Sen. Tom Daschle, Experts Tout Homecare As Cost-Effective Solution w/ Healthcare Reform Process

Sen. Tom Daschle, Rep. Jason Altmire, Healthcare Experts Tout Homecare As Cost-Effective Solution In The Healthcare Reform Process
Article Date: 26 Jul 2009 - 0:00 PDT

During a roundtable discussion on Capitol Hill on Tuesday, former Senate Majority Leader Tom Daschle and Blue Dog Democrat Rep. Jason Altmire (D-Pa.) stressed the cost-effective role that homecare can play in the reform of the U.S. healthcare system. The roundtable also addressed the controversial competitive bidding program for home medical equipment and services. The American Association for Homecare hosted the event, which was attended by congressional staff and media.

Senator Daschle and Representative Altmire were joined in the discussion by Peter Thomas, co-chair of the Consortium for Citizens with Disabilities' Health Task Force, and Georgetta Blackburn, vice president for government relations at Blackburn's, a home medical provider in Tarentum, Pa. Tyler Wilson, president of the American Association for Homecare, moderated the discussion.

Senator Tom Daschle noted, "We can provide low-cost good quality access in part through home healthcare. Home health is by far the most effective way to start producing wellness promotion and primary care…." Referring to the difference between the $7 per day cost of oxygen therapy to more than $5,000 per day for hospitalization under Medicare, Daschle said the difference "shows clearly how much of a panacea home healthcare can be."

"My mother's quality of life is a hundred times better given the fact that she can live at home rather than be institutionalized at 86. Her quality of life is proof positive that we can help improve quality, lower costs, and provide greater access if we put the emphasis where it belongs: at the base of the pyramid with good home healthcare."

Congressman Jason Altmire, a fiscally conservative Blue Dog Democrats in Congress, spoke about the role of home medical services and equipment in healthcare reform. "We're going to preserve what works in our current system, first and foremost, and one of the things that works best in the current system is homecare. And if you look at what the goals are for healthcare reform, homecare touches on every one of them. When you think about wellness and prevention … that can be done in the home better than anywhere else. There's no more cost-effective setting than in the home."

Altmire referred to findings from hearings on competitive bidding in the House Small Business Subcommittee on Investigations and Oversight, which he chairs. "What we found is when you have a regulation in place that's putting cost over quality, that's not only going to impact the beneficiary, and we all know how that works, it's also going to affect the small businesses that are staples to our communities in the durable medical equipment field."

Peter Thomas, representing the Consortium for Citizens with Disabilities, said, "Disability groups have long opposed competitive bidding for DMEPOS [durable medical equipment, prosthetics, orthotics, and supplies]. There is real concern about limitations on choice of provider. In many instances these are beneficiaries with long-standing relationships with providers…. Those relationships get fractured under competitive bidding…. We're very concerned that service is going to go out the window, that quality is going to decrease, and that patient choice is going to become compromised. There are other ways to get at overpayment in the DMEPOS fee schedule. We think that competitive bidding is not the way to do it."

"Homecare must be supported as a vital component of the healthcare system and recognized as a critical benefit under Medicare," said Tyler Wilson, president of the American Association for Homecare. "When the Office of Inspector General at HHS notes that a piece of equipment can be purchased over the Internet at a lower cost than at the Medicare rate, it presents a false analogy and demonstrates a fundamental misunderstanding of the benefit. Quality homecare and accessible homecare is not merely about equipment. That is not what Medicare beneficiaries want, nor is it the recipe for providing a standard of healthcare that everyone expects. Services include 24-hour on-call service; patient evaluation and education, caregiver education regarding equipment maintenance and safety and infection control; monitoring visits assessing patient compliance with the physician plan of care; ongoing maintenance of the home medical equipment; and ongoing provision of related supplies and back-up systems as needed."

In the wake of a 9.5 percent cut effective January 2009 for the most commonly used home medical equipment items and a 27 percent cut to home oxygen reimbursement so far in 2009, and the Association is urging Congress to enact budget-neutral reform of medical oxygen policy to make the Medicare benefit more patient focused, refrain from additional cuts, and enact a 13-point plan to dramatically reduce abuse and fraud in Medicare.

Daschle remains one of America's worst nightmares. In his book, Critical: What We Can Do About the Health-Care Crisis (2008) he determined that healthcare must be administered by a governing body akin to the Federal Reserve Board. He also advocates for the requirement that all who sign up for Medicare must also sign a document showing the degree to which they consent to be killed in an “end of life” situation.

