Friday, September 7, 2012

Long Life's Dear Cost

Living a long life used to be a good thing.

And if you're healthy, right up to the end, it may still be.

But for an increasing number of Americans, old age is not the good thing we've been led to believe.  The Lord has blessed our doctors, scientists, and other medical experts with incredible insight into how the bodies He created function, and that insight has led to some amazing advancements in healthcare, which have helped to lengthen lifespans.

Long life, remember, used to be considered a good thing worth striving towards.

In Biblical times, long life wasn't 80 years, or 100, but several hundred years.  We still don't know how the same human bones and flesh they had back then could last so much longer than ours does today.  Or, for that matter, what the quality of life was for those folks when they hit the 300-year mark.  Survival then was much tougher than it is today, which makes one wonder whether back-breaking labor might actually better for us than sitting at computer screens all day long.

We've just finished the last of our national political conventions, and today, the race for President of the United States goes into overdrive.  One of the key topics up for debate centers on how our country plans to care for its rapidly-aging population, including ideas for revising Medicare and, even more importantly, Medicaid.  Medicaid, after all, is what many middle-class families currently rely upon to fund the oftentimes exorbitant costs of long-term care for their loved ones.

Whether you're for vouchers, reducing the role of the federal government in healthcare generally and elder care specifically, or increasing Washington's role in determining and allocating funds for such care, we need to remember that funding elder care is not an abstract problem.  It's happening now.  Baby boomers pose a significant threat to the financial integrity of American families, charities, and the government, from the local to the state and federal levels.  And care isn't getting any cheaper.

Who Can Save Enough to Pay for Long Term Care?

It may be easy for all of the young fresh faces and voices of America's contemporary media, including blogs and political action groups, to view elder care as a cost-savings opportunity.  Letting policy shapers speak from lack of experience has become a dangerous trend in our country.  Speaking as a member of a family that has already begun the slow, expensive process of long-term elder care, however, I see this issue differently.  The loved ones in my family who need specialized attention have worked their entire lives in honorable yet modestly-paying jobs.  The kind of jobs most people have that, although ordinary, helped them afford decent homes and a few luxuries.  They've retired mortgage-free and credit-card-debt-free.  With savings.  So why should they worry about paying for their own care, right?

Sure, some right-wing Republicans might grouse that my family's loved ones should have striven to become independently wealthy, so they would know they could afford any healthcare contingency.  Meanwhile, any serious student of economics knows that not everybody can be a One Percenter.  Or even a Twenty Percenter.  My family's loved ones played the career and personal finance games as well as many other Americans have been able to.  Along the way, however, the retirement goalposts got moved.  And even if they'd earned twice what they did during their careers, it wouldn't be enough to pay for modern long-term care.

Hopefully, most rational conservatives can agree with many rational liberals, and recognize that personally funding retirement care these days requires much more than conventional savings and healthcare insurance, and experts differ as to whether long-term-care insurance is worth its steep cost.  Double the quandary when both spouses live into ripe old age.  Stories about running out of money, particularly because we're living longer than past generations, are incredibly frequent.  Even most long-term-care insurance policies cover only three years of care, while patients may live much longer.  Only an ignorant person would claim that any American worth their citizenship should be able to save up the money they'll need to pay for their own elder care, or hope three year's worth of expensive insurance provides enough protection.

Indeed, if there's one great equalizer in American society, it's elder care, because even if you've earned hundreds of thousands of dollars in retirement assets, you can burn through it quickly if you're not healthy.  And it strikes me as being a bit hypocritical of politicians - of all people - to be dictating how and what types of care should or shouldn't be funded anyway.  After all, many of them benefit from a federal healthcare program the rest of us Americans can only dream about.

Being Responsible for What God Expects of Us

People of faith, particularly those on the far-right side of the aisle who normally eschew anything that drains taxpayer dollars, need to remember that the Bible is explicit and repetitive on our mandate to care for the widows and needy among us.

If that means cutting back in other programs so that we can honor our elders by paying for the care they require, shouldn't we?

Of course, if that means cutting waste in the elder care programs we already have, shouldn't we?

Should it mean that family members currently working and trying to pay for their own retirement be forced to quit their jobs to perform the care for which our politicians don't want to pay?

Should it mean our pharmaceutical industry gets to set their prices for medications required to sustain life?  Or that nursing care providers and healthcare plan administrators get to inflate the costs of elder care by setting their own payment guidelines?

Where should the line be drawn between profit motive and pure greed when it comes to elder care?

Where should the line be drawn between our personal preference for low taxes and our ability to help out our fellow families grappling with elder care costs?  Granted, having the federal government administer elder care may not be the best approach.  The rules government bureaucrats and politicians concoct - particularly at the federal level - have a bad history of being woefully counterproductive.  Right now, Medicaid is run by individual states, and paid for by each state with matching funds from the federal government.  Technically, states can opt out of Medicaid, since their participation is voluntary.  So far, however, even though some states call their Medicaid program by a different name, all fifty states participate.

President Obama would like to expand Medicaid by broadening patient eligibility standards.  He says Obamacare will provide states more federal funds, but states will have to contribute more themselves, too, causing some to balk.  After all, whether we're talking state or federal funds, it's all still taxpayer dollars, so Obamacare doesn't really appear to be solving anything in terms of Medicaid.  Subtly expanding federal control over what has traditionally been a state-run program - which is what increasing federal participation would effectively do - doesn't sit well with conservatives, either.

Don't forget that Medicaid doesn't just pay for elder care.  It, along with Medicare, pays for a variety of healthcare costs for a variety of segments of our population.  When it comes to paying for elder care, however, it's usually Medicaid that taxpayers rely upon to cover the gaping cost gaps.  Unless somebody can come up with a better idea.

You've Aged Just Reading This

Fortunately, the recent trend towards home health care is helping to reduce some costs, and fast-paced advancements in the treatment of cancers and dementia may help provide cures to help senior citizens lead less dependent retirements.  But it's all still expensive.

A lot may hinge on what happens to Obamacare after this November's election.  Right now, depending on who you talk to, Obamacare is either lowering costs, or simply reducing the number of allowable medical procedures.  It's very difficult to parse the hype and rhetoric from reality.  Considering the resources required to provide the care you would expect for yourself or your parents, however, can we afford to spurn greater federal involvement in elder care?  If states opt out and lose federal funds, can our churches and community charities keep up with the growing demand?  Would you want your family to be one of the ones to find out?

Not that the government is the only hope for elder care.  But how realistic are we being by playing political gamesmanship with the needs of our aging population?  After all, even if we find ways to better manage elder care, and I hope we do, the demand for it won't go away.  None of us are getting any younger.

And we can't all hope to be the exception, and either earn enough or stay healthy enough to avoid the elder care cost crisis.

One of the blessings God offers His people in the Bible is long life.

How much of a blessing might long life really be?

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