Health care reform discussions will generate passion and headlines during this election season and into the new Congress next year. This presents another
by Tyler Wilson

Health care reform discussions will generate passion and
headlines during this election season and into the new Congress
next year. This presents another opportunity for our industry to
emphasize the value and cost-effectiveness of home care in the
health care system. There will be many moments to mention the
vital, cost-effective role of home care during candidates' debates
and town hall meetings and on the opinion pages of local newspapers
and Internet blogs.

The Medicare trustees claim in their most recent report that
Medicare's main source of funding, the Health Insurance Trust Fund,
will be exhausted by 2019. The trustees recommend solutions to the
coming funding crisis must include greater efficiencies and
cost-containment measures.

Home care should be at the top of the list of steps to move
Medicare toward greater efficiencies and cost containment.

American voters agree that home care is one of the solutions to
the rising cost of health care. In a Harris Interactive telephone
survey of 1,000 American adults conducted in December of 2007,
three-quarters of voters said home care is part of the solution to
the problem of rapidly increasing Medicare spending.

Furthermore, an overwhelming majority (78 percent) of American
voters say they would vote for congressional candidates who would
strengthen Medicare coverage for power wheelchairs, oxygen devices,
hospital beds and other durable medical equipment and services used
in the home.

Home care fits easily into both Democratic and Republican plans
for reform. The Democrats' health care platform states the party is
“united around a commitment to provide every American access
to affordable, comprehensive health care.” They advocate
affordable health insurance through new group options and by
expanding government programs like Medicaid. Strengthening
cost-effective home care coverage is consistent with that

During the Republican ABC-Facebook debate earlier this year,
presidential candidate John McCain advocated for expanded home
care, saying, “We need incentives for home health care as
opposed to long-term care. In my state of Arizona, we adopted a
proposal which incentivizes health care providers to keep people in
home health care settings. It's dramatically less expensive than
long-term care.”

We should urge all candidates from both parties to include
preservation of home care in their position papers. The potential
architects of health care reform need to be reminded of the
benefits of strengthening home care policy. We can make it easier
for candidates to stand behind the merits of home care by providing
them with sound research showing the cost-effective nature of home

While DME is the smallest and slowest-growing portion of
Medicare, it is sometimes a convenient target for policymakers in
Washington. Some believe Medicare prices for home medical equipment
and services should be based on what a consumer would pay for the
equipment alone if it were purchased on the Internet or at a
discount store. But Medicare beneficiaries who require home medical
devices, like oxygen concentrators, cannot simply order the
equipment over the Internet, adjust it to the prescribed level and
instruct themselves on proper use.

The American Association for Homecare continues its efforts to
inform policymakers and consumer journalists about the value of
home care. The expanding Stand Up for Homecare public awareness
campaign is one part of that effort. The importance of home care is
one that every family can understand and relate to. Four out of
five Americans (82 percent) agree with the statement, “If I
required medical services, I would prefer to receive it in my home
if possible, rather than in a hospital or nursing home.”

By reminding policymakers about these key messages, we can help
strengthen access to care for the millions of Americans who depend
on home medical equipment and services. Home medical care and
equipment will continue to be safe and cost-effective as long as
policymakers remember that this type of care requires services and
personal attention for seniors that you can't get over the

Tyler J. Wilson is president and CEO of the American Association
for Homecare, headquartered in Arlington, Va. He may be reached at For more information on
critical home care issues, visit the association's Web site at