Claims about nursing homes

From Neil Emery:

┬áNursing homes are chronically understaffed in times of economic prosperity. But, when the job market tightens, a one percent increase in unemployment sees full time employment in nursing facilities rise three times as fast. After a recession, when the economy picks back up and jobs become available again, low skilled workers abandon nursing homes jobs’ low pay and even fewer accolades for better prospects. The shift of workers in and out of nursing jobs drives the swings in the national death rate and underscores the importance of these under-appreciated jobs.

A look at the relationship between economic downturns and health outcomes in the United States reveals a complex picture: harm from lost insurance and increased anxiety but better care for the elderly. These two trends coexist because, while harm concentrates in working age people, retirees reap the majority of the benefit.

I do not know if these claims are true, but see the post for a discussion of the evidence.


Giffen job?

What is more interesting is that the source of the article, a study by Boston College , notes that the reason for the decline is the reduction in government reimbursement levels, thereby leading to staff reductions, etc.

Here is a quote from the study:

"Moreover, government reimbursement rates for some nursing-home services have been cut by Medicare and the industry is under growing financial pressure. Prospects are high for continued curbs on healthcare spending. Accordingly, operators of the nation's roughly 1.6 million certified nursing beds are looking for efficiencies and ways to streamline services, not add to staffing levels.

The traditional thinking about why death rates increase during strong economies was tied to job-related stress and behavior, the Center for Retirement Research study said. "During boom times, when more people are employed, job-related stress may increase obesity and smoking," it said. "High employment and long hours on the job also limit individuals' ability to find time for diet and exercise, causing health to deteriorate."

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The study's four authors, all from the University of California-Davis, looked at the age groups that had the biggest mortality increase tied to rising employment levels. Here, they found that nearly all of the impact was on people over age 65, and predominantly older women. They looked at deaths in 2006, a year in which the unemployment rate dropped by 1.1 percentage points, and determined that employment gains were associated with 6,700 additional deaths that year."

So, MR is coming out and endorsing higher reimbursement levels for nursing homes.

Happy Thanksgiving.

Here is a link:

"Moreover, government reimbursement rates for some nursing-home services have been cut by Medicare and the industry is under growing financial pressure. "

Just wait to the Obamacare reductions to healthcare providers kick in.

Are you sure about that?

You must be living in a state that is not participating in the Medicaid expansion.

Try getting your facts straight.

In other words: when times are tough, people are more willing to take crappy jobs. Dealing with incontinent and often crazy old people isn't anyone's idea of a great job, other than a few heroic angel types. But if times are tough, you gotta do what you gotta do.

Also, because nursing homes and caregiver jobs tend to be more regulated - and require English in the formal part of the market - there is less work for illegals (although there are still many illegals doing caregiving, particularly in the vast caregiver gray market, where old Chinese, in particular, will bring someone from China for a bit of cash + room & board to take care of them).

"I do not know if these claims are true" - but at least they are interesting. Not all economic claims satisfy that mild requirement.

The situation is a travesty. I wish someone could suggest some reforms to improve the lot of the elderly and those who take care of them.

Have lots of children and stay on good terms with them. Legalize marijuana so it can be used as a palliative agent.

Seriously, there is not much benefit to society at large by providing advanced, institutionalized geriatric care. You get more bang for the buck doing lots of other things, like fortifying foods with folic acid, iodide and vitamin D.

As our daughter is severely disabled and lives in a licensed care home, I can offer anecdotal support for the author's statement. Foobarista has it about right, save for a missing recognition that nursing homes currently house people who are our parents, and may one day house people who are ourselves. Bill is also correct that public funding cutbacks have had a negative impact on staffing levels as well as on quality of life for both staff and residents.

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