WACCRC Questionaire

I was recently approached by a member of WACCRA regarding their opposition to state oversight of CCRCs and I wanted to discuss my own understanding of, and approach to, the issue.

Background

Continuing Care Retirement Communities (CCRCs) are residential communities designed to offer a range of living arrangements and care levels for older adults. They typically provide a continuum of care, which means they offer different types of housing and support services that can adapt to changing needs over time. This can include the following:

• Independent Living: For seniors who are largely self-sufficient but want the convenience and social opportunities of a community setting.

• Assisted Living: For those who need help with daily activities like bathing, dressing, or medication management but do not require intensive medical care.

• Skilled Nursing Care: For residents who need more intensive medical care and support, often provided in a nursing home-like setting. CCRCs usually operate on a contractual basis where residents pay an entrance fee and/or monthly fees that cover their housing, services, and care as needed. The idea is to provide a stable and supportive environment where seniors can age in place without needing to move to a new facility if their health needs change.

WACCRC Opposition

Opposition to state oversight of Continuing Care Retirement Communities (CCRCs) can stem from several concerns:

• Regulatory Burden: Some argue that increased state oversight can impose additional regulations and bureaucratic requirements on CCRCs, which might lead to increased operational costs. This could, in turn, potentially drive up fees for residents or limit the community’s flexibility in managing its operations.

• Autonomy and Innovation: Critics may believe that stringent state oversight can stifle innovation and flexibility within CCRCs. They argue that communities should have the autonomy to implement their own policies and practices that best meet the needs of their residents without excessive external interference.

• Quality of Care and Efficiency: Some people worry that state regulations might not always align with the best practices for care and efficiency. They might argue that well-managed CCRCs should be allowed to maintain high standards of care without the imposition of state mandates that may not be tailored to their specific context.

• Market-Based Solutions: Proponents of less oversight often believe that market forces and consumer choice can be more effective in ensuring quality and accountability. They argue that residents and their families should be able to choose communities based on reputation and performance, rather than relying on state regulations.

• Administrative Challenges: Implementing and enforcing state oversight can be complex and resource-intensive. There are concerns that state agencies might lack the expertise or capacity to effectively monitor and regulate CCRCs, potentially leading to inconsistent or ineffective oversight.

• Freedom of Choice: Some advocate for minimal regulation to preserve a broad range of options for consumers. They argue that excessive oversight might limit the diversity of services and care models available, reducing choices for individuals seeking different types of retirement living arrangements.

Overall, while oversight can help ensure quality and protect residents, there is a concern for balance to be struck between regulation and operational freedom, and opinions on this balance can vary widely.

My Position

In general the profit motive does not mix well with health care. For profit companies must seek to maximize profits. Inevitably this results in two things. Firstly, workers’ wages and conditions are driven downward in a race to the bottom in order to increase profits at the top. Secondly,consolidation takes place which results in fewer and fewer consumer choices as the whales eat the little fish. Finally, the quality of service to the customer falls off as they have no options. Eventually they are served by an alienated, underpaid, and under caring staff, and foreign call centers run by robotic chat tools.

These are my concerns with the whole debate.

• Commodification of Care: - Like all other aspects of healthcare and social services under a profit driven model, CCRCs are commodified. This means that care for the elderly is treated as a marketable product rather than a basic human need. The need for profit can influence the quality of care and the accessibility of these services, potentially prioritizing financial returns over residents’ well-being.

• Economic Inequality: - Access to high-quality care within CCRCs can be stratified by your ability to pay. Those who can afford the entrance fees and ongoing costs can access better facilities and services, while those with fewer resources may be forced into less desirable or less well-funded options. This reflects broader social inequalities in access to healthcare and social services.

• Profit Motive: - The profit motive inherent in many CCRCs, especially those operated by private entities posess a drive for profit that can lead to cost-cutting measures that negatively impact the quality of care and staff working conditions. This profit-driven model contrasts with a Marxist ideal where care services are provided based on need rather than financial capacity.

• Alienation of Labor: - In the context of CCRCs, workers, including nurses, aides, and other staff, experience alienation. This occurs when workers are separated from the product of their labor and may be compelled to follow strict regulations and perform repetitive tasks without meaningful engagement or recognition of their contributions. This can lead to a disengaged workforce and declining quality of service for those receiving care.

• Ideology and Social Reproduction: - CCRCs reflect and reinforce a me first mentality regarding aging and care. The structure of these communities perpetuates the idea that individuals must pay for their care in their old age, reinforcing individualistic rather than collective approaches to social support.

• Potential for Reform: - I prefer to advocate for systemic change. I would rather propose alternatives, such as publicly funded and universally accessible elder care systems, which would aim to eliminate the profit motive and ensure that care is based on need rather than financial means.

I think that it is crucial that we emphasize the need to address the underlying profit driven structures that influence the provision of care and advocate for a system that prioritizes human needs over profit.