The Policy Proposition: our failure to provide for the elderly

by Alexander Chang (’23) | October 11, 2021

Art by Mia Patil (’22)

Two million Americans currently reside in long-term care facilities, and that number is set to skyrocket as our population ages. Yet our current support systems for the elderly have failed to protect them from harm. The pandemic has only exacerbated these shortcomings with long-term care facilities making up only one percent of our total population, but accounting for nearly thirty-three percent of all COVID-19-related deaths. These alarming data highlight the gritty reality behind the systems meant to provide for our senior citizens. Neglected and mistreated, their lives are directly subverted. 

Medicare only covers twenty days of care in assisted living, then partially covers an extra hundred days. Once the allotted period has passed, however, the patient is expected to cover the entire cost out of pocket. In fact, the only way individuals can receive taxpayer assistance for their care is to completely impoverish themselves to qualify for Medicaid. Additionally, care facilities now have an incentive to either over-provide or cut off senior assistance. Facilities bring in higher-paying patients by “resident dumping,” the practice of ejecting patients from care and “dumping” them on the streets. The levels at which the healthcare industry exploits our most vulnerable population raises the question of how our leaders are actively planning to remedy these situations.

Capitol Hill seems to believe that our current methods of oversight already address these issues. The evidence, however, is stacked against this belief. The industry is largely independent from federal government intervention, as facilities are allowed to rate their own performances. Such lax oversight is dangerous. For instance, Bonnie Walker, a ninety-year-old resident suffering from dementia at a senior living facility in Florida, drowned in a nearby lake after the nursing staff neglected her needs. The state of Florida only fined her nursing facility $6400 for the loss of her life. 

Oversight, when conducted correctly and efficiently, can have positive impacts on the current system. Increasing regulations on senior care facilities and transferring oversight to the federal level would address issues such as the abuse of Medicare compensation and resident dumping. Increased oversight is by no means a final solution, but it could provide a stepping stone for the holistic reform that our system desperately needs. 

Reform will not be a simple task. Injustice, exploitation, and abuse are intrinsic to our healthcare system. However, certain frameworks can help address these issues, especially for vulnerable communities like the elderly. The key issue with the current system is that while restricting and reducing the quality of care is profitable, there are alternative actions to serve both parties. Reorienting profit to quality care through incentives, tax breaks, and market regulation can provide easy pathways for facilities to adopt positive approaches in providing support. 

Thankfully, legislators nationwide are beginning to acknowledge these shortcomings. Connecticut recently passed SB 975, which requires video surveillance and monitoring in senior centers. Here in California, AB 895 seeks to introduce pilot programs in which social services may inspect licensed care facilities unannounced. Industry and government need to work jointly to take lasting action against lack of oversight in senior care facilities.

Categories: Column, Opinions

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