LTC Almanac Update (2)
LTC Comment: We’ve updated the “Almanac of Long-Term Care” in The Zone. More on the LTC Almanac and today’s update after the ***news.***
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LTC ALMANAC UPDATE
SPECIAL: We are making access
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LTC Almanac is divided into 11 sections:
section is divided into sub-sections and under each sub-section we provide
a list by date of the most important reports and articles published on the
topic, usually with a few highlights and sometimes with analysis.
of Long-Term Care is a
great way to find statistics you need quickly or to get current on topics
you need to know the latest information about.
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Caveat: With time, some
hyperlinks go bad. In a huge
document like the "LTC Almanac," we can't keep all the
links current all the time. If
you find a bad link, but want to get to the material, contact us.
We often have an electronic copy of the document and we can usually
find a current live link. We'll
also fix the link in the LTC Almanac so it will be current again
Suggestion: Read through the
following update to stay current on new resource materials. Then browse the full LTC Almanac at your leisure.
When you need a quick fact or the latest research on a particular
topic, you'll know right where to go.
Aging World: 2015 International Population Reports
“Relatively low percentage of U.S. residents in long-term care: report,” by
Lois A. Bowers, McKnight's Senior
“The percent of the over-65 population living in skilled nursing facilities
or other residential care settings or receiving care at home ranges from
0.8% in Poland to 22.1% in Israel, according to a new report from the U.S.
Census Bureau. Of 26 countries ranked in 2013 by the Organization for
Economic Cooperation and Development in research cited in the report, the
United States ranked seventh lowest, with 6.4% of the 65+ population
living in SNFs or other residential care settings or receiving home
healthcare. The bureau
Aging World: 2015”
(PDF) on March 28.”
If you think we have problems, explore the wide, wide world of long-term
care in this report.
boomer-expectations-for-retirement-April 2016 URL:
Expectations for Retirement 2016 Sixth Annual Update on the Retirement
Preparedness of the Boomer Generation,” Insured Retirement Institute (IRI)
Ahead! Baby Boomers’ Retirement Outlook on the Decline,”
“The Insured Retirement Institute (IRI) today released a new research
report that found less than a quarter of Baby Boomers, 24 percent, are
confident they will have enough savings to last throughout their
retirement years. This is the lowest level since IRI began this research
study in 2011, when 37 percent of Boomers had this same level of
confidence. … The entire report, “Boomer Expectations for Retirement
We are now beginning to see the unintended consequences of Social
Security, Medicare and Medicaid convincing consumers for decades that they
do not need to plan privately for retirement income security, health and
long-term care. Today this is
just a worry; by the 2030s it will become a national catastrophe of
Unfunded Liabilities--Social Security, Medicare, Pensions and
fiscal-imbalance-book 0416 URL: http://object.cato.org/sites/cato.org/files/pubs/pdf/fiscal-imbalance-book.pdf
Miron, “U.S. Fiscal Imbalance,” Cato Institute
also WSJ: “Inattention-to-the-Deficit
Disorder: By one estimate,
the government will spend $117.9 trillion more than it takes in this
century.” By George Melloan
May 26, 2016 6:07 p.m. ET
U.S. Fiscal Imbalance,
by Jeffrey Miron, Cato Institute
“The U.S. fiscal imbalance—the excess of what we expect to spend,
including repayment of our debt, over what government expects to receive
in revenue—is large and growing. And with politicians proposing large
new expenditures, little is being done to rectify the country’s fiscal
As of 2014, the fiscal imbalance stands at $117.9 trillion, with
few signs of future improvement even if GDP growth accelerates or tax
revenues increase relative to historic norms. Thus the only viable way to
restore fiscal balance is to scale back mandatory spending policies,
particularly on large health care programs such as Medicare, Medicaid, and
the Affordable Care Act (ACA).”
Our fiscal imbalance of $117.9 trillion is about 6.6 times the U.S. Gross
Domestic Product and getting worse all the time.
Fiscal and monetary shenanigans can delay the reckoning, but not
prevent it. The economic vise
is closing. I don’t think
the status quo can continue until, much less beyond, the 2030s when
boomers start turning 85 (2031) and Social Security (2034) and Medicare
(2030) become insolvent.
on Care Incidence 0216 URL: http://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201602.pdf
Release of Selected Estimates Based on Data From the January–September
2015 National Health Interview Survey,” Centers for Disease Control
“Number of seniors who
need personal care help increasing, CDC says,” by Emily Mongan, McKnight's LTC News
“The data, released last
Tuesday by the CDC's National
Center for Health Statistics,
shows 7.2% of seniors required help with activities of daily living in
2015, compared to 6.6% in 1997. The report included eating, bathing,
dressing and getting around as personal care needs.
