Healthcare’s stepchild seeks a home: A fable

Once upon a time in the late 1970s, a bright young man was sent to Washington, D.C., to cover healthcare politics and legislation for a national medical magazine. He learned that “national health insurance” was all the talk, that everyone had a “plan”—the hospitals, the doctors, a very famous senator named Kennedy, even the health insurers, God bless them. But a Wise Seer descended from on high and told the young man, “Never seek to find mention of long-term care in any of these plans. You will not find it. No one knows what to do about long-term care.”

Some years later he edited a magazine for physicians who practiced geriatric medicine. The magazine covered many, many topics pertaining to geriatric care. But a Fearless Leader sitting in a corner office once told him, “Don't bother to write about nursing homes. Physicians just aren't interested.”

Quite a few years later the now not-so-young editor observed with interest the fights, excruciating analyses, and heartrending decisions that went into creating something called Medicare Part D. My, what a complex plan! It touched base with virtually every segment of American healthcare to make it work. Except—whoops!—nursing homes. What about their complicated relationships with pharmacists and the many and varied reimbursement resources supporting residents? Gee, nobody thought about that! Oh, well….

Recently, the aging editor just finished reading a column by intrepid Washington reporter Michael J. Stoil. Michael told how the Democrats are mounting a fearsome attack on the Republicans, and achieving a surprisingly unified voice on healthcare policy, thanks to one Dr. Howard Dean. Dr. Dean, as a physician, presumably knows whereof he speaks—and, of course, happens to lead the Democratic National Committee. But wait, the Democrats aren't talking about long-term care just yet, Mr. Stoil notes. My, what a surprise!

But our editor has heard of giants in the land, men and women with names like Minnix, Yarwood, Grimes, and Grachek—people with powerful brains and strong voices. There is rumor afoot that they are closing in on the decision makers and powers that be in Washington and, at last, will make them listen. Indeed, their voices and their wisdom are blowing in the wind, so he hears.

Could it be? It just might be: Healthcare's poor stepchild, long-term care, will find a home at last.

The old editor weeps softly. He thought he would never see the day….


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