Not passing judgement on either side of the issue, but just sharing what I came across today.
https://thehill.com/opinion/healthcare/3619403-the-rich-are-using-long-term-care-funds-meant-for-the-poor/
My own family has come to the point of applying (and being approved, thank goodness!) for Medicaid. We had no choice, in order to keep my MIL properly cared for. Her children are all late-60s to 70s and with health challenges of our own, unable to do the back-breaking care she now requires. We cared for her in her home since 2019, going through the process of getting VA Aid & Attendance funds in order to hire part-time help, then placing her in a Board & Care. Soon after that she landed in ICU and came out with hospice, and care fees which strained her limited savings to where we are now needing to find a SNF so it can be paid by Medicaid.
Most of the advice given here on the forum says that costs should be paid by the elder's funds, and I agree. I always thought that my in-laws were very responsible, financially wise people. I was shocked to discover the lack of provision for funding their care in later years. My FIL passed in 2006, and MIL was left with only a small Social Security check for income, and her paid-off home. She took out a reverse mortgage at that time which gave her enough income to be comfortable, and she always helped the kids and grandkids with funds for special needs and activities. Well after so many years of collecting RM funds, there is no equity left in the house, so now that she's moved into care, the house will revert to the RM holder and the only money we can raise is from the contents of the home, and that won't be much.
I really don't want to put my son and his family in the position of caring for me or my husband, but we never have made much money or been able to afford LTC insurance or even life insurance, so I don't know how we can take steps to prevent leaning on them if we become unable to care for ourselves. I don't anticipate becoming wealthy at this point in life, so we would likely qualify for Medicaid, unless the system goes broke before then. I'm not really one to worry about the future, as it doesn't do any good, but it would be nice to be prepared. I am open to advice!
I live in the Bay Area of California. A home that cost 400k in even 2011 is now triple in value. Nothing stopping a family from renting it out, getting money, and Cashing in a decade later, at which point Medicaid is only owed what it spent 10 years ago.
https://www.msn.com/en-us/news/politics/the-rich-are-using-long-term-care-funds-meant-for-the-poor/ar-AA11flN4
The rich are likely to be willing to pay for their comforts rather than settle for shared rooms and the amenities offered at the Medicaid level facilities. A couple million or more, not counting the house, will pay for the average length of stay and likely leave a (smaller) inheritance anyway.
The dwindling middle class are more likely to try to exploit every loophole and settle for good enough care in the hope of giving their heirs a chance at a middle class life too.
Like avoiding income tax or maximizing available benefits, I can’t blame people for reasonable exploitation of the system as it currently exists. Still, I can see that adjusting the rules so the funds remain available to provide care to a growing demographic who don’t have the resources to pay makes sense.
I am of the opinion that all hospitals, nursing homes, assisted living facilities, clinics, and anything else assosicated with the field of caregiving should be non-profit if they want to collect government, tax-payer monies (Medicare/Medicaid). If they want to be private then go ahead. No Medicare/Medicaid.
Places like nursing homes charge a fortune then cut corners on things like CNA care, fod quality, housekeeping, all kind of things. Most nursing homes are a chain franchise owned by a giant parent company and if they're not then they are owned by a group of investors. Either way all the shareholders have to get paid and they do.
So really, the rich are getting paid off the fnds of the poor. Then again what else is new?
Over the last year I have spent several months in the nursing home and self paid. My long term care insurance has kicked in for some of my care. I am now at home and paying for aides. I am on home dialysis and in a wheelchair. I'm fortunate to have remodeled my home earlier with many handicap features which are good now.
I do not want to be in a nursing home that accepts Medicaid. I want the nicer amenities offered in private pay facilities. I don't want to share a room or bathroom. Medicaid facilities have to cut corners because of the low reimbursement.
My son and stepsons all had their educations at good schools paid for and all have successful careers. My son and his wife already inherited a bunch of money from their grandparents and her parents. We have gifted them money to pay on homes. etc. I don't feel a need to leave big inheritances. If I do fine, if I don't leave a bunch of money they don't care. They are all very supportive of me and want me to have the best care I can given my circumstances.
I believe that Medicaid rules should be standardized in every state. And I believe MERP should be uniformly enforced.
I truly admire those who have had the foresight and initiative to plan so well that they can afford "the nicer amenities offered in private pay facilities, not having to share a room or bathroom." I would hate to see any of them settle for Medicaid-level services for themselves or loved ones, simply to "game" the system or retain assets for inheritance.
Right now, I pray that what will be available for my mother-in-law will not be as dismal as it sounds like it may be. I have advocated for her in as many ways as I can, but can't do more than that.
So my parents didn't save enough for their old age, or have a LTC policy or life insurance policies that added up to more than $10K that came from an old job dad had at one time or another. The only $$ they had came from 2 stocks; one that mom got from profit sharing at Macy's and another that dad had bought decades earlier and never cashed out. So when the sh*t hit the fan and they had to go into Assisted Living, dad had to cash out those 2 stocks to the tune of $400K, believe it or not and by the grace of God, and put the $$$ in my name so I could manage their finances for the rest of their lives here on Earth. Which is what I did, w/o having to hide their assets & apply for Medicaid.
Dad died 10 months later and mom lived another 7 years. I managed to make that $$$ last all those years while mom lived in AL and then went into Memory Care AL to the tune of $7K a month not including incontinence supplies, meds or snacks/doctor co pays or extras. Mom died in February, about 6 months before she ran out of $$$ completely and I would have had to apply for Medicaid to fund her life in a SNF.
Many people seem to have a negative attitude about the 'haves' vs. the 'have nots' in life, the 'rich' vs. the 'poor'. My parents were the epitome of the 'have nots' who wound up 'having' a bit more in the end than anyone realized they had, them included. Yet we all chose to do the right thing with those found funds instead of squirreling them away for my inheritance or whatever, and placing them in a Medicaid funded SNF. I wanted them to have the best quality of life possible using their own hard earned money, is the point. If and when that $$$ ran out, Medicaid was there to use.
There was no 'financial smarts or awareness foresight or initiative' on my parents part with regard to their senior years and needs that would arise at that time. Because they didn't have any extra money to salt away FOR their senior years, basically. It was dumb luck that ensued, nothing more. The question became, do we apply for Medicaid when we have the $$$ to self pay, or do we self pay for a better level of private care and use up all that $$$?
THIS is what the article is talking about, in my opinion.
I also don't think the rich would want to be on Medicaid if they can afford the best.
Pitching people against each other based on income is a what politicians do best to gain votes and power.