The No. 1 health-related policy concern of older adults in the United States is the cost of long-term care, but a former US congressman and insurance commissioner said there is little political appetite for the kind of changes necessary to tackle this growing problem.
The research, published in JAMA Wednesday morning, asked 2,576 adults aged 50 to 101 years to rank 26 health-related issues, such as prescription drug costs, long-term care costs, social isolation and loneliness, and access to quality care. The costs of long-term care — services in nursing homes, assisted living communities and home care — rated as “very concerning” among 56.3% of participants, making it the top issue.
Access to “quality” long-term care also was a concern but ranked seventh on the list of overall worries.
“This remains a substantial unmet need to American families,” former US Rep. Earl Pomeroy (D-ND) told McKnight’s in a phone interview Tuesday. “Lower-income families have Medicaid and, for the most part, that response when people have low assets covers their risk. The middle class is basically looking at a modest nest egg that will be completely wiped out by long-term care costs, and there’s nothing protecting them at present time.”
Pomeroy was part of the US House Committee on Ways and Means while the Affordable Care Act was being written. Before his election to Congress in 1993, he served as North Dakota’s insurance commissioner.
Pomeroy said he was looking at increasing costs of long-term care even during his time as a commissioner.
“Here we are 40 years later, and we still haven’t figured it out,” he said.
The study, led by John Z. Ayanian, MD, of the Institute for Healthcare Policy and Innovation at the University of Michigan, found that older adults also were significantly concerned about the general cost of medical care, prescription drugs, insurance and Medicare, and dental care.
“To engage older voters, candidates for president and Congress should prioritize communicating their plans for controlling healthcare costs,” the study’s authors wrote.
But Pomeroy said there’s little chance of a workable plan to lower long-term care costs anytime soon, adding that it took a long time for politicians to take on the costs of prescription drugs for older adults. He said the only possible way forward is for the government to step in to lower costs, since the private sector “lost their shirts” in the late 1980s trying to manage those costs.
Since then, costs have continued to increase without feasible solutions.
“I don’t see a critical mass of politicians pushing on this,” Pomeroy said. “There are some ideas, but none really achieve a level of interest or excitement.”
In addition to Ayanian, the researchers are affiliated with the University of Michigan Medical School, the University of Michigan School of Public Health and the Center for Clinical Management Research at Veterans Affairs Ann Arbor Healthcare System.
The McKnight’s Tech Daily is an e-newsletter for the audiences of McKnight’s Long-Term Care News, McKnight’s Senior Living and McKnight’s Home Care.
