The President’s new proposal is a worthy step but we must expect more to happen quickly if all of us can count on living reasonably comfortably and meaningfully even at the end of life.Americans for Better Care of the Dying strongly supports President Clinton’s long-term care initiative announced in late January. Joanne Lynn stated that she “applauds the $3,000 tax credit for people with long-term care needs or their caregivers” which is triple the long-term care tax credit proposed by the President last year.
“ABCD endorses the comprehensive nature of the initiative, which includes a housing component, incentives to keep people in home and community based settings and additional funding for services to support family caregivers of older persons,” Lynn said.
Clinton’s long-term care proposal is an important first step in providing long-term care services that currently are not covered by Medicare. Unfortunately, Medicare is ill equipped to adequately cover this population. Medicare does not encourage teaching patients and families how to catch signs of worsening serious illness or to treat quickly symptoms, especially pain. It does not make available emergency care in the home or help in planning for comfortable and meaningful end-of-life experiences for patients and their families.
ABCD and the Center to Improve Care of the Dying have implemented a new long-term care pilot program that blends the best of palliative and hospice care with disease management. This approach, called MediCaring, would include having a care plan available for most people facing the end of life. MediCaring would also create a multidisciplinary team that would be financially accountable.
Furthermore, addressing the needs of seriously ill people would respond to pressures to stretch limited coverage by hospice and home health care. MediCaring would be available to a greater pool of individuals, those who are among the most seriously ill long-term care patients. A few dozen participating sites are already trying to develop better care systems for those with serious long-term illness; government should encourage and evaluate these endeavors.
According to Lynn, “The aim has to be for serious reform in Medicare - not just changing payment rates but changing what we are paying for.”
ABCD encourages the Congress and executive agencies to try out ways to provide Medicare coverage for family caregivers who would otherwise become uninsured by leaving employment to take care of seriously ill family members. ABCD supports better integration of available services so that people with serious illness can count on good medical care, symptom control, advance planning, and support to families.
“Most of us will be sick for months and years before death,” Lynn said. “However, our care system was never designed to support lengthy illness. Now is the time for change. The President’s new proposal is a worthy step but we must expect more to happen quickly if all of us can count on living reasonably comfortably and meaningfully even at the end of life.”
David Introcaso, Ph.D., is ABCD’s Director for Planning and Program Development. For more information, contact him at (202) 467-2222 or e-mail at dmi@gwu.edu.
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This content is provided by Americans for Better Care of the Dying. For more information, visit www.abcd-caring.org.