Bonnie Burns and Stephen Moses have different ideas about how the United States should prepare for the aging of the population, but they agree on the meaning of the election results: Voters want the programs now in place more or less the same.
Burns, a consultant at California Health Advocates and someone who helps speak for consumers’ interests in National Association of Insurance Commissioners proceedings, said she feels relieved.
“It looks like some of the more drastic changes to Medicare won’t be taking place,” Burns said today in an interview.
Moses, president of the Center for Long-Term Care Reform, said the results of the election seem to reduce the likelihood that Congress will change the U.S. acute health care or long-term care (LTC) finance systems for the better.
The voters “spoke loud and clear,” Moses said. “You saw a vote for the continuation of the status quo.”
Moses is supports changing federal laws, programs and tax rules in ways that would increase the sale of private long-term care insurance (LTCI).
Burns thinks private LTCI coverage might be part of the LTC finance solution for relatively healthy, affluent people who can afford to buy private LTCI coverage and can meet the insurers’ underwriting requirements, but she argues that the country has to scrape up the resources that will be needed to meet the needs of a growing population of frail and disabled elderly people whether the country can find those resources.
Even if a federal government could provide the modest $50-per-day benefit once promised by the ill-fated Community Living Assistance Services and Supports (CLASS) program, that could be enough to provide resources that could keep many older people in their homes and sharply reduce the need for costly institutional care, Burns said.
Both Moses and Burns had a hard time coming with ideas about LTC or elder care that might have enough bipartisan support to get through both the Republican-controlled House and the Democrat-controlled Senate.
“There’ll be nothing be passed that benefits the private long-term care insurance industry,” Moses. “No, not a prayer.”
The Patient Protection and Affordable Care Act (PPACA) effectively requires to maintain the Medicaid programs they had in effect when PPACA passed, and Maine can’t even get permission to realign benefits to keep millionaires from qualifying for Medicaid nursing home benefits, Moses said.
Moses would like to see Congress at least start taking baby steps toward controlling the federal budget deficit.
Taking another look at the budget-cutting proposals developed by the National Commission on Fiscal Responsibility and Reform could be one small, positive step, Moses said.
Moses said he thinks letting the country go over the “fiscal cliff” — letting automatic cuts in the defense budget and domestic spending take effect — could also be helpful.
Letting the country go off the fiscal cliff will probably cause a recession, but simply letting the federal government pile up huge deficits will probably cause a depression, Moses said.
Some Republicans in the House talked last spring about the idea of coming up with an alternative to the CLASS program.
Burns said she would be happy if Republicans and Democrats could simply start talking seriously about how to talk about elder care issues.
“This is a discussion we desperately need,” Burns said.
To keep elder care issues from ruining the lives of family caregivers, the country has to be talking about matters such as elder transportation programs and geriatric care management services as well as LTC finance, Burns said.