National Journal Reporter Details Personal Experience with Long-Term Care System
National Journal News Service reporter Spencer Rich in this week's National Journal details the difficulty he experienced navigating the "difficult and incomprehensible" long-term care system when trying to find care for his mother. Although Rich had worked as a Washington Post reporter for 30 years, specializing in public health programs and other health issues, he writes that he was unprepared to "deal with an almost overwhelming mass of details
-- an array of regulations, reports, documents, signatures, special accounts, difficult transfers of money and other stumbling blocks that hugely complicated" his efforts to provide care for his mother. Initially, Rich and his wife tried to take care of his mother in their home, but after finding that she needed someone to be with her at nearly all times, he investigated other options, including a live-in caregiver and placement in a nursing home or assisted-living facility, finally deciding on the latter (Rich, National Journal, 3/23). In a side bar, Rich notes that policy makers will need to confront the challenge of making long-term care more available to seniors, particularly as the baby boom generation ages. Seniors typically rely on Medicare, Medicaid or private insurance to pay for their long-term care services. Rich writes that one way to "eas[e] the financial burden" on seniors and public health programs would be for the federal government to expand eligibility for a tax deduction that would assist people in purchasing private long-term care insurance. President Bush has included such a provision in his fiscal year 2003 budget blueprint, and Rep. Nancy Johnson (R-Conn.) and Sen. Charles Grassley (R-Iowa) each are sponsoring legislation that would provide tax deductions for long-term care insurance. Currently, individuals can deduct the cost of long-term care insurance from their incomes only if their total out-of-pocket health costs exceed 7.5% of their incomes. Under the Johnson and Grassley measures, taxpayers would be able to deduct much of their long-term care insurance costs, even if they did not have any other health costs and even if they did not otherwise itemize income deductions. AARP Director of Policy and Strategy John Rother said, "We hope to see action this year" on the bills, but he added that such legislation would be "only a step -- not a solution." Even if the measures are approved, there are "drawbacks" to relying on private insurance. For example, premiums for such plans "would be higher than most modest-income families would be willing to pay," according to Joshua Wiener, a long-term care expert with the Urban Institute. Wiener suggested that the federal government spend more money on at-home care, beginning with seniors who have annual incomes less than 200% of the poverty level, or $17,720 for an individual (Rich, National Journal, 3/23).
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