Cracking the conundrum: Toward a rational financing of long-term care

In this article, Professor Kaplan identifies an issue emerging as one of the major crises in the American health care system: how seniors and their families will finance long-term care. Many individuals neither realize the potential expense of long-term care nor plan for the contingency that they will require such care. Even if an individual is conscientious and attempts to plan for her long-term care, she faces a myriad of uncoordinated options to provide for her care and may easily become confused and frustrated. Professor Kaplan reviews the wide array of long-term care options currently available, including home care, congregate living arrangements, and nursing homes. He then examines the extent of coverage for long-term care provided by the two government programs most older Americans rely upon for long-term care, Medicare and Medicaid. He identifies several coverage gaps in these programs. To fill these gaps, Professor Kaplan proposes that Medicare be amended to cover care provided in nursing homes. In addition, he recommends that long-term care insurance be re-oriented to less intensive care settings, such as assisted living facilities, and that insurance options and features be standardized. Standardization would facilitate easier consumer comparisons and ensure that all insurance options provide a minimal level of coverage.