… Seniors over age
85 were twice as likely as adults between age 75 and 84 to require
personal care help, and were five times as likely as adults age 65 to 74.
The report also found 6.4% of white seniors required personal care help,
compared to 9.6% of black and 11.3% of Hispanic seniors.
to read the full report, which also includes data on other health issues
like diabetes, influenza vaccinations and alcohol consumption.”
Comment: We not
only have more seniors, especially those over the critical age of 85, but
their rate of needing care is increasing as well.
A dangerous combination!
Mandates Minimum Wage for Home Care Workers 0316 URL:
Minimum Wage and Overtime to Home Care Workers:
A Guide for Consumers and their Families to the Fair Labor
Standards Act,” U.S. Department of Labor
“Paying Minimum Wage and Overtime to Home Care Workers:
A Guide for Consumers and their Families to the Fair Labor
Standards Act,” by U.S. Department of Labor
“Most home care workers must be paid at least the federal minimum wage
and overtime. The relevant question is often who is responsible for making
sure these workers are paid according to these FLSA requirements. Whether
you are responsible for the worker being paid federal minimum wage and
overtime depends on whether you are an “employer” as defined by the
Double whammy for LTC financing: first
the Labor Department mandates home care workers receive at least the
minimum wage (January 2015). Then
California and New York, and probably more states, increase the minimum
wage to $15 per hour. As
economic gravity prevails, jobs for home care workers (and hence their
availability) will decline and/or they’ll be increasingly replaced by
technology such as robots and other assistive devices.
This is a classic case of good intentions with unanticipated
consequences, though how can intentions be good when bad consequences are
inevitable and recognized by most economists?
Long-Term Care Providers
CDC on Assisted
Living Stats 0216 URL: http://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf
“CDC report details characteristics of assisted living residents,” by Lois
A. Bowers, McKnight's Senior Living
“‘Findings on differences and similarities in supply, provision and use,
and the characteristics of providers and users of long-term care services,
can inform policy and planning to meet the needs of an aging
population,’ according to the report, titled ‘Long-Term
Care Providers and Services Users in the United States: Data From the
National Study of Long-Term Care Providers, 2013–2014’
Valuable information well worth your time to review.
Financing and Burwell Data
URL 021716 URL: http://mercatus.org/sites/default/files/Blase-Medicaid-Provider-Taxes-v1.pdf
“Biden Was Right: Medicaid Provider Taxes A 'Scam' That Should Be
Scrapped,” by Brian Blase,
“In his book, The
Price of Politics, renowned journalist Bob Woodward chronicled
the 2011 negotiations between the Obama administration and Congress as the
sides attempted to reach a deal to trim future budget deficits. One area
of common ground between the administration and congressional Republicans
centered on Medicaid provider taxes, which happens to be the subject of my
most recent study,
Provider Taxes: The Gimmick That Exposes Flaws with Medicaid’s Financing,”
published today by the Mercatus Center at George Mason University.”
I’ve called Medicaid provider taxes “Medicaid planning writ large.”
They amount to states gaming the program in a manner similar to the
way elder law attorneys artificially impoverish their affluent clients.
Brian Blase’s excellent critique of the practice is right on
target with this proviso. The
extra federal revenue generated by provider taxes helps prevent
Medicaid’s dismally low LTC provider reimbursement rates from getting
even worse. In the bigger
picture, however, this fact is a further indictment of Medicaid LTC
financing, which crowds out responsible private planning for long-term
care, and not a justification for provider taxes.
Welfare Report Card 2015 URL: https://www.heartland.org/sites/default/files/03-18-15_welfare_report_card_final_0.pdf
“2015 Welfare Reform Report Card,” by Diane Bast, Matthew Glans,
Logan Pike, and Gary MacDougal,
“Most state governments can improve the
effectiveness of their efforts to help those in poverty. This 50-state
report card offers policymakers and the public a roadmap for how it can be
Trillions spent on welfare have failed to improve the lot of the poor and
arguably made it worse. See
which states have done relatively well in fighting poverty and which have
fared worse. This “report card” doesn’t address Medicaid or
long-term care financing, but many of the same principles of good public