It’s a shame we don’t have a U.S. long-term care insurance correspondent in Venezuela. 

Of course, Venezuela has just about nothing to do with how the United States will pay for nursing home care, home health care and adult day care for members of the generation born from 1925 through 1945, or for members of the baby boom generation.

But the problems Venezuela is going through right now have everything to do with how the United States and other developed countries will pay for long-term care services.

Related: On the Third Hand: Venezuela

Venezuela, a beautiful country with vast oil reserves, is having a terrible time even feeding its people, or paying its teachers, right now because of a combination of the following problems:

  • A steep drop in oil prices.

  • A horrendous drought.

  • Built-in government rules that, according to many accounts, encourage corruption and inefficiency.

  • Government efforts, developed in response to rising food prices, to set prices for essential commodities by fiat. (The rules were based on the assumption that suppliers were hoarding goods, or charging artificially high prices, to hurt the government.)

  • A president, Nicolás Maduro, who is a member of Venezuela’s United Socialist Party and has run his country in such an authoritarian way that he has alienated even other leaders in South America who generally share his socialist views.

The markets for many kinds of health care services, including long-term care services, may be different from the markets for many other kinds of services because the people who need long-term care services are usually in no position to shop for better deals, and most of us believe that we have some responsibility to help other human beings who are in desperate need. Even Ayn Rand, a theorist who believed most government efforts “to help people” were disguises for efforts to make the corrupt rich richer, believed private citizens should, and would, respond gallantly to people affected by disasters through no fault of their own.

Realistic vision

But, on the other hand, our instinctive desire to help the helpless has limits. Most of us may be willing to spend a minute to click on a Web link to get a big company to donate 50 cents to starving people in Africa. Many of us are resigned to pay payroll taxes to support government health care programs. Few of us would be cheerful about using half of our paychecks to pay for government health care programs for other people. Even fewer would be comfortable with the government forcing us to work, for wages below the minimum level needed to feed, clothe and house us, in nursing homes.

We need to have idealistic visions about the kind of minimum level of long-term care services a decent society should try to provide for people who have no ability to provide for themselves.

No matter what kind of government and economy we have, if we want our approach to long-term care finance to work, we need to have a realistic idea about how much providing long-term care services costs, how much government or private money we can spend on those services, and how we’re going to go about coming up with the money and reconciling the gap between the kinds of services we should provide and the kinds we can provide.

Failing to think realistically about the gap between what we should provide and what we can provide will lead to a long-term care services version of what’s going on today in supermarkets in Venezuela. Just substitute futuristic pictures of frail older people lying on the sidewalks outside overwhelmed nursing homes in the United States (or Europe) for the current pictures of empty grocery stores in Caracas.

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