Long Term Care: A Case Study

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One of the most pressing issues in present-day society concerning healthcare in the United States is the enormous – and rising – cost of long-term care (LTC), as it is very expensive and bankrupting the disabled elderly middle class. Long-term care is a myriad of services that help meet the medical, or often non-medical, needs of people who cannot care for themselves on a day-to-day basis (Hooyman, 2011). These people usually have a chronic illness or disability that prevents them from carrying out activities of daily living (ADLs) – routine, everyday activities, such as bathing, dressing, eating, etc. (What is Long Term Care and Who Pays for it?, 2014). The elderly are often those in need of LTC, as difficulty with ADLs becomes more common…show more content…
Medicare accounts for about 18 percent of all national LTC spending, with only limited coverage for chronic-care expenses. Limited to 100 days of care, nursing home care coverage under Medicare excludes ongoing care for chronic conditions. Medicaid, however, does pay for some medical benefits that Medicare does not cover, such as prescription drugs and LTC. However, even though Medicaid is the main funder of nursing home care, over 40 percent of additional expenses associated with such care are still paid by individuals out-of-pocket. So, despite the benefits of Medicaid, families with limited means often bear the full burden of providing personal care themselves. As its eligibility and coverage varies from state to state, Medicaid only covers the costs of LTC to an extent (Harrington, 2010). LTC is particularly expensive to middle class elderly citizens. Medicaid is only available to those with very limited income, so middle class families must pay out-of-pocket until they deplete their assets and Medicaid kicks in. The average bill for a private room in a U.S. nursing home now approaches $91,000 a year. The few who can afford it buy LTC insurance in advance when insurers are less likely to reject them, but even those with insurance often come up short (Craft,…show more content…
First, there is no reason that Medicare should not cover LTC costs, considering LTC’s necessity for elders of all income levels. Thus, we must expand Medicare to include LTC costs, which will also result in less confusion over what is or is not covered by Medicare and Medicaid. In addition, the government could subsidize home care, which would ultimately lower LTC costs for the elderly. Thus, to help reduce costs of LTC, Medicare or private long-term insurance should pay for in-home care and nursing home care. This would definitely require more money from the government, which could be funded by increasing Medicare taxes. However, with our current House and Senate controlled by the Republican party, this notion of raising taxes may not be so popular. Instead, the government could require employers to offer healthcare insurance to employees of big companies, and for lower-income adults, the government could offer tax deductions or subsidies. With these policy revisions, there would ultimately be a less complicated and more affordable LTC

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