Tipping point on caregiving?

Jane Gross says that we have reached one, and that the movement of the baby boomers into retirement age and the need for caregiving, both by and for them, will bring about changes. Writes Gross:

The elderly have changed dramatically; Medicare did not. Today’s recipients, as my mother would have said, live too long and die too slowly, at enormous financial and emotional cost to themselves and their families. The average 70-year-old gets the help he or she needs; the average 90-year-old doesn’t. Some 76 million baby boomers are approaching old age. All but certain cuts to Medicare, a program financed with payroll deductions, means they will get less and less of what they paid for and expected.

So why are we not leaning out our windows, in the midst of our own personal lightning storms, shouting, “I’m mad as hell and I’m not going to take this anymore,” like characters in the movie “Network’’? Denial, I’m told; ours is a death-denying culture. We do the right thing by our parents, and when it’s over, we squeeze our eyes shut.

Ellen Goodman, the former Boston Globe columnist who is an activist in this area says:

We haven’t rocked the boat. “We went from being working mothers to working daughters, and it blindsided us,’’ said Ms. Goodman.

“Nobody told us this was going to happen, but that’s no excuse. At the beginning of the women’s movement, it was, ‘Oh, I’m the only one.’ But I wasn’t the only one. Which brings us to this stage, again the realization of not being the only one.

“This has to be a social movement. And the first step in a social movement is changing norms from not talking to talking.’’

I agree that talking about the problem–which I would define as lack of planning to address long term care needs, thereby increasing the harm done to caregivers due to caring for their parents–is the first step to societal clarity about the costs of caregiving.

However, the next step of enacting policy changes to address this problem will be very hard, because any changes almost certainly would include forced risk pooling and financing of expanded LTC benefits via social insurance. We could of course develop “nudges” to increase private planning options, but I worry the politically charged nature of the CLASS discussion has greatly harmed our ability to do this. And such self planning efforts will increasingly be too late for baby boomers if we don’t get started soon.

The bottom line question is whether the current “self insurance” route to caregiving is understood to be a problem worthy of policy intervention, in the midst of all the other health care policy problems? I am not optimistic the answer will be yes.


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