With the ongoing debate over President Joe Biden’s infrastructure plan, Republican lawmakers have suddenly rediscovered their fiscal conservatism. They’re also praying America will forget both their massive free money giveaway to the one percent (meaning themselves and their donors), and that time they abetted a fascist, white supremacist coup against democracy, but it’s mainly about the deficit. Anyway, one of the element’s of President Biden’s bill that’s raised so much Republican wrath is the inclusion of funding for elder care as part of said bill, and, while John Oliver didn’t even mention the GOP once during his main story on Sunday’s Last Week Tonight, the entire, typically tight, 20-minute exposé on the appalling state of nursing home and assisted living care in America served as a deeply convincing (and depressing) riposte to all this GOP faux outrage.
And while it would have been easy for Oliver to point out how Republican lawmakers are overwhelmingly both old enough to need elder care and rich enough so they will never have to go through the bureaucratic hellscape most Americans inevitably will, the host instead did a scrupulously thorough job of focusing on the big picture. You know, how everyone gets old, most everyone will need some assistance (from professionals or untrained and overburdened family members) at some point, and how the nation’s Medicare and Medicaid systems are woefully stingy and beholden to a for-profit elder care industry most often left under-regulated and unsupervised. You know, like the one facility in South Carolina which allowed an elderly woman with dementia to wander off in the middle of the night and get eaten by a fucking alligator in a nearby pond. Don’t worry though, because of said government standards, the massive, for-profit corporation that still runs the home, Brookdale, was fined $6,400.
Of course, the broken nature of the nursing home and assisted living industry isn’t all alligators and COVID (Oliver notes that almost a third of all COVID deaths happened at long-term care facilities). As Oliver stresses, lax oversight of profit-driven elder care businesses means that even when families desperately trying to find a decent place for their in-need loved one do the research, finding out if the local old age facility is on a “we let grandma get eaten by a gator” watchlist becomes a farce. Companies are encouraged to maximize profits by overprescribing unnecessary and expensive care to patients whose Medicare can pay for it until they spend themselves onto Medicaid, where, as Oliver shows, some impoverished patients are deprived of needed care, or just pitched out the door entirely. “That’s just fucking evil,” Oliver explains in signature acid contempt, characterizing our current capitalism-fueled approach to elder care as, “at best indifference, and, at worst, abuse and neglect.”
As usual, there are solutions presented, should anyone give a shit. Returning authority and funding to oversight and enforcement might keep some more grandparents out of the alligator swamps, or, as in one interview with an elderly patient resorted to, actually calling the police on her own nursing home (Braintree Manor in Massachusetts) after being left alone and screaming in pain for hours. It might also keep people like this week’s representative villain, one Stephanie Costa, from driving her Ferrari to the set of something called The Millionaire Matchmaker to look for well-heeled, uptalking love while the assisted living businesses she ill-runs are cited for so many health, safety, and billing violations that she’s eventually banned from the industry for life. (Don’t worry, her dad still runs them.) More than that, though, Oliver points to both President Biden’s Republican-decried infrastructure bill (which sets aside some $400 billion for elder care services), and the under-discussion HCBS Access Act Of 2021, which would remove barriers to home care being covered by Medicaid. But, as Oliver sums things up in the manner most of his weekly stories could end, “It all starts with showing that we give a shit.”