Bloomberg: US Home Care System Woefully Inadequate

A report in Bloomberg Businessweek paints a dire picture of the state of home care for the aging U.S. population.

The article, published Feb. 9 and prepared in conjunction with the Investigative Fund at the Nation Institute, highlights a caregiver named Valia, describing her arduous 48-hour shifts to make a point about the lack of fair wages and working conditions in home care, as well as the inadequacy of the nation’s Medicaid program to fund the amount of care needed. The proliferation of home care labor lawsuits and the worsening shortage of workers, as well as the particularities of the managed care system in New York state, are among the other topics explored.

Here are five quotes from the article, capturing some of the findings of reporter E Tammy Kim:


— When Americans look for paid help, they’ll find their national infrastructure convoluted and wanting. It’s a problem the world over, but one compounded in the U.S. by the fragility of the welfare state.

—New York, one of the nation’s largest long-term-care markets and the only state whose Medicaid program covers around-the-clock help, comes closest to the future Americans say they want. But New York also demonstrates the system’s central problem: It’s untenable, given current funding levels, to pay workers for anywhere close to the number of hours they actually work.

—In less populous areas of the state and country, the problem is compounded by the lack of aides willing to work for low wages. A survey conducted last year in Wisconsin showed that 85 percent of home-care agencies didn’t have the workers to staff scheduled shifts.


—Over the past few decades the SEIU has unionized tens of thousands of aides, but to do so it struck compromises with home-care agencies and state governments, attempting to balance the need for fair jobs with the need for any jobs.

—As the first wave of 76 million baby boomers turns 70, our long-term-care infrastructure will bend from the strain. To keep up, the Medicaid budget will have to grow and properly reimburse managed-care plans. Home health aides will have to be recognized as medical professionals and paid accordingly. Nursing homes, a far costlier option, will occupy a smaller share of the market, and Medicare will have to chip in for long-term care.

Click here to read the article in full.

Written by Tim Mullaney

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