Long Term Care

Congressional lawmakers investigating the shortage of lifesaving drugs used to treat cancer and other illnesses are looking into three companies in North Carolina and Maryland that they believe set up "fake pharmacies" to access the drugs that they then sold at a markup. The lawmakers, led by Rep. Elijah E. Cummings, a Baltimore Democrat, said Wednesday that they sent letters to the three pharmacies that they believe sold drugs to wholesalers that they also owned, which then sold the drugs on the "gray market" to entities that do not manufacture drugs or treat patients.

MORE THAN the unstable economy, the damaged environment or the turbulent world political scene, the most serious crisis facing Americans today is in health care.The system (really a non-system) is in a state of crisis, crippled by spiraling costs -- and it is about to be overwhelmed by a tidal wave of older Americans in need of long-term care.A major solution to the crisis is right under our noses -- and has been for over 100 years. More people can be -- and want to be -- treated in the comfort of their own homes.

Manor Care Inc., the Gaithersburg operator of long-term care and assisted-living facilities, yesterday reported earnings of $61.4 million for the third quarter, including $37.1 million from the sale of part of its interest in Vitalink Pharmacy Services.Without the Vitalink proceeds, Manor Care earned $24.3 million, or 38 cents a share, up 16.3 percent from $20.9 million, or 33 cents a share, in the same quarter a year earlier.Earnings were 1 cent a share less than the average projected by nine analysts surveyed by I/B/E/S International.

Tom Binder wanted to prepare for the future - including the possibility that he or his wife could be stricken by a long, debilitating illness in the years ahead. "I don't think it's a good bet that you're just going to drop dead," said Binder, 50, an art dealer in Santa Monica, Calif. "What if you suffer a stroke in your 60s or 70s, and through the miracles of medicine you live into your 90s? "That was my worst-case scenario: that I would linger for many years." To make sure that he could survive financially, Binder made a purchase that has become increasingly common for a generation that once focused almost obsessively on being young: He agreed to pay $4,500 a year for insurance to cover the costs of long-term care for him and his wife, Betsy Cantor.

In a deal that would give Baltimore the corporate headquarters of a publicly traded company with more than $1 billion in annual revenue, Genesis Health Ventures Inc. announced yesterday that it plans to split itself. The piece remaining in Baltimore and regaining its independence would be NeighborCare, the pharmacy and medical equipment company that Genesis bought in 1996. NeighborCare has about 200 employees at its headquarters near the Inner Harbor and 1,250 in Maryland altogether, and is expected to add a few more when the split is completed.

HCC music center is changing its name The Musical Arts Center at Howard Community College has announced that it is changing its name to the Music Institute at HCC to promote its services and reach out to students of all ages. The institute offers local and affordable noncredit instruction for people of all ages and abilities. Classes in voice, piano, wind and stringed instruments are taught by the college's musical faculty. Instruction in Suzuki Violin, Colourstrings and Kindermusik is also available.

Elizabeth Jones turned frail eight years ago, unable to take care of herself, talking in gibberish, forgetting daily events, even names. She had Alzheimer's disease.Her family put her in Bon Secours Long-Term Care Facility in Ellicott City when they couldn't give her the hourly supervision she needed.But, like thousands of others across the state, Mrs. Jones might lose the round-the-clock care if the $7.3 million Medicaid cutback for long-term care takes effect. Members of her family don't know how they will take care of her. "She can't dress herself," said her daughter, Patricia Mahle, a registered nurse.

Integrated Health Services Inc., a privately held operator of nursing homes and long-term care centers, plans to sell 43 percent of the company to the public in an initial stock offering that could raise more than $48 million, according to a filing yesterday with the Securities and Exchange Commission.The Hunt Valley-based company said in the filing that 3 million shares would be sold for a maximum price of $14 a share and that an additional 450,000 shares would be issued if demand was strong.

IT SOUNDS logical that patients with health insurance would be less likely to seek unnecessary tests and treatment if they had to bear some of the cost - had "some skin in the game," as Arkansas Gov. Mike Huckabee put it the other day. In fact, co-pays and deductibles work well in employer-sponsored plans for middle-income workers to discourage overuse of specialists and frequent trips to the doctor's office. Erecting such barriers in Medicaid, though, as the National Governors Association recommends, would likely cost more than it would save.

The 34 million Americans who are age 65 or older remain an important political constituency. With voting participation well above that of the average registered voter and nearly twice that of 18- to 20-year-olds, votes of older Americans are being cultivated and courted this presidential season. The disposition of older voters in crucial swing states such as Florida and Michigan may hold the key to the presidency. Consequently, we have heard well-rehearsed lines from both Gov. George W. Bush and Vice President Al Gore about badly needed prescription drug coverage for the elderly and strategies to protect Social Security well into the future.