[acb-hsp] How Do We Care for the Elderly?

[peter altschul]

How Do We Care for the Elderly?
  Linda Chavez
  Last week, the Obama administration dropped one of the 
signature provisions of its healthcare plan.  The CLASS Act 
(Community Living Assistance Services) was intended to provide 
affordable insurance for long-term care to individuals who, 
because of infirmity or age, could no longer care for themselves.  
But the reality that not enough healthy Americans would sign up 
to make it self-supporting finally doomed the program.
  Many opponents of Obamacare will no doubt cheer this turn of 
events because it confirms the view that we cannot afford to, in 
essence, nationalize health care.  I agree --but I also recognize 
that the problem that the CLASS Act was trying to address is a 
legitimate concern for which we now have no workable solutions.
  The nation faces a looming crisis in caring for the elderly, 
whose life expectancy often exceeds their ability to live 
independently.  Millions of Americans need long-term care, but we 
currently have no system that adequately provides it a cost that 
most Americans can afford.
  This topic holds more than public policy interest for me.  
Three years ago, my then-87-year-old mother came to live with me 
when it became clear that it wasn't safe for her to continue to 
live on her own.  Although in good health, my mother is virtually 
blind and quite frail.  She values her independence, prepares all 
her own meals, has excellent long- and short-term memory and 
follows the news avidly.  But without daily assistance, she could 
not shop for food, get to the doctor or clean her own living 
space.
  Last week, however, her situation changed dramatically.  After 
returning from a doctor's visit, my mother fell on the last step 
of a steep climb down from the car to our home.  I was just a few 
feet away from her when I heard her hit the floor.  In that 
instant, her life and future changed dramatically.  She broke her 
hip -- the scourge of the elderly -- and within 24 hours had 
undergone partial hip replacement surgery.  Three days later, she 
was released from the hospital.
  Medicare provides coverage for up to 100 days in a 
rehabilitation facility so long as the patient needs daily 
services that can be provided only by a doctor or nurse or is 
receiving the rehabilitation therapies provided and making 
progress.  But when the 100 days are over, the patient is on his 
or her own.  My mother is now in an excellent rehabilitation 
center in Boulder, Colo.  -- but it's unclear what will happen 
when she's released.
  If you're very wealthy and can afford upwards of $60,000 a year 
in private, long-term care, the alternative of an assisted living 
facility is available.  But what if you don't have those means? I 
would gladly take my mother back into my home, but I don't think 
it's feasible for her to continue to live there.  If we can 
manage to get her down those same steep stairs and into the house 
again, she'll be trapped there indefinitely, unable to go to the 
doctor, grocery or anywhere else except to the hospital if she 
falls and injures herself again.  And she'll need someone with 
her 24 hours a day.
  Since my mother has never owned a home or any other assets -- 
only a meager Social Security and Veterans' pension and the help 
I've provided since my father died -- she is eligible for 
Medicaid.  And unlike Medicare, Medicaid does provide coverage 
for long-term care.  But having visited the local facilities that 
accept Medicaid, I can tell you the decent ones have long waiting 
lists -- a year or more -- and the ones that don't have waiting 
lists break a daughter's heart.  I simply cannot imagine putting 
her in one of these crowded, dreary, hopeless places.
  Currently, 40 million Americans are age 65 and older, and of 
these, nearly 6 million are 85 years of age or older.  One in 5 
elderly Americans are currently considered dependent, but the 
proportion will grow to nearly 40 percent by 2050.  We continue 
to expand the frontiers of life expectancy, but we have yet to 
figure out how to care for our ever-growing population of older 
Americans.
  The administration's failure to come up with a feasible plan to 
solve the problem is no cheering matter.  We must find a way -- 
not only for our parents but for all of our sakes.
  Linda Chavez is chairman of the Center for Equal Opportunity 
and author of Betrayal: How Union Bosses Shake Down Their Members 
and Corrupt American Politics.