| OCR Text |
Show Tt It Lake Tribune OPINION Sunday, January 24, 1999 Clinton Plan Is Only a Beginning in Addressing Long-Term Care But supporting caregivers is another BY JUDITH GRAHAM thing altogether: sensible, far less costly CHICAGO TRIBUNE and politically almost sure to win substantial support from Republicans and For most of the past decade, politi- cians studiously have avoided any seri- Democrats alike. That's where Clinton’s new five-year. $6.2 billion long-term care program ous discussion of long-term care. That's shortsighted and President proposedjust after the New Year, comes in. The president’s plan has four key Clinton deserves credit for realizing it Can it be done? Absolutely, Kane insists, noting that the Scandinavian na- ly, it’s important. 1.2 million older Americans. 250,000 children and more than 500,000 di: bled The second plank of the president’s plan addresses a much broader audi- adults will qualify What will the $1,000 tax credit buy ence. It wouldgive $625 million over five years them? The unfortunate reality is, not much, according to Pam Steinbach. administrator of Resurrection Home spent on everything from new housing optionsfor theelderly and disabled to enhanced home health care services. to local Area Agencies on Aging, which effectively function as one-stop Care, shops on long-term care, supplying information, referrals and direct services. an agency that serves about 150,000 who need long-term care, funding for spite care: ated with older people who needlong- community-based services, a Medicare education campaign andincentives to people in the metropolitan Chicago area For anelderlypersonon Medicare. for instance, an hour-long homehealth care visit by a nurse costs $100 to $110; 10 through acenter. Training for caregivers Debilitation. Disability. Consignment to spurthe private long-term careinsurancemarket The $1,000 annual tax credit for aides or certified nurse assistants operating under a nurse’s occasional supervisionbill at $50 to $70 anhour; at those visits Private duty aides operating without But his recently announced long-term care plan doesn’t go nearlyfar enough. planks: a $1,000 tax credit for people Long-term care is an anxiety-produc- ing subject. Consider the images associterm assistance. Dependency a nursing home. Politicians have especiallystrong rea sons to shy away from thetopic. By far people whoneed long-termcareorthe caregivers wholook after themis by far the bulk of long-term care — helping people with essential activities such the most important component. It’s mated that three-quartersofthe $5.5 bil- tions or going to the bathroom is per- ily caregivers. People who have severe esti lion in credits will go to spouses or fam- formed free by family members. friends dementia or adults who need assistance with threeactivities of daily living (such and neighbors to $200 billion a year, according to a ma The economicvalue of services pro- as bathing, eatingandtoileting) and who live with caregiversat least six months out of the year will qualify. There are also income eligibility standards tal Fund of New York. That's doublethe nearly $100 billion the government pres- nomic, vided by this huge caregiving network of more than 25 million Americans is close It’s thefirst major government recog nition of the substantial strains — e jor study last year by the United Hospi ently spends annually on nursing homes and groups representing caregivers quick pressed approval, with some reserva- and home health care through its two hugehealth programs, Medicare (for the elderly social and emotional — associat ed with caregiving, tions and disabled) and Medicaid (for This puts long-termcare back on the publiescreen after a long absence the poor) Thelast thingpoliticians want to do is es forthe services caregiverscurrentlypro- it's a verypositive first step,” said Gail Hunt, executive director of the National vide, especially in light of the hugetide of Baby Boomers who will be aging over the next several decades. It’s a potential- Alliance for Caregiving. But she cau tioned that people shouldn't get their hopes up too high, because only the most for which nosubstantial political will exists in Washington home-level care — aretargeted by the program. According to the government to substitute paid government servi ly budget-breaking proposition, and one feeble — people who need nursing Most of the funding would pay for re- visits will eatuptheentire credit. Nurses rates, the credit will pay for 20 or fewer supervision go for $20 to an hour. Thegoing rate for companions is $15to $18, an amount that wouldallowslightly more than one visit a week under the credit. About 22 adult day-care visits. costing about $45 a day, would be cov ered. The $1,000 could also be used to add a wheelchair accessible rampto an apartment entrance, for instance, or to wouldbe funded. Much-needed connections between the fragmented community organizations providing serv everything from churches to hospitals, could be strength- ened. Anyone needing information could benefit. The president's plan suggests tle if any help from the government agencies in recent offering the productto their workers. In- “What wereally issue, and the Baby Boomers’ experi- also sound a warning. need to do is make sure services are available and affordable to people who need them,” said JonathanLavin, execu- director of the Suburban (Coc termcare insuranceas a benefit for fed- state employee insurance programs to ry long way fromthat essential disconnect: Thepresent system is strongly biased toward nursing home onlong-termcare shows that 53 percent offrail older people. who need substan assistance with daily activities, re eive only unpaid aregivers Another 40 percent receive a combina care(threeof every four long-termcare dollars spent by the government arefor nursing homes), but consumers over. whelmingly want long-term care at home, he argt To build the infrastruc: tion of paid and unpaid help. Tothe ex tent the tax credit allows their caregivers based system of long-term care would a much-needed break. take if only oceasional ences with their own parents, may stimulate demand The president's plan might make a difference in the market by adding long- “We're Area Agency on Aging. A 1996 Commonwealth Fund report will surely be welcome however rates are strong, with more companies creasing attention to the long-term care