An elephant-sized problem

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If there's still any doubt that Washington should start caring about the financing of long-term care, one only has to listen to the president.

In his State of the Union speech Monday, President Bush once again called on Congress to reform the country's retirement structure.

"Every member in this chamber knows that spending on entitlement programs like Social Security, Medicare, and Medicaid is growing faster than we can afford," said Bush in a transcript of his speech. "We all know the painful choices ahead if America stays on this path: massive tax increases, sudden and drastic cuts in benefits, or crippling deficits."

Considering that Medicare and Medicaid jointly fund the majority of long-term care, it's no longer possible to ignore this segment of healthcare. It's fair to say the topic of long-term care and how the country is going to pay for it is the elephant in the room that is now starting to make some noise - especially with droves of aging baby boomers slinking around the corner.

Reform, on the other hand, is a work in progress. The president is expected to release his budget next Monday. In it, he will call for steep cuts to Medicare and Medicaid. These include a reduction of $1.2 billion from Medicaid and a 0% increase in the Medicare payment update for skilled nursing facilities next year. Not exactly the answer nursing homes are looking for.

Lawmakers, in their pursuit of funding solutions, would be wise to pay attention to the nursing home lobbyists. They have been devoting time and resources to finding financing answers to help avert the annual stripping of federal and state dollars.

The American Health Care Association; its sister group, the National Center for Assisted Living; and the Alliance for Quality Nursing Home Reform last month proposed a post-acute long-term care payment system that focuses on personal investment and private sector involvement.

The American Association of Homes and Services for the Aging also has been working on a long-term care payment model. It calls for working people 21 and older to invest around $3 a day. In return, if people vested in the program become disabled and homebound, they would be eligible to receive $75 a day to spend as they see fit.

As the presidential field narrows, you may be hearing long-term care pop up in a candidate's speech or two. If it doesn't, we should all be concerned.

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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 Marty Stempniak.