Wednesday March 3, 1999
The February 1999 issue of McKnight's Long-Term Care News contains a point/ counterpoint column entitled "Endorse the White House LTC Plan?" In this article, U.S. President Bill Clinton makes the case for his new four-point long-term care plan. Center for Long-Term Care Financing President Stephen Moses presents the counter argument. Excerpts from both positions follow.
"Long-term care is a complicated challenge that requires a range of responses. To improve long-term care in America, we propose to do four things: First, to provide a long-term care tax credit -- $1,000 for people with long-term care needs or for the families that shelter them..... Second, we should create a family caregiver support program -- a new national network to support people caring for older Americans.... Third, we must educate Medicare beneficiaries about long-term care options.... Fourth, I am proposing that the federal government, as the nation's largest employer, use its market leverage to set an example, offering private long-term care insurance to federal employees....
"The senior boom is one of the central challenges of the coming century.... We must do everything in our power, not only to lift the quality of life and the security of the aged and disabled, but to make sure that we do not impose that intolerable burden on our children."
"What if you needed a root canal, but your dentist offered
painkillers instead? You'd feel better for a while, but sooner
or later you would writhe in agony, lose the tooth and blame
"President Clinton's new long-term care plan is like that: great short-term politics, but terrible long-term public policy.
"The new Clinton plan would add $1.24 billion per year to an already burgeoning government investment in long-term care. From 1990 to 1997, the bill to taxpayers for home health and nursing home care shot up from $31billion to $69 billion--an increase of 123%. In the same period, private out-of-pocket costs for the same services edged up from $26 billion to $33 billion--an increase of only 27%.
"As public financing of long-term care increases and private spending decreases, the sense of urgency people feel about the need to plan early and insure fully for the risk of long-term care goes down.
"We can find a far better way to meet the long-term care financing challenge.
"The best strategy is to provide a fully collateralized, government-backed line of credit on the estates of all Americans who need long-term care.
"That would empower them to purchase red-carpet access to top-quality home care, assisted living and nursing home care in the private marketplace.
"The fact that they would have to pay this loan back out of their estates and inheritances would strongly encourage new generations of the aging and their heirs to plan ahead for long-term care and purchase private insurance while they are still young, healthy and affluent enough to afford it.
"Getting middle class people to take responsibility for themselves in this way would relieve the burden on Medicare and Medicaid programs to provide home health and nursing home care to both the needy and the middle class."
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