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The Future Of Elder Care

The Obama administration scraps long-term care insurance from the healthcare overhaul. What’s the future hold for elder care now?

Elmaze Joseph, left, works with therapist Jocelyne Denis doing foot exercises at the Miami Jewish Home and Hospital in Miami. Across the U.S., facilities are widely expanding in-home care and assisted living, and looking to new ways to generate income beyond their traditional role of housing the elderly during the last years of their lives. (AP)

Elmaze Joseph, left, works with therapist Jocelyne Denis doing foot exercises at the Miami Jewish Home and Hospital in Miami. Across the U.S., facilities are widely expanding in-home care and assisted living, and looking to new ways to generate income beyond their traditional role of housing the elderly during the last years of their lives. (AP)

Dear Listener, I hope you live happy, loved, and strong to 101, robust and healthy all the way. I really do. But the fact is that an awful lot of people end up needing help as they age. A lot need long-term care.

This week, long-term care has been bounced from the Obama health care reforms – by the Obama administration. “Suspended” is the word they’re using, but it’s gone. Too expensive. But the country’s population keeps on aging. A tsunami of boomer elders is coming. And then everybody else.

This hour On Point: what will happen to you when you’re old and need help?

-Tom Ashbrook


Rep. Michael Burgess, a medical doctor, he represents the 26th Texas congressional district.

Howard Gleckman, a resident fellow at the Urban Institute, he’s the author of Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America’s Most Urgent Health Care Crisis.

Judy Feder
, professor at the Georgetown University Public Policy Institute. She served in the Department of Health and Human Services during the Clinton administration.


The coming wave of Baby Boomers entering the elder care system is going to put a serious financial burden on the nation. There are currently 10 million people on long-term care today, a figure that will double in twenty years.

“I didn’t realize I was part of such a small group, but I am one of the 7 million Americans that have private long-term care insurance,” said Rep. Michael Burgess, a Republican from Texas. Burgess said that the making private insurance affordable was the only way to sustainably finance care for an aging population. “People of my generation need to be talking about this, talking about this. Many people can’t afford it.”

Howard Gleckman, a fellow at the Urban Institute said that the current state of elder long-term care is “untenable,” noting that many current caregivers for the elderly are hurting their own savings for the future. “We’re stacking this onto future generations,” Gleckman said.

“For the life of me, I can’t understand why Republicans, of all people, oppose an insurance-based model [like the CLASS Act] rather than relying on the Medicaid, welfare-based model that we have today.”

“It absolutely should be an insurance-based system,” Burgess countered, arguing that the CLASS act was unsustainable.

Public insurance for long-term care is the only answer, said Judy Feder, a professor at Georgetown University’s Public Policy Institute and a former Clinton administration official. “People are having trouble putting money away for pensions, let alone private long-term care,” she said. “And those private insurers are not reliable.”

Caller Phil in Clarksville, TN

This is a pretty apropos story for my family: My father’s funeral is, in fact, tomorrow. Dad had a stroke about 15 years ago. He only needed full-time, at home care, for the last month. My mother, my parents were both school teachers, not wealthy people. However, they had purchased long-term care insurance years ago. High premiums, but they believed it was the right thing to do.

My mother was very comforted by the fact that they had long-term care insurance. When it got to the point, a month ago, when my father did need round the clock care, she was very – we were all very disheartened to find that there was a 100 day deductable in the details of the policy. My parents are well educated, but they didn’t understand that there was a 100-day deductible. Meaning, that they had to pay out of pocket at least 100 days before the long-term care insurance kicked in.

Caller Jim from Pittsburgh, Pennsylvania

I would like to mention that one thing people don’t realize is that sometimes this process of getting old is sequential. First of all, I have put money in the bank, in addition to my annuity, which I had hoped would carry me into old age. I lost a lot of it, which a lot of us did. A few years ago, I developed prostate cancer that made me ineligible to get long-term care insurance until I waited some period of time. Then, I developed chronic pain issues, which cause me to be put on narcotics, which I continue to take. I can’t get long-term care insurance as long as I’m on those and I may be on them for the rest of my life. If someone has said to me that I could get it for $150 per month, I wouldn’t mind. Course no one wants to pay that, but I would pay it if I could get it.

I’m 68 now. These issues started when I was 57, when the prostate cancer started. I’m 68, I’m still functioning. I work part time and whatnot. I can’t get long-term health insurance.

Ken in Carlyle, Massachusetts

My wife and I bought long-term care insurance back in 2002, as rich a policy as we thought we could afford. We thought we were reasonably set. And then to our great surprise and really our great displeasure, early in 2008, we got a notice from our company, Monumental Life Insurance Company, of Cedar Rapids, Iowa, that our premiums were going up. The company was not direct in telling us how much they were going up.

I’m an economist by training and started digging around. What I found out was that our division of insurance has allowed them to increase our premiums by 70 percent. The increase didn’t come in instantly, but it was allowed to be phased in three incremental annual steps of 20 percent a piece. It’s enormous.

Mike in Acton, MA

To be brief, I had the opportunity to take of my spouses’ mother and father and they both had long-term care insurance policies that they’d had for many years, with a company called Unum. And he felt pretty good, because he’d planned ahead. He ended up in a nursing home at one point, and a nursing home in Massachusetts costs about $300 per day. Now, the policy had a 100 day deductible, but it also maxed out at $100 per day. It was a policy that he’d had for years and it probably sounded pretty good when he got it — $100 per day. How could it cost more than $100? But it turns out that $100 just doesn’t do it. The whole concept that the Congressman [Michael Burgess] from Texas is trying to push is essentially healthcare for the rich, health insurance for the rich. It has nothing to do with the vast majority of us whose only healthcare policy is not to get sick.

From Tom’s Reading List

The Washington Post “One way of looking at the administration’s decision is that it shows their commitment to fiscal responsibility. “What happened here is that government worked exactly the way it ought to,” wrote Kevin Drum at Mother Jones. “Even though it was a liberal program promoted by a longtime liberal icon, HHS analysts eventually concluded that its conservative critics were right and the program as passed was flawed. So they killed it.””

The New Republic “The Obama Administration is pulling the plug on CLASS, the long-term insurance program within the Affordable Care Act. The announcement came late Friday, most likely because administration officials hoped to bury the news. They did not succeed, as Republicans and their supporters were all over it.”

The Atlantic
“HHS, which was required to certify that the program was sustainable, couldn’t, and thus it is no more. The program has taken about half of ObamaCare’s projected deficit reduction to the grave with it. Conservatives are having a field day, but Kevin Drum argues that this is actually good news.”

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