Medicare—Does It Meet Long Term Care Challenges of the 21st Century?
With an aging “Boomer” population and with many of the “Boomers” themselves facing the responsibility of caring for their parents, several challenges are presented. Meeting long term care challenges is complicated and often expensive. Two possible forms of help include assisted living and home health care. Assisted living is a long term care alternative housing arrangement for older adults who need help dressing, eating, bathing and toileting, but don’t need intense medical or nursing care. In-home companion care is a long term care concept that can encompass many social and personalized services. These services are provided at home to recovering, disabled, chronically or terminally ill persons who need help with various essential activities of daily living. The problem is that neither of these long term care options qualifies for any financial assistance from Medicare. They have to be paid for with the personal finances of the family involved. Some health or long-term insurance policies may cover some of the costs connected to assisted living.
Even though most of the elder population wants to live the remainder of their lives in the comfort and familiarity of their own homes, particularly when facing health issues, this may be an unfulfilled dream. Unless they have saved a considerable amount of money or get creative, like getting a reverse home mortgage, long term care services they most need or want like assisted living or in-home companion care may elude them. Medicare has not yet and probably never will be able to address the need for these kinds of services. Medicare is in as much or more financial turmoil as Social Security. It is plagued by rising health care costs and an aging population. The system is paying out more benefits than it is receiving in taxes. Failure seems certain if it doesn’t soon get a major overhaul. It is a not a government-run health insurance program but rather a government-funded health insurance program. As long as private insurers and providers are involved, the motivation will be to raise prices–not to evaluate, expand, and improve programs.
Medicare has not done well in explaining or managing the implementation of its new drug prescription system. In addition to that debacle, there are other flaws in its daily operation, one of which I can speak to personally. My father recently had back surgery. When he was released from the hospital, he had visiting nurses assigned to him for several weeks. He was also given a prescription for physical therapy. Months later, the physical therapy center told him that he owed them several hundred dollars because Medicare would not pay for both a visiting nurse and physical therapy at the same time. How would the average person know this? At this juncture, theoretically, he does not have to pay as the transgression was determined not to be his. He spent a lot of time, however, worrying about the outcome of this. It seems that Medicare is facing perilous times ahead, both financially and logistically. Will it be up to the challenge?
Gerri Tyber, Operations Manager
Barton Home Care