So Who’s Responsibility Is It To Care For Our Aging Population?
It’s no secret that in today’s world, the aging population is living longer than ever before. In fact, in America 79 million baby boomers make up over one fourth of the population. Pew Research published that each year, for the next 18 years, boomers will reach the age of 65. The aging population’s life expectancy has increased dramatically. Gallup Polls state the average life expectancy for women is 81 and men 76. Gallup also reports the average retirement age for full-time employment is now 67 rather than 65.
Looking back on history, the boomer generation has completely transformed literally everything. Previous lifestyle patterns continue to differ from teen culture, young adult hood, middle age and retirement. Childbirth is now a family event and takes place in birthing suites. Emphasis on a natural birth with the father’s involvement as a coach has become common practice. The educational system embraces study abroad. College degrees have become the standard, rather than a high school degree.
Court systems restructured parental custody norms. Spousal support even had a make over. Women no longer automatically receive child custody and “alimony” in a divorce. The palimony process is now a part of the equation. This process determines which spouse’s income is considered to be “head of household” when deciding child and/or spousal support. The examples regarding boomer changes are ongoing. The point here circles back to the opening question, which points directly at the baby boomer generation. What will their impact be on our government programs that guarantee access for financial benefits and long term care, when they are of age.
Long Term Implications?
For years experts have predicted that our government’s social security program is in jeopardy. The good news is more people have entered into the workforce and paid into social security than previous generations. The bad news is with people living longer, there are more people who will enroll into social security, than exit it. On positive note, the government made an age based adjustment determining when people can begin to collect their benefits. Conversely, it will take years before the system realizes the impact. Social Security is just one of the programs at risk. Two other key programs that are also directly impacted are Medicare and Medicaid.
What Are The Funding Differences Between Medicare And Medicaid?
What about Medicare and Medicaid? First its important to understand the financial backing differences between the two programs. Medicare is solely a “federal” program. Medicaid is a “joint state and federal” program. This means each state operates its own Medicaid system. In order to receive grants or funding, each state’s system must conform to federal guidelines. Both programs were introduced to assist people with health insurance and long term care, for their end of life. These two programs were developed when the life expectancy was in the late 60’s early 70’s.
Medicare has undergone several revisions. The program has become so convoluted that
the average person does not fully grasp their own coverage. Many people seek out professionals to guide them through their coverage. Once people comprehend what the basic coverage provides, most purchase supplemental policies for additional protection. What’s concerning, is that the majority of Medicare participants don’t understand how to work within the coverage rules that revolve around a hospital stay. It’s essential to know when coverage ends and when you are personally liable. It’s also imperative to recognize the risks of being released too soon. When this happens there is an increased risk to exposure for a relapse or other related illness.
Over the years Medicaid migrated from a gap coverage program, to an entitlement
program. Gap, meaning a temporary solution to provide medical coverage for people until they are able to get back on their feet. Over the years it somehow morphed into a an assistance program without a coverage end point. The acid test for coverage qualification is tied to financial eligibility. Across the country there are generations of families who haven’t worked a day in their life and receive Medicaid benefits (not just medical) indefinitely. Over many years the program took an unplanned turn and migrated from “bridging the gap” to “providing assistance without accountability”. Translation, it became a benefit for all persons, not just those who contributed into the plan.
The Elephant In The Room.
Here is the unspoken conundrum for those approaching their end of life. The government believes people are entitled to health care. Ironically, individuals who have contributed into the system their entire career, are literally dying penniless, in order to receive end of life care. Why? Medicaid’s criteria for this particular type of care, requires a person to deplete their assets to $2,000. Basically, it requires them to go broke. The government continues to work with a one size fits all approach for an individual’s end of life care subsidization vs. creating a financial sliding scale for assistance. For this reason, people hire elder care attorneys to create a custom asset protection plan which enables then to qualify for assistance. They do this so they can leave some form of legacy to their family, receive assistance with end of life care and have a dignified funeral.
The numbers reflect that over the past few years, Medicaid on average takes up to 22% of each state’s budget. This portion is not federally subsidized. If the federal government must match each state, can you imagine the impact on the federal budget? With a significant strain on the system now, one must wonder if funds will be available when the influx of boomers age and need assistance. Making matters worse, the New York Times reported on November 27, 2012 that, “Medicaid is the nation’s largest health program in terms of number of recipients, serving 56 million to Medicare’s 48 million – AND – According to the Congressional Budget Office, in the 2010 fiscal year, 77 percent of people enrolled in Medicaid were children and families, while 23 percent were elderly or disabled. But 64 percent of Medicaid spending was for older Americans and people with disabilities, while 36 percent went to children and families.”
Bottom line – there is an entire generation of individuals who will be approaching the age where they will need medical and financial care in their final days.
What’s The Solution?
It may not be a political or governmental one. If you look outside of the United States, one could make the argument that the solution is cultural. It’s no secret other countries have similar or worse economic issues. One primary observation is that many other cultures place far more emphasis on providing care for the generations within the family unit. Unlike in the United States, it’s common practice to have multiple generations living together under one roof. It’s innate and simply considered a way of life. Finances or illness type aren’t even taken into the equation; it’s just the unspoken norm.
As a country, can we learn something here, what’s your thought? Please take a minute to share.