Update: Commission on Long-Term Care

Back in January I wrote a blog post entitled, Such is Hope, sarcastically ascribing what I felt then was the eventual reality for the Commission on Long-Term Care. Wish I could say I was wrong, but that was fairly put to rest this afternoon in a webinar sponsored by the Friday Morning Collaborative and underwritten by the SCAN Foundation.

Entitled, Long-Term Care Commission: Learn More About It and How You Can Engage, it felt very much like a perfunctory effort to engage public discourse while candidly acknowledging there isn’t much time left available for such input to really matter.    I would say it was like trying to make a silk purse out of sow’s ear, but that would be unfair to the pig. Just as it would be grossly unfair to pin blame for such an outcome on the Commission.

I can only imagine that webinar presenter and Commission Staff Director, Larry Adkins, must have felt like the general manager of a small market baseball team trying to explain to local sportswriters why his team with a $40 million budget can’t be as competitive as the Yankees with a $400 million budget. Because from a policy – and politics – vantage the Commission was set up for failure from the very start.

Created pursuant to the Taxpayer Relief Act of 2012 it was given six months post appointment of its 15 members (which meant the clock started ticking in mid-March) to assess, analyze and report on one of the most vexing social challenges this nation has ever faced. And then Congress did not fund its work efforts until mid-June, leaving three months instead of six. Now, if that doesn’t make it clear where long-term services and support ranks as a public policy concern in Washington, then I don’t know what would.

It was widely held (or at least this was my assertion) that the Commission’s establishment was little more than placation to those stakeholders and constituencies smarting from having given much to see the CLASS Act included in the Affordable Care Act, only to watch it repealed in the Taxpayer Relief Act when shown to be actuarially unviable. And that is truly a shame because failure to address the financial realities of long-term services, support and care is the poison pill that has the potential to dramatically impact the US economy (see graph below depicting potential impact on GDP).

This is a social issue with very stark realities that has been unwittingly discounted as a national policy concern for far, far too long. Though emerging technologies can help improve the lives of those individuals with disabilities and/or chronic disease, the primary cost component of long-term services and support will remain human resources – compensated and uncompensated (both carry economic costs). There is no sliver bullet solution waiting in the wings to change that reality.

After several decades now of floundering around in the dark just how many ways are there to describe an elephant!? We need to take the damn blindfolds off and look at what’s in front of us. Or maybe we leave the blindfolds on and wait for the elephant to make its move. It doesn’t take a great deal of imagination to know how that plays out for those in its way – but apparently more than we currently have at our collective disposal.


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