By John Ballard
Sixty-four.
Hmm...
Been there. Done that.
Thus far I have been blessed to dodge the long-term care bullet, but my first-hand experience includes two grandparents and both parents (now gone), as well as several friends and relatives now spending their final years in nursing homes or assisted living facilities.
Long-Term Care: Another Time Bomb for the Economy in The Fiscal Times reminds us of another dark prospect in store as we get older, and what health care legislation may and may not do to ameliorate that threat.
Just a few weeks ago Richard Doelger opened a letter to find that the premiums on his long-term care insurance were set to jump 25 percent in November � that�s on top of a 25 percent increase last year. The increases will jack up his payments to $434 a month for the policy, which covers in-home, nursing home and other assistance if he becomes disabled.Now Doelger, 76, fears that what began as an affordable rate 10 years ago could keep rising, forcing him to walk away from the $30,000 he has already invested. �This whole action borders on the criminal,� says Doelger, a retired marketing vice president in Shrewsbury, N.J. Like thousands of others in his state, he might get some help from Rep. Frank Pallone, D-N.J., who is probing such rate hikes and says he will seek to roll them back if they reflect gouging. (Full disclosure: My own long-term care premiums also have jumped.)
Doelger�s plight symbolizes an urgent but largely unheralded fiscal problem: the nation�s failure to lay the foundation for affordable long-term care insurance as 78 million baby boomers move into their senior years. Some 70 percent of Americans who reach 65 will eventually require help with daily activities like dressing and feeding themselves, according to studies, and 20 percent will require assistance for more than five years.
The writer follows this opening with a snide description of the long-term care component of the Affordable Care Act replete with a negative swipe calling it a Ponzi scheme. Formerly known as the CLASS Act (Community Living Assistance Service and Support), crafted years ago by the late Senator Kennedy and Congressman Frank pallone (D-NJ), this feature of the new health care legislation is a pitiful first step in the right direction still being maligned by health care opponents who offer no meaningful alternatives. One of our posts in February had a few links fot the interested reader.
We can read about the "three-legged stool" approach, referring to the three security measures for those golden years (Social Security, pensions and savings), overlooking the obvious reality that a large and growing population of aging Americans are lucky to have one or two of those legs, and even then they fall short of what is required for safety and security.
The writer had no way to know that links at the end of the article would include an excellent piece from January, How Does U.S. Long-Term Care Stack Up Against the Rest of the World? , a piece worth studying since it shows how far behind the US is failing to take care of an aging population.
Two decades ago, most of the developed world relied on the same sort of welfare-based, Medicaid-type system that the U.S. still uses. That is, if you were poor enough and sick enough, the state would provide some modest personal assistance. If you were middle class, you were on your own�that is, until you spent so much on care that you became poor enough to qualify for government aid.Most developed countries recognized this system was both needlessly cruel and fiscally unsustainable. The U.S. tried to keep people off Medicaid by encouraging them to buy private long-term care insurance. It tried tax subsidies, a government marketing campaign, and an effort to better coordinate private insurance with public benefits. For the most part, it failed, and today, only about seven million Americans own private insurance.
It seems global free market capitalism has yet to provide a meaningful method to insure safety and security for old people except for those fortunate enough to have access to sturdy three-legged financial stools. Everyone else should prepare to spend down until they qualify for welfare or take what Alan Grayson described so well as the Republican plan: die early.
I'm half way through my 64th year and I have pretty much given up my life (like I really had one) to make sure my 88 year old mother does not have to go into a nursing home. To be blunt I would hope that mom will pass away before it reaches the point that I can no longer care for her. In my case there is no one who will do for me what I have been happy to do for my mother. I have not been to a doctor for years because I have had no insurance for years. In a few months I will be eligible for Medicare. I will sign up to cover medical emergencies but but still won't go to the doctor on a regular basis because I probably wouldn't do anything they told me to do anyway. I have no desire to live long enough to need nursing home care because from what I've seen that is not really living. It's not about how long you live but how well you live and when you can no longer live well there is no advantage to living.
ReplyDeleteThanks for covering the eldercare beat, John. And thanks for sharing, Ron. Crucial information for one who's just turned 60 and has an aged mother running out of money, though with LTC insurance. Forewarned about rate hike.
ReplyDeleteWhatever you decide, Ron, you have my full support and encouragement. How families and individuals spend their final years is strictly a lifestyle choice, foundational to the real meaning of freedom. "Living well" has different meanings for different people. Your mother is fortunate to have you for a son. Most of our aging population is not that fortunate.
ReplyDeletePart of the challenge of long-term care is appropriate placement of people as the effects of age and disease take their toll, not only on those requiring care but on their care-givers as well. I'm sure you appreciate the challenge of being a caregiver more than most. Your desire that your mother not outlive you is simply realistic, no different from the parental impulse to care for children.
In my mother's case my wife and I were her primary care-givers while she lived with us for two years, after which she went to an assisted living environment with paid care-givers where she lived comfortably "independent" for two more years. As the result of a fall and advancing senile dementia she went to a nursing home where she lived comfortably another year. For me and my sister, our mother's safety and security were the main concerns. Since she had no assets and only a small Social Security check she was eligible for subsidized expenses (one of which was medigap insurance) and Medicaid which covered all her needs. When she passed at the age of 92 she was taking no prescriptions, only a daily multivitamin and baby aspirin.
Russ, you and I were writing comments simultaneously.
ReplyDeleteLTC insurance is something about which I know little or nothing. In more than twenty assignments over the last two years I have been in several assisted living, hospital and LTC environments and am only aware of one instance of someone using long-term care insurance -- and that was not one of my clients. As with all insurance, rates will forever protect profits ahead of benefits, but like everything else in America whoever can afford to pay will have those benefits.
The Cadillac of aging environments are the growing numbers of continuing care retirement communities (CCRC's) which insure that all who are accepted will have all their needs met -- up to and including Alzheimer's and skilled nursing care -- as long as they live. Part of the monthly fee may include a group LTC policy (imagine that) which spreads the risk for a very select group of aging people.