OLYMPIA, Wa. – Un reporte publicado este lunes esboza algunas de las barreras que enfrenta el estado de Washington para dotar de fondos a los cuidados de largo plazo que necesitan cada vez más residentes para su vejez.

Esto coincide con un mitin que se celebrará en el Capitolio estatal, donde un grupo de defensores de los washingtonianos mayores aplauden la publicación del reporte, el cual esboza los desafíos que enfrenta la financiación de los servicios para la gente mayor, conforme va envejeciendo la población del estado.

Este análisis, elaborado por la organización “Washingtonians for a Responsible Future” (Washingtonianos por un Futuro Responsable), muestra que los servicios de atención de larga vida, como Medicaid y Medicare, podrían costarle al estado 6.3 billones de dólares para 2030.

Jerry Reilly, director de la “Elder Care Alliance” (Alianza para el Cuidado de los Ancianos), dice que a futuro el modelo actual no será sustentable para fondear los servicios para los adultos mayores.

“El ‘Social Security’, Medicaid y Medicare actuales son enormemente importantes, pero no han tenido que enfrentarse al estrés de esta enorme población creciente, que necesitará servicios y cuidados de largo plazo.”

Comenta que uno de los hallazgos más preocupantes del reporte es que la persona promedio de 65 años y más necesita unos 260 mil dólares para su atención de largo plazo, mientras que la media de ahorro de los adultos mayores es de 148 mil dólares. Frecuentemente son los familiares quienes cubren el faltante brindándole atención sin compensación a sus seres amados.

El estado contrató a la firma actuarial Milliman para analizar dos opciones de fondeo futuro para sostener los servicios y cuidados de largo plazo. Una es abrir un fideicomiso público que los trabajadores pagarían a través de deducciones en sus salarios.

Otra es una opción público-privada, en la que el estado trabajaría con aseguradoras privadas para garantizar la atención a precios más accesibles.

Reilly considera que el reporte le dará al estado bases para comenzar un nuevo capítulo en el financiamiento de los cuidados de larga duración.

“Vamos muy adelante de muchos estados en el manejo de este problema, pero ya es hora de la siguiente fase, que es cómo empezar a estructurar los recursos para que la gente los tenga cuando los necesite.”

La firma Milliman entregará su análisis a la legislatura estatal en diciembre.


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Health disparities in Texas are not only making some people sick, but affecting the state's economy.

A new study shows Texas is losing $7 billion a year because it does not adequately address quality-of-life issues and the health care needs of its lower-income residents.

The research was sponsored by the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and St. David's Foundation.

Brian Sasser, chief communications officer for the Episcopal Health Foundation, said health care includes more than doctors' visits and medication.

"Everything from increasing access to affordable health insurance to investing in under-resourced neighborhoods to give them more options, whether that's exercise options or food options," Sasser outlined. "Look at policy changes that expand health insurance coverage for new moms."

The report breaks down the economic costs of preventable health differences for every Texas county. It found Bexar, Dallas, Harris, Tarrant and Travis counties are losing the most money annually because of health disparities.

The amount of the economic impact depends on the racial and ethnic makeup of the county and the size of its working-age population. Sasser added the report shows Black and Hispanic children are more likely to grow up in neighborhoods with high poverty levels, and higher rates of diabetes and obesity.

"What can we do to work to make sure that the rate of diabetes isn't dramatically different between white households and Black households?" Sasser asked. "That we can make sure the food insecurity isn't dramatically different between someone who makes over $100,000 and someone who makes less than $30,000?"

The Texas Legislature has passed laws to address some of the disparities, including House Bill 12. It extends Medicaid health coverage for 12 months for new mothers, and pays for maternal health services for community health workers and doulas.

There is light at the end of the tunnel for Tennesseans struggling with opioid addiction, as a bill has been passed to increase access to treatment for opioid use disorder at Community Health Centers.

More than 3,800 lives were lost to overdose in the state in 2021, according to the Tennessee Department of Health.

Emily Waitt, policy and advocacy manager for the Tennessee Primary Care Association, said the original bill limited the number of patients nurse practitioners and physician assistants could treat with buprenorphine. The update removes the limitations, allowing more Tennesseans to access medication assisted treatment in their communities.

"It allows NPs and PAs to prescribe to 100 patients at a time, versus 50," Waitt explained. "Basically doubling the number of patients that they can prescribe to."

Community Health Centers serve more than 423,000 patients across Tennessee, regardless of their insurance status or ability to pay. About 7.7% of Tennesseans do not have health insurance.

Libby Thurman, CEO of the Tennessee Primary Care Association, said bringing the treatment to rural health centers expands access to a crucial service for patients who otherwise could not afford it. She noted it is important because people in remote areas often face challenges finding specialists and treatment facilities.

"We really wanted to work on this issue, because we know our Community Health Centers are where patients go for care," Thurman emphasized. "We really believe in an integrated model. So we want to treat the whole person, including if they are struggling with an addiction issue or a substance abuse disorder issue."

Health Centers offer behavioral health care, including counseling, along with treatment. The clinics also focus on creating a supportive network to help patients with family resources, job assistance and community connections.

While Black Maternal Health Week is wrapping up, health disparities for pregnant Black women continues to be an issue.

From April 11-17 this year, the high death rate of Black mothers is in the spotlight. Black women are three times more likely to die from pregnancy-related causes than their white counterparts.

Dr. Patricia Egwuatu, a family practice physician at Kaiser Permanente in Seattle, said racism is at the root of the disparities, which create barriers to health care access. She pointed out lack of access can lead to problems during pregnancy that are preventable or treatable.

"They may exist prior to pregnancy and then it gets worse during pregnancy if it's not managed as part of that maternity care," Egwuatu emphasized. "There are more pregnant women that have chronic conditions such as hypertension, diabetes and heart disease that are amplified during pregnancy."

The White House released a proclamation recognizing Black Maternal Health Week. The Biden administration began recognizing the week in 2021.

Egwuatu noted there are some warning signs any pregnant woman should be aware of and check in with their physician if they develop.

"You might get some changes in your vision that is not your normal. So, like, fuzziness, you can't see as well, or an excruciating headache," Egwuatu outlined. "You could also develop new swelling in your lower extremities that's making it difficult to get around or even new shortness of breath."

Egwuatu stressed physicians also need to recognize the role of racism in medicine. She argued continuous medical education is important for learning how to confront biases, and it is important for doctors to understand how they can provide people with resources.

"Asking the questions about personal barriers," Egwuatu suggested. "Does a patient have issues with getting to work, child care, transportation? What's their education, what's their cultural background and language? And do they even have a cell phone so we can connect with them?"