The Issues, No. 53 - National Health Care

Because my family is currently experiencing it, I believe now, more than ever, that if any part of our medical care needs to be nationalized, it is when a person's medical situation requires institutionalization in a hospital, nursing home, or an assisted living facility, or the person requires around the clock attention by a professional care giver in their home beyond the time and dollar limits established by a private medical insurer or Medicare. These situations are financially catastrophic for most families, including families that may be considered to be upper middle to lower upper class as far as income is concerned.

We all know how expensive it is to stay in the hospital and fortunately, if one has a good health insurance plan, most of the hospital charges are paid for by insurance up to a certain amount. For individuals over 65 who are Medicare subscribers and who have secondary insurance coverage, their medical and rehabilitation charges are essentially covered for 100 days for each separate occurrence. But a person who has a condition that continues beyond the dollar or time limits is subject to having to pay for everything. In the area in which we live, the average rate for a nursing home is about $260 a day. That's $7,800 per month. The average cost for an assisted living facility may be $3,000 to $3,500 less than a nursing home, but who among us has an extra $4,000 to $8,000 available each month to pay for it beyond the normal monthly expenses we already have?

Unless a person is wealthy, after they have expended their life savings, many are forced to go on Medicaid. Medicaid will pay for everything, but only after a person's resources have dwindled to practically nothing. And what happens to the spouse when that happens? It's just not a pretty picture. Long term care insurance, which is a relatively new concept, will help many of us in the future with these expenses but long term care insurance is expensive too and may only cover an individual for two or three years. I would guess that most people who are eligible for long term care insurance are not buying it because of the expense.

So, what are we as a nation going to do? Well, how about if we all bite the bullet and institute a national long term care addition to social security that will provide long term care coverage beyond what private insurance and Medicare currently cover. The unpleasant part to this proposal is that we would increase every person's social security contributions by 1 to 3 percent. Not many of us will like that when everything is fine and it's not needed but I guarantee that when the time comes that it's needed, those affected will very much appreciate that because of it they do not have to exhaust their life savings and become destitute before something like Medicaid takes over for them. And, because of it they will be able to continue to live their normal lives.