The United States needs to get employers and workers involved with preparing for future long term care costs.

Speakers delivered that message here at a long term care symposium sponsored by Genworth Financial Inc., Richmond, Va.

Already, “because LTC costs drive much of Medicaid growth, LTC care reform–primarily within Medicaid reform efforts–has become a top policy priority for the federal government and most states,” according to the authors of a paper released by the American Health Care Association, Washington, and the National Center for Assisted Living, Washington.

Meanwhile, the federal government has only about half as much money as it needs to finance existing benefits promises made through the Social Security, Medicare and Medicaid LTC programs, according to Douglas Holtz-Eakin, who was director of the Congressional Budget Office from 2003 to 2005.

“There has to be reductions in these commitments,” said Holtz-Eakin, who is now director of the Maurice Greenberg Center for Geoeconomic Studies at the Council on Foreign Relations, New York.

But other speakers talked about the need to expand LTC support mechanisms, particularly for Americans who provide unpaid, informal home care for friends and relatives.

Meryl Comer, a former television personality, said she is taking care both of her husband, who has Alzheimer’s disease, and of her elderly mother.

Comer told the audience that most people believe Medicare will pay most of the cost of treating Alzheimer’s patients, but she noted that technicalities in the rules governing what Medicare will pay for non-acute care loom large.

“For women, the issue of providing LTC care is just huge,” she said. “Somebody has to tell it like it is.”