Friday, February 29, 2008

NCPA on health spending by seniors

The National Center for Policy Analysis offers a sobering analysis of personal spending by seniors on health care.

The NCPA Study 297, Feb. 2007, by Liqun Liu, Andrew J. Rettenmaier, and Zijun Wang makes for sobering reading. The link is here. Today, seniors spend an average of 17% of their incomes on health care. By 2030, that number will rise to 23.5%. By 2039, total spending, including public spending, will be 100% of seniors’ incomes.
Particularly sobering is “Retiree Health Spending: Who Pays?”, here.

Employers have progressively less incentive to keep retiree health insurance (pre Medicare eligibility). They are typically very expensive with high deductibles, especially for inpatient care.

Nevertheless, the current debate among the presidential candidates on health care does not properly reflect the segmentation of the problem. We do have “single payer” of sorts for over 65 – Medicare, with its limitations (particularly with outpatient) and controvesies over prescription drug coverage (the “doughnut hole”). And Medicare does not cover custodial nursing home care; Medicaid does, after meeting spend-down requirements, with the prospect that some states might start enforcing filial responsibility laws on adult children. Even overseas, custodial nursing home care is typically not covered, although some countries (like Japan) are trying to change this.

So it seems that a responsible health care debate would recognize there are three interconnected problems – “ordinary” health care (and prevention), catastrophic care (including children with incidents like childhood cancers and autism – admittedly Obama has said more about this), and eldercare, which is predictable and has both medical and caregiving (filial) aspects. Yet the candidates don’t seem to want to say this.

The Erickson Tribune (March 2008) mentioned the NCPA study in an article by Lisa M. Davila and Lisa Rademakers, “What’s at stake for health care?”

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