Long term Care- The Uncovered cost of health care.

When we consider health care costs, we think of costly procedures or medication. Magnetic Resonance Imaging or MRIs is an example costing $2,000 - $4,000 with doctor’s fees additional. Medications used for anemia such as procrit can run over $6,000 for one course of medication.

What is rarely thought of is the cost of day to day long term care. Most people tend to think they will never need long-term care; however the fact is that more than 60% of Americans are expected to need some form of long-term care at some point in their lives. When they do need long term care, they are not prepared for the financial burden it may cause.

Most Americans believe that their private health insurance or Medicare will cover for all their health care needs. Contrary to this belief, insurance does not cover the greatest need for long term care: custodial care.

When you or a loved one is stricken with a chronic or degenerative condition such as diabetes, cancer, a stroke or Alzheimer's performing simple Activities of Daily Living becomes impossible without the assistance of another person. Chronic illnesses and disabilities require personal care, meal preparation, assistance with bathing and ambulation. This type of care is custodial care not medical care therefore it is usually not covered by health insurance.

Custodial care is a term for care provided to patients on an on-going maintenance basis. Most care at home and the majority of care in nursing homes is considered custodial. Non-medical care that helps an individual with his or her activities of daily living, preparation of special diets and self-administration of medication not requiring constant attention of medical personnel.

MetLife Mature Market Institute reports that the cost of private and semi-private nursing home rooms in the United States increased an average of more than three percent, in 2007.
The average cost of a private room in a nursing home this year was $213 a day ($77,745 a year), compared with $206 a day in 2006. A semi-private room cost $189 a day in 2007, compared to $183 a day last year. This rate generally reflects just room and board in a nursing home with therapies, tests, physician visits and medication charged in addition to the basic rate.

Alaska had the highest nursing home rates ($510 daily or $15,300/monthly) in 2007, while Baton Rouge, La., had the lowest rates ($123 daily or $3690/monthly). I am from New York which averages $ 340 a day or $10,300/ monthly.

Assisted living rates nationwide were $2,969 monthly in 2007 ($35,628 yearly) in 2007. Assisted living rates were highest in the Washington, D.C., area ($5,031 monthly) and lowest in Indianapolis ($1,963 monthly).
Another study by MetLife reported that the national average cost of Home Health Aide Services nationwide was $19/hour and the national average hourly rate for a companion or homemaker is $18/hour. The highest rates being in Rochester Minnesota at $30/hour for Home Health Aide and $25/hour for Companion or homemaker. The lowest rate in Shreveport, Louisiana was $13/hour for Home Health Aide and $12 for a companion or homemaker.

• To find out the cost in your area for Home Health Aide, Assisted Living Facilities and Skilled Nursing Home rates check the following MetLife Studies:

Assisted Living
http://www.metlife.com/WPSAssets/12768452431193759307V1F2007NH.AL.pdf
Home Health Aide
http://www.metlife.com/WPSAssets/56853157701190812646V1F2007ADSHCCStudy.pdf
Skilled Nursing Homes
http://www.metlife.com/WPSAssets/21052872211163445734V1F2006NHHCMarketSurvey.pdf

Medicaid will eventually pay for your long term care expenses; however the benefits only begin after the majority of your assets have been depleted.

In my home state of New York Medicaid does cover custodial care for Home Attendant Services, Housekeepers and Homemakers but Medicaid and most public long-term care (LTC) programs vary from state to state. In most states Medicaid covers custodial care only as long as it is provided within a nursing facility. Custodial care at home is typically covered only under LTC insurance - not by Medicaid in most states.

Medicare, on the other hand, covers only medically necessary, skilled care and will cover at-home custodial care only if it is provided in conjunction with skilled care. This means that as long as there is a need for a registered nurse or therapist to visit intermittently limited Home Health Aide services can be covered by Medicare. Medicare can cover nursing home for up to 100 days a year if there is a skilled need for short term rehabilitation or intravenous antibiotics therapy.

This leaves private pay or long term care insurance as the primary options for care. Even if you are financially independent custodial care can be costly. A Home Health Aide in Rochester Minnesota to cover just custodial care for a loved one or yourself for 24 hours a day would cost $ 720/day or more than a quarter of a million dollars a year. Consider also that almost 60% of the nursing home residents were institutionalized more than a year with the average stay in a nursing home being 2.5 years. In Alaska that length of stay could run almost a half a million dollars.

Long term care options will be discussed in a future article but check out the following sites for information on Long Term Care.

Long Term Care
http://www.investopedia.com/articles/04/112904.asp?partner=answers

http://www.mrltc.com/

Medicare
http://www.medicare.gov/

Medicare Long term care
http://www.medicare.gov/LongTermCare/Static/Home.asp

National Clearing house founded by the US Dept Health and Human Services.
http://www.longtermcare.gov/LTC/Main_Site/index.aspx

War on Health Care

President Bush 2008 Budget has vowed to spend taxpayers’ dollars wisely. He also vowed to make health care fairer, more affordable, more accessible, and flexible.

http://www.whitehouse.gov/infocus/budget/2008/index.html

On October 22, a request was made for a further $45.9 billion in war-related spending for fiscal year 2008. This request is on top of $147 billion already requested for the Department of Defense and $3.6 billion for other agencies for the fiscal year. If appropriated by Congress, the vast majority would be spent on Iraq. Total spending for the Iraq War would rise to approximately $611 billion.

According to testimony by the Congressional Budget Office, if one includes debt service costs in long-term U.S. deployment scenarios, the total cost for U.S. operations in Iraq and Afghanistan will reach between $1.765 trillion and $2.365 trillion by 2017.

The United States accounts for half of all the military spending in the world.
Congress and the White House allocate $522 billion a year to the Defense Budget. The country with the next highest military budget is China with $63 billion dollars per year.


To put it in perspective the proposed spending budget for the Iraq War for the year 2008 is $155.5 Billion but if these tax dollars were put into Health Care could provide 44,330,909 People in the United States with Health Care.

President Bush vetoed the SCHIP Child Health Insurance which could have provided health care for 5 million children. The cost of the Iraq war for the year 2007 is $ 137.6 billion which if spent for children’s health could have covered 58,681,896 children for a year.

To find out the trade off in education, housing, or health care for our defense budget by state or congressional district check out the following site:

http://www.nationalpriorities.org/Trade-Offs.html

Is this the best use of taxpayers’ money, Mr. Bush?
$611 Billion for the Iraq War- YES
Children’s Health Insurance- NO

Children's Health Care -Trick or Treat

On Halloween, President Bush announced that the State Children's Health Insurance Program (SCHIP) reauthorization bill currently pending in the Congress was a "trick." Congress passed bipartisan legislation to expand SCHIP and help children get the coverage they need. The bill would have covered almost 4 million additional children. The federal cost of the program would have been an additional $35 billion over 5 years. The program has helped reduce the number of uninsured, low-income children by one-third. However due to inadequate funding another 6 million children who qualify for SCHIP or Medicaid remain uninsured as a result.

Is the SCHIP reauthorization bill a "trick" or is the president just failing to medically “treat” millions of children? Make your opinion known.