Congress eyes cuts to Medicare home health care services

Maryalene LaPonsie | January 13, 2011

With a $1.17 trillion federal deficit and a public anxious to eliminate $14 trillion in national debt, Congress has signaled willingness to cut some programs that were previously considered sacred cows. For example, the Medicare Payment Advisory Commission (MPAC) has made formal recommendation that Congress eliminate free home health care benefits for seniors on Medicare, according to a report on the Bloomberg Businessweek website.

Saving money at seniors' expense

The MPAC recommendation is not the only suggestion that Medicare health insurance benefits be curbed. The National Commission on Fiscal Responsibility and Reform - also known as the deficit commission - included a number of Medicare changes in its final report. Among those were suggestions to standardize various Medicare co-insurance and deductible amounts and a more unified out-of-pocket expense system, all of which will undoubtedly cost seniors more money in the long run.

Where the deficit commission's proposals applied to Medicare in general, a benefit that allows 3 million seniors the opportunity to receive nursing services, physical therapy and personal care in the comfort of their own homes was squarely in the crosshairs. Currently, these home services are provided free without co-insurance requirements. Under the MPAC recommendation, this care would no longer be free. The commission did not formally recommend a co-insurance amount, but some staff members suggested $150 fee for a series of related visits.

Limiting access to care

Ironically, just as Congress considers ways to restrict home health care services, private health insurance companies are in the process of expanding home health care options for their customers. These health insurance companies, working to contain costs, have discovered this simple fact: keeping people healthy is cheaper than curing sick people.

In fact, when it comes to seniors with limited mobility and even more limited funds, it makes little sense to cut off a much-needed lifeline. Visiting nurses and therapists provide more than immediate health care services, they are also the eyes and ears that can detect potential threats to the well-being of the patient.

A $150 co-payment might be enough for some to say "no thanks" to home care. The problem is that "no home health care" probably equals "no health care period." That's certainly the case for individuals unable to secure transportation to the doctor's office or unwilling to endure a long wait once they got there. At a time when we should be making access to health care easier - especially for vulnerable populations - eliminating free home health care seems to epitomize the phrase penny-wise, pound-foolish.

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