Alex Spanko

More than two years after the first COVID-19 outbreak in a nursing home outside of Seattle brought the disease into the national conversation – and more than 200,000 deaths in those facilities later – nothing much has changed about the way we fund, regulate, and deliver long-term care in this country.

In those dark days of 2020 and 2021, when I was covering the carnage for a business-focused trade publication and feeling increasingly complicit in the maintenance and defense of a broken system, I tried to soothe myself with the thought that surely the pandemic’s death toll would generate true change. This was 9/11 and Pearl Harbor rolled into one, a disaster so great and so obvious that even the wheels of bureaucracy would start spinning toward some kind of solution.

That, it turns out, was simply naive. Faced with mass death during the system-wide failure of a long-term care infrastructure that was never built to do what we currently expect it to do, the key interest groups involved in the space have fallen on the same old tactics that, for decades now, have never even come close to creating real improvement.

The people, officials, and organizations that can remake eldercare showed up to a nuclear war with muskets and a fife-and-drum corps, and while they keep walking slowly toward each other and firing inaccurately, more and more people will enter the system, receive poor and dehumanizing care, and die. As I write this, I am 32 years old; at this rate, my great-grandchildren will have the same care options as I will in the 2070s.

So why doesn’t anything ever change with nursing homes? Keep in mind that I’m just an observer with a bachelor’s degree in journalism and a general interest in learning how byzantine systems work. I don’t have an advanced degree in public health or training as a geriatrician or certified nursing assistant, but hey – neither do the vast majority of people who control the narrative and make the regulations that govern eldercare in America. What’s one more schmuck’s opinion going to hurt?

We'll start with the one thing I’m technically most qualified to discuss, if you’re into academic credentials: the media narrative.