Pollster John Zogby thinks the Iraq war will be the top issue in the 2008 presidential campaign and he's probably right, but my vote will go to the candidate with the best plan to fix health care. Next to the war, it is also the one issue I find my baby boomer friends and I discussing when we get together. We're caught in the middle between our adult children and parents. We worry about our children who don't have employee provided health insurance and the ones who have it and struggle to pay increasingly expensive deductibles and co-pays, not to mention our children who simply don't have insurance at all.
On the other side, we have our elderly parents who find it difficult to pay for prescriptions, home health care or - God forbid - long-term care. One serious medical emergency can wipe out a lifetime of savings and leave our parents destitute. The fortunate ones will have children they can turn to for help. The others will be at the mercy of the overburdened and underfunded Medicaid system they'll be forced to turn to when they become penniless.
I'm speaking from experience here. Several months ago, I told you about my mother who was then in a skilled-care nursing home covered by Medicare and her supplemental insurance plan. She regained her health and was discharged to go back home to live with my sister and brother-in-law. Mom is almost 90-years-old and has had Alzheimer's for nearly a decade, but she moved in with my sister years ago simply because she outlived her money and couldn't afford to live on her own. Her only source of income is social security, and mom was too proud to live in a rent subsidized senior apartment.
Moving in with my sister turned out to be a godsend. We noticed the early symptoms of Alzheimer's sooner than we might have and got mom the help she needed, which included the extremely expensive medication Aricept (one month's supply was more than $350). Over time, however, the disease progressed and it became clear that mom needed someone with her 24 hours a day, so my brother-in-law retired a few years earlier than planned and stayed home to care for my mom.
Out of respect for my mother's modesty, we hired an aide to come in to help her bathe, wash her hair, etc., and that worked out well until my mother became totally incontinent and we needed the aide 5 days a week. My sister and I were splitting the cost of the aide and mom's medications and the expenses were becoming a burden. We eventually turned to Medicaid for help and mom was instantly approved. She is now considered dual-enrolled since she has Medicare and Medicaid, in addition to the prescription program.
How does all of this relate to what I said at the top about voting for the candidate with the best plan to fix health care? Simple, I think Medicare and Medicaid have provided my mother with a level of care that all people should have access to - regardless of age.
That being said, Medicare and Medicaid don't do enough to help families caring for loved ones in their homes. Medicare only covers a home health aide for a short period of time after hospitalization or transition from a rehab facility. Medicaid provides home care assistance, but there's a long waiting list in our area (my mom's been on the list for 18 months). Respite care isn't available either, unless the person is terminal and a doctor certifies the patient has less than 6 months to live.
The government is penny wise and pound foolish when it comes to helping loved ones care for family at home, as we found out firsthand. Overwhelmed by the level of care my mother has needed for years, and the out-of-pocket expense of having to hire aides to deal with her daily hygiene, my sister and I decided last week it was time to put mom in a long-term care facility. It was the hardest thing we ever had to do. We cried and we prayed. We wanted to honor mom's wishes to die at home someday, but we just don't have the strength or the financial means to do so anymore. Instead, mom will soon be going to live in a nursing home that accepts Medicaid.
This is where the government is being foolish. They limit the funds available to provide home health care support, but they'll spend thousands of dollars a year to keep someone in a nursing home. In my mother's case, my sister saved the government thousands of dollars over the years by caring for my mother at home, and we waited for years after my mom exhausted all her resources to apply for help...help that just wasn't enough and didn't come in time. How many other people can't manage to hold on as long as we did?
So, my vote, my sister's vote, my husband's vote, and I'm sure the votes of millions of others will go to the candidate that has a plan to insure all Americans and expand the level of home care available to families taking care of loved ones.
Iraq may be the top issue, but among my friends there's a lot of anger about health care in this country. Our thinking goes something like this: If there are tax dollars available to keep an American presence in Iraq for up to 50 years, then there darn well better be tax dollars to take care of people here at home.
(I've started researching where the candidates stand on this issue and I'll be posting something on it real soon. In the meantime, here's a link that gives more information on Michigan's Medicaid Program.)