“The ongoing debate about government’s role in health care involves a compelling reality – namely, that when elected officials are charged with guiding help for the sick and the elderly, political expedience can trump policy choices that do the most good for the most people.
Louisiana offers a vivid case study of such cynical gamesmanship in the way that lawmakers and governors have steered patients and money toward nursing homes over the years when cheaper and more effective options such as community and home-based care are available. It’s no secret why nursing homes remain favored at the state Capitol, as a three-part Advocate special report that concludes today makes clear. The industry contributes lavishly to political campaigns, virtually ensuring that when governors and legislators decide how lucrative Medicaid dollars get spent, nursing home operators stand at the head of the line.
It’s a nice deal for the nursing homes and the politicos who feed at the industry’s campaign trough, but the losers, of course, are the frail and physically impaired Louisiana citizens who depend on state government to be their champion. Taxpayers at large get the shaft, too. Louisiana could, by one estimate, eventually save up to $200 million a year by guiding patients toward other kinds of care beyond nursing homes. As the state continues to hemorrhage red ink, such a wrong-headed fiscal policy should be a public scandal.
Nursing homes will always be needed for those who require specialized, around-the-clock care. But The Advocate’s investigation revealed that patients who seem ideal candidates for cheaper, less extensive assistance are often driven into nursing homes because state policy is stacked against them.
Nursing homes now get 77 cents of every Medicaid dollar Louisiana spends on care for the elderly and physically disabled, while home- and community-based programs get the rest. That ratio, among the highest in the country, has been increasing steadily since 2013.
On average, a nursing home costs the state $47,331 per resident per year. By comparison, it costs the state between $13,758 a year and $33,117 a year to care for an elderly or disabled person at home, depending on the level of care they require.
In Louisiana, where so many residents trumpet family values, self-sufficiency, and fiscal discipline, state leaders should embrace health care alternatives that keep people at home with their loved ones, allow them to do what they can for themselves, and save as many tax dollars as possible.
As The Advocate’s special report demonstrated, our present Medicaid policies do exactly the opposite.”