Long Care - Term Paper Example

Long Term Care Long term care refers to a variety of services that include non medical and medical care, especially to people with chronic illness or disabilities. Largely, the need for long term care requires that the individual meets the health needs or other personal needs. Most long term care programs therefore assist people with other support services such as daily living activities what would include dressing, bathing, and using the bathroom (Medicare gov, 2009). Long-term care can therefore be offered at home, in the society or community, in assisted living or in nursing homes. It is important to note that long term care might be needed at any age and is not only meant for the aging population. Non skilled or custodial care does not fall under Medicare programs while most long term care assists in activities such as bathing, dressing and using the bathroom as argued above. Long term health care facilities portray different levels of charges according to the income of the individual and the services required by such an individual. According to Moon (3) a nursing home stay may cost at least $ 35,000 per year in some homes, this being on the lower end. On the higher level, Moon explains that such services may cost $60,000 or more for a nursing home stay. There is another program of home care that is not round the clock or intensive, and as Moon (3) elaborates it is less costly and range between $20 and $ 80 according to the services received. In 1987 for example, the average visit cost was about $49 and, for a person with average disabilities, the average charges were over $4000. It is important to note that these charges may have tripled since then, and the costs are significantly high currently. The Department of Health and Human Services (5) indicates the number of people above 65years who required long term care between 1990 and 2000 was about 12.4 %, with those above 85 years being 1.5%. This numbers according to the report by DHHS has increased rapidly since then and might be 15% or more. Moon (3) argues that the long-term care contributions are largely from different sources. Family resources are the first option that those under this care have to depend on to pay the upkeep costs. Moon argues that in 1993, women over 75 years in this care had an average income of about $8,365, which amounts to about a quarter of the total costs of the nursing homes annually. O’Brien (2) explains the sources of the nursing home costs as follows: public sources 6.1%, Medicaid 46.0%, private insurance 7.7%, out of pockets 27.8% and Medicare at about 12.4% as at in 2003. The total cost of the entire program in the US accounts to about $111 billion annually, and is shared according to the above percentages in contributions. According to OECD Report (32) the long term care costs in the US has been relatively constant between 1990 and 2002, compared to other OECD countries. The effects of family contributions on long-term care have been constrained resources in the family, and this has led many to prefer the home care as compared to nursing homes, which have become more expensive. Many families on the lower edge might not afford the costs in these facilities considering other expenses that have to be catered for. The long term care programs have therefore led to serious constraints in resources in many families (Tumlinson and Lambrew, 5). Total spending for Healthcare under CBO’s extended baseline scenario Percentage of gross domestic product (Source: CBO Gov, 2011). The figure above portrays the costs of long term care from 1960s and the expected costs that would be incurred in this program until 2080. Increase in income and expansion of insurance coverage of the decades as well as improvements in technology especially in the medical field increases this spending in Medicare. US gov.(2011) further argues that spending growth in this long term programs and Medicare programs has been attributed to the increasing spending in these care facilities as more people spend more on long term care facilities.. The spending according to US gov (2011) would increase to 31% of GDP by 2035 and further increase to 46% of GDP by 2080 as the above figure indicate. US gov (2011) elaborates that Medicare provides federal health insurance to about 45 million people who are either disabled or elderly, with the elderly making about 85% of all the members in Medicare scheme. Upon reaching the age of 65, anyone becomes eligible member of Medicare, while disabled individuals become eligible for Medicare 24 months after they become eligible for benefits under the social Security Disability Insurance Program (US gov, 2011). Part A of Medicare insurance covers the important services and is also called the Hospital insurance. This scheme covers skilled nursing and the hospice care. Part B on the other hand is a supplementary Medical Insurance that covers medical equipment and other services, and is also provided to physicians and other practitioners on the outpatient departments of the hospital, in addition to covering drugs most of which are administered by injection in the outpatients departments (Journal of Risk Insurance, 5). On