Few good options
As boomers age, suitable care is in short supply
Long-term care is so expensive that insurance companies have stopped selling policies for it or jacked up the premiums to the point where policyholders face an agonizing question: Do they keep shelling out more for the insurance or try to get by without it?
Skyrocketing premiums eat into the policyholders’ standard of living, but forgoing the insurance could have devastating financial consequences down the line. This Catch-22, which the PostGazette’s Kris B. Mamula explored in a recent story, reflects a much broader problem.
As the baby boomers retire in growing numbers, the nation has no comprehensive infrastructure in place to support them. In-home care, personal care, rehabilitation beds and skilled nursing aren’t available in amounts that are affordable, evenly distributed and of sufficient quality.
If long-term care costs so much money that insurance companies have stopped writing policies for it, it’s little wonder that other parties, including the government, struggle to pay for it, too. Maine has lost numerous nursing homes in recent years, including six in 2018, because of inadequate Medicaid reimbursements, the Bangor Daily News reported. Low Medicare and Medicaid rates also are to blame for nursing home closures in South Dakota, and facilities in small towns are especially vulnerable, according to a report last month by South Dakota News Watch.
The elderly would rather live at home than in facilities of one kind or another, so why isn’t the health care system oriented more toward the concept long known as “aging in place”? Medicare traditionally refused coverage of non-skilled services in the home, but a regulatory change this year allows Medicare Advantage plans to provide certain kinds of assistance — such as help with bathing and dressing — in private residences for the first time. That’s a start.
Many elderly, especially in Pittsburgh, live in homes that have too many steps or other accessibility issues. That’s why when a ranch home goes on the market in the Pittsburgh area, it’s snapped up almost immediately. Oddly, the market hasn’t responded to the growing demand for one-story, level-entrance homes. It’s a niche ready to be filled.
In June, Clearfield County and state officials unveiled the state’s first “elder cottage,” freestanding housing for an elderly person to be placed on a relative’s property and moved when no longer needed. That’s OK as a stopgap measure, but it’s really just another sign of the nation’s need to fashion an affordable, complete continuum of services for the legions of Americans who are going to need it.