CHICAGO — Three keys to solving workforce shortages in senior living and skilled nursing are changes to the country’s social safety net, reforms to immigration policies, and the use of technology, according to Paul Ryan. Those potential solutions come with challenges, however, he said.
Ryan, a Republican, was speaker of the US House of Representatives from 2015 to 2019, a tenure overlapping with the presidencies of Barack Obama (D) and Donald Trump (R). Today, he is a partner at private equity investment firm Solamere Capital, serves on numerous boards, teaches at the University of Notre Dame and is a visiting fellow at the American Enterprise Institute, a center-right public policy think tank.
Tuesday, delivering a keynote address to a standing-room-only crowd at the National Investment Center for Seniors Housing & Care Fall Conference, he also spoke as the son of a soon-to-be senior living resident, sharing the news that his 89-year-old mother is moving into an independent living cottage on a long-term care campus in his native Janesville, WI.
“I haven’t seen her this happy in years. It’s a fantastic facility. …We’re actually really excited,” he said, noting that his mother was moving to be with “all of her friends.”
She and her friends won’t have to worry about cuts to their Social Security, Medicare or Medicaid benefits under current government proposals, Ryan said.
“Nobody is suggesting we do anything to hurt current seniors. Nobody. …It’s all prospective reforms to reform these programs so they don’t go bankrupt, so they’re economically viable and they don’t bankrupt the country,” he said. “You’ve got to tackle this issue fast.”
The leading Democrat and Republican candidates for the nomination for president, Joe Biden and Donald Trump, respectively, have promised not to make cuts to “entitlement” programs, Ryan said. But “reform to our social safety nets to make sure that able-bodied people are actually going into the workforce” is a must, he added. Doing so, Ryan contended, would promote upward mobility and strengthen family finances and the economy.
“We have incentives and disincentives to that, and that needs to be cleaned up,” he said, noting that he works on this issue at his American Idea Foundation and at the AEI.
Immigration reform difficult politically
After social safety net reform, immigration reform is “the hardest issue to deal with politically,” Ryan said, noting that he worked on the issue for his entire congressional career.
“But I am convinced, like entitlement reform, immigration reform is going to get done, for one reason: It has to get done,” he said, noting that there simply aren’t enough US citizens to fill open positions. The long-term care industry, he added, “desperately” needs immigration reform.
Some people have concerns about fentanyl coming to the United States from China via Mexico and a “porous” southern US border, Ryan asserted. He added that it is possible, however, to create a “technologically savvy” immigration reform package that includes border and national security and also includes guest worker programs and “visas that are offered to fill big gaps in labor supply” while “not taking jobs away from a person that’s here, so you’re not depressing a person’s wage.”
“In this day and age, we know how to do visas … and we have people that want to come. You can fill our labor demand with great immigration,” he said. “And speaking from a pure economics point of view … that’s the only way we can get our economy going back to a 3% trend growth.”
Labor challenges, Ryan told attendees, are “very unique in this industry, because this is an industry feeling the demographic crunch, doubling the people who need the services and cutting the people who supply the services. It’s no more acute than it is in this industry.”
Ultimately, however, “[t]he labor shortage that you’re experiencing in healthcare can be solved. We just don’t have the politics right, right now,” he said. “We have unserious politics. But the point I’m trying to say is, it’s a good-news story. It’s not an unsolvable problem.”
Ryan also spoke of immigration and social safety net reform at the 2019 NIC Spring Conference in what was his first speech following his tenure as speaker of the House.
Tech can improve productivity
Tuesday, he said that a third solution to workforce challenges is technology, because its use can lead to greater productivity.
There is an “explosion of technology coming in this society, with machine learning and quantum computing and AI [artificial intelligence] that can make you more productive in a SNF and in an assisted living facility,” Ryan said.
AI needs to be regulated carefully, in a way that allows for innovation while protecting people from potential risks and protecting national security, he said. And the United States must take the lead in the effort on behalf of the free world, which values freedom and liberty and privacy, Ryan added.
“If we overregulate this, we will push this stuff overseas. We will lose the mantle, and countries that do not have our values or our best interests in mind will dominate this space,” he said.
But “this is going to be enormously beneficial for our economy if we don’t screw it up,” Ryan added.
The state of politics
The former speaker spent the hour answering questions from Direct Supply CEO Bob Hillis and the audience about labor, the economy, federal policies and related issues, but he also took the time to share his predictions and thoughts on the current state of politics nationally:
- If the 2024 presidential race comes down to Biden versus Trump, Biden will win, Ryan said, but if either campaign puts forth a “fresh face” and the other side does not, then the side with the fresh face will win.
- If the contenders for the Republican nomination for president other than Trump can reduce their numbers before Super Tuesday, a resulting Republican candidate could win the nomination, he said.
- Assuming that a new speaker of the House is elected, the current continuing resolution keeping the government running may be extended for a month, Ryan said. A shutdown could happen in December, however, and the extension could cost the new speaker his or her job, he added. And delays could hurt the military.
- Funding for Ukraine and Israel is the right thing to do, and most Republicans feel that way, Ryan said. Party members in the minority, however, are “loud,” he added.
- Ryan said he is not considering a run for political office, as he is enjoying spending time with his family, teaching at Notre Dame and his other work.
This year’s NIC Fall Conference drew 2,800 attendees, according to the organization. The meeting ends today.
Read additional coverage of Ryan’s talk in sister publication McKnight’s Long-Term Care News.
