1 Chapter 5 Abortion: The Unexplored Middle Ground 3 The Current Position on Abortion • Despite health care reform, there is still a constant debate between the rights of the unborn and the right of privacy. • Each side makes uncompromised arguments. • The arguments between morality and public policy continue to be a battle. 4 What About a Middle Ground? • There is a need to: • Establish a format for public conversation on the abortion. • Avoid labels and move to true discourse. • Design a peaceable public policy. 5 Twenty Elements of the Common Ground • The intentional taking of human life is presumed to be immoral. • Abortion is a killing act. • Abortion to save the life of the mother is a morally acceptable action. 6 Twenty Elements of the Common Ground • Judgment about the morality of abortion cannot be based just on a woman’s right to choose. • Abortion for convenience is morally wrong. • Conditions that lead to abortion should be abolished as much as possible. 7 Twenty Elements of the Common Ground • Abortion is a tragic experience and should be avoided if possible. • There should be alternatives to abortion. • Abortion is not just a private affair. 8 Twenty Elements of the Common Ground • Roe v. Wade is offensive to many people. • If a law cannot be enforced, it is a bad law. • An “absolutely prohibitive” law on abortion is not enforceable. 9 Twenty Elements of the Common Ground • There should be some public restrictions on abortion. • The best education about abortion is witness. • Abortion is frequently a subtlety coerced decision. 10 Twenty Elements of the Common Ground • The availability of contraceptives does not reduce the number of abortions. • Permissive laws forfeit the sanctity of life for the unborn. • Hospitals that perform abortions should have to follow policy. 11 Twenty Elements of the Common Ground • The “consistent ethic of life” should be taken seriously. • Whenever a discussion about abortion becomes heated, it should stop. 12 Discussions Should Continue • To find middle ground, one should understand the 20 elements surrounding abortion. • The issue of religious and ethics beliefs should be considered dispassionately. • Issues will continue to be both political and ethical as PPACA is implemented. 13 In Summary… 14 Slide Number 1Chapter 5Slide Number 3The Current Position on AbortionWhat About a Middle Ground?Twenty Elements of the Common Ground Twenty Elements of the Common Ground Twenty Elements of the Common Ground Twenty Elements of the Common Ground Twenty Elements of the Common Ground Twenty Elements of the Common Ground Twenty Elements of the Common Ground Discussions Should ContinueIn Summary… You will be expected to read and formulate 150-300 words responses to one or more of the readings. Don’t summarize the readings!! Ar.

1. 1
Chapter 5
Abortion: The Unexplored
Middle Ground
3
The Current Position on Abortion
• Despite health care reform, there is still a
constant debate between the rights of the
unborn and the right of privacy.
• Each side makes uncompromised arguments.
• The arguments between morality and public
policy continue to be a battle.
4
What About a Middle Ground?

2. • There is a need to:
• Establish a format for public conversation on
the abortion.
• Avoid labels and move to true discourse.
• Design a peaceable public policy.
5
Twenty Elements of the Common Ground
• The intentional taking of human life is
presumed to be immoral.
• Abortion is a killing act.
• Abortion to save the life of the mother is a
morally acceptable action.
6
Twenty Elements of the Common Ground
• Judgment about the morality of abortion
cannot be based just on a woman’s right to
choose.
• Abortion for convenience is morally wrong.
• Conditions that lead to abortion should be
abolished as much as possible.

3. 7
Twenty Elements of the Common Ground
• Abortion is a tragic experience and should be
avoided if possible.
• There should be alternatives to abortion.
• Abortion is not just a private affair.
8
Twenty Elements of the Common Ground
• Roe v. Wade is offensive to many people.
• If a law cannot be enforced, it is a bad law.
• An “absolutely prohibitive” law on abortion is
not enforceable.
9
Twenty Elements of the Common Ground
• There should be some public restrictions on
abortion.
• The best education about abortion is witness.
• Abortion is frequently a subtlety coerced

4. decision.
10
Twenty Elements of the Common Ground
• The availability of contraceptives does not
reduce the number of abortions.
• Permissive laws forfeit the sanctity of life for
the unborn.
• Hospitals that perform abortions should have
to follow policy.
11
Twenty Elements of the Common Ground
• The “consistent ethic of life” should be taken
seriously.
• Whenever a discussion about abortion
becomes heated, it should stop.
12
Discussions Should Continue

5. • To find middle ground, one should understand
the 20 elements surrounding abortion.
• The issue of religious and ethics beliefs should
be considered dispassionately.
• Issues will continue to be both political and
ethical as PPACA is implemented.
13
In Summary…
14
Slide Number 1Chapter 5Slide Number 3The Current Position
on AbortionWhat About a Middle Ground?Twenty Elements of
the Common Ground Twenty Elements of the Common Ground
Twenty Elements of the Common Ground Twenty Elements of
the Common Ground Twenty Elements of the Common Ground
Twenty Elements of the Common Ground Twenty Elements of
the Common Ground Discussions Should ContinueIn
Summary…
You will be expected to read and formulate 150-300 words
responses to one or more of the
readings.
Don’t summarize the readings!! Articulate your reactions and
thoughts on the readings. They
should be written with the goal of showing your interpretation
and understanding of the text. You
should refer to specific passages and quote them from the text,

