Thread by @asymmetricinfo

My hot take is that the problem isn't regulation, the problem is that seniors with dementia sometimes become a danger to themselves and others and no one wants to pay for the enormous staffing levels that would be required to care for them without sedation.

https://twitter.com/mattyglesias/status/1437229087920111620

We would like to think that the problem is that we're just not cracking down on nursing homes hard enough to keep those greedy bastards from neglecting patients for fun and profit, or that Republicans just hate welfare spending, but actually it's just fantastically expensive.

Obviously there are terrible nursing home operators, because there are terrible people doing any profession you'd care to name, but mostly my sense is that they negotiate a huge gap between the lavish care we want them to provide, and the middling sums we want to spend on it.

And that in turn is actually its own hard tradeoff because society has just never had to deal with so many completely incapacitated old people living so long, with so relatively few young people to care for them.

Conservatives love to complain that this is all selfish women's lib types refusing to provide traditional home care, but very few victorian women cared for such extremely debilitated people for very long, because before modern medicine they tended to die.

Even in the 1960s, my great grandmother got dementia, broke her hip, and died soon afterwards. My grandmother broke her hip, and spent another five years in a nursing home getting a literally impossible level of care for any family to provide in 1960.

Providing that level of care is actually fantastically expensive, because it's mostly labor. Labor is expensive! Skilled labor, more so!

If we want this to stop, we need to talk about being willing to actually pay a lot more for nursing home care, rather than demanding that nursing homes care for aggressive patients without either sedating them, or charging us what it costs to care for them without sedation

Especially now, because huge numbers of workers appear to have noped out of nursing home work, and we might need to drastically up wages to lure them back.