Anne Montgomery, senior policy analyst for Altarum Institute's Center for Elder Care and Advanced Illness, received at least two awards this year for her insights into the complex world of retirement planning, nursing home policy and long-term care.
She says it's not going to be easy to fix a system that is not only broken, but also never worked in the first place. She has five suggestions for small steps that together would make a big difference -- before the onslaught of aging boomers entering retirement makes things worse.
Reconsider the income limits for Medicaid's long-term care assistance. Medicaid -- not Medicare -- provides help with long-term care. In order to qualify, you must spend all of your money until you are down to $2,000. "That number hasn't been raised in years, and it's not much help to the middle class," Montgomery says.
Make Medicare address the long-term care problem. Medicare is the insurance resource for everybody 65 and older, but today it only provides short-term skilled services following hospitalization. "Medicare has tried very hard not to cover long-term care," Montgomery says. "We still need to work on how Medicare can be part of the solution."
Standardize private long-term care insurance. Long-term care is expensive, and the policy basics vary from state to state. There is no national standard that consumers can count on. On top of that, insurers are backing away from selling these policies because people are living longer than insurers used to think they would. "We need laws that define standards for tax-qualified long-term care insurance," Montgomery says.
Create career ladders for direct-care workers. There are few ways that a person who gives care to older people can get training and a better job within the field. For instance, Montgomery believes there should be certification programs for dementia caregivers. "There isn't any way for direct care workers to grow. It can and should be a real profession," she says.
Give community health care providers money and encouragement to work together. Existing valuable services like Meals on Wheels are being cut because of federal sequestration, while recently allocated government money is being spent on new and untried programs. "We're underfunding the less expensive models," she says.
None of these ideas have to be extraordinarily expensive or complicated. Smart, retired baby boomers can fix this by stepping up and getting involved.