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Posted: January 14, 2008

Practical Caregiving

Presidential Candidates and Caregiving: Do They Have a POV?

For the past month, I have been trying to get answers from the presidential candidates about their positions on helping the unpaid family caregiver of the elderly. That’s you and me, but I'm sure you didn't need me to point that out.

I have sent several emails and made several phone calls to each candidate’s office, realizing that it’s the staff that responds to inquiries like mine, not the actual candidate. But the staff of each candidate does know what their official position is on various topics; that is one of their main jobs, and doing their job properly has a lot to do with the success of each candidate’s bid for their party’s presidential nomination.

But, guess what? Each time I called, I was assured that someone would get back to me with an answer. That didn’t always happen. I don’t know why -- perhaps the staff is just too busy to answer questions from a columnist like me. Maybe.

What worries me more is that minimal feedback makes it appear that the candidates by and large don’t have a plan on how to help the family caregiver. And our numbers are big and getting bigger more than one out of every four US households caring for an older family member, nearly 50 million Americans and voters total. If I were a candidate or key staffer, I’d pay attention! Wouldn’t you?

I looked through each website and found a fairly thorough outline of Hillary Clinton’s plan (yes, it appears she has one), so I didn’t need to keep calling her office to get an answer. However, I didn’t find anything on the other websites, so I had to depend on people staffers and aides -- to answer my question. I received answers from Joe Biden, John Edwards, John McCain, and Bill Richardson. The rest simply didn’t answer.

So, today, I at least want to update you on what I’ve heard from the major candidates’ camps:

John McCain

"Caregivers bear dual burdens in time and money. John McCain believes health reform should make the system responsive to the needs of American families; providing quality care at lower cost. Lower health care costs will ease the financial burden on seniors and their caregivers. Families not the government, not insurance, companies, not tort lawyers, not even doctors and hospitals should be in charge of their health care dollars and have more control over their care. John McCain’s reforms will preserve advances in medical science central to providing quality care.

"The centerpiece of John McCain’s reform is to control the rising costs of health care which will reduce the growth in seniors’ Medicare premium payments. John McCain will reform payments in Medicare to compensate providers for diagnosis, prevention, and care coordination, but not pay for preventable medical errors or mismanagement.

"John McCain believes that there should be a more robust market for private long-term care insurance that will provide caregivers with the capacity to meet the burden of financing care, and to permit greater options to share the burden with professional caregivers."

John Edwards

"The federal government has an important role in ensuring that every man, woman and child in America has quality, affordable health care, including long-term care in the most flexible and independent setting possible.

"I will reform Medicaid and Medicare to let people to choose home-based care in their communities and test innovations such as asset and income protection programs. I will also support states and communities offering much-needed and often less expensive alternatives -- like adult day care and senior villages -- that allow seniors to live at home with their loved ones.

"Independence is the goal, but we also need to strengthen quality and safety protection in nursing homes. I will establish national standards for nursing home care, increase national enforcement against abusive nursing home chains, expand inspections and increase penalties for homes that fail to provide decent care. I will also help improve quality of care with measures like reducing patient-staff ratios and improving care provider training.

"To help relieve the strain for families caring for loved ones, my health care plan also supports respite care. To help families save for long-term care or other retirement needs, I will require employers to offer all workers access to a retirement savings plan. Workers without another pension will be able to build up savings in a new universal retirement account, no matter how many times they change jobs. The government will match worker contributions up to dollar-for-dollar on the first $500 with a new tax credit.

"Educating and training the next generation of health care workers is essential to meeting the increased demand of a universal health care system like the one I have proposed. When we ask nurses' aides and home health aides to deliver care with dignity, we need to treat those workers with dignity too. I will provide resources to improve wages, training, and working conditions for aides. Critical to getting the best workers is making sure that they are paid a living wage. I will cover agency-employed home health aides under the nation’s minimum wage and overtime protections, effectively reversing the Long Island Care at Home v. Coke Supreme Court decision."

Hillary Clinton

"Supporting Seniors With Long-term Care Needs, and The Invisible Army of Caregivers that Support them:

  • "Enacting a new $3,000 Caregiving Tax Credit to provide financial relief to millions of seniors, people with disabilities and their families. Hillary will also invest more than $300 million per year to support unpaid family caregivers.
  • "Giving more seniors the ability to access long-term care services where and when they need them, including in their homes.
  • "Doubling the elderly standard deduction to provide additional financial relief for 11 million elderly tax filers.

"Helping the Elderly Prepare for Long-term Care Needs by Making Long-Term Care Insurance More Secure and Affordable:

  • "Requiring tough new consumer protections for long-term care insurance, including ending discrimination against veterans and helping states create consumer advocates for long-term care insurance.
  • "Offering consumers the same secure long-term care insurance options that members of Congress enjoy.
  • "Providing a new Long-Term Care Insurance Tax Credit to make secure, high-quality insurance plans affordable.

"Protecting our Seniors By Improving the Quality of Our Nursing Homes:

  • "Tripling federal support for nursing home ombudsmen programs to protect consumers of long-term care.
  • "Directing the Department of Justice and the Federal Trade Commission to assist state consumer advocates and prosecutors to tackle persistent abuses and new challenges in the long-term care industry.
  • "Reversing the inexcusable policy of the Centers for Medicare and Medicaid Services (CMS) of withholding information on poor-performing nursing homes and giving seniors full access to usable data on nursing homes, including data on nursing home ownership structures.
  • "Strengthening our nursing and direct care workforce with a national system of background checks for long-term care workers and $125 million investment in Workforce Improvement Programs."

OK, so there you have it. A few points of view from a few candidates in a presidential race crowded with many, many candidates. I wonder where the other candidates fit with their views? Do they have any? Are we just too "invisible" for some of these candidates to care? Is caregiving just not enough of a hot-button to win the candidates’ attention?

Gee, I don’t know, but I know how important this issue is for me (and I’ll bet upwards of 50 million stressed and under-appreciated others like me), so I know where my attention is in looking at these candidates. I’d love to hear what you think.

Who knows, maybe some of the candidates’ staffers will read this column and understand that their presidential hopeful had better wake up and smell the roses about the need for sincere and well-articulated positions on meeting the needs of caregivers.

Now, I’ll get off my stump. For now!

© 2008 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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Please send me your questions, comments and issues regarding the practical side of caregiving at ASKJEAN@caregivershome.com, and remember to take advantage of our professionals and experts in the Ask an Expert section of our website. You'll find it in the left column on our homepage.

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