By Maureen O’Hara
Capital News Service
LANSING — State community health officials are urging Michigan senior citizens to pay more attention to potential long-term care needs.
In particular, they said, check the fine print of insurance policies to be sure the soaring costs of long-term care really are covered.
Karl Chew of Statefarm Insurance Agency in Midland said that unlike other types of state mandated insurance, long-term care forces clients to be aware of the cost.
“We advise them on the average daily costs because we want to make sure they are able to stick with the plan,” he said. “They want to know about costs and what exactly can fit within their budget.”
Geralyn Lasher, director of communications of the Department of Community Health, emphasizes education because of the high hidden costs.
“There is not much awareness among the elderly,” she. “They think, ‘I’ve got insurance and I’m sure it covers it,’ but they really need to pay attention to the details.”
The Michigan Long-Term Care Work Group formed in March 1999 in an effort to redesign the state’s long-term health insurance system. The bipartisan group came together to help voice the concern over adequate health coverage for the elderly, Lasher said.
“People don’t think that they will ever need long-term care. It’s kind of a new niche that insurance companies are really pushing,” she said.
“We know what the people want. Different options and more choices are important to better long-term health care.”
Group member Rep. Marc Shulman, R-West Bloomfield, acknowledges that long-term care is a top priority since a growing part of the population is choosing to age at home.
“The elderly and care providers need to start collaborating,” he said. “Part of the solution is education and we need to encourage people to take responsibility for their own long-term care.”
A September 2000 preliminary report cited several areas that needed assistance. Included in the recommendations were improving the quality of life and quality of care, promoting independent living and updating nursing homes to fit the changing needs of society.
With 71 percent of Medicaid funds going to serve the elderly or disabled, it becomes one of the largest components in long-term health care. The program provides medical assistance to low-income families with limited assets. Both the state and federal government share the program’s costs.
Gov. John Engler’s new Medicaid Assessment Initiative will benefit nursing homes in the long run, said DCH Director James K. Haveman Jr.
“The support for it is almost 100 percent,” he said. “Overall for the public good, it’s the right policy.”
The proposal would impose a daily charge of $2.77 per bed and 1.93 percent of premiums for the Medicaid Health Maintenance Organization. With the generated $100.4 million, the federal government would then supplement it with $122.8 million.
An accelerating caseload and utilization of medical services caused state Medicaid costs to increase, but with the funds from the assessment, Michigan will be able to reimburse the participating nursing home and HMO community.
But Lasher contends that while the elderly are receiving Medicaid benefits, their savings are decreasing dramatically.
“They end up spending themselves into poverty in order for the state to spend money on the bed,” she said. “We need to do something.”
Improvement of nursing homes is another key issue, according to the study group. It predicts a shift in practice and financing that could lead to inferior treatment for the elderly.
Shulman suggests that two improvements are needed for the nursing home community to improve. Changing the services available and attracting more workers are “very critical as nursing homes will start to need to think outside of the box,” he said.
While people in their later years are concerned about long-term health care, younger individuals are now thinking ahead to what they will experience, she said. The baby boomer generation is witnessing the treatment of their parents and making decisions that will later affect their lives.
“You want choice and options, and how do you do that in a system that is very much controlled by the long-term care lobby?” Haveman said.
Haveman also contends that new medical technology will make the elderly want to receive treatment at home rather than at an assisted-living community, but with the increasing price for long-term coverage, caregivers are being forced to deal with adequate care on a tight budget.
“People now want to stay and age at home,” he said. “There’s not enough money in the world to do everything for these people, but we are trying.”
© 2002, Capital News Service, Michigan State University School of Journalism
By Maureen O’Hara