Friday, August 7, 2015

Clinton Meets With Home Care Workers - California Healthline

As we struggle towards nominating conventions Hillary Clinton addresses home health care.

Democratic presidential hopeful and former Secretary of State Hillary Clinton speaks during a Service Employees International Union event with home care providers in Los Angeles on Thursday. Getty Images

This subject will become more important as  health care transitions to lower cost and patient-centered care....in the home with remote monitoring, wearables, telehealth and home care organizations.

Home care has a spectrum of tiers

1. Professional certified care givers, RNs LVNs Hospice, Domestic aides, and family or friends.
2. Private agencies
3. Public agencies, which may contract with any of the above for patients with Medicaid.

Caregivers in general are paid very poorly. If we rate the importance of health care at home according to reimbursement, then it is abysmally unimportant both economically and in terms of quality of care.

A succession of home health caregivers and some recipients of that care told their stories to Clinton and they spoke generally about the changes needed in home care.  
Sumer Spika, a caregiver from Minnesota, said when she first started, she entered a profession with low pay, no benefits, no retirement, no overtime and no paid time off.
Home care workers are advocating for a $15 minimum wage, which would approach a living wage, they say. Lizabeth Bonilla said she has been a caregiver for 42 years, the last 23 of them in Nevada, where she made $10 an hour when she first came to Nevada 23 years ago -- and, she said, she still makes the same $10 an hour. This amounts to a huge decrease in real income, when the consumer price index has risen more than 250 % in those intervening years. What that means is that to buy $ 100.00 of merchandise in 1980 would cost $289.00 today in 2015.
Clinton commented, ""The work you're doing actually saves Medicaid money," she said. "People do better when they get care at home. That's good medicine." "If you think about the fact that we're going to have more and more elderly in this country, we are going to face a care crisis," Clinton said. "If we don't think through that, I don't know how we're going to be able care for people. Our highest obligation we have is to take care of each other. At the end of the day, I don't think anything matters more."
This economic chasm will be even more difficult to close with the emphasis on cost containment by the Affordable Care Act.

Clinton Meets With Home Care Workers - California Healthline
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