6. including page numbers.
(Quotations are not included in the word count.)
Add a title to your post – something creative that gives a hint of
what
your posting focuses on .
Try to write on topics that encourage discussion. Opening a line
of inquiry for further
discussion with your classmates
Displays careful, thoughtful reading that pays attention to the
details of the text and/or integrates
ideas and demonstrates a strong grasp of the work and its effect.
Presents well-founded ideas in
an articulate manner and refers to specific passages in the text.
Shows original analysis that
challenges assumptions and goes beyond plot summary or
rudimentary reactions to
characters or events.
Readings:
1) Yu Miri – Tokyo Ueno Station
https://www.scribd.com/document/419030738/Tokyo-Ueno-
Station-Yu-Miri#
Additional resources:
https://tonysreadinglist.wordpress.com/2019/01/31/tokyo-ueno-
station-by-yu-miri-review/
https://www.scribd.com/document/419030738/Tokyo-Ueno-
Station-Yu-Miri#

7. https://tonysreadinglist.wordpress.com/2019/01/31/tokyo-ueno-
station-by-yu-miri-review/
Chapter Five
Older People and Long-Term Care: Issues of Access
1
2
Why the new interest in long-term care?
The Baby Boomers are adding to the growth in the population
over 65.
There is increasing fear of dependency on long-term care.
Adult children of the elderly having to find care for their
parents.
Healthcare reform promises great changes that are not well
understood.
3
3
The Growing Population Needing Care
The need for ADL and IADL assistance continues to grow.
Table 8-1 presents the broad range of services needed by the
disabled.
Most of the population needing long-term care do not live in
nursing homes.
Many factors contribute to the inability to predict the exact

8. number needing services in the future.
4
4
The Growing Population Needing Care
Future populations may be better educated which is associated
with lower levels of disability.
Ethnic composition suggests a greater need for care and
government support.
Boomers will bring greater numbers of people needing services.
The number of those over 75 will greatly increase.
5
5
The Growing Population Needing Care
Disability rates will increase among those who are not in
nursing homes.
The most common disability is physical.
In addition, the nursing home population is expected to have
profound increases until it triples by 2030.
The number of younger persons with disability has also
increased.
6
6
Issues of Access
The current system is far from ideal.

9. There is not an adequate supply particularly for the poor.
The system itself continues to be so fragmented that many are
not aware of what is offered.
Financing is an underlying problem.
7
7
The Costs of Care
Expenses for this care are sizable and will increase in the
future.
Private insurance only pays for a small percentage of the care.
Medicaid pays for over 85% of nursing home care.
8
8
The Costs of Care
Annual costs of nursing home care can average $58,000 per year
and may exceed $100,000. For many, the costs of this care is
just not affordable.
With the addition of the Baby Boomers, costs will most
certainly increase in the future.
The effects of reform are not currently known.
9
9
The Care-giving Role of Families
About 74% of dependent community-based elders receive care

10. from family members.
The majority of caregivers are women.
The number and willingness of family caregivers may decline as
the Boomers become in need for assistance.
10
10
The Role of Private Insurance
Private insurance for long-term care is a relatively new product.
Improvements in coverage are being made, but only an
estimated 20% of the population will use it.
CCRCs and LCAHs hold promise for the future.
11
11
The Role of Medicaid
Medicaid is changing under PPACA to include more eligible
adults who will receive benchmark coverage.
Medicaid is used for those elders who meet certain criteria.
Medicaid does not pay for the full range of services including
home-based care.
Some states are using a waiver to offer non-medical home-care
services.
12
12
The Role of Medicaid

11. Some elders qualify for Medicaid once they are institutionalized
and have used all of their assets.
Other elders are trying to shelter their assets so that they can be
poor without really being poor.
Healthcare reform requires an office within CMS to address the
issue of dual edibility.
13
13
Forces for Improving Access
Advocates for Alzheimer’s disease patients and for others have
worked for changes.
The Pepper Bill and other legislation recommended changes.
Attempts to limit the growth of Medicaid are part of the
national health care debate.
14
14
Future Prospects
Baby Boomer numbers and healthcare reform will result in
changes to the system.
Government involvement will increase as demand increases
without the funding for access.
Government involvement may not be the only or best answer.
15
15

12. Future Prospects
Future elders are concerned about what their care will be like
under healthcare reform.
The political climate must be willing to address future concerns.
Ethical questions such as beneficence, autonomy, and justice
need to be part of policy discourse.
16
16
Future Prospects
Issues of the elderly and non-elderly disabled need to be
addressed.
Given the cost and complexity, the medical model is not the
only one to be considered.
Long term care needs to be part of health care.
17
17
Update from a Practitioner’s View
Even with healthcare reform the trends and issues for long-term
care are the same.
Barriers to real change are driven by the political climate that
controls funding.
What will be America’s legacy about the treatment of its
elderly?
18
In Summary…

13. 19
19