The only people who can get Medicare to pay for homecare are those defined as homebound. People who have cancer, who maintain a life and go out, even if only to the doctor s office, are not considered homebound even if they are terminal. This works against the well-being of the patient. So does Medicare s policy on prescription drugs. There s a tremendous need to expand coverage for people who are not hospitalized, she says.
Most treatments now involve shorter hospital stays because of advances in prescription drugs.
Services in New York, sees the fragmented manner in which services are delivered as another area ripe for reform. We have programs and policies that vary from state to state and leave big gaps in availability and access. But many supplemental policies only provide homecare if a person is unable to perform the functions of daily living, things like getting dressed, toileting, moving from one place to another, preparing meals and bathing. Holman s outrage about America s idiosyncratic provision of care is palpable. We need to acknowledge that what we have now is a dysfunctional array of services that are not coordinated or easy to obtain.