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Neither Party Has A Solution For The Oncoming Deluge of Medicare/Medicaid Services

September 25, 2012 by Honey Leave a Comment

Republicans DemocratsI was happy to see in Steven Rattner’s September 16, 2012 New York Times Op-Ed column at least a faint acknowledgement of a looming catastrophe. Because of its highly unsavory political nature, neither Democrats or Republicans really want to address the oncoming deluge of aging Americans who will further glut our already hobbled Medicare and Medicaid programs.

Mr. Rattner sticks to describing Medicare in his peice, although he does refer to the oncoming deluge of ill-prepared aging parents who will need long-term care.

Politicians are even less inclined to discuss Medicaid, which pays for more than half of all long-term care in the US. However, I have recently blogged about Medicaid’s bleak future, no matter which party wins the election.

Medicaid payments affect the quality of Medicaid-paid long-term care. Medicaid-paid nursing homes count on Medicare covered expenses to offset the money they lose on every Medicaid patient.

In past blogs I have explained why budget shortfalls make Medicaid-paid long-term care inferior in many regards. With this knowledge, why aren’t more people motivated to act responsibly and protect themselves and families against the high costs, high risks of needing long-term care? This remains a mystery to me. Reasonably priced long-term care insurance is still the cheapest way to access and pay for the long-term care options people want, and that are preferable to Medicaid-paid care.

I’ve added the bolded type below, for emphasis.

Mr. Rattner writes, “The Obama and Ryan plans are not without common ground; both propose an identical formula for capping the growth in Medicare spending per beneficiary. And both dip into the same toolbox (particularly lower payments to providers) to achieve a reduction of nearly $1 trillion in Medicare expenditures over the next decade from projected levels.”

“Mr. Ryan believes that meeting the goal over the long term requires introducing more competition into Medicare through vouchers to purchase private insurance. But Ryan’s approach was rendered toothless when the issue’s brutal politics forced him to retreat from his initial tough plan to simply cap the growth in government spending on Medicare and stick the inevitable overage onto beneficiaries. Under his revised plan, private insurers would be required to offer the same level of benefits as traditional Medicare, meaning that any savings would have to come from unidentified efficiencies (the ever-popular “waste, fraud and abuse”).”

“To be sure, health care cost increases have moderated, in part because of the recession and in part because Medicare has been tightening its reimbursements. But those thumbscrews can’t be tightened forever; Medicare reimbursement rates are already well below those of private providers.”

Mr. Rattner concludes, “the Independent Payment Advisory Board should be allowed to offer changes in services and costs. We may shrink from such stomach-wrenching choices, but they are inescapable.”

Government-paid long-term care will get worse before it gets better. Be forewarned with this knowledge and act accordingly and  responsibly. If you want to be assured greater dignity and options, buy reasonably priced long-term care insurance NOW!

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: Honey Leveen, Medicaid, Medicare, New York Times, Obama, Ryan, Steven Rattner, www.honeyleveen.com

The Government Doesn’t Pay For Long-Term Care!

September 17, 2012 by Honey Leave a Comment

US GovernmentI can’t say it any better than William Gaston in the fall edition of Democracy: A Journal of Ideas (818 18th Street, NW Suite 750 Washington, DC 20006): “Medicaid already constitutes the single largest share of state budgets—24 percent, a figure that rises relentlessly year by year. State spending on the program rose by 20 percent in the most recent reporting year and by even more—23 percent—in the previous year. By the end of fiscal year 2013, total Medicaid enrollment for low-income Americans and the dependent elderly will have risen by 12.5 percent in just three years.”

“Because state revenues are growing much more slowly than Medicaid outlays, other priorities are getting squeezed. In many states, for example, public higher education—key not only to future prosperity and competitiveness but also to opportunity and mobility—is reaching a breaking point.”

“I had no idea how long-term care was financed. I soon learned that Medicare paid for at most 100 days of rehabilitation (useless in my mother’s case) and that Medicaid required beneficiaries to “spend down” nearly all their assets. Private long-term care insurance policies were available, I learned, but my parents—along with most Americans who can afford them—had not purchased one.”

