Policy Documents

Long-Term Care or Long-Term Dependency?

Conrad Meier –
March 7, 2001

In this document, Conrad Meier writes that society has changed significantly on the road to the 21st century. We are a nation of scattered families with many disconnected family ties. Seniors are living longer, making the decision to take in a family elder a much longer commitment than ever before. Since we have the advanced knowledge to help us live longer, an incapacity like Alzheimer’s complicates the problem of family-centered care.

Long-term health care will become long-term government dependency. He wants to spend $6.2 billion to provide a $1,000 annual tax break for individuals and families who need long-term nursing home care and chronic care. What at first sounds like a caring and reasonable idea is really a slick way to make seniors even more dependent upon government largesse and, in turn, guaranteeing continued voter support of big government entitlement programs. Clinton’s approach is consistent with the administration’s desire to take us away from independence by encouraging people to wait until a family member needs long-term care rather than encouraging people to insure themselves for the event beforehand. This is the same kind of social policy that placed brass handcuffs on many Americans. By guaranteeing a modest income to citizens, the government stole many a citizen’s desire to plan his or her own financial independence from government. In the long view, long-term nursing home security provided by government would be no different than Social Security.

Long-term care can wipe you out both emotionally and financially. My wife’s Grandma Schafer was cared for in a loving home setting until the need for round-the-clock care exceeded the ability to provide it. She remained fiercely independent of government help until a nearly $200,000 estate had been exhausted for nursing-home care. By 2020, the age-65 population will reach 54 million or one-in-six Americans. More significant is the larger proportion of citizens over the age of 85, a group represented by Grandma

Schafer, who require day-to-day assistance with routine activities. So more and more Americans turn to nursing homes and assisted-living canters as the solution to providing a safe and caring environment. Medicare covers little or none of this expense for most people. As in Grandma Schafer’s case, only about 24 percent of families will pay for care of out personal funds. Almost 70 percent will use Medicaid.

The reality is problematic for policy makers. The increased demand for these services is making states nervous about how to pay for them.