You Can Run, but You Can’t Hide: Long-Term Care for Older People and Younger Persons with Disabilities
Wiener, J. M. Testimony at a Congressional Hearing, You Can Run, but You Can't Hide: Long-Term Care for Older People and Younger Persons with Disabilities, Testimony presented at the Unites States House Committee on Energy and Commerce Hearing on Planning for Long-Term Care, Washington, DC, May 2006
The financing and organization of long-term care for older people and younger persons with disabilities needs reform. Although long-term disability is a normal life risk and nearly half of all older persons will spend some time in a nursing home, the need for long-term care comes as a surprise to most Americans and their families who have to cope with it (Spillman and Lubitz, 2002). With very little public or private insurance against the high costs of nursing home and home care available, users of long-term care incur very high out-of-pocket costs. As a result, Medicaid is the principal source of financing for long-term care, even though many of the users were not initially poor. Although most persons prefer home and community-based services, the vast bulk of long-term care expenditures are for institutional care. Finally, with the aging of the population, demand for long-term care will increase in the future, placing financial pressure on public programs and private resources.