Caring for the Aging: Designing a long-term healthcare system that works

By Arooj Ashraf, La Prensa Cleveland Correspondent

The City Club of Cleveland hosted Josefina G. Carbonell, U.S. Assistant Secretary for Aging, on May 9, 2008. The forum was sponsored by the Medical Mutual of Ohio Endowed Forum on Health Care, and focused on the shortcomings of the current system and the urgency of creating a system that will accommodate a graying nation.

Josefina G. Carbonell
La Prensa photo by Arooj Ashraf.

“I believe long-term healthcare is the biggest challenge of our time, and the government can not handle it alone,” she said.

Carbonell spent 30 years in Florida serving the largest Latino community-based, long-term-care organization in the nation, which specialized in providing health, nutrition, transportation, adult-day and personal care services through community partnerships [Little Havana Activities & Nutrition Centers. Visit: http://www.aarp.org/ltcbrussels/speakers/jcarbonell.html ].

Carbonell described the long-term healthcare system in the U.S. as a “hotchpotch” of community programs and services with relatives and family bearing 80 percent of the burden for long term care.

“If you need to pay for long term healthcare you are on your own, unless of course, you impoverish yourself through nursing home care, then when you are poor and in the nursing home the U.S. taxpayers will foot the bills,” Carbonell said.

Nursing home care comes with a steep price tag of $60,000 for a one year stay. Carbonell stressed the current system is biased in favor of expensive nursing homes, and while they may be the best option for many they shouldn’t be the only option.

Despite the high costs, Carbonell said U.S.-Americans are uninformed about what their health insurance covers and often find out they are responsible for paying long term bills in the time of crisis. “There is a sense of urgency here,” she said, especially now because medical advancements have increased the population of aging U.S.-Americans.

The government spends $200 billion dollars on long term care and 60-85 percent of that is spent on nursing homes.

Ms. Lee Friedman, president of the City Club of Cleveland, with Josefina G. Carbonell.

She encouraged personal responsibility in early financial planning for healthcare costs after retirement and discussing the role of healthcare providers. “This is a self interest issue,” Carbonell said, but the goal of the government is to build a healthcare system that will service the needs of future generations. The government has invested nearly $300 billion dollars into the healthcare budget and Carbonell said practical lifestyle changes need to be adopted to increase the effectiveness and improve the quality of healthcare. “Some solutions are right in front of us,” she said.

Carbonell outlined six initiatives she personally believes will improve the healthcare system: One, greater personal responsibility in planning financially, buying proper insurance, and designating care providers. Two, making healthcare services easier to understand and educating consumers so they may make informed decisions. Three, providing low-income consumers’ greater controls in forms of healthcare services they wish to receive, providing more targeted care. Four, building healthcare goods and technology that improve screenings and assist in early detection. Five, educating and providing assistance to first-care responders. Six, making prevention the central focus of long-term care.

“Falls alone take $20-$30 million out of the healthcare economy and are the leading cause of injuries,” she said.

Carbonell said the infrastructure for a quality healthcare system exists, and campaigns, like One Stop Shop and Own Your Own Future, help seniors plan for their long-term healthcare. She stressed the government can not improve the system on its own and tax payers and consumers need to raise their voices and speak out for the healthcare system they want to see in this country.

“The time to act is now, we have a serious challenge ahead of us and there is no time to waste,” Carbonell said.

For a full podcast of   Josefina G. Carbonell’s speech visit: www.cityclub.org