the other hand, US gov (2011) argues that the Medicaid program is a joint federal-state program that aims at paying healthcare costs for many individuals mostly on the lower edge of income in the country. The scheme was initiated in 1965 under the same act with Medicare. For example, in 2008 the Federal government spent about $ 201billion in Medicaid, of which more than $108 billion were benefits of those enrolled under this program. This was in addition to paying administrative costs to hospitals that treat low income patients, costs of children vaccines and other expenses. Generally as US gov (2010) explains states spend about 57% of Medicaid on benefits but was expected to increase to 67% by 2009. Medicaid is administered under the federal guidelines that specify the set of guidelines that have to be provided to the poor individuals (Tumlinson and Lambrew, 15). These poor groups include poor children, pregnant women, and most of the elderly and disabled individuals who qualify for the Supplemental Security income program (US gov, 2011). This program requires one to have a low income and fewer assets to enroll as compared to the other programs. Bragg (140) explains that Look back period to be the balancing act between provision of Medicare by the government and the desire to leave the properties to heirs in a trust. It is the penalty period where one is ineligible for the transferred assets upon applying of the Medicaid program. It means that one cannot just apply or give away property and then continue to receive Medicaid immediately. The Look back period for example as Bragg explains is about 5 years for transfers that were affected after February 8, 2006; the date when the DRA was made effective. The length of the ineligibility period is calculated by dividing the amount transferred by the average monthly costs of the nursing home care in your area. The look back period cannot be considered to be unfair in that the look back period once the assets are transferred will enable the government to use these assets to provide the required care to others before one is allowed to benefit under Medicare. It might be thought to be a time to compensate the government for the care that it will offer to the future upon becoming eligible for Medicare program. According to AAAR (2009) Georgia in 2007 had an occupancy rate of about 89% with the Georgia’s nursing homes ranking 39th in the country, in the private daily rates. The private rates were at $17/hr for home care on the lower side, and $49/day in nursing homes. This was relatively lower than the national average, and was much lower compared to the other states. However, Georgia has among the highest rate of Medicare-certified home health costs at about $66/hr (AAAR, 2009) . Incidentally, according to Medicare gov (2009) there are various different policies under the long term care policies. These include; home health care, in –law apartments, housing of aging and disabling individuals, nursing homes, continuing care retirements communities, board and care homes and the community based services policy. Medicare gov (2009) further elaborates that before buying these policies, one has to consider the cost of the policy in relation to their income, the services and benefits offered under each pension, the availability of additional services offered in these policies among are other reasons that would make particular policy in long term care to be more appealing and have more value compared to the rest. Work Cited AARP. Knowledge Management . Long term care in Georgia. AARP, Dec. 2009. http://assets.aarp.org/rgcenter/health/state_ltcb_09_ga.pdf. 29th Nov. 2011 Bragg M. Steven. Accounting for payroll: a comprehensive guide. NJ: Wiley & Sons, 2004. CBO .gov. The Long-Term Outlook for Medicare, Medicaid, and Total Health Care Spending. 2011. http://www.cbo.gov/ftpdocs/102xx/doc10297/Chapter1.4.1.shtml 29th Nov. 2011 Department of Health and Human Services. Health care in America: trends in Utilization. CDC http://www.cdc.gov/nchs/data/misc/healthcare.pdf 29th Nov. 2011 Introduction to the special issue on long-term care insurance and health insurance. The Journal of Risk and Insurance76.1, (2009), 1-4 Moon, Marilyn. Long term care in the United States. 1995. Paper (No. 06472-01) prepared for the Options for Long Term Care Conference, Manchester, England, November 30-December 1, 1995 http://www.commonwealthfund.org/usr_doc/moonlt.pdf 29th Nov. 2011 O’Brien, Ellen. Medicaid’s coverage of nursing home costs: Asset shelter for the wealthy or essential safety net? Long Term care Financing Project: Georgetown University. 2005, May. http://ltc.georgetown.edu/pdfs/nursinghomecosts.pdf 29th Nov. 2011 Organization for Economic Co-operation and Development. Long term care for older people. Paris: OECD publishing, 2005 Tumplinson ,Anne and Lambrew, Jeanne. Linking Medicare and Private Health Insurance for Long-Term Care: Health Policy Institute George Town Universities. 2007 June . http://ltc.georgetown.edu/forum/6tumlinsonlambrew061107.pdf 29th Nov. 2011 USA.gov. types of long term care. Medicare.gov. 2009 http://www.medicare.gov/longtermcare/static/typesoverview.asp 29th Nov. 2011 Read More