THE DAILY MINING GAZETTE
Friday, January 12, 2007

EDITORIAL

Health care system is on life support

Gov. Jennifer Granholm recently signed legislation designed to strengthen the state’s long-term care system. The bills implement recommendations made by the Long-Term Care Task Force appointed by the governor in 2004.

Two recommendations in particular are addressed in the bill — cutting red tape and building long-term care partnerships in communities.

Four single point of entry sites have been developed around the state enabling a consumer to obtain information, screening, assessment of need, care planning and support, and referral services at a single location.

Long-term care partnerships provide additional care options to citizens once insurance benefits have been depleted. Currently, Michigan residents who have long-term care needs as a result of illness or injury must liquidate their assets and spend their savings before they qualify for Medicaid assistance. Under a long-term care partnership, residents will be able to retain some assets and still qualify for assistance. Until recently, federal law prohibited Michigan and 45 other states from offering such policies. But a recent change in federal law, called for in the governor’s task force report, eliminated the prohibition.

While all this is helpful, the bills do not address one key problem with long-term care in Michigan and across the nation — wages of the thousands of men and women who work as certified nursing assistants. The average wage of CNAs barely hits $10 an hour and is even less at some facilities. Many of these workers’ families qualify for Medicaid, the very program that helps pay their salaries.

CNAs are some of the hardest working people in health care, providing everything from basic care such as feeding and toileting to companionship. But being a CNA involves a lot more than changing sheets and emptying bed pans. It requires at least 40 hours of training in a variety of subjects including medical procedures such as taking blood pressures and temperatures and handling combative residents (Alzheimer’s disease and dementia can have a horrifying impact on a person’s personality.)

CNAs are the only people with whom nursing home residents interact on a regular basis, making it all the more important that consistency in staff is maintained. But while progress has been made, there is still a high rate of turnover in CNA ranks, due mostly to inadequate compensation.

The problem is that reimbursement from Medicaid and insurance is not enough to provide a living wage for CNAs. Michigan is already struggling to balance spiraling costs of Medicaid benefits with the need to fully fund education and public safety. Providing more funding for wages is not an option.

This is just one more symptom of a health system that is on life support and failing fast. Momentum is growing in Washington to address this issue, but there is still too much talk and not enough action. This must change with the new Congress. Our future depends on it.