The Growing Burden of Elder Care
Board: Living Below Your Means

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By WendyBG
March 20, 2007

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The linked article addresses the mind-boggling upcoming burden of caring for the elderly.

...In the next thirty years, the number of Americans over the age of 65 is expected to double. More specifically, there will be an 83% increase in the number of men and women between the ages of 65-74. There will be an 119% increase in those aged 75-84, and there will be a whopping 143% increase in people older than eighty-five! A majority of these men and women will require long term care....

America is on the threshold of a national crisis when it comes to its old age social assistance programs. In its first year, Medicare had a budget of $1 billion. According to the most recent budget, the cost is now $394 billion. Likewise, the budget for Medicaid has gone from $1 billion in its first year to its current $276 billion annually. With the graying of America, these budgets will only grow larger in the coming years. All of this leads to the year 2018, when Medicare will likely run out of money. ...
[end quote]

The article has a strongly religious (specifically Christian) slant. I'm not Christian, but the author's moral points are worth considering, for other religions (or no religion), as they are, for Christians. The author believes that preserving life, at any cost, is a moral good, and that considering quality of life is a slippery slope, toward devaluing life.

Personally, I tend more toward the quality-of-life side, of the continuum. My Advance Directive specifically requests withholding of extreme life-preserving measures, at the end of life.

Currently, the high-cost, life-at-any-price option is the default option, and society pays. It requires substantial effort, to write an Advance Directive, and choose the option of palliative care. Most people won't do this.

Currently, 40% of a person's lifetime medical expenditures occur, in the last 6 months of life. This is an expensive exercise in futility. As the burden increases, government may cover less, than it does now (for example, expensive, futile, life-extending mechanical resuscitation may not be covered).

Switching from end-of-life care, to long-term care, who will pay for years, perhaps decades, of care, for the enormous numbers of elderly?

Even if the national consensus is that government should pay for long-term care (as it now does, with Medicaid), would you want that "Medicaid" quality of care? Or would you want to be able to afford a higher quality of care?

For those of us, on the LBYM Board, the issue may be central, to our decision to curtail current consumption.

If our aging parents don't have sufficient means, we may have to help them, with long-term care. The cost of long-term care varies, from place to place, but the U.S. average is about $55,000 per year.

If we don't have our own children, we will be forced to provide our own care, at the second-most-vulnerable time, in our lives. There are few sights more horrifying, or more depressing, than helpless, abandoned old nursing home patients, waiting for death, while suffering pressure sores, because they don't have the strength to turn over, in bed.

Multiply this by millions...that's the future...if we don't have the resources, to pay for better care.

How will our society be able to deal with this?

I believe that there will be profound impacts, on immigration laws and labor laws, as well as on the government and insurance regulation of end-of-life care.

I also believe that only LBYMers show the personal responsibility to take control of their own future care.


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