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Questioning Obama's Healthcare Reform: What He Plans for America's Elderly

June 11, 2008
by Kevin Kolus, LTL editorial intern
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While his healthcare reform ideas—a selling point in the eyes of some pundits—might have inspired voters, American LTC providers must be wondering: What “change” does Obama propose for stressed long-term care?

In November 2007, the Leadership Council of Aging Organizations (LCAO) mailed out a survey, comprised of 15 questions on national aging issues, to Republican and Democratic presidential campaigns. Clinton and Obama’s responses are posted on LCAO’s Web site.

What follow are summaries to Obama’s explanations on significant Medicare, LTC, and senior housing queries.

Ensuring financial stability of Medicare

Obama plans on reducing Medicare premiums for the average family by up to $2,500 a year. This will be achieved, he says, with a proposed cut in subsidies provided to the Medicare Advantage program, totaling as much as $150 billion in the next decade.

The cut, combined with larger investments in information technology, greater reductions in medical errors, and longer delays on drug and insurance company price-gouging, would offer up the savings for American families—and the Medicare program itself. This is all part of Obama’s tentative universal healthcare bill that he claims would be signed by the end of his first term.

In order to strengthen Medicare, I believe that we must both tackle healthcare spending across our economy, which includes placing more focus on prevention and chronic care management, as well as eliminate wasteful spending in the Medicare program, including in the Medicare Advantage program.”

Improving Medicare Part D drug benefits

To stifle rising prescription drug prices for beneficiaries, closing the so-called “doughnut hole” in the Medicare drug benefit program, Obama formulated a three-tiered proposal:

1. Support legislation allowing Medicare to negotiate prices for prescription drugs, repealing the current ban on direct negotiation with drug companies. The resulting savings—which Obama estimates could be as large as $30 billion—will then be reinvested into improving healthcare.

2. Allow Americans to purchase drugs from other developed nations. Because drug companies overcharge for medications in the United States, compared to what is sold in Europe and Canada, Obama says he will support drug reimportation.

3. Encourage use and development of generic medications. The plan will increase the use of generic drugs in Medicare, Medicaid, and the Federal Employees Health Benefit Plan.

Financing LTC services

Obama says his healthcare reform will rely heavily on giving seniors “choices that are consistent with their genuine needs,” moving the focus away from institutional care.

While progress has been made, the long-term care system remains heavily biased towards the use of nursing homes even though most people would rather remain at home. At the same time, nursing home and home care are expensive, and federal coverage for both is limited, making high expenses routine for individuals and their families.”

To provide security for family caregivers, Obama says protections will be enacted against caregiver discrimination by expanding the Family and Medical Leave Act (FMLA), covering elder and family care.

Advancing quality of life

If the quality of LTC is to improve, the problems that inhibit progress in the field—such as the recruitment and retention of sufficient numbers of direct care workers—must be addressed systematically, Obama says.

He supports training of more nurses and healthcare workers in geriatrics, as well as LTC workers at every level in the industry. Obama also places emphasis on the issue of “helping to better understand and manage pain.”

To assist LTC workers, Obama expects greater implementation of electronic health records in nursing homes, hoping to mirror the success this technology has had in hospitals.

Creating affordable senior housing

As a senator, Obama says he has supported greater funding for nonprofit programs that provide affordable housing options to seniors. As an example, he cites his work with Sen. Debbie Stabenow (D-Michigan) to increase funding for housing for grandparents raising children.

As president, I will build off of those efforts to ensure that seniors have access to safe and affordable housing options. I will create an Affordable Housing Trust Fund to develop affordable housing in mixed-income neighborhoods.”

The Affordable Housing Trust Fund would absorb a small percentage of profits from the government-sponsored housing agencies Fannie Mae and Freddie Mac to create new housing units each year, Obama says.

Enhancing senior transportation

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