Newspaper article THE JOURNAL RECORD

Strong Push Expected to Expand Home Health Care Services

Newspaper article THE JOURNAL RECORD

Strong Push Expected to Expand Home Health Care Services

Article excerpt

Look for a strong push next year for the expansion of home health care services under Medicare.

Every time this issue crops up, the debate revolves around costs - comparative costs between nursing care in a long-term care facility and nursing care in the home. It may be no different when the arguments break out again in 1988.

Perhaps the most fascinating question now is how it will play in a presidential election year. Will the timing make it less likely or more likely that a major home health care bill will get through Congress and be signed into law by a lame duck president?

Opponents of the pending legislation may take comfort in the knowledge that the first independent study to be reported shows little difference in cost. Home health care apparently is just as expensive as nursing home care, or nearly so.

From the government's point of view, however, overall expenditures for home health care might be greater in the long run because community services would, in all probability, be expanded considerably. That would mean more people being served.

The U.S. House of Representatives Rules Committee already has authorized a $5 billion home health bill to reach the floor next year. It's a product of the committee chairman, Rep. Claude Pepper of Florida and Rep. Edward Roybal of California.

As written, the bill would offer home care benefits to people who need help for two or more normal activities of daily living; eating, bathing or dressing, or moving from one part of the house to another, for example.

Sponsors of the legislation make the point that a high proportion of the people living in these circumstances would otherwise "require costly nursing home and hospital care without proper home care services."

A study of 16 experimental projects, underwritten in part by the National Center for Health Services Research and Health Care Technology Assessment, comes to the conclusion that home health care probably will end up costing a bit more than nursing home care. But it goes on to set up another bitter fight on Capitol Hill next year by suggesting that the lack of savings should not be used as an excuse to abandon plans to improve home care. …

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