Why invest US$400 billion in elderly care?

This is a long-term investment and task. If the investment plan is implemented well, it will definitely improve the quality of nursing services and ultimately benefit the elderly. At the same time, increasing the salaries of nursing workers will help attract new people to join, increase the number of nursing workers, and alleviate the serious shortage of nursing workers. This has a positive impact on the healthy development of elderly care services and the elderly care industry.

One of U.S. President Biden’s big GoBig projects is the US$2 trillion in infrastructure investment. It includes two parts: one part is investment in domestic manufacturing, research and development, a caring economy, climate infrastructure, and roads, bridges, and railways; the first is investment in domestic manufacturing, research and development, a caring economy, climate infrastructure, and roads, bridges, and railways. The second part is childcare, health care and education infrastructure. Among them, the most criticized by the Republican Party was the second part of the investment, which was criticized as having nothing to do with infrastructure. Then the Democrats ingeniously coined a new word to refute it-“Human Infrastructure”, this “new concept” “Under the explanation and promotion of the media and politicians, it quickly became popular. Because this investment is for children, the elderly and education, it is related to the interests of every family, and of course it is welcomed by the public.

What I am most concerned about is what is included in the US$400 billion “health” investment bill, what problems it can solve, and what impact it will have on American aged care services.

The large US$400 billion investment, which set a record in American history, is mainly used for home care workers and elderly and disabled care. It will be invested in “family and community-centered long-term care for the elderly and disabled in the next 8 years.” , The purpose is to promote and improve “home health care services.”

Why is it so anxious to rank aged care before childcare? Why is it specifically stated that it is limited to family- and community-centered care for the elderly and the disabled, and does not include nursing services in nursing homes or welfare homes?

In fiscal year 2019, Medicare (the U.S. government’s health insurance for poor seniors over 65) spent $644 billion in total, accounting for 14% of the federal government’s total expenditure, an increase of 6.7% over 2018, while CMS (U.S. The Public Medicaid and Medical Insurance Service Center) expects that this expenditure will continue to increase at an annual rate of 7.6% during the ten years from 2019 to 2028, which is the fastest growth rate. At the same time, data released by CMS shows that the medical expenses of the elderly over 65 are more than five times that of children and three times that of the labor force. It can be seen that the cost of nursing care for the elderly is too high and the growth rate is too fast, which puts more and more pressure on the government. The Democratic Party believes that in terms of funding or the quantity and quality of nursing services, the United States is simply not prepared for the next surge in the elderly population.

During the COVID-19 pandemic from 2020 to the present, more than 170,000 elderly people living in nursing homes and nursing facilities have died of infection, which has exacerbated Americans’ distrust of nursing homes. The main conclusion of the social discussion is that we can’t just rely on elderly care institutions. The second option is to allow the elderly to live at home while getting the nursing services they need. Therefore, the US government decided to invest 400 billion US dollars to improve and enrich the quality and content of home long-term care services, hoping to effectively help the elderly care for the elderly at home, or at least delay their stay in nursing homes.

The purpose of this reform is to separate long-term care services from elderly care institutions, reduce the dependence of the elderly and the government on elderly care institutions, thereby weakening the pricing power of elderly care institutions, which is conducive to forcing them to reduce prices and improve service quality.

What’s in the $400 billion investment bill? To put it more accurately, it is home long-term care services. This is a special fund that will be used to increase the content of home care services, increase compensation items, strengthen the training of nursing workers, increase the salaries of nursing workers, and improve the quality of nursing services. The content is still being refined. At the end of March, Biden announced that it would expand Medicaid (a public medical assistance system for people under 65) to include family medical care.

The contents of home care services mainly include: nurses or physical therapists visiting the house, helping individuals with necessary living assistance services, such as eating and bathing, etc.; getting help from the case manager; participating in the adult sunshine center to help with housework, including cooking, Laundry and cleaning, etc.; assistance in travel; assistance in home repair or transformation; assistance in the purchase of medical equipment, such as wheelchairs or oxygen tanks, etc. The service content will continue to increase.

What is the demand for home care services for the elderly in the United States? Statistics show that 70% of the elderly in the United States will need certain personal services for 2 to 4 years in their lives, such as cooking, dressing, bathing and toileting, moving, personal financial management, and housework. With the increasing aging of the US population, it is estimated that there will be 74 million elderly people by 2030, and an additional 40 million by 2050, and the total number of elderly people over 85 years old will be three times the current number. In addition to the disabled population, the current number of nursing workers and the quality of nursing services cannot cope with this huge demand. According to data released by DHHS (U.S. Department of Health and Human Services), in 2018, a total of 820,000 elderly people in 41 states were on the “waiting list” waiting for applications for home care services to be approved. The average waiting time was 39 months. Obviously, the huge demand for home care services and the insufficient supply of services are imminent.

There is no Japanese-style nursing care insurance in the United States. Only very limited long-term care services are included in Medicare, and the rest are at their own expense. According to statistics in 2018, 3.4 million elderly people received home care services through Medicare and received service fees, which accounted for 57% of the country’s total long-term care service fees. However, the current home care services that can be claimed are limited to home visits by nurses and physiotherapists, and they do not pay for 24-hour services; and the compensation for elderly people living in nursing homes only includes up to 100 days of physiotherapy services, which is completely unsatisfactory for the elderly. And the needs of care services for people with disabilities.