Predicting the Future of Long Term Care … Maybe
January 27th, 2010
The crystal ball says…a public long term care insurance program may, or may not, be successfully implemented in the coming years. What are your thoughts?
The folks over at the Center for Long Term Care reform seem to have their own predictions:
- No broad-based health reform will come to pass, much less reform that includes long-term care.
- Another economic “stimulus” will fail as they all do, only shifting wealth, not creating it.
- Huge increases in the federal deficit and debt will require additional borrowing to the point where interest on the public debt will crowd out new–and even much current–social spending. [President Obama announced last night a three-year freeze on discretionary spending.]
- The present economic crisis will worsen precipitating immediately problems with Social Security and Medicare unfunded liabilities ($102 trillion [now $107 trillion, 1/26/10]) that Pollyannas think we won’t confront until 2041 and 2017 respectively.
- Several states will declare bankruptcy, or whatever they choose to call acknowledging their financial insolvency. [Hello, California and New York]
- Medicare will cut reimbursements to skilled nursing facilities dramatically leaving the nursing home industry unable to meet even current standards of care access and quality for publicly financed patients. [Hello, MedPAC]
- Medicaid costs will skyrocket. After a one-time federal matching fund supplement, state and federal Medicaid programs will cut reimbursement, then benefits, and finally eligibility. Expect a new Deficit Reduction Act within five years that will make DRA ‘05 look like child’s play.
- Medicaid will not increase funding for home and community-based services significantly and Medicaid financing of nursing home care will be dramatically reduced. [Medicaid HCBS expansion slows as HCBS payments from LTC insurance expand.]
- No new federal tax deductibility for LTC insurance will pass, not even Section 125.
- Middle class and affluent people will be far more personally responsible for their own long-term care in the future.
- Within five years, reverse mortgages will become a major source of financing for long-term care.
- Within ten years, the market penetration of private long-term care insurance will have doubled at least.
- The “New, New Deal” will prove as infeasible to finance as the old “New Deal,” and the United States will slowly return to the principles that made our country great in the first place: personal responsibility, self-sufficiency, free minds, free markets, competition and risk without moral hazard.
Let’s check back in a few weeks, months and years and see where we are at. You can read more about their opinions here
