As our country continues to discuss health care reform and how to best provide quality care to all Americans, we must remember to address our nation’s most vulnerable citizens. Unfortunately, however, health care for the elderly is often left out of health care debates, despite the fact that the elderly often have long-term needs and there are millions of seniors and persons with disabilities who cannot afford health care. Providing health care for the elderly is only going to become an increasingly growing problem as baby boomers age and are faced with expensive and persistent health crises. Today, there are nearly 10 million Americans who need long term care services, and this number will increase to 15 million by 2020 – evidence that our nation must address long-term care issues and its exorbitant costs.
Of people turning 65 years old today, 69 percent will need some type of long-term care – a statistic that is daunting when considering the extreme costs of care, combined with the reality that many elderly are retired and are therefore on a fixed income. Currently, there is no single, coherent system to help the elderly pay for long-term care. Instead, various sources (such as family budgets, Medicaid, a small portion of Medicare, and private insurance) are relied upon to help fund long-term care. With the reality of a growing baby boom population, and thus a growing demand for long-term care, this fragmented system is not sustainable. Currently, only one in five people can afford to pay for long-term care, and to further compound issues of coverage, many health insurance companies refuse to serve people with pre-existing conditions. The majority of people who are in need of long-term care, therefore, have no means to pay for such services, and current policies require Medicaid recipients to be impoverished before they can receive assistance.
Financing long-term care will not only be beneficial for the growing population who cannot afford it, but also for sustaining current, pivotal programs – such as Medicaid – which are becoming burdened by this growing demand for long-term care. The extent to which the entire health care system is currently being crippled by the unbearable costs of long-term care is evidenced by the fact that one third of Medicaid’s budget is directed towards providing long-term coverage, even though only ten percent of its beneficiaries use these services. The need to create a program that provides long-term care coverage, therefore, is necessary to aid the elderly, as well as to relieve state budgets and to ensure that programs such as Medicaid do not collapse.
In acknowledging the dire need to address issues of long-term care coverage, we suggest implementing a program that will subsidize costs for patients through an additional program to Medicare and Medicaid. This plan would call for the creation of an employer-based, national long-term care insurance program that will be funded through an additional tax taken out of workers’ paychecks similar to Social Security. This tax would be deducted on an “opt-out” system, allowing for individuals to opt out if he or she does not wish to participate in funding this program. All people eighteen and older in the work force would be eligible to participate, and would need to contribute for at least twenty years before they could benefit from the program—with a grandfather clause that would not require those in the workforce now to contribute for this long. Additionally, the institutional bias that is in place now in the Medicaid system needs to be removed so that individuals in need of long-term assistance have the choice of receiving their care and services in their own communities. This system would allow not only for more funding for long-term care patients, but also a variety in the kind of care that would be available to them to ensure better and more effective care for more people.
Additionally, another aspect of our plan would include providing a tax credit for families who choose to take care of their loved ones in their own home. Currently, family spending is in the billions per year and it has created a strain on many family incomes as a result. This tax credit would provide incentive for more families to provide long-term care for their family members in their own homes, which could additionally help with the burden felt by insurance companies and private sector health care providers. We believe that this tax credit would greatly assist many families who are currently spending significant funds on their loved ones as well as help decrease the inevitable stress the baby boom generation will be placing on health institutions over the next few decades.
While our nation is currently focusing much attention to health care reform, little of this debate has been directed toward the issue of long-term care and the rising number of baby boomers that will be needing it in the very near future. It is our belief that this kind of policy is necessary to ensure there is sustainable coverage for those in need of long-term care. This plan not only provides funding for these kinds of services, but it also creates the possibility for various types of care for long-term care patients, which could open up a new market for private sector care providers in this area. A long-term health care coverage plan, therefore, can be regarded as a positive reform measure not only for those in need of services, but for the entire nation.
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