This column is about long-term care. In other words, it won't offer any easy answers. Instead, it's a call for many aging baby boomers to factor into their retirement planning the possibility of caring for frail family members, spouse, relatives and longtime friends. Sad to say, the current long-term care system is badly broken.
Case in point: The private long-term care insurance market. Even though specialists estimate that 30 to 40 percent of elderly individuals should buy long-term care insurance, only about 13 percent of older Americans own a policy. A major reason for the shortfall is cost. Tom McInerney, CEO of Genworth, the nation's largest long-term care insurance company, estimates that between half and two-thirds of Americans can't afford to buy in the traditional long-term care insurance market.
Insurance companies are also cutting back on benefits and hiking prices. Potential customer choice is down dramatically, too. The ranks of insurance companies selling policies has declined from about 100 a decade ago to about a dozen companies currently.
Medicaid, the joint federal and state safety net, is the main public program for meeting these long-term care expenses. However, Medicaid is a "means tested" program: To qualify, you can't have much in the way of assets or income. Medicare doesn't cover much except for a limited list of expenses, such as short-term skilled nursing care in a facility following a hospital stay of more than three consecutive days.
Families provide the bulk of care. More than 44 million caregivers are helping out aging elders. The value of the service is huge. The Rand Corp. estimates Americans spend over 30 billion hours a year providing informal elder care at an annual cost of $522 billion. To put that figure in context, the cost of replacing informal care with skilled nurses would be $642 billion and with unskilled labor, $221 billion.
Reform will come with an aging population. Question is, how quickly or slowly (way too slowly, in my opinion). In the meantime, you should shop around and see if you can afford long-term care insurance. Even if you can, given the steep odds that some kind of caregiving lies in your future, I would include the potential responsibility into your retirement plans. For most of us, caregiving translates into planning on saving more and working longer, well into the traditional retirement years.
Chris Farrell is senior economics contributor, Marketplace, and commentator, Minnesota Public Radio