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Old 04-04-2016, 05:27 AM
 
29,766 posts, read 34,851,819 times
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Numerous threads contain discussions about our future health needs as we age and the resources we expect to be there for us. Many would say we could be in for a rude awakening and that the sustainabilty of current government programs especially those Medicaid based is not there. Many indicate they want to die broke expecting Medicaid to pay for any long term health care needs etc. The following widely circulated article should provide some food for thought:

http://wtop.com/health/2016/04/new-p...ased-programs/

Quote:
The federal government is pushing states to keep more low-income seniors out of nursing homes and, instead, enroll them in home and community-based programs.

The shift comes as demand for long-term care is rising. By 2050, the number of people older than 85 is expected to triple to more than 18 million. These seniors tend to have the highest disability rate and the greatest need for long-term care.


The tug-of-war between rising demand and controlling costs has advocates for seniors worrying about quality of care.

Medicaid is one of the largest expenses for states, and a it’s a program they look to for savings when budgets are tight. Medicaid spending on long-term care for seniors rose by 4 percent, to nearly $89 billion in fiscal year 2013.

Advocates say programs for seniors often wind up on the chopping block.

For example, Illinois is considering changes to its home and community-based program that would reduce funding by about $200 million.
Another nugget of thought for folks when considering where to live in retirement might be, will that community have the resources and will to support me in my later life years? Will they have other more pressing priorities? Will they favor limited medicaid type resources being used for the elderly or for young poor children?
What percentage of the state/local population will be elderly in need as a percentage of the needy vs limited income in need.

These sound like cruel questions but reality can often be cruel and increasing debt payment obligations now mean more future resources devoted to government debt service and less to programming.

As a side note what impact will mandatory increases in minimum wage have on health care cost? Will they drive the cost of human labor providing services up and make it more unaffordable to the individual and government?

Consider a $15 hourly mandatory national minimum wage and what it would do to the cost structure where you live or might want to transplant to. The low COL areas we often seek out could be devesated the most as the percentage increase in labor cost there would be the greatest. This is not just health care but in most consumption expenses.
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Old 04-04-2016, 06:35 AM
 
Location: NC Piedmont
3,911 posts, read 2,876,213 times
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I do some volunteer work for a caregiver organization whose mission is to allow people to live independently when it would be difficult or impossible for them to do so without at least a little help. Many of these people are in a tough spot financially also - they are getting enough in retirement income so that they don't qualify for many programs but they don't have enough for private help. It's also one of the better programs I have found for being able to fit into pretty much any schedule; whether you have a little time or a lot and no matter when it is, there is generally someone they can match you up with that you can do something for. the one I work with is local to me, but there are various ones all over. Here is a link to the national organization that has a program locator you can use if you want to volunteer or if you need a little help to be able to live independently:
Welcome to NVCNetwork - National Volunteer Caregiving Network


EDIT TO ADD - I hope we don't get off on a tangential argument, but I take exception with this:
Quote:
Consider a $15 hourly mandatory national minimum wage and what it would do to the cost structure where you live or might want to transplant to. The low COL areas we often seek out could be devesated the most as the percentage increase in labor cost there would be the greatest. This is not just health care but in most consumption expenses.
http://www.dailydot.com/opinion/mini...verty-seattle/
Quote:
Myth: An increase in the minimum wage won't help anyone if all other costs go up, too

One assumption about increasing the minimum wage is that it will force to the cost of living to increase at the same rate, and in doing so, we’d really just be speeding up inflation.

This isn’t really how economics works. A 2013 study by the Chicago Fed found that increasing the minimum wage even just to $9 would increase consumer spending by $28 billion. When spending—i.e. demand—increases, manufacturers and other purveyors of goods and services can actually charge less or at least avoid increasing their prices, because they’re increasing overall revenue.

While increasing minimum wage, thus, benefits the economy, there are hidden costs of low-wage work which impact everyone. Working full-time at the current federal minimum wage of $7.25 means employees make just about $165 per month above the federal poverty level. If they have even one child, they are well below it, which means they are dependent on social services to the tune of about $152.8 billion in taxpayer money per year.

