Editorial: Medicaid waivers real roller coaster | TribLIVE.com

Editorial: Medicaid waivers real roller coaster


It is easy to have a plan. It’s a little harder to assemble it.

It is a lot harder to make it function the way it should.

Kennywood can speak to that. The idea of the Steel Curtain roller coaster has been a hit from the beginning. It’s been months in the making. And it’s been a lot of starts and stops along the way with long lines, unexpected glitches and delays.

But the implementation of Pennsylvania’s Medicaid waiver program is a lot less fun and a lot more important. And the wait? That’s so much longer.

The program is supposed to be a money-saving, reassuring alternative to expensive nursing home care for the elderly. In a Sunday article by Deb Erdley, the Tribune-Review found that, instead, many end up in a winding queue waiting for promised help.

The blankets of red tape are complicated by a drastic shortage of people to provide the care that eligible seniors need.

“Staffing of direct care has been a problem for a long time. It’s a problem in nursing homes and in home care. It’s hard work,” John Lovelace, UPMC’s president of government programs, said.

But part of the problem is just the way the pieces are assembled.

Providers like UPMC’s Community Health Choices receive a flat fee for care. The more expensive and time-consuming the care, the less profit is made.

Direct care workers make about $10 an hour — more than minimum wage but less than you can make pouring lattes at Starbucks or stocking shelves at Target.

Yes, the providers could make more, but if costs go up, would they be able to afford to provide any care?

It just shows that the whole operation is like the old joke about a moose being a horse made by a committee. But it’s not funny, because this wasn’t supposed to be a horse.

It was supposed to be a train that would get you safely through your last days, like Vilma Morgante, 100, of Lower Burrell, who had dementia and contracted infections that led to approval for 24-hour home care but a one-year wait to find it. Her journey ended July 4 when she died still waiting.

Instead of a train, we get a roller coaster, all steep drops and whiplash curves that can be scary and intimidating. And that’s just the line to get on.

Everyone involved in laying out these plans and snapping them in place should do so with this thought:

If the only thing your mother had in the world was the home she wanted to die in, rather than spending her last days in a nursing home, is this the system you would design for her?

Didn’t think so.

Categories: Opinion | Editorials
TribLIVE commenting policy

You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.

We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.

While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.

We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers

We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.

We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.

We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.

We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.