Please take heed and plan responsibly, ahead of time, for a possible long-term care need.

Filed Under: Helpful Information About LTC, Information About LTC Tagged With: Democracy, Honey Leveen, Long-Term Care Planning, LTC Insurance, Medicaid, Medicare, William Gaston, www.honeyleveen.com

For Retirees, 70 May Not Be The New 65

September 10, 2012 by Honey Leave a Comment

70 New 65A recent Wall Street Journal MarketWatch article by Elizabeth O’Brien (August 30, 2012) describes a new study by the Employee Benefit Research Institute (ERBI). The study finds that about a third of today’s households won’t be financially prepared to retire, even if they continue working until age 70.

ERBI’s findings are at odds with a prior study by the Center for Retiree Research at Boston College, which found that 86% of households would be able to retire if they worked until age 70.

According to ERBI’s Jack VanDerhei, the reason for the vast descrepency between both studies is “the Center for Retirement Research analysis didn’t factor in the prohibitively high costs of nursing home care, which typically isn’t fully covered by Medicare and is only covered by Medicaid in some cases. His own methodology included the probability of nursing home expenses and arrived at a less optimistic conclusion.”

Here’s an additional quote from the article: “Many workers don’t even have the luxury of delaying retirement. In EBRI’s 2012 Retirement Confidence Survey, 50% of current retirees reported they left the workforce earlier than planned—because of health concerns for themselves or their spouse, changes at their company or other reasons.”

The bottom line: take heed. Medicare does not pay for long-term care. Long-term care costs can be catastophically high. Medicaid-paid long-term care offers little choice and less dignity. Plan accordingly, now! Reasonably priced long-term care insurance is a sane, empowering, logical investment.

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: Boston College Center for Retirement, Elizabeth O'Brien, Employee Benefits Research Institute, ERBI, Honey Leveen, Long Term Care insurance, Long-Term Care Planning, LTC Insurance, MarketWatch, Medicaid, Medicare, Wall Street Journal, www.honeyleveen.com

The State of FL is Dumping Disabled Children

September 8, 2012 by Honey Leave a Comment

State Of FloridaA story in today’s Houston Chronicle, titled “Florida hit for putting disabled kids in nursing homes”, ties in beautifully to the blog I wrote yesterday, “Medicaid in Deep Trouble No Matter Which Party Wins the Election”.

The Chronicle article illustrates the great lengths some money-strained governments are already going to to slash their Medicaid budgets. Medicaid is what pays for long-term care for the disabled children described and impoverished elderly.

I have good reason to fear that what this article describes is just “the tip of the iceberg” compared to what’s in store. People don’t properly prepare and the government just can’t afford to provide decent long-term care. This trend does not show signs of reversing.

If you want to ensure quality choices, dignity, and reduced family stress and strife, and you don’t want to risk wiping out your life savings doing so, you need to talk about reasonable and responsible long-term care planning, then take action and prepare, NOW!

Here are some quotes from the Houston Chronicle story:

“Florida health and disability administrators have been systematically dumping sick and disabled children – some of them babies – in nursing homes designed to care for elders, in violation of the youngsters’ civil rights, the U.S. Justice Department says.”

“In recent years, however, Florida health administrators have relied upon nursing homes to house hundreds of children who could safely live at home with their parents – often at less expense to the state, advocates claim. Assistant US Attorney General Thomas Perez said the state has cut millions from programs that support the parents of disabled youngsters, refused $40 million in federal aid that would have enabled some children to stay or return home, encouraged nursing homes to house children by increasing their per diem rate – and even repealed state rules that limited the number of kids who could be housed in adult nursing homes.”

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: Honey Leveen, Houston Chronicle, long-term care, LTC Insurance, Medicaid, Nursing Homes, US Justice Department, www.honeyleveen.com

Medicaid is in Deep Trouble, No Matter Which Party Wins the Election

September 7, 2012 by Honey Leave a Comment

MedicareA 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.

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: Honey Leveen, long-term care, LTC Insurance, Medicaid, Medicare, New York Times, Nina Bernstein, www.honeyleveen.com

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