Every day another Minnesota family learns that a loved one has Alzheimer’s disease or other chronic illness or physical disability that requires long-term care. While the wealthiest households can pay for this care privately without spending into poverty, most middle-class Minnesotans experience substantial strain on their finances and overall lives as they try to cobble together caregiving help via family or friends.
Many people do an exhausting balance trying to do their full-time job and provide care to a loved one, or they leave the workforce altogether, losing income and retirement savings. This “caregiver penalty” is especially hard on women trying to save for retirement.
Often families hit their breaking point before turning to professional care services. While such services provide essential help, they cost money. Purchasing that long-term care can (think of the person who lives with Alzheimer’s for 5, 10, 15 or 20 or more years) quickly deplete one’s finances if they’re not prepared. And most of us aren’t. Why? We don’t have the right financial tools. This is care that is not covered by Medicare or the health insurance sold on the MNSure Health Exchange. These are out-of-pocket-care-costs.
Some say this is a national issue. Unfortunately, it has been studied, talked about, looked at, debated and moved nowhere on Capitol Hill for years. The most recent effort was The Commission on Long-Term Care, whose members were appointed by Congress and The President. Commission members took testimony, talked about the problem, but again, no solution. Based on current events, and decades of inertia on this issue, do you think that Washington, D.C., will come together on this to create the solution?
The Costs of Alzheimer’s and Related Dementias
We can’t wait. Take Alzheimer’s and related dementias alone:
As more and more Minnesotans live with Alzheimer’s disease and other dementias, the costs and challenges can be overwhelming for them, their families, our communities and our state. Some interesting facts from Alzheimer’s Association and Minnesota’s Act on Alzheimer’s:
(With no new affordable way to pay for care, the State of Minnesota will be spending a great deal on Alzheimer’s . . . )
(And we think Minnesota has a problem with the cost of hospital readmissions now . . . ?)
(These caregivers are doing a great service, but many are getting financially penalized, which is a sick paradigm. . . )
(It’s a vicious high-cost circle that doesn’t have to be . . . )
This Must Be Solved. Minnesota Can Show the Way.
Thankfully, there are many people with good minds and hearts that live in Minnesota. And this could very well be the place that a solution(s) comes forth. As Sen. David Durenberger – who teed this issue up in Congress when it wasn’t in absolute gridlock - recently wrote:
“We Americans are aging into our predictable disabilities at record speed. Geriatricians and others who care deeply about us are trying to get the health system’s attention for just a few hours to demonstrate how much we could ‘bend the cost curve’ if we simply tried one or more of the great solutions that have been kicked around for decades.”
Well, we might see Minnesota get beyond dysfunction and show the way nationally. The Dayton-Prettner Solon administration has convened a wide range of citizens through an effort called “Own Your Future” to explore options identified as possible products (or concepts that could become products) that would provide new options to help middle-income households pay for long-term care.
Such an approach could make lives better on multiple levels and help strengthen Medical Assistance for low-income Minnesotans. Here's the paper that summarizes these concepts. A number of the ideas grew out of an earlier citizens work group led by the non-partisan Citizens League.
The Own Your Future group working on this is seeking your feedback and will use it to prepare a report to the Administration on what specific products or concepts have the greatest potential to meet the needs of Minnesota’s middle-income market, and what next steps are necessary to move them forward. Here are the meeting details and ways to share your thoughts if you can’t attend the meeting in person.
How to Participate
Sponsored by the Advisory Panel for Own Your Future, Subgroup on Product Availability
Friday, October 18, 2013, 9:00 am – 12:00 pm
Room 2360 (public access, badge not necessary)
Elmer L. Andersen Building
540 Cedar Street, St. Paul, MN
If you would like to speak at the public meeting, the State asks that you email firstname.lastname@example.org, and provide your name, mailing address, organization affiliation (if any) and an email and/or telephone number so they may contact you prior to the meeting if necessary.
The State also provides a way for you to provide written comments until October 31, 2013, by emailing your comments to email@example.com or through direct mail to Own Your Future, PO Box 64974, St. Paul, MN 55164-0974. Contact the Own Your Future staff at 651-431-2606 or 651-431-4908 if you have any questions regarding this public meeting.
Long-term care. What an opportunity for Minnesota to help show how big ideas can still move forward when people care to move forward for the common good.
