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McKnight’s Editorial Director John O’Connor
John O'Connor
John O’Connor

Things got a bit cray cray Tuesday night, during Joe Biden’s State of the Union address.

Opposition lawmakers repeatedly booed and heckled the president. As for what incited the pushback: it was Biden’s suggestion that some GOP lawmakers want to sunset Social Security and Medicare benefits.

Never mind that one of their own, Florida Sen. Rick Scott — a man who is hardly a fringe player within the party — has introduced a policy plan that would do exactly that.

One thing lawmakers know how to do is count. They also know that seniors are the nation’s most reliable voters. As a general rule, you probably don’t want to alienate that crowd by removing two hugely popular benefits. So Republicans in the audience got a bit testy at Biden’s suggestion. That’s understandable.

But here’s the thing: Medicare and Social Security will not go away. Long-term care operators, on the other hand, just might.

It’s no secret that there have been scant few skilled care facilities built in the past half decade. It’s also well-documented that many communities are facing severe financial challenges these days. A few, and perhaps a lot more than a few, just might not survive. From a needed caregiving perspective, that development would create a massive hole.

Yet rather than deal with these realities, both Republicans and Democrats continue to bash the industry. In an unprecedented development, the State of the Union address again singled out nursing home operators as bad citizens.

To keep using nursing homes for target practice is beyond unfair. Frankly, it’s a bit cruel.

Are there bad apples in the field? Are shady funding schemes out there? Yes and yes. But it’s not as if there aren’t already ample laws and regulations on the books to help ferret out troublemakers.

Operators have to play by the myriad rules and hustle for the relative scraps they receive for taking care of more than a million and a half people each year.

What happens should nursing homes get wiped out? Are other settings going to provide the same level of care at the same rates? Memo to those who try: Good luck with that.

Yes, the long-term care system we now have is a mess. But it’s a mess largely of the making of Congress and the White House. Politicians of both persuasions helped create and continue to mismanage what’s now in place.

So instead of screaming at each other and pointing fingers, perhaps lawmakers should do something that actually will help that senior voting block they covet: start making long-term care better.

As for how to do so, perhaps they could start by knocking off the silly rules, putting ironclad accountability requirements in place, cracking down on double-dippers, prosecuting law breakers and paying reasonable rates to facilities. Any economist will tell you that people respond to incentives. Why is this concept so hard for Congress to understand?

Of course, fixing a fractured long-term care system surely would be a heavy lift. Or at least a heavier lift than acting insulted.

John O’Connor is editorial director for McKnight’s Senior Living and its sister media brands, McKnight’s Long-Term Care News, which focuses on skilled nursing, and McKnight’s Home Care. Read more of his columns here.

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