We need long-term solutions to address long-term care

As Robert Weisman describes in his article, “Groups revisit plans to pay for long-term care,” (Page A1, April 11) efforts to pay for senior care needs through expanded long-term care insurance are almost certainly doomed to failure. While we’re in a long-term care crunch today, in about a decade we’ll be facing a crisis. This is due to demographics.

Many people don’t need care until they are in their late 80s. According to a 2019 Urban Institute report, “40 percent of Americans aged 85 and older have severe long-term care needs as compared with just 8 percent of those between 65 and 74.” There are just 23 million members of the “Silent Generation” in the United States who are today between the ages of 78 and 90. Their number is dwarfed by the 71 million baby boomers who will start crossing the age-85 threshold in 2031.

Tinkering with long-term care insurance, which today only the most well-off can afford, will not meet the huge need that’s barreling our way. Instead, we need a huge expansion of Medicaid (MassHealth in Massachusetts), which is by default the long-term care insurance of the middle class; higher wages, benefits, and training for caregivers; and more support for family caregivers. Immigration reform would also be important, given that many caregivers are immigrants.

Some of these remedies require federal initiatives, but many can be accomplished by the Commonwealth if it has the will.

HARRY S. MARGOLIS Brookline

The writer is an elder law attorney in Wellesley and author of the Substack blog, “Risking Old Age in America.”