Ashley Cleek, Al Jazeera America - October 2, 2013
This is the best, most thorough news story about Medicaid, nursing homes, and home care that I've ever seen. The only real problem with it is that it could lead people to think the problem is unique to Alabama. It's not. Every state has a different ratio of Medicaid spending for nursing homes vs. home care. Some are are better, some are worse. A few states are really ahead of the curve. A few are far behind. But, it's a problem nation-wide.
Activist and disability policy wonk Steve Gold has some comparison data. It's a few years old now, and the presentation isn't very pretty, but it illustrates the point pretty well. If, in fact, nursing home care and home are are such fundamentally different services … are "apples and oranges" … then how do states manage to have such radical different allocation ratios between the two? Peoples' needs aren't that different, and none of these states have massive die-offs of elderly and disabled people. Some states just manage to do as well or better with home-based services, while others are either scared to, or are in the pockets of nursing home companies, or both.
I would also add that it isn't just "young people" who want … who need ... to get out of nursing homes. Almost nobody should be in a nursing home, and 95 year olds can benefit from home care as well as 35 year olds.
As a side note, if this is typical of the quality of journalism Al Jazeera offers on domestic topics, then I really hope they make a go of it here in the US.
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