“Medicare will pay for heroic care for women who are dying of old age, not a disease that could be treated: diagnostic tests, all manner of surgery. Expensive medications. Trips to the emergency room or hospital. Yet Medicare, except in rare cases does not pay for long-term care in a supervised, safe place or for home aides to help with shopping, transportation, bathing and using the toilet.” These remarks are the opinion of Jane Gross, former New York Times reporter, and appeared in “How Medicare Fails the Elderly,” Sunday October 16, 2011 New York Times.
Ms. Gross goes on to refer to the “dirty little secret” of health care in America for the elderly. When Medicare was created life spans were shorter and we did not have the medical technological advances that we have today. Bottom Line: Many of us will live a very long life with little life line for the type of care we actually need as we age. Do you and your parents have a half million dollars for old age? As Ms. Grossman says, “denial
is powerful, but it doesn’t pay the bills.”
Ms. Gross also comments that this mismatch between what is covered and what is actually useful is the central flaw in Medicare today, a shock to families who have no clue until they are smack in the middle of it. Why is nobody outside the insular community of long-term care providers even mentioning the difference between acute and chronic care and how
each is paid for (or not.)?
The Federal Government’s attempt to implement a long-term care entitlement
solution, the Community Living Assistance Services and Supports Act, known as
the Class Act, has been removed from the Patient Protection and Affordable Care Act due to its financial unsustainability. It is extremely unlikely that we will have a government solution or even partial relief for long-term care expenses while Medicaid dollars are being slashed. As a point of clarification, CLASS has been referred to as an “insurance program.” But insurance implies risk management and underwriting. There was no underwriting
in the act which was just one of the underlying reasons for its financial unsustainability.
Thank you, Ms. Gross, for letting the cat out of the bag. A patient with Parkinson’s or someone who has experienced a stroke does not make the distinction between medical care aimed at curing and care required to help the chronically ill with activities of daily living. Unfortunately this distinction often only becomes clear when suddenly there is no one to pay the bills except for the patient and his or her family.
Long-term care insurance is intended to address this mismatch. It offers policyholders a choice about where and how assistance is received and a way to pay for the care that
is often required as we age and become frail or experience an accident or develop a chronic illness. Sadly, only seven percent of long-term care expense in our country is paid by private insurance. Primarily because so few Americans have planned for long-term care expense.
*How Medicare Fails the Elderly” the New York Times, Sunday, October 16, 2011 Jane G
Cynthia DeGeorge holds the CLTC, Certified in Long-Term Care, designation. She is also a Certified Financial Planner, CFP® and one of the few CFPs who specialize exclusively in long-term care expense planning. Realizing the enormous exposure that long-term care expense posed for clients, Cynthia specializes in developing long-term care insurance solutions in the context of her clients’ holistic financial health and lifestyle choices.
Cynthia DeGeorge, CFP® CLTC 928.445.7060
Visit us at www.GurleyLTCI.com
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