Dr. Joanne Lynn has a radical proposal for Medicare reform – center the program around the actual needs of elderly people. As Director of the Altarum Center for Elder Care and Advanced Illness (CECAI), Lynn has had the chance to ask dozens of people who rely on Medicare about what they want from their health insurance. Generally, they are more concerned with having access to hearing aids, affordable housing, personal care, and vision aids, rather than hospital services, emergency care, and medical procedures. But while Medicare covers medications and procedures, it does nothing to help elderly people with concerns such as transportation assistance and help for family caregivers.
“Today, physicians can order up a drug or treatment regimen that costs $100,000. But they can’t order home-delivered meals, or suitable housing, or a hearing aid,” Lynn writes in a recent blog post on Medicaring.org.
These issues with Medicare mirror those in the health care system more generally. Health insurance may cover all the scans in the world, but it generally cannot give families access to nutritious food, safe neighborhoods, clean air, and other social advantages that impact health as much as medical care.
However, elderly Americans face challenges that makes Medicare reform especially urgent. Long-term care is incredibly expensive, but nearly half of Baby Boomers will not have enough savings to to afford even basic expenses in retirement. Pensions are practically non-existent and the financial crisis wiped out savings for many in the Boomer generation. And each new generation is relying less on their families to provide unpaid elder care. We need a more sustainable system, and soon.
Making Medicare sustainable will require us to transfer health care resources from hospitals back to communities, says Lynn. “For a fast-growing population of elders living with worsening disabilities, the community where they live is their most important resource,” she says.
That’s why CECAI is designing, implementing, and evaluating pilots of community-based care, to create a policy path forward. The “Medicaring Communities” model includes a comprehensive care plan, reliable around-the-clock support, and integrated social services. Radical reforms like these are exactly what we need to move towards right care.