When the Elderly Can’t Afford the High Cost of Long-Term Care

To the Editor:

Re “Assisted-Living Fees Pile Up, as Do the Profits” (front page, Nov. 23):

The recent series of articles examining the impact of our nation’s rapidly aging population sheds much needed light on a significant and unavoidable societal issue.

Many Americans do have sufficient savings and home equity to pay for long-term care at home or in assisted living. But many have underestimated the consequences of longer life spans and have either been unable to adequately save or have not prepared for the costs associated with the myriad physical and cognitive care needs that are common at advanced ages.

Our society does not have an adequate answer in place to help those whose savings are insufficient or who do not qualify for Medicaid funds toward assisted living (which are limited and not an option in all states).

Your reporting goes a long way in calling attention to the difficulty of finding solutions to address the cost of long-term care for our aging population. These challenges can be met with some hard work in Congress, the states, and federal and state agencies to create more options for our seniors. Policymakers need to think broadly for ways to incentivize saving for retirement, reactivate the market for long-term care insurance, expand Medicare benefits and much more.

The senior living industry has devoted considerable resources to exploring solutions to the issues raised and stands ready to continue working diligently to find innovative ways to provide for the needs of the aging American population.

David Schless
The writer is president and C.E.O. of the American Seniors Housing Association.

To the Editor:

Re “The Ruinous Cost of Elder Care in America” (front page, Nov. 18):

From early childhood to older adulthood, U.S. systems of care are supported by two pillars: women’s labor and the system that profits from the lifetime savings of vulnerable Americans.

Those of us who are lucky enough can afford to pay into private-equity-owned boutique services. Those of us who are unlucky might deplete our savings and get services through Medicaid or go without care at all.

Yet, Senator Mike Braun of Indiana says Americans need to save for when they will inevitably need care. I ask you, Mr. Braun, is this savings that Americans should take from their children’s day care payments, their college funds or their retirement funds?

We bank on the labor of women to fill in on both ends of life, yet when these women (and some men) are left without money to care for themselves, they suffer alone, sometimes unable to eat independently, or are stuck in bed all day, every day, or are unable to bathe.

Maybe this is a government problem of no compassion and no will, rather than no funding.

We need a long-term care policy for all.

Stacey Gordon
New York
The writer, a social worker and gerontologist, is program director of Next Phase Adult Caregiving and Retirement at New York University.

To the Editor:

There have been plenty of offered policy options that could be solutions. What is missing? Political will to address this classic pocketbook issue.

Without question the solution must be public-private partnerships. The long-term care insurance industry must produce better products with more choices in care, which are in turn rewarded with tax code changes to allow the cost to be partly or fully deductible. We must enact a family caregiver tax credit. Medicaid must increase coverage for home and community-based care, which is preferred by older adults and their families.

This issue should be raised in every remaining presidential debate. Our next president should take a lead in offering our nation its first real long-term care policy.

Robert B. Blancato
The writer is national coordinator of the Elder Justice Coalition.

To the Editor:

I am a geriatric nurse practitioner in New York and have seen stories like those in your “Dying Broke” series time and time again. Families go broke finding care for their loved ones or women give up their lives and jobs to care for their family members instead, which worsens gender inequity.

Many believe they will not need help when they get older, but most do. My patients are shocked when we review the options and associated costs. Medicaid alone cannot meet these needs.

Congress must establish a better system to finance long-term care. The WISH Act is the most viable option proposed to help middle-class Americans pay for long-term care, whether with paid caregivers at home or in a facility. The WISH Act combines the public and private sectors by creating a fallback public program to limit what middle-income Americans would be expected to pay, while promoting a more reasonable private insurance market to encourage people to buy long-term care insurance.

The WISH Act should be urgently reintroduced and passed to alleviate the financial burdens of caregiving, advance health equity and stabilize the private insurance market.

Sarah Romanelli
New York
The writer is the founder of Allied Aging.

To the Editor:

“Flaws and Rising Costs in Long-Term Insurance” (front page, Nov. 29) is an informative review of the pitfalls of long-term care insurance from both the insured and insurers’ perspective. However, one persistent problem with these insurance products goes unmentioned.

Long-term care insurance contracts are typically complicated documents that are laden with incomprehensible and convoluted language. Insureds are ultimately at the mercy of insurance carriers that interpret claims in their favor by exploiting fine print and ambiguous definitions.

As a New York attorney, I’ve advised clients on these products many times. Slogging through these contracts is mind-numbing and ultimately leaves more questions than answers. Insurers seem to word their contracts in such a way as to maximize the opportunity to commit mischief with claims.

Regulators need to clamp down on these unintelligible contracts. Plain language laws should be the standard. There is too much at stake to allow carriers to play fast and loose with claims interpretations by exploiting the ambiguities and murky language that they deliberately create.

Peter Janoff
Stamford, Conn.

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