In the following opinion piece in Newsday, former New York City mayor Ed Koch and former chief of staff of the House Committee on Aging Robert Weiner argue for restoring home health care funding.

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Congress must restore funds for home health care
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BY EDWARD I. KOCH AND ROBERT S. WEINER

July 6, 2007

As the health care debate takes off in the presidential campaign and in
Congress, let's not ignore the silent sadness of growing numbers of
elderly being forced unnecessarily into nursing homes.

In the last seven years, while the Medicare budget for nursing home
stays has dramatically increased from $13.6 billion to $15.7 billion,
home health care has been cut by 25 percent, from $14 billion to $10.5
billion. It is cut further in the Bush administration's proposed fiscal
year 2008 budget, which calls for an "inflation freeze" that would slash
$410 million in fiscal 2008 and $9.68 billion over five years.

New York would be one of the five states hit hardest, losing $567
million in aid for home health care during that period.

None of this makes common sense. Home care allows the elderly who have
become frail to maintain their dignity and independence, sleep in their
own beds, use their own kitchens and stay in the house they have long
enjoyed (or in the house of a child or relative) - unless their
condition deteriorates to the point where moving into an institution is
absolutely necessary.

Many of us have or have had older grandparents, parents, other relatives
or friends living in nursing homes. In nearly every case, the elderly
person did not want to go; many cried over it.

Besides offering a higher quality of life, home care is far cheaper than
the alternatives - averaging one-fifth the price of nursing homes and a
tiny fraction (3 percent) of the cost of hospitalization. It costs
roughly $109 per visit, compared to $499 per day in a skilled nursing
facility and $3,838 for hospitalization, according to Medicare
statistics.

In the 1970s, together with House Committee on Aging chairman Claude
Pepper, we worked to pass federal legislation that eliminated the visit
limit for home care under Medicare and required home health inclusion in
Medicaid. Unfortunately, in the last decade the national policy was
reversed. Starting in 1997, under the Balanced Budget Act, Medicare home
health spending was cut by half. This forced the closing of nearly 25
percent of all home health agencies in the United States.

The last seven years have added insult to injury. The National
Association for Home Care and Hospice president, Val Halamandaris,
former senior counsel to the House Committee on Aging and a man who has
devoted his life to this issue, is right that cuts in home care "cut
away at the American public's hope for an effective national health care
solution."

Congress has decided to transfer limited funds to other priorities such
as nursing homes, physicians' fees and children's health. The reason?
Home health care, which is offered by small agencies that send nurses,
physical therapists, speech pathologists, homemakers and social workers
into people's homes, doesn't have nearly the lobbying power of big
institutions like the nursing home industry and the hospitals.

According to the Center for Responsive Politics, "hospitals / nursing
homes" gave more than $30 million to candidates in the 2004- 2006
federal election cycles, based on Federal Election Commission data, and
they are among the top third of 80 "industries" ranked. Home health does
not even rate a mention on the chart.

Many in today's workforce will live well beyond the expected limits of
past generations. More than 20 million seniors 85 and older will
populate the United States by the year 2050, compared to 3 million at
the beginning of the new millennium. In 1900, fewer than 5 million
Americans reached the age of 65. Now, that figure is 40 million.

There are some 1.6 million people in nursing homes today. Sometimes,
senior citizens are able to live normal lives and care for themselves,
but as people age, many have problems compounded by poor health and need
caretakers. They should not be forced into nursing homes for lack of
alternatives. The new Democratic Congress needs to restore the priority
of home health care for senior citizens.

Edward I. Koch, left, is a former mayor of New York City and member of
Congress. Robert S. Weiner is a former chief of staff of the House
Committee on Aging and was legislative assistant to Koch.

Copyright (c) 2007, Newsday, Inc.

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This article originally appeared at:
http://www.newsday.com/news/printedition/opinion/ny-opkoc065282430jul06,0,6736556.story?coll=ny-opinion-print

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