Healthcare Reform that Doesn't Address Long Term Care Would Be a Failure

By John Aloysius Farrell, Thomas Jefferson Street blog

"It is absurd," writes Howard Gleckman, "to expect someone to clean feces from a dementia patient every day for nine dollars an hour for no benefits."

But, as anyone who has cared for an aging parent or terminally ill friend or disabled neighbor or relative knows, America's hodge-podge system of long-term care is packed with such assumptions. And some 54 million of us wrestle with them every day.

Here is one of my favorites: if you suffer a massive heart attack and need expensive medical care in your golden years, it is likely that Medicare will cover your bills.

But if you have the bad luck to contract Alzheimer's disease, it's sorry pal, you're on your own.

Gleckman is a longtime Business Week correspondent, now at the Urban Institute, whose new book Caring for Our Parents could not be better timed. It pokes into all the nooks—nursing homes, assisted living, home care—in which most of us, frail and lonely, will spend our final years.

We may say, "Shoot me first," but nobody ever does. We may pray for a sudden stroke, or a heart attack that takes us in our sleep, but four out of five of us won't leave this life so neatly.

Congress is tackling health care reform, and Gleckman makes a persuasive argument that any new plan needs a strong long-term care component.

Indeed, after reading Gleckman's eloquent mix of compelling real-life stories, and stunning statistics, you will come away with the firm conviction that any health care legislation that does not address the issue of long term care is, on the face of it, a failure.

Gleckman doesn't just address our failings, he looks at how other modern industrial nations cope with aging populations.

And it is hard, after reading his book, to not believe that a new social insurance program, like Germany's, built along the lines of Medicare and Social Security should be part of whatever health care reform leaves Capitol Hill.

If you're a conservative, and don't like the idea of federal entitlement programs, then a universal mandate to purchase long-term care insurance from the private U.S. insurance industry may sound more appealing.

In either case, it is something we Americans need to address. If you have had "the Phone Call" you know what I mean. If you have not had it yet, you will.

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