Another MaineCare Funding Crisis

Some Maine nursing homes are threatening to close due to inadequate funding from Augusta.  Most of these facilities are in poor rural areas and receive the majority of their funding from MaineCare, the maine Medicaid program.  Legislators fear a backlash from relatives of nursing home patients and house, senate and Gov. LePage will undoubtedly find funds to add to MaineCare budget.

78% of nursing home care in Maine is funded by MaineCare and Medicare and Maine Nursing Homes are 92% full.

Read on for libertarian perspective on this problem:

  1. It is nearly impossible to open a new healthcare facility in Maine.  The burden of the Certificate of Need process in Augusta is unbearable to many proprietors who may have interest in opening a new healthcare facility.  This protects existing facilities by keeping occupancy above 90% and making it unnecessary to innovate and compete for new patients.  In a further dysfunctional twist the burden of high occupancy falls on hospitals that have patients who are waiting for weeks and sometimes months to be discharged to a nursing home.
  2. Running a nursing home to the exacting and "one size fits all" CMS standards and enduring grueling inspections is even harder than opening a new facility.  In the past care was poor in a few nursing homes.  Now CMS would like it to be mediocre in ever nursing home.  Apparently the same folk who spend so much energy on the internet reviewing hotels restaurants and doctors cannot be responsible or even involved in making sure their loved one is in a good nursing home.
  3. Medicare usually does not cover long term care.  This is an example of an unfair, arbitrary and inflexible program.  A taxpayer who paid Medicare tax for decades can expect no problems with Medicare  coverage for expensive surgery, cancer treatment or organ transplants.  If the same taxpayer needs to be in a nursing home for $210 per day Medicare will be of no help even for someone who paid in a lot when young and used little when old.
  4. The tiny private long term care insurance market struggles due to low enrollment.  This expensive insurance is purchased with after tax money.  Meanwhile attorneys are helping some educated seniors to carefully transfer assets to their heirs so as to be able to appear poor enough for Medicaid when the time comes to be in the nursing home