For three hours Senate Finance Committee Chairman Max Baucus led discussions on how to reform health care and how to pay for that reform. Single-payer health insurance advocates stood and walked out in silent protest. Others shouted to interrupt the opening remarks of Chairman Baucus (some later re-entered the room in different clothes!). Chairman Baucus pleaded with the remaining audience members to allow the hearing on healthcare reform to proceed. He indicated that he’d meet with people personally rather than have further interruptions of the hearing. As an ADAPT members with a certain prowess for interrupting bureaucratic proceedings, I had been considering a one person protest for the Community Choice Act… but, now I’ll be contacting his office to set up the meeting he promised me.

For three hours, a variety of Senators and healthcare experts discussed options. And for three hours, not one person said anything about long term services and supports (long term care, by another name).

Sadly, the closest that the hearing came to a mention of long term services and supports (LTSS) was when they engaged in a discussion of “the high cost of dying.”

Yup, the Senate, in all its gentle wisdom, is showing more interest in how much it costs for seniors and others to stay alive at the very end than they have shown in how seniors and people with disabilities live for the DECADES before we get around to dying.

There was a lot of talk about how to fund healthcare reform. We heard that the employer exclusion tax system is both a regressive and a progressive tax and that it should be eliminated and that it should be only very mildly tweaked. We heard that so-called “lifestyle taxes” (alcohol, cigarettes, soda, etc) were great ideas and that they are horrible ideas.

Three hours of back and forth, explaining both sides multiple times of the same ideas, but never once did any of the many Senators and experts mention that part of the challenge of reforming healthcare is that we have an institutionally biased long term care system. Chairman Baucus cautioned several times against trying to do too much at once. He emphasized that reform needs to focus on what is “politically palatable.”

I’m sorry, what? Politically palatable?

Let me make sure I’ve got this right, the high cost of letting people live until they die is not taboo, but creating too much reform in the reform process might be too touchy?!

As I sat in the hearing pondering that point, I could barely resist shouting out “what about the very reasonable cost of letting us live in our homes and communities?” I didn’t, so, Chairman Baucus, you owe me a meeting.