Prescribing a Financial Fix for Post-Acute and Long Term Care David Hebert As we head into yet another Presidential race, it seems that The American Health Care Association (AHCA), the every candidate is focusing on the need for health care reform National Center for Assisted Living (NCAL) and our nearly and we have seen many proposals put forth into the court of 11,000 member long term care providers believe that a public opinion. comprehensive long term care system should promote and While the goals of fixing a troubled and ailing healthcare integrate a comprehensive array of public and private financing system are laudable, it is greatly distressing that no candidate options that meet consumer and family needs and respond to has included long term care – no addressing skilled nursing their preferences. care, assisted living, hospice, or home care – in their reform As long term care and post-acute care expenditures are plans. This is why long term care professionals are actively expected to increase dramatically over the next fifty years due engaged in bringing long term to the aging of the baby boom care issues to the forefront as generation, the enormous part of the 2008 presidential financial pressure on federal debate. and state budgets will continue According to the U.S. to escalate. However, not Department of Health and only do state and federal Human Services, nearly 40% governments need to plan for of all Americans will require the future of long term care, but nursing home care at some individuals must take personal point in their lives. In addition, responsibility in planning for they estimate that by 2020, 12 their future care needs. million older Americans will First off, we must clear need long term care services. up misconceptions about how These startling facts reveal one long term care is financed in very important truth – that it this nation. Many consumers is critical that policymakers are under the impression that As greater numbers of address long term care reform these services are automatically patients and residents enter now in order to prepare for funded by Medicare, Medicaid America’s future long term or their traditional health care our nation’s long term care care needs. insurance. However, Medicare system, it is imperative that our has a limited benefit for postAs greater numbers of policymakers address America’s acute long term care and in patients and residents enter our nation’s long term care order for Medicaid to fund entitlement programs. system, it is imperative that individuals’ long term care and our policymakers address America’s entitlement programs. services, individuals must impoverish themselves. As well, Unfortunately, at present, nursing facility care is predominantly many are unaware that health care insurance has no long term funded by the overextended Medicaid and Medicare programs. care benefit and that long term care insurance is a completely Currently, 80 percent of the patients and residents receiving separate policy required to fund this type of care. care and services in the nearly 1.5 million nursing facilities Personal investment and future planning through the nationwide rely on funding from one or both of these programs purchase of a long term care insurance policy is one step to to pay for their long term care. This strain on the system, take the pressure off Medicare and Medicaid in their role of coupled with the need to care for an ever increasing number of funding long term care. In order to encourage such personal patients, clearly points to the need to address these programs, responsibility, incentives must be built in to the system. and soon. Through the Deficit Reduction Act of 2005, Congress took 10
RIPON FORUM October/November 2007