Last edited by ReachTheBeach; 04-04-2016 at 06:44 AM..
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Old 04-04-2016, 06:46 AM
 
29,766 posts, read 34,851,819 times
Reputation: 11675
Quote:
Originally Posted by ReachTheBeach View Post
I do some volunteer work for a caregiver organization whose mission is to allow people to live independently when it would be difficult or impossible for them to do so without at least a little help. Many of these people are in a tough spot financially also - they are getting enough in retirement income so that they don't qualify for many programs but they don't have enough for private help. It's also one of the better programs I have found for being able to fit into pretty much any schedule; whether you have a little time or a lot and no matter when it is, there is generally someone they can match you up with that you can do something for. the one I work with is local to me, but there are various ones all over. Here is a link to the national organization that has a program locator you can use if you want to volunteer or if you need a little help to be able to live independently:
Welcome to NVCNetwork - National Volunteer Caregiving Network


EDIT TO ADD - I hope we don't get off on a tangential argument, but I take exception with this:

The 7 most dangerous myths about the fight for $15 minimum wage
There is also the village movement. One problem with community based programs could be the ability of different communities to service seniors.
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Old 04-04-2016, 07:12 AM
 
Location: NC Piedmont
3,911 posts, read 2,876,213 times
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Quote:
Originally Posted by TuborgP View Post
There is also the village movement. One problem with community based programs could be the ability of different communities to service seniors.
I see that because the center I work with puts out a list of needs and many are not being met. We help, but there are too many needs to be addressed only by those who will step up and volunteer. Some people require skilled help. To be clear, I did not post the link because I think we can solve the problem that way, but at least we can make it a little less bad until we address it better.
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Old 04-04-2016, 07:28 AM
 
29,766 posts, read 34,851,819 times
Reputation: 11675
Quote:
Originally Posted by ReachTheBeach View Post
I see that because the center I work with puts out a list of needs and many are not being met. We help, but there are too many needs to be addressed only by those who will step up and volunteer. Some people require skilled help. To be clear, I did not post the link because I think we can solve the problem that way, but at least we can make it a little less bad until we address it better.
That is part of the problem. Who is the we? When it becomes community based the we becomes localized and limited by the wealth, creativity and willingness of the local community. That can be impacted by age, income, education, unemployment, poverty level etc. Drive around rural NC and other states and it becomes a sorta scary proposition.
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Old 04-04-2016, 07:38 AM
 
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since 1990 medicaid has cut nursing home spending by 50% and has been leaning towards more in home care payments and community based services .

one of the reasons the census showed only 5% of seniors in a home is for two reasons .

they cut the budget for snf care by 1/2 of what it was and the over 65 population was about 70% less then it will be when the census was taken . back in 2010 only 13% of the population was 65 or older , now it is increasing into the twenty percent range as the wave of baby boomers hits 65 or older .


in reality 70% of those over 65 will require some form of long term care services

Last edited by mathjak107; 04-04-2016 at 07:53 AM..
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Old 04-04-2016, 07:50 AM
 
29,766 posts, read 34,851,819 times
Reputation: 11675
Quote:
Originally Posted by mathjak107 View Post
since 1990 medicaid has cut nursing home spending by 50% and has been leaning towards more in home care payments and community based services .

one of the reasons the census showed only 5% of seniors in a home is for two reasons .

they cut the budget and the over 65 population was about 70% less then it will be . back in 2010 only 13% of the population was 65 or older , now it is increasing into the twenty percent range as the wave of baby boomers hits 65 or older .


in reality 70% of those over 65 will require some form of long term care services
Hmmm you said will require. Got it! Care to guess what the percentage will be that will receive? That is the trillion dollar question. Thus the fund your own movement which I believe you belong to.
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Old 04-04-2016, 07:55 AM
 
71,474 posts, read 71,652,652 times
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i couldn't even guess . many will attempt their own family care rather then outside care and just end up exploding their family's apart when the feuding starts as one sibling steps up and the rest step back .

once the spouse of the sibling starts with why are we helping and your brothers and sisters are not all hell breaks loose .
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Old 04-04-2016, 07:56 AM
 
Location: NC Piedmont
3,911 posts, read 2,876,213 times
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Quote:
Originally Posted by TuborgP View Post
That is part of the problem. Who is the we? When it becomes community based the we becomes localized and limited by the wealth, creativity and willingness of the local community. That can be impacted by age, income, education, unemployment, poverty level etc. Drive around rural NC and other states and it becomes a sorta scary proposition.
Willingness is a big problem. I got a little annoyed with a healthy young coworker a while back who walked into the break room when I was discussing the center with someone else who works with a similar program. The healthy youngster was very interested and got information from both of us. A few days later I asked if he had contacted the center yet. Turns out that isn't what he wanted the info for; he shared it with older relatives so they could sign up to receive help. He is "just too busy to volunteer right now"...
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Old 04-04-2016, 08:12 AM
 
Location: Tennessee
23,556 posts, read 17,535,380 times
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Quote:
Originally Posted by mathjak107 View Post
i couldn't even guess . many will attempt their own family care rather then outside care and just end up exploding their family's apart when the feuding starts as one sibling steps up and the rest step back .

once the spouse of the sibling starts with why are we helping and your brothers and sisters are not all hell breaks loose .
Sadly, any sort of family crisis like this often drives people who already have a difference of opinion further apart.
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