President Obama has signed health reform, including the CLASS Act, into law. Now, his administration needs to turn a law into an insurance product people will buy. It won't be easy. No other country has tried to create a voluntary public long-term care insurance program, which is what CLASS is. The challenge will be to design a policy that provides a respectable benefit at an [...]
The health reform bill passed by Congress last night includes big changes in the way we pay for long-term care, both at home and in nursing facilities. The reforms will give the elderly and disabled far more flexibility in the way they get care and, at the same time, begin turning long-term care from largely a welfare program to an insurance system. The biggest change [...]
It is tough enough to age in America if you are white and middle-class. You struggle with the loss of physical vigor, social connections, and independence. You face difficult financial challenges and profound changes in your relationships with family. Now, imagine aging if you are out of the cultural mainstream of the U.S. Imagine if you came to America as an adult 40 years ago. [...]
A typical couple would have to save nearly $200,000 to pay for their out-of-pocket medical costs from the time they are 65 until they die, according to an important new study by the Center for Retirement Research at Boston College. Add in nursing home costs, and they are likely to need $260,000. But that's only part of the story. About 5 percent of 65-year-old couples will [...]
Mike Vitez at the Philadelphia Inquirer has done a great story on palliative care at a community hospital. Mike weaves the deeply touching story of Mary Tole, a 74-year-old woman who spent two months in the suburban Philadelphia hospital with an undiagnosed illness. She spent much of that time in an intensive care bed in a coma. Mike describes how the hospital's palliative care team [...]
The compromise health reform plan proposed today by President Obama includes many of the key long-term care provisions that were included in the earlier House and Senate bills. The CLASS Act--the national long-term care insurance program--along with federal incentives to encourage states to expand their home and community based care programs under Medicaid, and improved care coordination for those receiving both Medicare and Medicaid [...]
While the United States struggles to figure out how it is going to pay for long-term care, it is important for policymakers, care providers, and those of us caring for our parents to see how other countries do it. The Commonwealth Fund has just published my new paper, LongTerm Care Financing Reform: Lessons from the U.S. and Abroad that looks at where the [...]
If you think the U.S. is struggling over how to finance long-term care, just take a look at what's happening in the U.K. There, Prime Minister Gordon Brown, who faces an uphill battle for reelection this spring, has proposed to expand free long-term care to 280,000 of the most needy. His proposal has not only come under fire from the opposition conservatives, but also from many in [...]
Today, The Washington Post and Kaiser Health News jointly published an article I wrote on aging in place villages--an important element in the effort to help seniors remain in their communities. There are close to 50 villages now operating around the country, and at least 600 communities interested enough to send representatives to workshops held over the past year by the non-profit community development group NCB Capital [...]
Those of us who have been caring for our parents know very well the physical toll it takes. I helped care for my dad for 18 months. And after he died, one of the first things I did was make an appointment to see my own doctor. I had never felt so exhausted and worn out in my life. Now, an important new study describes the health effects [...]