Retirement: A Drive for Home and Community Care


When the Obama administration decided that the long-term care portion of the health reform package was unaffordable, the bottom dropped out for millions of Americans.

Where there was once a glimmer of hope that middle-class families would have some protection against ruinous nursing home expenses, today a catastrophic specter looms large and very real. A single decision to retreat from establishment of a national long-term care insurance plan markedly escalates the retirement insecurity of millions of families — both old and young.  While no one expects Congress to create another entitlement program, the fact that there is little debate or discussion underscores the need for home and community care.

With the number of Americans older than 65 expected to more than double over the next generation — increasing from 34 million in 2000 to 70 million in 2030 — the long-held maxim that the only sure things in life are death and taxes now has another component. The truth is that most 21st-century Americans who surpass the age of 65 will eventually confront the need for comprehensive long-term care. The stark reality is that access to affordable comprehensive long-term care coverage remains elusive to the vast majority of people who will need it.

The staggering costs of nursing home care today swamp any middle-income family’s ability to cope. Daily care averages $168 — almost $60,000 per year — a burden that can easily bankrupt all but the wealthiest families. Many elderly couples who are coping with one spouse’s need for the 24/7 skilled care of a nursing facility while the other spouse is capable of living independently often find their income and savings quickly depleted. Sadly, this frequently leads to both spouses being institutionalized and neither living as long or as happy a life as they — or their families — anticipated.

Incredibly, the more affordable and humane alternative — home and community care — remains an unrealized dream. Why can’t our nation resolve this painful reality, which confronts almost everyone in our lifetimes, whether as a spouse, supporting family member, or caretaker?

With the leading edge of the baby boom generation now on the cusp of retirement and prescription drug and long-term care costs certain to wreak havoc with even the best-laid retirement plans, it is critical that we ask President Obama and the Republican presidential candidates this question: What is your strategy for creating a comprehensive long-term care plan for elderly and disabled Americans?

Now is not a time for the escapist mentality of another national commission or super congressional committee. Instead, Americans want national leaders who will bite the bullet instead of continuing to dodge it on this and other issues.

It presents a test for politicians to demonstrate real leadership and respond to the economically vexing challenges that long-term care represents. Long-term care has no political boundaries; it is color blind and gender neutral.

The 2012 election presents a historic opportunity for voters to demand that candidates put forth viable solutions and detailed programs, not just half-baked plans and hollow rhetoric. Leadership is not about slogans or 30-second sound bites or the promise of hope. Real leadership is about honesty, truth, and results.

Struggling middle-class Americans deserve answers to these questions. It is time for substance not symbolism, time to move past previous declarations and present people with a solution to long-term care. There is no more time for indifference, and we are long past comparing apples and oranges.

In 1990, the late Sen. John Heinz said a “graying America speaks to the national urgency.” More than 20 years later, we cannot allow the distillations of problems and the deeply entrenched political parties of today to further ravage the economic well-being of middle-class families.

The need for a dialogue is now. The 2012 Senate elections and re-elections should be used to ask the tough questions of incumbents and candidates. That dialogue should begin in Michigan.

Jeffrey Lewis, the chief operating officer at EHIM Inc. in Southfield and the former Republican Staff Director for the late United States Senator John Heinz. You can email Jeffrey at