The current fight over what happens to people with health problems if the Affordable Care Act ban on medical underwriting goes away may be a baby version of the coming battle over how we pay for baby boomers who need long-term care.
The root of the ACA medical underwriting problem is the same as the root of the future long-term care funding problem: We have soft hearts and thin wallets. We want all nice people to have the care they need, but we don’t want to make tough decisions about how we pay for the care.
So, we keep rolling that bad funding hot potato around society.
The medical research funding in the 21st Century Cures Act could lead to new ways to prevent or cure conditions such as Alzheimer’s disease. That could help a lot.
We could raise taxes. We could get all of those people who have about $25 in their checking accounts at the end of the month to save more.
The U.S. government could persuade people in China to lend us the money to pay for all that care. (If people in China are not using their money to pay for care for their own aging parents and grandparents.)
We could boost sales of long-term care insurance, to use tax incentives and the power of insurance company dunning notices to make up for some of the self-discipline we lack.
We could impose official rationing, and find some way to get the resources we do have for long-term care to the people in the most desperate need.
Or, we could just try to hum to ourselves and look the other way when we find out about that the bad funding hot potato has rolled randomly around the countryside landed in the homes of sick, poor people, and left them in misery.
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