Persons Of The Year: U.S. Border Patrol Agents

That publication fossil--Time Magazine--selected singer Taylor Swift as its Person of the Year.  The pop diva narrowly beat out stuffy King Charles III and Barbie, a plastic doll.  Apparently, there is a dearth of humans who met the magazine's news-maker criteria. 

How hard can it be to select the person who shook up the world's news? In 1938, the magazine chose Germany's Adolf Hitler.  In view of the conceited editors' shallow standards, it's surprising Time overlooked the Hamas leader in Gaza Yahya Sinwar, who dominated worldwide news.  

Since Time bungled its selection, the Diatribe is offering a nominee that few appreciate. 

The top news makers arguably are the 16,878 Border Patrol Agents stationed along the 1,954-mile border between Mexico and the United States. These courageous men and women are on the frontlines of an ongoing war with Mexico's human and drug smuggling cartels.

Their bravery and service is ignored by most Americans who consume news from The Washington Post, New York Times, Associated Press, ABC, NBC and CBS News.  Cartels use social media to peddle fentanyl, so these disinformation platforms are blind to the role of border agents. 

The agents are the last line of defense against criminal syndicates that rake in billions of dollars annually by controlling the tide of drugs and migrants flowing from Mexico into the U.S. Their jobs are made harder by a lack of resources, technology, manpower and support from Homeland Security.

This year in particular has been the most challenging in the 20-year history of the U.S. Customers and Border Protection. Agents were swamped by 2.4 illegal immigrants who crossed the southern border from Mexico.  September saw the highest number of crossings, an 86% increase from June of this year.

Encounters, a sanitized word used by the government, increased 4% over 2022, but it represents a 40% hike since fiscal year 2021.  The numbers are staggering: 7.5 million encounters since January, 2021, at the southwest border.  The data does not include 1.7 million getaways.  

Just this year, agents arrested 35,433 immigrants with criminal convictions, 598 known gang members, including 178 were members of the notorious MS-13 gang, risking their lives to catch these law breakers.  Agents also apprehended 169 illegal immigrants on the terror watch list. 

Agents and their partners in Air and Marine Operations seized 27,293 pounds of deadly fentanyl that was smuggled across the southwest border.  That's enough fentanyl to kill more than 6 billion people. A total of 73,654 Americans died of fentanyl overdoses in 2022, according to the most recent data.

Fentanyl wasn't the only dangerous drug exported into the country. Agents seized a total of 241,000 pounds of illicit drugs this fiscal year.  In a drug bust in Temecula, California, Border Patrol agents stopped a gray sedan, driving suspiciously.

When the agents inspected the cedar, they discovered 62 bundles of the blue fentanyl pills concealed inside its door panels and seats. The pills weighed 81.4 pounds with an estimated street value of $3.6 million. Often, seizures follow dangerous high-speed car chases as the drug mules flee from agents.

Agents are in harm's way every day on the job.  In two separate instances, Customs and Border Protection agents were shot at by cartel members on the Mexican side of the border.  In May agents tended to a four-year old child dropped from a border barrier by smugglers.  

As agents rushed to aid the injured boy, cartel members opened fire on the agents.  Fire and rescue first-responders on the scene were forced to take cover.  An Air and Marine Operations helicopter came to the rescue, providing cover for the agents transport the boy to the helicopter.

In another incident, agents patrolling the San Isidro Mountains at nightfall came under heavy fire.  Remote surveillance camera operators captured video of an individual, armed with a rifle.  The shooter was firing from the Mexico side of the border.

One border agent was killed in 2023.  Since January 2021, 43 Customs and Border Protection agents have died in the line of duty, according to Homeland Security.  Likely, this may be the first time you are reading about this tragic death toll.   

The media cabal only covers the border patrol if there is an activist group accusing an agent of abuse. The deaths of agents apparently don't warrant a mention on the national news.  Perhaps, it's because Homeland Security Secretary Alejandro Mayorkas keeps assuring Americans the border is secure.

The unprecedented flood of drugs and immigrants is overwhelming the agents, who protect Americans.   They are the unsung heroes of 2023. The women and men of the Border Patrol deserve to be recognized as the Persons of the Year, despite the lack of news coverage. 

Warehousing America's Elderly

More than 1.4 million Americans reside in nursing homes. A few go voluntarily.  Most are placed in facilities by spouses or family members no longer able to provide around the clock assistance, despite their heroic dedication.  Costs are steep, the quality of care varies and abuse can be a problem.  

There are more than 15,500 Medicare and Medicaid-certified nursing homes nationwide. The Centers for Disease Control and Prevention estimates there are 1.7 million beds in licensed nursing homes.  The majority are small facilities with 61 beds are fewer.  About 70% are for-profit operations.

Typically, nursing homes provide assistance with daily living, including preparing meals, bathing, dressing and assisting residents to the toilet, managing medications and feeding residents. Skilled nursing is often available on site.  

