Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
These laws are archaic and were not designed with the realities of modern medical expenses in mind.
I make a considerably above median wage for the poor town I live in, and am a bit above the national median. Still, a month's stay at the average to better SNFs in my area is usually more than my monthly gross wage.
I'm an only child. Both of my parents are still alive. I couldn't afford to pay for one of their stays out of my entire monthly net wage. My income would basically have to double, into the six figures, for me to be able to afford a basic lifestyle, plus pay for one's SNF care. Keep in mind that's just the SNF portion of the bill, not counting all other medical expenses they run up or whatever other personal bills must be paid.
Only one person in my extended family makes enough to pay for their own lifestyle plus even one parent's skilled nursing care, and this person is in the local 1%.
I don't know if Medicaid is the answer, but shifting the burden to working folks is just going to bankrupt even more people.
Make that "Modern medical expenses AND other expenses in general"!
Years ago, my mother was fishing around to see if the offspring would indulge her wishes. She "hinted" to me that she had found a retirement facility. It was in one of the wealthiest towns in MA. I told her that the monthly fee at those places was higher than the combined gross income of my husband and me. I don't think it sank in. The other ideas she presented were just as ludicrous and all of them hinged on someone ELSE paying. Every time she came up with a new unrealistic idea I told her she would have to pay for it herself, so she had better have been saving and investing.
Not that she ever listened to any practical advice.
She has not transferred any assets to me, ever. We were never wealthy. So I am furious that rich families have all kinds of ways of protecting their gifts to the heirs, meanwhile running up the same Medicare bills that the states could hold nonwealthy, nongiftee children hostage for.
The other problem nowadays is that too many people are being kept alive too long, at any expense. But that is a whole other topic.
My first reaction is that's a sure way to ensure that the kids will be impoverished for their OWN medical care and perhaps even their general retirement or their kids' college education - a very short-sighted "solution".
Here's a sentence that sends shivers down the spines of every Medicaid agency in all 50 states.
Let me see if I can translate that into the terrifying statistic it is: 1 out of every 2 women age 15 to 44 have foregone having kids. That means that the likelihood is the 50 of these women will be "elder orphans" no one--read that again: NO ONE to take care of them.
Culturally we rely on children to look after parents in their twilight. But these women elected to not have kids and not having kids virtually assures us the states are going to have to take up the slack of paying to house and feed them. Recall my earlier statistics $7000/month for nursing care. Then ask yourself," If there are no children and no close relatives to take care of them, then who in God's name is going to take care of them" How do the states, many already near bankruptcy, pay a bill like $10,000/month (inflation) to house, feed and look after these millions upon millions of women??????
My wife and I are such people. We didn't have children and so there's no one to look after me if my wife should die. If I died my wife at least has two younger sisters to look after her and they are very close. With my health problems should I find myself old, infirmed with nobody around I haven't got the slightest qualms religiously, morally or practically about just traveling to Switzerland to take advantage of their euthanasia laws. Not many people would choose such a path. I have given it serious consideration over the years should things go south for me and I have inured myself to the idea. I have no problem with it.
This is a ticking time bomb for state governments. I have no idea how they're going to solve this. The sheer numbers make this a problem big enough the swamp the entire country financially. They can levy taxes to pay for it but if only 50% of women are having kids where is the tax base going to come from?
Well, it's not quite that bad (50% childless) as the teenage years are skewing the results. I am very encouraged that 15-19 year old girls are NOT having babies at a higher rate as that is now a major predictor of poverty for them and their children for the rest of their lives.
When you read the article, the number of childless women in their early thirties drops to less than 29% and some will have future children in that group. Many woman don't even get married now until their thirties.
The people who used to mainly take care of their elders were women. Many younger women saw their mothers struggle later in life with a lack of money and meager Social Security due to divorce, death of their spouse or leaving the work force for various reasons (including elder care). It was a powerful lesson and I think many young women learned that they need the ability to provide for themselves or accept the consequences.
Well, it's not quite that bad (50% childless) as the teenage years are skewing the results. I am very encouraged that 15-19 year old girls are NOT having babies at a higher rate as that is now a major predictor of poverty for them and their children for the rest of their lives.
When you read the article, the number of childless women in their early thirties drops to less than 29% and some will have future children in that group. Many woman don't even get married now until their thirties.
The people who used to mainly take care of their elders were women. Many younger women saw their mothers struggle later in life with a lack of money and meager Social Security due to divorce, death of their spouse or leaving the work force for various reasons (including elder care). It was a powerful lesson and I think many young women learned that they need the ability to provide for themselves or accept the consequences.
I'm not sure younger women are making plans for providing for themselves in their 70's-90's. In fact I don't think it's even on their radar. The young women I see today are too busy planning for a career, or traveling the world, or getting their first apartment, or just having good times with their friends. Marriage, children, college funds, etc. might as well be on the other side of the moon for all the serious thought they give it.
Yes and somebody has to pay the increased taxes to raise the additional revenues needed as costs spiral up
The solution is spending related, not revenue related. The revenue would stay about the same, but with more people taking care of their parents in the earlier stages, Medicaid would be spending less, paying their relatives to stop working than they had been paying to institutionalize the elder.
I foresee the day when states will eliminate the lookout period entirely or greatly extend it to 20 years or something. The states are going to be bankrupted by this iceberg called "baby boomers who are elder orphans". That term should strike the worst kind of fear in the government body of every state. Basically it means that something like 30 million BB's have no family or children to take care of them. In 10 years the average cost of a nursing home will be $10,000/month; it's $7,000/month right now. Add Alzheimer care into that and it's potentially a 2 trillion dollar cost per year for the states, going up every year from there until the last of the BB's starting dying off around 2050 or so and then the costs will start to lower. The states won't survive this Greenland-sized iceberg.
