Long-Term Care A Problem Too Long Ignored

(This article appeared in the September/October 2007 issue of The American Postal Worker magazine.)

Doug Holbrook, Director

Our nation has too long ignored the need to address in a fiscally responsible manner the emerging long-term crisis facing seniors, baby boomers, and younger people with disabilities.

Our current system forces people into institutions prematurely; requires many to spend their way into poverty before receiving the help they need; fails to provide realistic opportunities for personal responsibility; and fails to make it easier for families.

Nursing-home costs average $62,000 a year, and since Medicare and basic healthcare will not cover most of those costs, you can imagine the financial problems this creates, especially for those who are not prepared. We need a continuing education program regarding longterm care that will encourage younger workers to more carefully consider their future.

The need is urgent: America can — and must — do better. The following can provide a framework for focusing attention, generating discussion, and crafting a solution to the long-term care crisis:

National Problem, National Solution: We must recognize that although states, communities, families, and individuals have important roles to play, long-term financing is a national problem that requires a national solution.

Universal Care With Voluntary Opt-Out: A public program must be created that allows all people – including individuals with disabilities and those near retirement – the opportunity to contribute to and prepare for the cost of long-term care. The chance to participate must be made as convenient as possible, such as through an automatic payroll deduction. (Participants should, of course, have the choice to opt out.)

Public/Private Partnership: A publicly-funded program must provide a minimum floor of protection while providing incentives for planning and personal responsibility that ensure a vital role for private-sector solutions.

Affordability and Risk Pooling: The program must provide for broad pooling of risk to make premiums affordable enough so that all people, regardless of income and health status, can participate.

Fiscal Responsibility: The long-term care solution should provide actuarially sound funding, primarily through voluntary premiums that build reserves over time sufficient to pay for future needs.

Relieve Pressure on Medicaid :We need an additional long-term funding mechanism that will help to contain future Medicaid expenditures, while preserving the guaranteed safety net.

Consumer Choice: It will be important to promote independence and dignity across the continuum of care by ensuring beneficiaries the right to control what services they receive and to choose how, where, and from whom.

Support Families: Everyone should recognize and support the central role that families play in planning for and providing long-term care.

Invest in Quality Care: To combat high turnover, expand the workforce, and improve the quality of care, funding should be targeted to ensure sufficient training and compensation for long-term care workers.

The number of Americans over the age of 75 will more than double, and the number of those over 85 will roughly quadruple in the first half of this century, which is likely to overwhelm the nation’s long-term care services for a population that is already mostly underserved or worse.

America’s current healthcare system is poorly suited to serve the needs of the elderly and their families, and we lack a framework to address and improve it. It’s clear that we need to have a national discussion on solutions to the problems of long-term care.