Friday, July 21, 2006
Kansas City, KS--
LTC Comment: The
full transcript of a hearing on the future of LTC and Medicaid that we
reported on last week is now available.
Find out what lawmakers, policy makers, and opinion leaders are
saying, after the ***news.***
*** TRIPLE TROUBLE.
We've reported here the ominous growth of obesity and its link to
diabetes as a health and long-term care problem. Now comes evidence of another tie in: "Studies
reinforce link between diabetes, Alzheimer's disease.
There is more evidence that diabetes increases the risk of
Alzheimer's disease. Two
new studies definitively tie Type 2 diabetes, the kind usually related
to obesity, with increased risk of Alzheimer's. One of the studies
reported by the Alzheimer's Association at a six-day conference in
Madrid, Spain, found that even people who had borderline diabetes were
70% more likely than those with normal blood sugar to develop
Alzheimer's. Another study
determined that diabetics with higher blood sugar levels are at a
greater the risk of dementia. Higher
levels of blood sugar mean the diabetes is severe or is being poorly
treated, or both, said researcher Rachel A. Whitmer of the Division of
Research at Kaiser Permanente in Oakland, CA.
Results imply there should be tight control of blood sugar in
elderly patients, even though some doctors tend to relax the rules for
them, Whitmer said." Source:
McKnight's LTC News Daily Update, 7/19/6 ***
YOU THINK WE'VE GOT LTC PROBLEMS? "Global
caregiving cost of Alzheimer's tops $248 billion worldwide.
The estimated total global cost of caring for people with
Alzheimer's disease and dementia is now more than $248 billion annually,
according to researchers. Swedish researchers reported their findings over the weekend
during the annual International Conference on Alzheimer's Disease and
Related Disorders, in Madrid, Spain.
They based their estimate on the estimated costs of informal and
indirect care for nearly 28 million with Alzheimer's and dementia
worldwide. Informal care refers to patient care provided at no cost,
usually by family members and friends.
Direct care refers to paid professional healthcare services. The estimates indicate great challenges for both families and
our national healthcare systems, said William Thies, Alzheimer's
Association vice president of medical and scientific relations, in a
prepared statement." Source:
McKnight's LTC News Daily Update, 7/18/6 ***
LTC BULLET: THE
FUTURE OF LTC AND MEDICAID
LTC Comment: Following
below are the opening introductory comments by House Small Business
Committee Chairman Manzullo (R, IL) and Vice Chairman Bartlett (R, MD)
at the Committee's July 10 hearing on the future of long-term care and
Medicaid. Read the entire
hearing transcript in The Zone at http://www.centerltc.com/members/hill_longterm.pdf
For background on this hearing and a full
transcript of Steve Moses's testimony, see the LTC Bullets at http://www.centerltc.com/members/ltcbullets/642.htm
respectively. Both Bullets
remain in The Zone, available only to dues-paying members of the Center.
They'll go into our public archives at www.centerltc.com
in a few weeks. To read
them now, contact Damon at 206-283-7036 or email@example.com
to join the Center. Alternatively,
you can find much of the content on our public LTC Blog at www.centerltc.com.
Just keep scrolling down.
FUTURE OF LONG-TERM CARE AND MEDICAID:
SMALL BUSINESS ROUNDTABLE"
10, 2006, 1:00 - 4:00 p.m. EDT
County Commissioners Meeting Room
HONORABLE DONALD MANZULLO (R-16-IL)
HONORABLE ROSCOE BARTLETT (R-6-MD)
R O C E E D I N G S
MANZULLO: The increasing
cost of long-term care is one of the most significant challenges we're
faced with. In 2000, there
were an estimated 9.5 million people with long-term care needs in the
U.S., including 6 million elderly and 3.5 million non-elderly.
numbers are projected to grow significantly in the coming years,
especially after 2030, when the Baby Boom Generation begins to reach 85.
The senior population, 12 percent in 2000, by the year 2030 will
grow to 20 percent.
a matter [of fact], in the twenty-first century, the provisions and
financing of long-term care is a daunting challenge for seniors, soon to
be seniors, and their children. The
cost of long-term care is high and increasing, averaging over $70,000
annually for a private room, $25 an hour for a visit by home health
aide, and an average annual base rate of over $32,000 for the services
of an assisted-living center.
1990, the price of nursing-home care has increased at an average annual
rate of 5.8 percent, almost double the overall inflation rate.
