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This Article explores issues that we, as a society, would rather not, but must, discuss. These issues include aging, how the future costs of long-term care will be paid, and what form and quality of long-term care will continue to be financed through Medicare. More specifically, this Article discusses the philosophical issues raised by the cuts, as well as the practical implications of the cuts for patients and residents. It also attempts, primarily through information about the administrative and other costs of the federal bankruptcy process, to refute government claims that these cuts have not and will not affect patient care. Part I of this Article describes the extent of the financial failure in the nursing home and home-health industries, briefly explains what funds were cut by the BBA, and briefly describes the Government's position with respect to the effects of the cuts. Because so many long-term care providers are now operating under Chapter 11 of the Bankruptcy Code, Part II describes the general Chapter 11 process, the difficulty of successfully reorganizing under Chapter 11, the high direct and indirect costs of all bankruptcy proceedings, and the risks that bankruptcy poses for patients and residents. Part III discusses other risks created by the cuts, particularly the unavailability of necessary care. Part IV calls for a public discourse about our national policy with respect to both aging and funding long-term care with public funds. Ultimately this Article concludes that we left too much up to Congress, in expecting it to be able to address this complex and taboo issue.

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Cornell Journal of Law and Public Policy



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