August 19, 2010
The Motion Picture Home closure: Callous act or necessary evil?
In the months I spent investigating the pending closure of The Motion Picture Home for this week’s cover story, I was moved by the courage of the home’s residents and their families. Leaving your home is rarely easy, and in this case, made more complicated by the fact that these residents were asked to leave against their will.
But while my knee-jerk reaction was to rail against the Motion Picture and Television Fund (MPTF), the non-profit charity that runs the home and is supported by many of the biggest names in Hollywood—Spielberg, Katzenberg, Douglas, to name just a few—I came to discover a far more complex situation than a battle between opposing forces.
Because the fund is seen as an enterprise of the wealthy and powerful, many wouldn’t accept the claim that they couldn’t afford to operate long-term care. I heard many times over: How could Steven Spielberg let this happen? Are you telling me that Jeffrey Katzenberg can’t give away a few more million? In this battle, there is certainly a camp that believes Hollywood’s wealthy should step up and pay for the cost discrepancy between health care reimbursements and what it costs to operate the nursing home—which the fund claims is about $1 million per month. But what gets lost in that demand is the acknowledgment that many of those people already give—and give a lot. Are we really going to suggest that Spielberg and Katzenberg aren’t philanthropic enough? That seems a dangerous line.
Now it’s true that in recent years, the fund has shifted their financial priorities from covering the costs of long-term care to developing lifestyle facilities for independent and active adults. Some see this as unfair and shallow, but the MPTF believes it is the more sustainable model for their organization and they have a right to prioritize their solvency. Irma Kalish, a former MPTF board member who served the organization for 27 years aptly pointed out that the fund, which was founded as a social justice initiative, has, in recent years, become more corporate and therefore most concerned about its bottom line.
Most of all, the tragedy at the Motion Picture Home is about the utter vulnerability of the nation’s elderly poor. Their health care is so expensive, not even a well-endowed Hollywood charity could support it—and continue to support the 60,000 other people it serves through its outpatient health care clinics. To preserve itself, the fund chose a utilitarian model of health care: provide the greatest number of services to the greatest number of people. That does not obviate the tragedy the impact of closing long-term care has on its residents, but it does help explain it.
This is a battle with no clear villain, a problem with no clear solution.
According to a 2006 essay on aging in Commentary Magazine by Leon R. Kass and Eric Cohen, [due to medical advances] “Average life expectancy in the United States is now seventy-eight years and rising (up from forty-seven in 1900), and those over age eighty-five are already the fastest growing segment of the population.” But along with longer life expectancy comes a period of frailty and decline, placing increasing demands on end-of-life caregivers. The article cites a Rand Study that found “roughly 40 percent of deaths in the United States are now preceded by a period of enfeeblement, debility, and (often) dementia lasting up to a decade.”
Because of lower birthrates, the number of working-age caregivers is dwindling, while modern families, according to the article, are “smaller, less stable and more geographically spread out”. The wealthy, who can afford round the clock care, have to contend with a shortage of professional help, which may be related to the unglamorous work associated with caregiving. But the majority of the American population, however, will struggle with the rising costs of long-term care. And inevitable demands for social reform will pose a huge fiscal challenge to government sponsored health care.
The Commentary article concluded: “Endless chatter about ‘healthy aging’ is at bottom a form of denial. Ultimately, the nursing home refutes the dream of limitless progress toward ageless bodies, and America will surely be building many more nursing homes in the years ahead.”
Is the Motion Picture and Television Fund abandoning its mission? Maybe, in part. The only thing that could preserve the remaining residents’ way of life would be an incredible act of charity. I suppose, the kind of act the MPTF’s founders hoped to make real.
Read my full story on the closure of the Motion Picture Home here: