The eagerly awaited Pepper Commission report represents a first step toward resolving the nation's catastrophic-care problem, but there's still a long way to go. That's the consensus among legislative leaders and advocates for senior citizens.
In March, the 15-member Pepper Commission approved by an 11-4 vote a long-term care program. It would provide home-care services, protect nursing-home residents and their families from impoverishment and pay virtually all costs of a three-month nursing-home stay. The Commission's health-care plan calls for mandatory health coverage for all firms with 100 or more employees."The message in our long-term-care recommendations is access to care and freedom from fear," Sen. John D. (Jay) Rockefeller IV, D-W.Va., chairman of the Pepper Commission, said. He acknowledged, however, that the effort to reform the health- and long-term-care systems "has only begun" and will require continued support from consumers as well as policymakers.
Sen. Dave Durenberger, R-Minn., vice chairman of the Pepper Commission, approved the report's long-term-care plan because, he said, it would establish a social-insurance system for people who need extended care, and promote coverage for catastrophic-care expenses through investments and private insurance. Durenberger does not expect to see legislative action on the issue until after the next presidential election because of the costs and complexity of creating a new program.
Sen. David Pryor, D-Ark., a member of the commission and chairman of the Senate Special Committee on Aging, was similarly reserved in a statement praising the long-term-care program for supporting home care as well as nursing-home coverage. Pryor called it "an ambitious goal, and one that I know we would have trouble enacting immediately." Nevertheless, he continued, the plan "is an important blueprint for action for the next several years."
Rep. Edward R. Roybal, D-Calif., expressed "support with reservations" for the commission's recommendations. Of the long-term-care plan, he said, "it may not be a perfect solution but it's a building block for future action." He extolled the plan for providing long-term-care coverage for Americans of all ages, but faulted its reliance on a modified "spend down" strategy for nursing-home care.
Keith Tarr-Whelan of the Long Term Care Campaign, a coalition of 138 national organizations committed to enacting catastrophic care legislation, said the recommendations "represent a major step forward and take us into the (upcoming) legislative debates in good shape." The group is working to make long-term care a major issue in the November elections, and plans to spur more action in 1991.
The National Committee to Preserve Social Security, which last year strongly advocated repeal of the Medicare Catastrophic Care Act, has not fully analyzed the proposal. Based on preliminary reports, William R. Ritz of the committee said, "we're concerned about the lack of details on financing throughout the report. We want to make sure (the long-term-care program) is not financed as the Medicare Catastrophic Care program was (through a seniors-only surtax)."
QUESTION: I'm a 67-year-old widow who recently was put on a low-fat diet by my doctor. My women's club eats out once a month and I'm afraid that now I will have to miss these outings. Any suggestions?
ANSWER: You should be able to stick to your diet while dining out if you follow these guidelines recommended by the American Heart Association.
For starters, call the restaurant you plan to patronize and ask how the food is prepared, and whether the chef is able to honor special requests.
Study the menu carefully before making your choice. One low-fat staple is fish of all kinds, broiled dry or with a little margarine or cooking oil and seasoned with spices, herbs and lemon. When selecting other dishes, look for "buzz words" that denote low-fat preparation. These include:
- in its own juice
- garden fresh
- tomato juice
- dry broiled (in lemon juice or wine)
Be aware that some low-fat, low-cholesterol preparations are high in sodium. Avoid foods that are:
- in broth
- in a tomato base.
To cut down on foods high in saturated fat, cholesterol and/or salt, avoid dishes that are:
- buttery, in butter sauce
- sauteed, fried, crispy, braised
- creamed, in cream sauce, in gravy, hollandaise
- au gratin, Parmesan, in cheese sauce, escalloped
- marinated (in oil), stewed, basted
- casserole, prime, hash, pot pie
Order sauces or dressings "on the side" so that you can control the amount used. For a tasty, fat-free salad dressing, try freshly-squeezed lemon juice. When it's time for dessert, order fresh fruit, sherbert, gelatin or angel food cake.
If any dish is not prepared as you requested, send it back. Be firm.
For more hints on how to enjoy eating out, contact your local American Heart Association for the free pamphlet, "Dining Out, A Guide to Restaurant Dining."
Send questions about growing older to On Aging, P.O. Box 84256, Los Angeles, CA 90073.