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America has a long-term care crisis

The crisis is compounded by the singular focus of Congress and many state legislators across the country on caring for the uninsured.

Jeffrey Lewis, Institute for Healthcare Innovation

Modern healthcare has changed the way we eat, exercise, and live. It consumes approximately 18 percent of our gross domestic product and continues to be one of the most divisive issues in politics, changing the electoral landscape from Arkansas to Alaska.

Unfortunately, when it comes to preparing for the health necessities of old age – ensuring healthy, affordable independence for seniors – we are failing.

America is swiftly approaching critical mass in our long-term home and healthcare sector. Almost 10,000 Americans are turning 65 everyday – more than doubling the number of retirees who will require long-term care by 2050. Even more startling, roughly 70 percent of America’s seniors will need some type of long-term care. That’s why today, more than 45 million Americans are caring for an elderly family member.

The long-term care crisis is compounded by the singular focus of Congress and many state legislators across the country on caring for the uninsured. While the needs of the uninsured are important and must be addressed, they cannot and should not hide the unanswered needs of retired and disabled Americans.

Long-term care is America’s single largest healthcare crisis. It has and will continue to bankrupt middle class families unless there is a national solution. The costs of ignoring America’s long-term care catastrophe are not going to shrink just because elected officials are closing their eyes to the problem.

Solutions to America’s long-term care problem should start with the most basic issues we face: awareness, cost, accessibility and gender. We cannot ignore the fact that the face of poverty in old age is distinctly the face of a woman.
No one wants to acknowledge aging. Growing older is shunned, demeaned and avoided at any cost. Children don’t talk to their parents about the eventual needs that arrive with old age. Parents, understandably, don’t want to cede their independence.

Like all important issues – long-term care solutions start at home. Given that American families will continue this struggle alone, we must alter our perception of aging. Instead of fear we should take a pragmatic look at ways to spark discussions, provide information, and give all Americans a fair choice in how they spend their golden years.

Families of all ages should know their options. Seniors should understand the choices, the opportunities and the pitfalls. So too must children of aging parents. But information is only one part of our long-term care equation. Without affordable long term care services to assist people in remaining independent, the prospect of quality independence shrinks.

Elected leaders must also explore new reforms that will spur younger generations to begin investing in their future while easing costs for today’s seniors. No one should be forced to deplete their life savings and place further stress on their families as our economy struggles to rebound.

Younger Americans who start planning today should have their long-term care investments shielded from burdensome taxes. Government should explore options for older Americans that would allow Medicare to shoulder part of home health and senior independence costs. These options should offer subsidies for our seniors who are living in poverty and be tied to income so wealthy seniors pay more.

Finally, we must address the issue of access. By 2030, nearly one fifth of our population will be over the age of 65 and 70 percent of them will require some form of long-term care. Without a viable infrastructure for providing senior independence, there will continue to be a large portion of seniors who must rely on already over-stretched family members for long-term care.

There is no greater challenge facing America, and no greater opportunity confronting Congress.

Jeffrey Lewis is the president of the Institute for Healthcare Innovation (

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