One of the most memorable letters to the editor I ever read was written by a former U.S. senator, a liberal who, in his days in the senate, always came down on the side of big government.
After he retired, the senator attempted to own and operate his own business, and ran head-on into the very controls and regulations he had favored during his days in Washington.
His letter to The Wall Street Journal was basically an apology; he had not realized, he said, what it really meant to live with government regulation. This is especially true today in the arena of health care.
Government, in attempting to "fix" the nation’s home health care industry, has rendered grievous harm.
In the name of wiping out Medicare fraud and abuse, the federal government passed the Balanced Budget Act of 1997, which slashed Medicare service reimbursement to home care agencies across the nation. True, the provisions of the act did eliminate many private agencies that had gone into the business primarily to make a profit. In the process however, it also put out of business about 20 percent of the nation’s charitable visiting nurse associations – those that provide the majority of the charitable and reduced-fee home care.
After considerable struggle, the industry has negotiated a fairer formula that goes into effect this October.
For the agency I chair, this is not, unfortunately, the end of the story. It will take a long time for Visiting Nurse Association of Central Jersey (VNACJ) and other charitable agencies to recover from the Medicare cuts they have endured for nearly three years.
As a result, VNACJ an-nounced on July 10, reductions in a number of programs, including the elimination of an entire department that provides psychiatric home care services.
The agency is also forced to transition one of its four primary care centers to another provider and reduce hours at another of the centers. We cannot afford any longer to have our charitable funding subsidize government programs. But we are absolutely committed to maintaining the high quality of care for which we have been known since our founding 88 years ago.
It didn’t have to be this way. Government at all levels needs to go to school on issues such as home health care, that affect thousands of lives and save the health care system money.
It is not the reimbursement to agencies that is the sad story here, but the loss of services to patients.
Government needs to remember that when it denies funding to provide home care patients with the care they need, the next step is institutionalization – an alternative that will cost government and society far more.
Judith H. Stanley
Middletown