Long term care often is viewed as an inevitable expense of old age. In reality, people cannot predict what they will need. On average, someone turning age 65 this year will need either formal or informal long term care for three years, but this average masks enormous variation. While some 30% of 65 year olds will not need any long term care before they die, 20% will need care for more than five years.
Few people have insurance against the expense of long term care, which can reach $26,000 a year at home and more than twice that amount in an institution. Medicare covers long term care only tangentially through its limited skilled nursing facility and home health benefits. The private health insurance policies that cover most working-age Americans for acute health care services provide little protection for long term care. As a result, almost half of formal long term care is financed by the federal-state Medicaid program, which becomes available only when a person is impoverished.
Why has this situation not given greater impetus to reforming the financing of long term care? To learn more, the National Academy of Social Insurance's study panel on long term care commissioned a poll of baby boomers (those aged 40 to 60) and seniors (aged 60 or over). Peter D. Hart Research Associates and American Viewpoint–two of the nation's leading survey research firms–conducted the poll.
The poll found a high level of public concern about paying for long term care and widespread discontent with the current system of financing. Americans seem to understand that the financing of long term care is a serious policy problem and are receptive to change. Specifically, among adults aged 40 and over:
o The vast majority (90%) recognizes that affording the costs of long term care is a difficult proposition, including 62% who say it is very difficult. Affording long term care is considered far more difficult than problems that sometimes receive more attention, such as finding high-quality care or information about government financial help.
o Nearly three-quarters are concerned either a great deal (54%) or a fair amount (18%) about paying for long term care–a proportion nearly identical to proportions expressing concern with paying for a major illness or a comfortable retirement.
o Seven in 10 believe that government should do more to help people meet the costs of long term care (see Figure 1).
