According to Koch, while spending for Medicare home health care spending has decreased since 2000, spending on nursing home care has increased by several billion dollars even though home care "is far cheaper" and offers a
"higher quality of life" than nursing home care.
The reason (according to Koch)? Because the home
care industry (typically composed of small health employment agencies) does not "have nearly the lobbying power of big institutions like the nursing
home industry and the hospitals."
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
I must agree with Mr. Koch. Home care is far cheaper
than alternatives like nursing homes. Yet, even long term insurance companies pay less per day for home care than they do for nursing homes. It just does not make sense.
But I am optimistic this will all change - soon. The Baby Boomer's are fast becoming caregivers for their parents and they (Boomer's) will likely have as much impact on the institution of aging as they have on so many other institutions.