Last night, in a televised dabate in the campaign for Indiana governor, the issue of home health care as opposed to nursing home care came up. Mr. Gregg, the Democrat, as I heard it, supported home health care, and would strengthen it. Mr. Boneham, the Libertarian, also supported it, for whatever that's worth. Mr. Pence, the Republican and leader in the polls, was more noncommital.
Gregg argued that home health care was not only better for individuals, allowing them to stay in their own homes, but that it was also more cost effective to pay aides to go into private homes rather than to put people in nursing homes with all the overhead that involves. Presumably, he has the numbers to back that up, but it makes intuitive sense to me.
If we are going to lean more on home health care overall, however, perhaps we should reform and revitalize it. Waivers should be focused more on individual needs than on bureaucratic or statutory definitions. Yes, that would put more authority in the hands of those who actually operate the system on a daily basis, but it would also make the rules more accessible to the public and the press, making it easier for advocates and reporters to hold feet to fire. Money should also be distributed more on a case-by-case basis and put away less in bureaucratically constructed silos that force individuals into largely artificial categories. The goal of such a slice-and-dice system, I assume, is to see that taxpayers' money is used correctly, but a system more open to public scrutiny could also do that. Another reform might be to pay aides and those immediately above them more. This kind of human-based sysstem works best when those operating it are experienced. If we want people to make careers in this area and gain that experience, giving them a better financial standing in the healthcare system makes some sense.
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