Warning: this is very much a TLDR type of post. It will get someplace, eventually, but it's a long trip.
Actually - I've moved that long trip into a separate thread, here. I'm putting it into the IRL sub-forum because I just don't think it's really going to mean anything for people who aren't already members of our community. If there's a great hue and cry I won't object to seeing it moved, but as is, I think it would be TLDR for anyone not interested on a personal level.
The reason I bring all this up, though is because of one of the portions of the recently passed health care act: The CLASS Act. Here's a quick look at it from the NYT.
On the one hand, I think it's great, if it works the way it should: i.e. if enough people start buying into the premiums while they're young enough for it to be self-sustaining. By making it an opt-out program, I've got more hope for that than I would have otherwise. But either way, even a modest long term care insurance plan is going to seem expensive to anyone who hasn't had to deal with the realities of care costs for the aging. I've read at least one article where the author complains that he and his wife pay $5000 in annual premiums for their long term care insurance.
Which seems a lot.
Until you realize that my father's care last year, where half the year was in either Medicare covered rehab facilities or an assisted living facility, instead of a full long term care facility, cost almost $77,000. In that one year of benefits, my parents have already recouped everything my father put into his own long term care premiums. It's would even be a return of 15 years of premiums for the couple in the article I mentioned. It's very easy to see how that kind of premium would prove its worth.
But that doesn't change the real perception of expense for that kind of insurance.
The problem I have is that on the other hand, the pay out is going to be $50-$100 per day. Which, again, sounds like a lot. Until you start pricing care. And the people most pleased with this payment are talking about how it will allow more people to stay in their home longer. Which isn't a bad thing, but I think that already people are staying in the home longer than is safe and prudent. And this benefit is going to be large enough to provide for some accommodation, while not enough to really pay for a full support system for caretakers. A cheap home health aide here in Rochester was quoted to me at $75/hr, with a minimum 2 hour visit. Which is not a bad deal, really. But it will eat up that benefit like popcorn.
I think that for the best health of everyone involved the current attitude that nursing homes are teh EVIL should be moderated. I have sometimes cursed my grandmother's example of keeping her husband home long past the point where he would have been best cared for in a nursing facility, because it provided an example for my mother that she cannot live up to, and that nearly killed her trying to. My mother still feels huge guilt for not being able to care for dad at home.
I have now been involved, if only peripherally, with three close family members going into some level of eldercare facility. In each case, I believe, with the benefit of hindsight, that the transition to those facilities happened later than it should have, for the health of the patient, and the health of the caregivers.
Keeping people at home is a nice goal, but I think that we already keep too many of our infirm at home too long, and this seems to be targeted to increase those numbers. Which worries me.
I think that it would be really good if this insurance could be made available without adding to the burden on families by saying it's going to make it easier to keep people at home.