The Neglect of Long-Term Care

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(via USA Today)

Click here to read all posts in our Care Work series. 

Allison K. Hoffman—

Caregiving has long been shunted aside and undervalued in the United States. Long-term care (LTC) is no exception. Sometimes called “long term services and supports,” LTC is the help that over 40 million Americans who are sick or disabled need every day to complete basic tasks like bathing, eating, getting dressed, going to the bathroom, paying bills, or buying groceries.

American social welfare policy has largely ignored LTC, and families, who are largely left to manage it on their own, increasingly strain to meet loved ones’ needs. This problem will only worsen with the collapse of private insurance for long-term care and the large number of people with dementia-related conditions.

Resistance to developing social policy to help people with LTC comes in two main forms: First, some people say the problem of designing public support for LTC is too big to solve. Second, others suggest that it’s not a problem at all—caregiving is just what families do, so the state need not intervene. Neither of these arguments holds up well. Continue reading

Medicare for All as a Democratic Movement

This post is part of our symposium on Medicare for All. You can find all the posts in the series here.

Allison K. Hoffman – 

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Medicare for All (MFA) has become the symbol of a larger, brewing movement that is attempting to bring major change to how we pay for and regulate health care in the United States. Even if MFA never becomes law, the conversation around it is building popular support for significant reforms and is creating fissures in the decades-old market-based approach to health care financing and regulation—and in the justification that this approach promotes choice.

Many Americans are well aware that our current health care system is failing them, as nearly 27.4 million people (14 percent of adults) remain uninsured, even after the Patient Protection and Affordable Care Act (ACA), and even those with insurance are struggling to pay for the care they need. The U.S. spends twice as much per capita on health care than the average OECD nation and has worse outcomes on critical measures, like life expectancy and infant mortality.

Over the past three decades, the primary policy solution to the mismatch between high spending and poor outcomes has been to turn to consumerism and market competition for a fix. The underlying theory is that if people have options—options for health plans, hospitals, prescription drugs, providers, and so on—they will choose the higher-value options. In turn, competitors will in theory produce higher-value options to win more customers.

Continue reading