A great front page New York Times story came out Sept 7, 2012 by Nina Bernstein, called “With Medicaid, Cost of Long-Term Care Looms as a Rising Cost”.

The gist of this article is that no matter which party wins the election, hold on to your hats concerning Medicaid, which pays for about half of the cost of long-term care, nationwide. Medicaid is going to erode. It is eroding. It has eroded. Due to slashed reimbursements and broad middle-class access, Medicaid is already the last choice if home health care or assisted living are feasible instead.

I’ve pasted some quotes from the article, below.

“With baby boomers and their parents living longer than ever, few families can count on their own money to go the distance.”

“Many people mistakenly assume that Medicare will cover long-term care, but at most it covers 100 days of rehabilitation, not so-called custodial care — the help with activities of daily life, like eating and bathing, that the aged can need for years.”

(It should already be clear to readers of this blog that Medicare can’t, and won’t pay for long-term care. Only reasonably priced long-term care insurance or personal savings and sacrifice pay for the more dignified options people prefer.)

“More than $80,000 a year on average for a nursing home — who can sustain that?” said Robyn Grant, director of public policy and advocacy for the National Consumer Voice for Quality Long Term Care. “We’re forced, most of us, to go onto Medicaid. People don’t realize this.”” (I inject that many people are not forced to go on Medicaid unless they’ve failed to make responsible – and reasonable – plans for long-term care in advance.)

“While Medicare has drawn more attention in the election campaign, seniors and their families may have even more at stake in the future of Medicaid changes — those proposed, and others already under way…The presidential election may decide Medicaid’s future. But many states faced with rising Medicaid costs and budget deficits are already trying to cut the cost of long-term care by profoundly changing Medicaid coverage, through the use of federal waivers.”

“Medicaid spends just under a third of its budget paying for long-term care for the disabled and elderly in nursing homes; this is more than five times as much as it spends on each poor child.”

The article goes into more detail on the different techniques states are using to try to trim their Medicaid budgets. It is my opinion that none of the proposed changes will improve the quality of Medicaid-paid long-term care; they will just shift around costs and add instability to this already strained program.

The bottom line is that the government cannot afford to provide decent long-term care. With the looming “Silver Tsunami” of Baby Boomers who are going to deluge it, the quality of Medicaid-paid long-term care is likely to continue to deteriorate. Counting on the government to pay for long-term care is foolhardy.

This article excellently describes Medicaid’s crisis and why it is ill-equipped to pay for long-term care. What it doesn’t even touch on is the fact that Medicaid-paid long-term care facilities are already the bleakest and scariest places to receive care. People do not choose Medicaid-paid long-term care. They default to Medicaid because they have no other options.  And the real tragedy is that vast majority of American could have avoided this fate, but they denied that they would EVER need long-term care and therefore failed to take action before it was too late.