Does it appear that system-level policymakers have considered the possible consequences that changes to Medicare have on vulnerable patient populations?

1. Karen is a seventy-year-old patient who has been cared for by a not-for-profit home health agency over the past two years. She has insulin-dependent diabetes, severe chronic lung disease, obesity, and complications from a stroke involving the left side of the body. Her husband Jimmy maintains the household and provides some support for the activities of daily living but cannot be trained to do nursing skills. Karen requires care at a relatively high level: the preparation of insulin syringes, blood sugar monitoring, blood pressure checking, and the administration of several medicines according to a strict routine.
With a Medicare policy change, Karen’s home health agency will no longer be able to provide her care. Her husband is unable to provide the high acuity assistance she needs. With the new Medicare policy, Karen will have to move into a nursing home and away from her family. Does it appear that system-level policymakers have considered the possible consequences that changes to Medicare have on vulnerable patient populations?
Though it will be cheaper to care for Karen in a nursing home than in her own home, do you think that patient preference should be considered when it comes to policy changes for Medicare?
Should the home health agency lower its prices to be able to keep more patients? Do you think that Karen will have the same health outcomes with the home health agency vs. a nursing home?
What action is needed to influence the political level of decision-making in such a way as to help protect vulnerable patients?

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