If you look at the bios of the new Minnesota Health Exchange Board members, you see common themes weaving among them. They all appear to have plenty else going on in their lives. They represent a diverse skill set. And they each have taken on big responsibilities during their lives. You don’t find such characteristics in people who want to waste time driving on a road to nowhere. Their collective success will be Minnesota’s success. A successful MNSure will open the door to new positives that often get lost in “sky is falling” rhetoric. Such emerging benefits include:
1. Better Workforce, More Innovation: How many times have you heard a person say, “I hate my job, and I’d love to do something different, but I stay because I need health insurance.” How sad and counterproductive. Making affordable health insurance available will remove “health insurance handcuffs,” empowering people who have desire to try another career to do that or to embark on an entrepreneurial pursuit without losing insurance coverage. That should benefit Minnesota with more engaged workers and more start-ups that grow through entrepreneurial endeavors. (Interestingly, most entrepreneurial start-ups come from older Americans (50-64), an age band that also comprises the largest group of pre-Medicare health care spenders.
2. AgeSURE – A Path to a Stronger Safety Net and Keeping More People from Poverty: A goal of MNSure is to take out the complexities of purchasing health insurance with easy-to-understand online apple-to-apples comparisons and quality rankings. Success here could move to taking complexities out of insurance for aging services that help people stay healthfully independent for as long as possible and help prevent expensive “bounce-back” visits to the emergency room.
Most people don’t purchase long-term care insurance. Consumers often say it’s too expensive, too complex, or they fear it won’t be there when they need it. A statewide AgeSure Exchange could eliminate those complexities and help people more easily connect to financial products that fit their needs. Such a market would help products improve and fit needs of more people and income levels. Improved products and a one-stop marketplace improves sales opportunities. More people with insurance for home care, transportation assistance, and other elder services slows Medicaid spending, strengthening a safety net for those most in need, and helping strengthen state finances.
3. Collaboration that Trumps Complexity: MNSure is a big opportunity to stoke our state’s innovation mojo and prove Minnesotans can make things better instead of waddling in complexity and hyperpartisanship. That will only happen if people work together. MNSure’s success should provide a confidence jolt to the state that we can cut through complexities of other thorny areas that have major public-private consequences, such as education and poverty, and make things better for more Minnesotans.
Many people helped get the Exchange to the Legislature. There Rep. Joe Atkins, chief author of the Minnesota Health Insurance Exchange legislation, shepherded it through 73.5 hours of public hearings in 18 different legislative committees. Many ideas by many people were exchanged on the Exchange. Now the MNSure Board and MNSure staff continue the hard work. With their success, MNSure will succeed, and Minnesota will show it can come together to take on 21st Century challenges rather than wallowing in complexity and gridlock.
Yesterday the Associated Press-NORC Center for Public Affairs introduced new national polling of Americans 40 or older that illustrates how disconnected many of us are from reality when it comes to aging and costs that can come with it.
Key findings include:
Alex Hiniker, my colleague at Ecumen, had a great opportunity recently to ride horses with former Minnesota Governor Al Quie. You can read her post about it here. Interesting tidbits from this video include:
- The horse that Gov. Quie so skillfully rides is being guided by Gov. Quie’s body cues, which is pretty amazing. This horse didn't start off as the most cooperative horse until it went to class with Gov. Quie.
- Gov. Quie had set a goal for himself many years ago to ride horses until he’s 80. He’ll be 90 in September.
- Even if you don’t know how to ride a horse, there’s some good advice from Gov. Quie in this video.
In 1965, 24 percent of the country’s 65+ population had graduated from high school, and only 5 percent had at least a bachelor's degree. Today about 80% of the U.S.'s older population is comprised of high school graduates or more, and about 25 percent has a bachelor's degree or more. Aging is changing.
Tom Agan's piece “Why Innovators Get Better With Age,” says the most common image of an innovator is that of a kid developing a great idea in a garage, a dorm room or a makeshift office.” (Think Zuckerberg, Gates, Jobs, Wozniak and now Nick D’Aloisio, the 17-year-old genius who just sold his news-reading app to Yahoo for a reported $30 million.)
But these examples are the exception, not the rule.
As Vivek Wadhwa writes in the MIT’s Technology Review story Innovation Without Age Limits: Ideas are dime a dozen. The value comes from translating ideas into inventions and inventions into successful ventures. To do this, you have to collaborate with others, obtain financing, understand markets, price products, develop distribution channels, and deal with rejection and failure. In other words, you need business and management skills and maturity. These come with education, experience, and age.
According to Kauffman Foundation data, the highest rate of U.S. entrepreneurship has shifted to the 55–64 age group, with people over 55 almost twice as likely to found successful companies than those between 20 and 34. Yes, part of that increase likely comes from older workers being downsized as many companies shift to younger (cheaper) workers. But it also comes from people who are better educated, more secure in who they are, hungry to learn, more experienced, and know how to work with others to get things done.
Minnesota has the most educated, most accomplished older populace in its history. What an opportunity for our state's future.