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Who will take care of Grandma? And how will we pay for it? All politics are personal, but what each of us reacts to differs. For some, environmental issues are their primary concern; others react to labor issues; others to other things.

As a retired investment professional, my background is working with individuals and families on household financial matters. One thing that matters to most individuals is how to pay for retirement, including health care.  

That's why I sat up and took notice last night when President Clinton told us

They also want to block grant Medicaid and cut it by a third over the coming decade.  Of course, that will hurt poor kids, but that's not all.  Almost two-thirds of Medicaid is spent on nursing home care for seniors and on people with disabilities...

(emphasis added by diarist and hat-tip to Transcript Editors for the quote)

Medicaid is the federal program, funded by both state and federal funds, that pays for health care for low-income individuals of all ages. Again, nursing care absorbs the bulk of health care payments from Medicaid. Why? Because nursing care is expensive and individuals and families do not have resources to pay for it on their own.

How Much Does Nursing Care Cost, and Who Needs It?

According to the National Clearinghouse for Long Term Care Information,

The average costs for long-term care in the United States (in 2010) are:

    $205 per day or $6,235 per month for a semi-private room in a nursing home
    $229 per day or $6,965 per month for a private room in a nursing home

Consider that. If you need a year of care in a nursing home, staying in a semi-private room, the cost would average about $75,000. In Iowa it's substantially less expensive at approximately $53,000. (Find your state's costs on this cool chart.)

Maybe you aren't concerned about needing nursing home care for yourself or a family member. Maybe you should be.

About 70 percent of people over age 65 will require some type of long-term care services during their lifetime. More than 40 percent will need care in a nursing home.


Service and support needs vary from person to person and often change over time.

  • On average, someone who is 65 today will need some type of long-term care services and supports for three years.
  • Women need care longer (on average 3.7 years) than men (on average 2.2 years), mostly because women usually live longer.
  • While about one-third of today’s 65-year-olds may never need long-term care services and supports, 20 percent will need care for longer than 5 years.

Source: National Clearinghouse for Long Term Care Information

As President Clinton said last night, it's arithmetic. When you do the math and multiply the average cost per year of $75,000 times 3 years, the average need for services, it's a pile of money. A pile amounting to $225,000.

It gets worse: if there are two members of a household needing this type of care, spouses whose physical decline makes them unable to care for themselves or each other, the cost can be well above $300,000 without blinking.

How Is Nursing Care Paid For?

If you have enough income and savings/investments, including the equity in your home, you might pay for 100% of long-term care on your own. In addition you could buy long-term care insurance to help cover the costs. Just don't count on Medicare to pay for it. Medicare only covers some portions of medical care, and generally it covers nursing home care for short periods under very specific circumstances.

What about when those resources run out? After all, the median household net worth was $77,300 in 2010. (Net worth is the difference between assets and debt. If a family liquidated all assets including the home, and paid off all debt, it is what would remain.) This would pay for about one year of care.

If you a Republican, a Randian, or generally a heartless person, you may think each person or family should take care of themselves and their own needs. Once an individual's resources are depleted, "the Republicans want you to die quickly, if you get sick," according to Alan Grayson.

Fortunately, we do have Medicaid to help individuals who have limited resources. That is, we have Medicaid for now. Under the Romney-Ryan budget, block grants would replace the current system, forcing reductions in care. Ryan says

We don't want to turn the safety net into a hammock that lulls able-bodied people into lives of dependency and complacency, that drains them of their will and their incentive to make the most of their lives.
Whose plan forces death panels and rationing? Is it Obamacare or the Romney-Ryan "plan"?

Politics Are Personal

All politics are personal, and at its best, our political process helps define our priorities and how we will pay for them. Will we decide as a nation that older people are not worth paying for? Will we decide that families who cannot afford extended care for their elderly will not receive help? Will we decide that if you get sick, you should die quickly?

If you are old, or if you know old people, or if you care about old people generally, the Romney-Ryan budget should frighten you. If you know old people or anyone who might get old, please share this information with them. The costs of care are high, higher than most people can bear on their own.

The costs of NOT caring are more than we as a nation can bear.

Democrats believe we have obligations to respect and help care for those less fortunate, including our elderly. That is why we must re-elect President Obama. That is why we must work to elect as many Democrats down ticket as possible.

And that is why I will vote for Democrats.

1:12 PM PT: Thanks to Rescue Rangers for the chance to bring this into the Spotlight!

ALSO please see Joan McCarter's front page diary on same issue. The comments are enlightening.

2:55 PM PT: Heading out now for a couple hours, but I will read and respond to comments when I return. Thanks to everyone who takes the time to read and to comment.

Originally posted to Jim & Melanie in IA on Thu Sep 06, 2012 at 06:51 AM PDT.

Also republished by I Vote for Democrats and Community Spotlight.

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