From Our 2013 Archives
Many Americans Worry About Cost of Long-Term Care: PollBy Amy Norton
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MONDAY, Sept. 30 (HealthDay News) -- Worried about how you'll pay for long-term care in old age? You're not alone.
A new Harris Interactive/HealthDay poll released Monday finds that more than two-thirds of Americans are anxious and uncertain about how they'll meet nursing home or home care costs should they need them.
Most people were also wrong about how most of these costs are covered under the current system. About half (49 percent) mistakenly thought the bulk of the bill was paid by individuals, while one-third guessed Medicare. Only 19 percent understood that the major funder of long-term care is actually Medicaid, the government agency that covers health services for the poor.
One thing most people agree on: as America ages, the problem of how to pay for seniors' long-term care will only get worse. Eighty-seven percent called the situation "serious" or "somewhat serious."
They're right to be worried, said Howard Gleckman, a fellow at the Urban Institute in Washington, D.C., who focuses on long-term care issues.
"This is a huge and growing problem," he said. There are currently about 12 million Americans in some form of long-term care, he noted, and that's expected to double within the next 20 years.
It's estimated that most Americans -- more than two-thirds of those aged 65 and up -- will need some type of long-term care, such as a nursing home, home health aide or adult "day care" center.
In the new poll, a similar percentage -- 68 percent -- expressed worry about how to pay for it all.
The problem of how to pay for rising costs of senior care was not addressed by the Affordable Care Act, or what some call "Obamacare." And Gleckman said that policymakers have shown no agreement on where to go from here.
As for the general public, past research proves that few of us even know how long-term care is currently financed, Gleckman noted. And the new poll confirms that.
For example, "very few people understand Medicaid's role in long-term care," Gleckman said. The problem for families is that Medicaid coverage only kicks in once people have spent down their assets enough to qualify for assistance.
The other option is for people to plan in advance and buy pricey private insurance that specifically covers long-term care. The poll found that 64 percent of Americans think "most people" should buy long-term care insurance.
But thinking that something sounds good, and actually doing it for yourself are two distinct things, Gleckman pointed out. Based on current statistics, less than 8 percent of U.S. adults have bought long-term care insurance, he noted.
In the new poll, 79 percent said they supported the notion of tax breaks that would help people purchase long-term care insurance, with similar numbers of Republican and Democrat respondents in favor of such a move. Whether any tax perk would actually encourage more Americans to invest in private insurance is the big question, Gleckman said.
With the age of the average voter steadily rising, "how we will pay for long-term care in the future is likely to become a huge political issue," added Harris Poll chairman Humphrey Taylor. "The cost is already well over $200 billion and is almost certain to grow rapidly as many more baby boomers grow older."
Just last week, the federal Long-Term Care Commission -- an expert panel established by Congress -- issued recommendations on how to improve the delivery of long-term care.
"Where they couldn't reach any consensus at all," Gleckman said, "was how to finance it."
But in the new poll, he noted, the public showed a surprising amount of agreement on some financing options. Over two-thirds were in favor of a "new government program" to help out. Even among Republicans, half liked the idea -- which was particularly striking, Gleckman said.
Another expert in long-term care said the poll shows that Americans are becoming more aware of the issue.
"Most Americans now will live for some years with an inability to take care of themselves due to the illnesses associated with advanced old age," said Dr. Joanne Lynn, director of the Center for Elder Care and Advanced Illness at the non-profit Altarum Institute.
"This will be the most expensive part of most of our lives," Lynn said, "yet insurance does not cover it -- at least not until the person has spent down to poverty, when Medicaid will pitch in."
She added that "very few" Americans can save enough money to pay for long-term care in their final years. "It's good that most Americans are beginning to recognize the need for some public support," she said.
According to Gleckman, the financing solution does not have to be strictly "private" or "public," but could involve some mix.
One possibility, he said, is a program where private insurers sell long-term care coverage "under the auspices" of the Medicare program -- similar to the current "Medigap" system, where older adults can get supplemental private insurance for services that Medicare does not cover.
Everyone agreed that the long-term care problem is only going to get more complex in the years to come. Not only will there be more elderly Americans in need, there will also be fewer family caregivers.
"Lower birth rates mean there are going to be fewer and fewer adult children available to provide care," Gleckman said.
The baby boomers who are caring for an elderly parent, or have in the past, already know the shortcomings of the current system, according to Lynn.
"Their frustration should fuel real reforms," she said.
The Harris Interactive/HealthDay poll is based on interviews with 2,013 adults who were surveyed online between Sept. 10-12.
SOURCES: Howard Gleckman, resident fellow, Urban Institute, Washington, D.C.; Joanne Lynn, M.D., director, Center for Elder Care and Advanced Illness, Altarum Institute, Ann Arbor, Mich.; Harris Interactive/HealthDay poll, Sept. 10-12, 2013
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