Doctor Joanne Lynn

Workable Financing of Eldercare: The Window is Closing

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By Joanne Lynn

Within just a dozen years, the U.S. will have nearly double the current number of frail and disabled elderly people needing daily supportive services. Look around! What is being done to prepare for this expectable increase? Already most cities have long waiting lists for home-delivered meals, and no city in the U.S. has adequate affordable disability-adapted housing. We have all sorts of improvements “proven” to work in research or demonstrations, but we have no long-term plan. A recent Health Affairs article showed that most of the people who retired from “middle class” jobs will be unable to afford housing and health care within a decade.

America mostly deals with issues no more than a few years into the future. But private savings for supportive services in old age requires planning more than 30 years ahead – the person at age 50 has to plan for the risks at age 80 and beyond. And the nation has no real plan for how to arrange savings, taxes, and services to keep frail and disabled elders having food, shelter, and personal care. Indeed, even the Presidential candidates don’t debate these issues!

Delaying action until the suffering is so widespread and severe that taxes rise to support more of what is already haphazard and costly “care” would severely weaken the economy and curtail needed investments in other areas, such as childhood development and transportation infrastructure.

One clever proposal calls for federal coverage of long-term care after a period of need that depends upon the person’s lifetime earnings. If low-wage earners had to cover a year and high-wage earners had to cover 5 years, the cost would be less than 1% added to the Medicare tax. And we’d suddenly have long-term-care insurance vehicles that are affordable and widely purchased.

Well-proven improvements in medical care, preventive services, housing, and food delivery are easy to identify – they just need to be demanded and implemented.

In an editorial in the Journal of the American Geriatrics Society, I have called on all of us who serve frail and disabled elderly people to speak up – to push civic leaders for urgent planning and policy improvements. Click here to read the editorial – and then take action! Find a few other people willing to speak up! Get organizations to push for attention to these issues! It’s our future, claim it and make it better! Let us know how to help.

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