Health Affairs, 23, no. 4 (2004): 191-196 doi: 10.1377/hlthaff.23.4.191 © 2004 by Project HOPE	New Online   How Would Obama, McCain Cover The Uninsured?   Debating Cost Of Uninsured   Try Medicare-For-All   HA Blog Top 10

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Narrative Matters

Shopping For Long-Term Care

PREFACE: In a rational world, all of us would make decisions about the kind of long-term care we want in our later years while we are of sound body and mind. In reality, most people find it difficult to contemplate old age, let alone to predict our future health needs or select from a confusing array of options once the time approaches. The result is a nation of elders who in their last, most vulnerable years are likely to experience resignation and entrapment rather than choice. Deborah Stone, a political scientist and health policy expert, debunks what she calls the "myth" of "consumer-driven care" choices for ill elderly people like her mother, who in her prime might have been a savvy shopper but is no longer in a position to make appropriate "market-based" decisions about her long-term care. In our second story, physician Danielle Ofri also derails a myth: the assumption gleaned from her academic medical training that routine blood tests should not be conducted on healthy patients, lacking hard evidence that the benefits outweigh the costs. She relates a lesson she learned years ago while working in a New Mexico clinic about the need for flexibility in testing and treating patients.

Before dementia crept up, Mom was a consummate shopper. She has impeccable taste; she savors clothes, furniture, kitchen gear, plants, and most of all, contemporary art. She used to spend her days keeping in touch with friends, gardening, visiting galleries and museums, and shopping. I doubt there was a day of her life, save a few spent in the hospital, when she didn’t shop. I inherited the gene, and shopping is one of the things we most enjoy doing together.

People like my mother should be perfect candidates for the kind of rational decision making about their long-term care that . . . [Full Text of this Article]

The Wise Consumer Myth

 

Real Behavior

 

Finding A Compassionate Solution

 

Services Unwanted But Not Unneeded

 

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