Longer life expectancy has an underside

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A child born in 2007 can expect to live to nearly 78, according to preliminary findings from the Centers for Disease Control and Prevention.

Of course, that is good news. Everyone should be entitled to long life. L'Chayim (To Life)!

Or is it so wonderful? Maybe I've been steeped in too much long-term care news, but for some reason that finding also has an ominous ring to it. After all, not only is it likely that many babies born today will make it to 78 over this century but many more will live until their 80s, 90s, and, gulp, 100s. I hate to be so clinical and cynical about it, but it also raises the question: Who will care for all these people?

Of course, I am not alone in my worries. Long-term care providers, experts and nearly everyone involved in healthcare know the reality: We don't have the resources now to care for all the people who are growing older. By resources, I mean nurses, gerontologists and frontline staff.

I also mean financing. We don't have a government program right now that is equipped to handle the massive amount of people who will require long-term care in coming years. Medicaid is already being stretched beyond its limits, and Medicare, which currently compensates for insufficient Medicaid payments, may not be the answer.

Congress certainly is making that apparent with healthcare reform proposals that call for steep cuts to Medicare. The American Health Care Association reported today that 15 states could each face total nursing home Medicare funding cuts in excess of $1 billion over 10 years. That is taking into account Medicare reductions in pending House healthcare reform legislation and a new regulation that would recalibrate Medicare payment rates to nursing homes.

So where does the answer lie? One bright spot is a long-term care disability proposal known as the CLASS Act. It is still alive in Senate healthcare reform legislation. Under the plan, employees would pay out of their checks to a fund that would offer them a daily allowance if they no longer can perform two or more activities of daily living.

One of its merits is it would help to take some of the financial burden away from Medicaid. It also would give people an option of how they want to spend their long-term care dollars: a home care aide, groceries or other living expenses. The money also could go toward a nursing home stay.

As far as I can see, it is the only real option we have going for us. Sure, it would be a government program. But so is Medicare, and I don't hear many seniors asking for that to go away.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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