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Hearing Of The Senate Special Committee On Aging


Location: Washington, DC

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SEN. KOHL: Well, good morning, everybody. It's so good to see so many of you here today, and I know many of you have come quite a long distance to be at this hearing, so we express our deepest appreciation to each and every one of you who have made this trip to be with us.

We're pleased to welcome everybody here to this first hearing on the issue of national health reform. Our message today is a simple one. Any serious health reform proposal must address long-term care. With America aging at a rapid rate and with the high and rising costs of caring for a loved one, it's crucial that long-term care services are addressed. Today we'll initiate a conversation about how we can work together to improve long-term care services while also taking steps to make them more cost effective.

We all know family members, friends and neighbors who have struggled to recover from a bout of severe illness or a serious accident and need care for a prolonged period, or even for the rest of their lives. These individuals need long-term care services and supports to help them with day-to-day activities. But let's be clear. The ultimate goal of long-term care is to allow older or disabled Americans to live as independently as possible.

However, as we know, one size does not fit all. Given the variety of circumstances requiring long-term care, any update to our current system must be flexible, must offer choices tailored to everybody's needs.

With the help of our outstanding witnesses today, we're going to try to spark some creative ideas about how this can be offered in a way that will get costs under control. Today we'll be focusing most of our attention on the provision of long-care through Medicare, a federal program, and Medicaid, which is administered jointly by the federal and the state governments.

Some states have expressed concern that their aging and disabled Medicaid populations are swamping their budgets, and that this financial strain will only worsen. However, a handful of states, including my own state of Wisconsin, are addressing long-term care in a proactive, thoughtful manner, and have made important strides in not only expanding the range of services, but also when controlling costs. Though it's not easy, it is achievable and requires strong leadership and political commitment.

We will hear today from HHS about a range of innovative grant programs that the federal government has created to provide several states with financial resources and incentives to broaden the range of Medicaid services offered to roughly a million people in their homes and communities.

However, we need to make sure that our economic troubles do not lead to diminished services. The recently enacted Stimulus Bill provides states with an additional $87 million -- $87 billion in Medicaid funding. And I believe the funding should be used by states to strengthen these popular and vital programs.

We also need to find ways to coordinate and improve care for the more than $7 million beneficiaries who are eligible for both Medicare and Medicaid, which includes some of the sickest and the poorest of our citizens. The care that these dual eligibles receive is very often not coordinated well and very costly.

Today, we'll examine ways to deliver more comprehensive and fully integrated care at a lower cost. We should acknowledge that the rising costs of healthcare and long-term care do not only affect the government. More than one fifth of all long-term care spending comes directly out of the pockets of individuals and their family members.

We also know that tens of millions of family caregivers provide long-term care to loved ones every day, yet have little or no access to support for themselves. As part of our long-term care strategy, we need to provide support for family caregivers through entities such as the Aging and Disability Resource Centers, which were pioneered in Wisconsin.

On that note, I recently introduced bicameral legislation to expand education and training opportunities in geriatrics and long- term care for licensed healthcare professionals, direct care workers and family caregivers. Our country is facing a severe shortage of healthcare workers who are well trained and prepared to care for older Americans, and this too must be addressed by the President and by congressional leaders as they move forward with national healthcare reform.

My colleagues on the Finance and Health Committees do not have an easy task ahead, but my hope is that the lessons we learn and the ideas we generate in this committee will be a resource for them.

We thank our witnesses for being here, and before I turn the microphone over to the ranking member, Senator Martinez, I have a statement from Senator Edward Kennedy. He writes, "A major goal of health reform must be to give our citizens a chance to lead full and independent lives. That means that reasonable healthcare should include services to help individuals maintain their function and prevent deterioration of their condition, just as it should cover services for acute illness and injury."

"So I join Senator Kohl in expressing the importance of including long-term services and supports in any healthcare reform initiative. And I applaud him for holding this hearing today." We thank Senator Kennedy for that inspirational message.

We turn now to Senator Martinez from Florida, who's the ranking member.

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