Robert Kane, a professor at the Uni versity of Minnesota School of Public Health and author of a new book on long- termcare, agrees. The problemlies in an contributions. for its home health benefit. Clearly, the private market hasa role to play in funding long-term care. Insurance industry experts are optimistic. flat funding for aging years. But officials with those programs modest. these Isit politically feasible? Perhaps not, given the current emphasis on curbing thegrowthinentitlement programs such as Medicare, which recentlycut funding Nearly 6million people have sometype of long-termcare insurance and growth The proposai is welcome, in light of make home modifications such as installing handrails in bathrooms, or to reim- For families that presently receive lit- affordto meetthe needsofthe elderlyif current levels of economic growth are sustained in the future. that 250,000 families would get some typeof services. burse a friendor family member providing care short-term relief for care- givers provided either in the home or tions serve as an example of what can be done. Is it affordable? Yes, insists Robert Friedland, director of the Washingtonbased National Academy on an Aging Society, whichthis past week issued a major report arguing that society can eral workers and their families. The federal planis a gold standard for bene- fits, and may spur other companies or follow the government's example any details are still uncertain. But onething is very clear: The long-term care problem begs to be addressed, through plans like the president's and many other measures. It’s only going to become bigger. and more significant, over time ture needed to support a community “billions and billions” of dollars. Judith Graham is the Chicago Tri. bune’s Denver correspondent. Increasing Defense Spending Is Sound Move byPresident But if the height of the Cold Var is considered to be 1985 BY M. THOMAS DAVIS FOR THELOS ANGELES TIMES President Clinton recently an rather than 1975, defense spend- ing actually has decreased37 per- nouncedadecision to increasede. cent. his budget for next fiscal year as trillion. A second common rationale for fense spending by $12 billion in part of an approximately $110 billion increase over 2000-05. It was a courageous move. Notonly did the president place himself at oddswith manyofhis own political constituencies, but he implicitly acknowledged the inadequacy of previous defense budgets and the growing signs of erosion with. in the military The 14-year downwardtrend in military spending had to end. the heavy deployment demands on combat forces had to be recog- nized, the increasingly difficult recruiting environment hadto be addressed and the expanding need for replacing and moderniz ing aging equipment had to be faced. Those whoopposethis defense increase have raised numerous arguments supporting their views. Some have merit. As last yielding a cumulative sav- ings to the taxpayers ofnearly $1 opposing increased defense outlays is that our spending equals that ofthe next five major spend ers combined. Again, this is literally true. The defense budgets of Russia, China. Japan, Franceand Germany reflect the conditions of countries that have largely re- gional interests: none plays a global role in keeping interna. tional order. Global power projection, preci- sionstrike capability and defend. ing against threats fromtank ar mies to terrorists — all of these are expensive. But is there any one better suited than the United States to play this leadership role Finally is the argument that the agon would have all the mon. needed if Congress would stop diverting funds to various month's operationagainstIraq in pet projects. Members of Con gress are elected by their constit around increasingly more pre cise, unmanned systems. The Pen: That is theessence of a democrat ic process, Comparedwith the en tire defense budget, pork canbe than it has so far demonstrated. But other criticisms — that cur tax that is paying for democracy Giventhe alternatives, we should be please dicated, weareon thecuspof new military capabilities evolving tagon should pursue such ap proaches with greater enthusiasm rent spending equals that of the Cold War, the next that it exceeds that of five largest defense spenders combined and that m of the shortages are caused t congressional pork-barreling are much less compelling Several defense authorities have noted that today’s defense budget. in constant dollars uents to serve Tn fulfillin, Ss Of life ya military force ca ing. It was the year South Viet nam fell to the North. the year the xpectations, native to paying faced a major and ene armed crisis f id the hort notice so is costly stile to reduce and protecting ats while it doing Unless we are willing r role or lower have little a the bill it crea our r the were transitioning olunteer Here’s a great U.S. Bank Home Equity Loan that can save you money every month. We had to be sure you didn't miss it. economic from the an aft to an all force responsibilities projecting power on from nation the as accepted. the United States has inere pasingly been forced to rely on its military instrument When it doe s so, the national ex pectations igh that the mis: formed effective the “height of the Cold War This is commonly de seribed as 1975, which makes the 1 interests. viewed as a 2 percent marginal equals the defense spending at observation literally true was alow point for defen: their 1 M. anal Th ya N Washington h retired nior defi Gru ve do it: With competitive rates. No fees 0! No payments for EE HIVE nths. Low All example. Wher 1 thly Bank | tax deductible, y ‘u'll understand 5 I ; an AFFORDABLE 24 HR. ELDERLY CARE * © © © ® © WE PROVIDE: 24 HOUR CARE Dietician approved meals Assistance with all aspects of daily living Daily housekeeping Laundry Individual and group activity PRIVATE ROOM COMPLETE WITH: © Bed, Dresser © Private 1/2 Bath ® Intercom @ TV hookup © Phone hookup r————-— >" COME SEE OUR HOMESAT: ! Bring in this ad SANDY 115W, 9400S 561-7574 and receive | So JORDAN 10386S, 2200W, 259-2882 | $100 OFF|j E SANDY 8670S. 19258 | L 10 Months Re Rent at | RIVERTON 128948,1615W. 255-8865 254-8966 r you th. can put money in your Look at the payment chart for ar financial had t HOMES §. Bank, excellent: I Appl Just stop asy, | W US. I from turning the page offer immediate approval all 1-800-285-7575 (Sbank Your needs. Our tools |