Daschle and his wife have their hands so deep in the healthcare industry, profit, not real care or reform, is their driving motivation. And using “cost-effective” in conjunction with socialized healthcare is a misnomer especially when one considers the overall costs of said healthcare increases exponentially with each passing year.

Homecare CAN be an effective way to reduce healthcare costs.

Let’s face facts here; hospital time is expensive, and I see, every day, case after case where the patient could be cared for in their own home as effectively and for far lesser cost.

However, I suspect Dasshole’s motives anytime he opens his piehole.

Not that Daschle has any credibility to contribute, but most people would prefer to live healthy as long as possible and die at home than spend the last months or weeks of their life in a hospital. Reimbursement isn't the main issue, however. Most people either don't know or don't bother to do what it takes to keep them healthy.

No matter how it's paid for, the nation will be hard-pressed to afford the death throes of millions of baby boomers who didn't take care of themselves. If you plan to be sick for any period of time before you die, you better be stuffing a lot of money in your mattress, or start making up with your kids.

Home health care is so 1990s. By now it’s old hat. It’s so old that state agencies are miffed that home health care costs have risen so much. They forget that in-patient stays have been dramatically reduced due to the emergence of a robust home health care industry. Hell, they pushed for it.

So now they trash home health care agencies as if they were all crooks or something. Daschel better bone up on this one before he looks the fool AGAIN. He’s about two cycles behind the eight ball on this one.

I know people who made a decent, but not exorbitant, living doing home health care for a private provider. Then, the small companies went out of business, fired everyone and suddenly, there were a couple of very large home health care providers connected to huge regional hospital networks who hired all the fired workers at about a $5/hr reduction in pay. Something was going on above and beyond any malpractice by the original smaller firms, IMO.

I am old enough to hope home health care is available when/if I or my husband need it. However, my liberal, affluent relatives all say:”Well, it isn’t FREE, you know.” Of course it isn’t free! Not one of those complainers would lift a finger to do any of the routine chores the home health care folks do, but they are all medical professionals and are quite upset about their own compensation levels. Oh, and don’t forget, that the home health care is only covered on insurance if you have an expensive RN as a care provider. Although, I believe Medicaid covers some services for the elderly and perhaps for the disabled.

I had my one child relatively young, so when either of us need assistance, he will already be in his 60s. He is an EMT and would be willing, but we just hope it doesn’t come to that. I cared for my late former husband for 13 years and even with hired assistants, it was draining and strained the relationship. Luckily, I was young and we could afford the help. Many folks just can not cope or are not physically or educationally competent to do some of the things that absolutely need to be done on a daily basis.

At first reimbursements were relatively good for home health care services, because the feds and the states wanted to reduce hospital days. Once they got what they wanted, significant reductions in hospital stays, they zeroed in on the home health care agencies. Now they bitch about them, and have acted to reduce their reimbursements. I suspect that’s why you’ve seen the small firms drop out. The only way someone could make a go of it, was to gut the pay of field workers and operate on volume.

I believe meals on wheels programs and home health care are very important programs. They are particularly vital lifelines to people who are older and have lost connections to people who could help out. As you have stated, private folks are hard pressed to dedicate as much time as is needed, and particularly to provide the professional care that is needed.

I’m tired of seeing politicians act as if health care providers are ripping the nation off if they require reimbursement for services rendered. The demonization of these vital health providers is both calculated and vile.

It verges on the wicked as far as I am concerned.

The fascist way is to always have an enemy, especially if you need a crisis. Of course it is wicked (not just *verging upon*). As I have posted before, I know a lot of medical professionals all the way up and down the food chain and so very many of them voted for these fascist devils and are now getting the Chicago treatment. Not one believed us when we pointed out that there is no way health care for all except the very rich could be free of cost to the patient and still provide a living for the worker, be they professional or ancillary.

The only silver lining is that zerO and the donks are alienating every faction of their base, one demographic at a time.

Even Acorn and all its myriad incarnations will not be able to steal the election if 10%-15% of the donk base sits out the election or votes 3rd party AND if all the clueless elderly wake up to see what is going to happen to them. That will take 20%+ away from them, leaving only a base of 1/3 of the electorate. I really think some of the states, like Indiana and Ohio will go back to the GOP column in the midterms. Then zerO will have to run against Congress and the Governors. That should be entertaining, at the very least.

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