The Post argues that our proposals to provide needed home health-care services to chronically ill and disabled Americans, young and old alike, should not be sold as a money saver.
Contrary to The Post's arguments, we have not sold our proposal as a money saver but rather as the first appropriate step toward improving the quality of life for chronically ill and disabled Americans. Further, our legislation pays for these improvements in quality of life by removing the wage cap on the Medicare payroll tax, not by "counting savings." However, we are not ready to agree that a well-run home-care program could not save money.
The Post cites a recent federally financed study which concludes that although expanded home health-care services improve the recipients' quality of life, big savings cannot be expected. Regrettably, this federal study did not evaluate the state programs with the most experience in this area.
Contrary to The Post's conclusion that increased home-care services will not save money, the state of New York's "Nursing Home Without Walls" program, in operation since 1977, provides services in the home to individuals eligible for nursing-home care at 51 percent of the cost of nursing home care. Also, the study The Post relied on ignores another recent U.S. Department of Health and Human Services report on 18 state Medicaid programs that substituted home care for nursing-home care. This study found that care provided at home cost only 38 percent of what would have been charged in a nursing home.
Home-care cost savings have also been experienced by the insurance industry. In 1986, Aetna Insurance Co. said it saved more than $36 million in 1985 alone simply by reimbursing home care for chronically ill children instead of hospitalization.
As The Post noted, our proposal is one that enjoys tremendous support by the American people. One hundred of our House colleagues and some 110 national organizations representing millions of Americans of all ages have endorsed our bill. A recent poll by the Long-Term Care '88 campaign shows that six out of seven Americans feel it is time to consider some government program for long-term care and, by a 5-to-2 margin, are willing to see taxes increased to pay for such a program.
Any compelling argument against the provision of comprehensive home care on the basis of cost savings must be balanced against the cost, in human terms, of premature institutionalization, denial of care or forced impoverishment. In the name of compassion and in the name of decency, we cannot continue to permit 1 million Americans to face destitution and bankruptcy annually, just because they have the misfortune of having a long-term illness.
No one in America will go bankrupt financing our program, but most Americans will continue to face bankruptcy without it. For those of us in Congress not to address this serious need at this important juncture would be a catastrophe.
CLAUDE PEPPER U.S. Representative (D-Fla.)
EDWARD ROYBAL U.S. Representative (D-Calif.) Washington