Nursing homes can’t have it both ways 

A recent Washington Examiner editorial was correct in pointing out the irony of nursing homeowners seeking an exemption from the new federal health care requirements.

The new rules require employers (of 50 or more employees) to pay for minimum health benefits for their employees. But as someone who is deeply involved with the way these homes operate, I believe the irony is actually deeper than reported.

The Washington Examiner focused on the problems faced by small mom-and-pop operators (who are likely already exempt). But the vast majority of nursing homes in America are run by large and even multinational corporations, as well as private investment firms. These mega-corporate owners are extremely profitable.

The nursing homes are not operating in a normal free market. American nursing homes exist in a socialized system where competition is limited by the government, where payments are guaranteed — regardless of quality — and where a steady stream of “clients” is also guaranteed.

Most people are shocked to realize that if the service is poor, there is no legal mechanism where a resident or the payee (most often a governmental entity) can get their money back. And a centralized governmental body controls access and limits consumer choice.

In a normal free-market business or capitalistic environment, such restrictions would normally also limit profits (low risk equals low reward). Instead, we see an industry with low risk and high reward — all at taxpayer expense.

Now this same sector of the government-run health care system says they don’t want to participate in a key part of the new government-run health care system. Unbelievably, they blame the very payments they receive from that same government as the cause of their woes.

And with the money the nursing homes supposedly do not have in their coffers to pay for the basic health care of their employees, they somehow find a way to procure the services of high-powered lobbyists to beseech Congress for more money in reimbursements.

The nursing home industry has also contributed $12.4 million to members of Congress in the relatively recent past. This does not include lobbying fees, nor does it include donations to state-level politicians.

You couldn’t make this stuff up!

Nursing homes can’t have it both ways. They can’t live off the government’s dole, enjoy the government’s protections from the free market and enjoy fantastic profits by playing the government’s game but not play by the government’s rules.

Brian Lee is executive director of Families for Better Care, a Tallahassee, Fla.-based citizen advocacy organization dedicated to quality nursing home care.

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Brian Lee

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