Medicaid, paid for by federal and state taxpayers, has become a
primary way of financing long-term care for elderly people in nursing
homes. The 40 percent or
more of those who need long-term care during their lives, about
two-thirds of all recipients of long-term care must depend on Medicaid.
current mix of financing for long-term care, in which a significant
share of financing comes from government programs, that a depression
that the federal government will experience with the aging of the Baby
Boom Generation. Entitlement,
or mandatory spending, is the largest proportion of the federal budget,
and has been increasing at faster rates than the GDP and discretionary
is a huge entitlement, and has become the entitlement program with the
fastest rate of increase. Expenditures
top $300 billion annually, and rise at eight percent annually. In total, Medicaid's expenditures for long-term care for
elderly people since 1992 have grown at an average annual rate of about
Congressional Budget Office estimates that in 2004 Medicaid's payments
for institutional care for seniors, including both state and federal
expenditures, totaled about $36 billion for about 77 percent of all
Medicaid long-term care spending. Medicaid's
payments cover the care of more than half of all elderly, nursing-home
Deficit Reduction Act, which became law on February 8, 2006, makes
several changes to the long-term care and Medicaid dynamic, and that's
what we're here today to discuss. I'm
looking forward to the discussion that will follow.
And, again, I want to thank Congressman Bartlett for inviting me
here to discuss this important issue. . . .
I turn it over to -- thank you -- to Roscoe, we try to keep the
testimony at about five minutes. And
at about 4 minutes, there may be a gentle tap; at five minutes I take it
and I throw the gavel at you, to give you an idea.
That will give us plenty of time for discussion.
BARTLETT: . . .
So thank you very much for being here.
I want to thank my Chairman and my friend -- we came in together,
as Don mentioned, in '92 -- for coming out today.
This is a subject that concerns a lot of people.
is graying, of course, and more and more of us are living longer and
longer. Just a few weeks
ago, I passed my eightieth birthday, and I was just wondering to my wife
when I would enter mid-life, because I haven't yet.
And this is true of America, we're getting -- we're graying,
getting older and older, and more of us will be ending up needing
Deficit Reduction Act made some changes, and the general intent of these
changes was to prevent people from impoverishing themselves, so that
they could then get their healthcare really from their friends and
neighbors. The average
person looks at it, and frequently they're encouraged by their attorney
to look at it this way: Don't
worry about it; it's government money.
But, of course, basically government has no money.
is no such thing as a "federal dollar".
Every dollar the federal government has, they took from the
paycheck of some hard-working American.
Notice that I didn't include businesses because really,
fundamentally you cannot tax a business, because a tax on the business
simply becomes a part of the cost of doing business, and they pass it on
to the consumer. So ultimately all of our taxes are paid by consumers, are
there's an interesting phenomenon, and this relates to that. When I came to Congress, Tax Freedom Day was about the ninth
day of May, and Government Freedom Day was about the fourth of July,
which gave a special significance to Independence Day because it was not
until Independence Day that you could work to get any money for
yourself, because up until Independence Day, you were working to pay
your taxes and the additional costs of government.
was that roughly two-month period between when you'd finished paying all
your federal, state, and local taxes and you finished paying for the
cost of government? That
represented the time that you were working to pay for unfunded federal
we've done a little better on taxes.
We tried really hard to reduce taxes.
We've done a little better.
We moved that day from the ninth of May back to sometime near the
end of April, maybe almost two weeks back.
But Government Freedom Day, Don, has gone from about the fourth
of July to about the ninth of July.
So although we've reduced taxes, the unfunded federal mandates
have grown until now you're working even a longer time to pay for the
total cost of government than you were working to pay for government in
'92, when we came to the Congress.
course, Medicaid is a part of that because the cost of Medicaid to the
states is mandated by a formula, and I understand that no states have
opted out. You can't opt
out of Medicaid. Nobody has
opted out of Medicaid. And
so when people artificially impoverish themselves so that they qualify
for Medicaid, what they're doing -- not just asking their friends and
neighbors to pay for their healthcare.
increasingly today, Don, we're asking our kids and our grandkids to pay
for it because we're amassing an incredibly large -- this is the largest
inter-generational-debt transfer in the history of the world, and we're
bequeathing this to our kids and our grandkids.
what this legislation did was intend to require those who could pay for
their healthcare to pay for their healthcare so that their friends and
neighbors weren't paying for it. And,
even worse, so that their kids and their grandkids weren't paying for
know, I know of no seniors, when they understand, who really want their
kids and their grandkids to pay for their healthcare.
And so I think that when you get the information out there, that
seniors are going to be the strongest supporters of these changes that
we've made in eligibility for Medicaid.
I wanted to thank you for chairing this hearing, this roundtable.
And I want to thank our witnesses and those in the audience for
coming. Thank you very
At this point, the testimony of two panels of witnesses began. Read the entire transcript of this hearing in The Zone at http://www.centerltc.com/members/hill_longterm.pdf