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October 28, 2013 at 08:00 PM
Obamacare was originally supposed to include an affordable provision for long-term care through the CLASS Act. When that proved to be untenable, it was dropped.
Instead, the Commission on Long-Term Care was tasked with putting together a report that laid out the problems and provided a solution. The 15-person commission produced a 114-page report—a lot of work considering they only had from June till September—but a solution? Not so much.
In fact, there was so much disagreement that six commissioners voted against passing the report, and five issued their own dissent and recommendations.
LTC difficulties were divided into three basic categories: delivery system challenges, work force challenges and financing challenges.
Delivery system challenges include a lack of coordination in delivering long-term support and services (LTSS) partly due to “misalignment of benefit structures, conflicting rules and separate funding streams of Medicare, Medicaid and other public and private programs.” Lack of integration between agencies and professionals compounds the problem.
Stating the obvious, the report also pointed out that the cost of LTSS is a challenge for families and governments facing severe financial pressures.
LTC insurance isn’t the only answer, either. Coverage is expensive and increasingly hard to get. The report pointed out that “a significant number of insurers have left the private LTCI market and closed blocks of policies due to low interest rates that have affected the products’ financial performance and unexpectedly low forfeiture rates, among other reasons. Many policies that are in force have recently experienced substantial premium increases.”
The report suggested changing the way services were provided so those who need them are offered more appropriate levels of care and bound by fewer restrictions.
The work force challenges section addressed the need to improve the “availability and quality of paid and unpaid caregivers.” Suggested solutions ranged from integrating family caregivers into the system to improving the career potential of care worker positions, allowing nurses to delegate some of their responsibilities and performing more criminal background checks on caregivers.