Forget 10 years, my mother paid $9,500 per month for the first 4 months of her nursing home stay. After the second assessment, the amount dropped to around $6,500 per month, but I am worried that it will go back up after the third assessment. We weren't prepared for the scheme that they use, but are aware of it now.
Basically, the state we live in has a medical assistance program that kicks in once the nursing home patient's net worth drops below around $3,000. Before then, one must be self-paying. And they do look back at the prior 5 years' worth of bank and other account information to make sure no money was being shielded from view.
As soon as someone enters the nursing home, they are given a 7-day assessment. Of course, they had several "therapists" coming in every day to assess her: speech therapist, physical therapist, and an occupational therapist (??). Thus, her first assessment was high and set her first 3 months' rate high. The state also requires the nursing home to charge 30% above that assessed rate for the first 30 days. Thus, we ended up with $9,500/month billing after that first month which was monstrous.
For the second assessment, I went in and told the nurses that we did not want any therapy, which my mother had cancelled after that first assessment period anyway. The second assessment came in lower putting her down in the $6,500/month range.
What we have figured out is that the investors in the nursing home (probably doctors and lawyers) have made it so that they can front-load much of the billing and get as much money as possible before the patient dies or goes onto medical assistance. I have sat in two "family conferences" where my simple, straight forward questions have not gotten simple answers. I do know that nursing homes are highly regulated, but it is clear that nursing homes are part of the "Confusopoly" that Scott Adams talks about. Keep the billing confused and convoluted so that people don't understand and give up trying to understand.
I suspect that once my mother's money runs out, she will still get nearly the same level of service but the nursing home will be compensated at a much lower monthly rate by the state. Thus, the front-loading. Get as much money as possible before the patient passes away. Not everyone will survive until medical assistance kicks in.
The lesson is to start passing your inheritance along to your children long before you need to go into a nursing home.
As to state finances under the weight of Baby Boomers in nursing homes, I agree with your assessment. It is sad because the Certified Nurse Assistants working in the home are very friendly and compassionate, but I suspect they get fairly low wages, maybe only $10-11 per hour; thus, the bulk of the $300/day goes to the investors.
I think a 2-year lookback is reasonable when the elder parent has Alzheimer's disease, because it should be obvious that the parent is going to need care, it isn't the kind of thing where someone could reasonably believe that the elder is independent and then suddenly they need assisted living. Doesn't happen, the progression is gradual.
But if the elder parent falls one day and hits their head and undergoes unexpected brain damage...then yes, I would say the lookback period in that case should be zero.
I just had to rep you on that! Because at least that's more reasonable IMO than what we have now.
Interesting correlation of most adults advocating that child support is required of parents - or Legally defined parents anyways.. ...but let it be a human who is also for lack of a better word, incapable of tending to themselves, and adults balk at the idea of contributing.
I for one am NOT a believer in forced support....but this is the society of double standards and encouraging those who can pay...to pay. Never mind that they themselves will be destitute should any of these laws be enforced.
I concur with the one poster about signatures and READING EVERY page they toss at you. I had the wherewithal to catch two pages tucked inside a packet that basically said I( personally) would be liable for all billings that superseded the insurance or other secondary coverage that was denied. I quickly gave the paper back to the Administrator and said.Nice try. How about I just take this entire packet to my lawyer to see if I am legally obligated to sign these in order for my parent to receive her proper medical treatment at your facility? Her eyes got wide and suddenly she played coy, as if to say...Gee I wonder how THOSE pages got in there?
My sister had Power of Attorney as well, But I signed it the first time. The second time My parent was re-admitted they scurried to get my sister to sign off on the pages...and she did!!! I was so furious with her. She isn't the brightest bulb in the shed when it comes to legal ramifications or financial obligations.
These laws are archaic and were not designed with the realities of modern medical expenses in mind.
I make a considerably above median wage for the poor town I live in, and am a bit above the national median. Still, a month's stay at the average to better SNFs in my area is usually more than my monthly gross wage.
I'm an only child. Both of my parents are still alive. I couldn't afford to pay for one of their stays out of my entire monthly net wage. My income would basically have to double, into the six figures, for me to be able to afford a basic lifestyle, plus pay for one's SNF care. Keep in mind that's just the SNF portion of the bill, not counting all other medical expenses they run up or whatever other personal bills must be paid.
Only one person in my extended family makes enough to pay for their own lifestyle plus even one parent's skilled nursing care, and this person is in the local 1%.
I don't know if Medicaid is the answer, but shifting the burden to working folks is just going to bankrupt even more people.
Although I understand your concern, I think that taxpayers cannot be expected to pay in full, either.
In Japan, children (even single children) take care of their elderly parents by actually caring for them in the same home along with financial and medical help from the government.
The biggest problem in the U.S. is that children (not saying you, but in general) who have been raised (fed, clothed, had expenses paid for) by their parents think that any payback to support their parents is unthinkable. Many seem not to want to take care of them physically or contribute financially. Many want the estate, or the family home, but don't want to fund their parents as their parents funded them as they were growing up.
If you google "are adult children responsible for parents debt" you'll see by and large the answer is no. Can they be sued for such debt? Of course, but can this be won and enforced? Not likely.
You're confusing state law with enforcement of state law. Today, many states have filial responsibility laws but they don't enforce them. The law varies from state to state. Today, 30%+ of Medicaid spending is for long term care. If you adopt the Republican "Medicaid reforms", the states are going to get crushed footing the bill on aging boomer Medicaid nursing home bills. There's nothing to stop the states from enforcing their filial responsibility laws and chasing anyone with deep pockets.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