Costs are an added stress for families.  A 2021 study by Genworth Financial, the most recent data available, found the average nationwide cost of care in a private room at a nursing home costs $108,405 annually, versus $94,000 for a semi-private room.  Costs vary by state but prices are towering. 

An estimated 80% of aged adults lack the financial resources to pay for two years of nursing care, reports a study by the National Council on Aging. The data shatters the myth that most seniors, especially Baby Boomers, have the financial resources to pay for nursing care.    

Only 12.6% of seniors have long-term care insurance to cover the cost. Medicare pays for the first 20 days at a skilled nursing facility. Many seniors are forced to sell their homes, cash in insurance policies, drain savings and bank accounts.  Often the money runs out while they are in the nursing home.  

A report by the National Center for Health Statistics documented that 83% of nursing home residents are 65 or older.  However, 38% are 85 or older and 26% are between the ages of 75 and 84.  Nearly one-half (49.1%) have Alzheimers or another form of dementia. 

About 818,000 Americans reside in assisted living facilities, which offer less care than nursing homes because patients are usually mobile and able to perform general hygiene.  About 18% of assisted living facilities have a dementia unit and 11% serve only patients with dementia or Alzheimers.  

Research published by the National Institutes of Health (NIH) found patients in long-term care settings are at high risk for abuse and neglect.  Physical abuse may include hitting, slapping, pushing or striking patients with objects, according to the research. Incidents of theft too often occur at a facilities.

Oversight of facilities is spotty at best.  The Centers for Medicare and Medical Services (CMS) is tasked with broad oversight. State regulators, licenses and inspects skilled nursing homes. Significant  violations of standards, may result in a state rescinding a facility's license.

Statistics are a sterile view of the nursing home industry.  Your reporter has seen first-hand the level of care at facilities where family members were housed.  These observations are admittedly unscientific, but most have been collaborated by others with loved ones in nursing homes.

A heartbreaking issue for patients being warehoused: About 7 in 10 receive no visitors. Ever. These poor souls are lonely, frail and virtually shackled to their beds.  They stare vacantly at a small television.  It is an existence in name only.  

It is gut-wrenching to watch patients waiting to be fed, their heads slumped down on tables.  Staff is too busy with other patients, which means some residents wait an hour or more for a meal.  Even those who can feed themselves, are not served in a timely manner in the dining area.  

The meals may include the minimum daily calories and dietary proteins but at the expense of appetizing food. Patient complaints about meals are disregarded as the ramblings of a grumpy old people. If staff were forced to eat the same meals, it would make a difference in quality and variety.

Patient rooms, even the private ones, are spartan and void of color. Wafer thin mattresses on the beds and lumpy pillows are standard. Some patients have televisions, but in many facilities the TVs are provided by the family.  The smell wafting from some rooms testifies to the lack of constant cleaning.

These conditions exist, despite dedicated, trained staff. Facilities are nearly always understaffed.  COVID dealt a devastating blow to nursing homes, killing more than 200,000 residents and staff, according to the Kaiser Family Foundation. 

Isolation protocols forced staff to work excessive long hours, which caused burnout, triggering a worker exodus at many facilities.  As of the fourth quarter of 2022, the annual turnover rate at a nursing home was 53%. One-quarter of facilities reported turnover rates greater than 64%. 

Industry experts estimates there is a shortage of 200,000 nurses at long term care facilities. Recruiting firms forecast it may take five years or longer to reach pre-2020 staff levels.  The workforce problem must be addressed to improve care at nursing facilities.

Another issue is economic.  Although Medicaid pays for most patients' care, the government program reimburses facilities only 86% of the costs for a patient.  Nearly half of nursing homes are losing money, according to the American Health Care Association (AHCA).

As a result, the number of nursing homes is dwindling. An estimated 300 closed in 2020 and a combined 400 went out of business from 2021 to 2022.  This year already 135 facilities shuttered their doors.  These statistics were culled from reports by the Centers for Medicare and Medicaid.   

Understaffing and economics aren't the only problems. With so many aged adults unable to afford more than two years of nursing care, Medicare and Medicaid are ill equipped to provide the safety net for the elderly. Both programs face financial shortfalls and prospects are dim for a short term fix. 

Nothing short of an overhaul of the nursing home model is required for America to meet the needs of a population living longer.  By 2030 more than 73 million Baby Boomers will be 65 or older. In 2035, the number of Americans 65 and older will outnumber those 18 years old and younger. 

Congress can help, but often Washington's heavy hand leads to regulations that add costs and disincentivize the adoption of technology and innovation. Throwing money at a problem without a coordinated plan leads to wasteful spending, fraud and misapplication of funds. See COVID spending. 

This issue requires an all hands of deck approach.

Solutions must involve the long term care industry, state governments, Medicare, Medicaid, nursing schools and organizations that represent seniors.  The technology industry has a role to play also. One solution to the staffing shortage is to use wearable devices to monitor patients. 

Alarm bells are sounding. Urgent action is required to prevent long term care from erupting into a national crisis. Up to now, the siren call is being ignored, putting in peril millions of elderly Americans.