. The government health care plan for the elderly has for many years required people in these situations, in order to be covered, to demonstrate that such treatments would mean a likelihood of improvement in their medical conditions or their ability to function.
Many were thus out in the cold, as their conditions, often multiple conditions, weren’t really going to improve. As a result, their savings were depleted and their families disrupted by the need to pitch in.
Now, the Obama administration has proposed a compassionate change in response to a class action lawsuit on behalf of 10,000 people whose claims were denied before the suit was filed.
Under the proposal, many thousands of people now are likely to find it easier to get coverage because they won’t have to show that the care they need will improve their conditions. The care would have to be shown to be important to helping them maintain their current conditions or prevent them from getting worse.
The change will be expensive. But the rules as applied have lacked a realistic view of what Medicare will be called upon to deliver given the aging of America’s population. Baby boomers are moving into retirement and people are living longer, two factors that most certainly will increase the strains on Medicare, and on Social Security as well.
But the government can’t deal with issues arising from the increasing numbers of elderly simply by standing behind unreasonable or antiquated rules.
This change is humane and also sensible when considered in the context of the confused, inefficient and horrendously expensive American health care system.
With Medicare coverage – not a giveaway to beneficiaries, by the way – these seniors and disabled people will not drain their resources or those of their families.
Given that there are tens of thousands of people involved here, that will prevent greater burdens on emergency rooms, for one example, having to treat people who might not have needed treatment if they had been able to get maintenance care at home under Medicare. Families will not go bankrupt and thus become dependent on public assistance themselves.
Medicare has become some sort of target used by Republicans to cite government waste. Vice presidential candidate Paul Ryan, a Republican, is among those who have talked about something akin to privatization of this program on which millions of people depend.
But here is an example of how the program can help individuals and society as a whole.
Will it be expensive? Yes. But the alternative of allowing people to go without care and thus deteriorate, whereupon they need even more intense care, surely would be more expensive.
This is a clear case of where the right thing to do also happens to be the smart thing to do.