Congress must fill the gap on long- term care

Millions of elderly and disabled Americans need help with the basic activities of daily life— from getting dressed to preparing meals and taking medications. Yet few can afford the care they need under the current system.

In an important move, the U. S. Congress and the White House are setting up a new congressional commission that will deliver a plan— within six months— to reform long- term care assistance. I hope the commission will conclude that our country urgently needs a long- term care insurance program that is widely available and affordable.

That was what the Pepper Commission concluded more than 20 years ago, when it was set up with the very same goal. In the time since, long- term care costs have skyrocketed. Americans spent approximately $ 342 billion on long- term care services and support in 2010, according to the Kaiser Family Foundation.

These costs will only grow without reform. About 10,000 baby boomers turn 65 every day. And the U. S. Department of Health and Human Services projects that 70 percent of them will need long- term care services.

We’re fortunate to have some of the best infrastructure in the world to provide this support. From dedicated family members and caregivers to sophisticated organizations that support people, we have the skill and the will to help people get the services they need, when they need them, in the place they call home.

That support, however, often costs more than many people can afford. A home care attendant costs, on average, $ 21 per hour. A one- bedroom unit in a typical assisted living care facility costs more than $ 3,500 per month. A private room in a nursing home could double the expense.

Providing the care ourselves also has a price. According to the Alzheimer’s Association, more than 15 million Americans provide unpaid care for someone with Alzheimer’s or another form of dementia.

This takes an enormous toll — not only through the financial and emotional burdens of care, but in the sacrifices made to provide it. A Gallup national survey found that caregiving- related absenteeism cost the U. S. economy more than $ 25 billion in 2010.

Many people simply don’t anticipate the need for long- term care, or assume Medicaid will cover it. But that’s not the case.

Of the $ 342 billion spent on long- term care in 2010, Medicaid covered only 41 percent. Seven percent was covered by private insurance, and individuals bore 15 percent of the cost out of pocket — fully $ 51 billion.

Medicaid only covers longterm care once an individual’s assets have fallen below a certain threshold. This can be a valuable safety net, but it can also create a tragic incentive for seniors to impoverish themselves — leaving nothing to their children and loved ones— in order to qualify for government assistance.

The commission members will have an important mandate to act quickly and to push Congress to act too. They will need to find the right balance to provide Congress with both viable policy solutions and the political incentives to apply them.

In the 25 years since the Pepper Commission recommended a national long- term care insurance program, millions of Americans have grown older or become disabled, and they now need help with the basic activities of daily life. Millions more have become their caregivers as professionals, as loving relatives and caring friends. By 2020, another 5 million people will need long- term care services and support that they may not be able to afford. Surely the greatest nation on Earth can find a way to ensure that they receive them.