HEALTH CARE REFORM AND THE CAREGIVER

April 22, 2010

As health care reform becomes the law of the land, a huge segment of Americans with a unique interest in the way it unravels, are watching on the sidelines. We’re talking about the 49 million people who care for older family members. They are hidden in plain sight, as usual, quietly shouldering a burden that so often takes a heavy toll on their finances and their physical and emotional well-being. Hardly any of them are aware that this new reform includes one of the most important steps ever taken to improve the caregivers’ lot, especially those of the middle-class persuasion.

The Community Living Assistance Services and Supports Act, otherwise known as CLASS, provides for a national insurance program to help cover the cost of long-term care – something 70 percent of people over 65 will need at some point along the way. The premiums will be much lower than those for private plans, and you won’t get screened out because you’ve already had some health problems. Once vested after five years, enrollees unable to care for themselves will be able to claim cash benefits for as long as needed.

The new health care reform law could “transform long-term care” and make it possible for more patients to stay at home, said the chief of the National Council on Aging. If you’re rich, you don’t require much financial help with long-term care. If you’re poor and can no longer fend for yourself, Medicaid pays the bills, often at a nursing home. For the rest of us, long-term care – at home or in an institution – now requires that we, or our caregivers, choose from among some unpleasant options.

We can spend down our retirement savings until we’re eligible for Medicaid funds. We can protect our savings by taking out expensive long-term care insurance – it can cost a couple more than $5,000 a year. Or, depending on how dependent we are, we can throw ourselves, or be thrown, on the mercy of our families.

CLASS, one of the legacies of the late Ted Kennedy, offers caregivers and care recipients another option. “If it’s successful, if a large enough number of people sign up, it will transform long-term care, “ says James Firman, president and CEO of the National Council on Aging. “It will create a market-based economy for keeping aging people at home.”

That’s an important “if,” since the program, by law, must be self-sustaining. Premiums will generally be collected as part of the workers’ payroll deductions unless they opt out. The younger the worker, the smaller the premium.

There is a vicious circle built into the current arrangements. Many caregivers must hold down a job and maintain their own separate family household while also watching over an aging parent. That kind of pressure can have consequences.

In recent studies, workers 18 to 39 years of age who were caring for an older relative had significantly higher rates of hypertension, depression and heart disease than non-caregivers of the same age. Overall, caregivers cost their companies an extra 8 percent a year in health care charges and many more unplanned days off. In other words, the strains of family caregiving can hasten the caregiver’s need to be the recipient of care.

CLASS bids to crack if not break that vicious circle. Its benefits would make it much simpler and less expensive for families to make sure Mom gets the support she needs to be able to spend life’s endgame where she wants – in her own home. Good news for Mom, and good news for the future health of her caregivers.

Source: www.aol.com, 3/26/10