I 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!