The basic problem is obvious and will become more so with each passing year: More and more people will find themselves in need of physical help toward the end of their lives without having a way to pay for it. The aging of the baby-boom generation — the so-called "silver wave" of retirement and elder-care needs — has been anticipated for years.
Now, confirming the dire predictions of many, a survey of 800 isle residents released this week by AARP Hawaii shows that almost two-thirds of those age 50 and up doubt they’ll be able to afford a single year of nursing-home care when they need it.
While nearly six in 10 seniors expect that nursing care will be a future need, fewer than four in 10 say they’ve saved for it or have long-term care insurance that will help them pay the bills, according to the report.
The state will need to adopt the right policy to help head off a serious mismatch between resources and community needs. One that encourages more people to make financial preparations seems the right course. Further, people should be armed with the information needed to choose the right providers when the time comes.
Several pieces of legislation suggest credible courses to take in pursuit of these aims. Following an earlier recommendation of the state Long Term Care Commission, Senate Bill 104 would authorize a study for a proposed mandatory public long-term care insurance plan for working adults.
The study would be an actuarial analysis of the program. The commission’s approach was a payroll-deduction premium plan that would limit the benefit period to one year, with the daily benefit of $70. This limitation may make the program more sustainable.
But if lawmakers pass the bill as they should, the analysis would start with a clean slate. It would examine various means of public participation — including a payroll tax, an income tax or a dedicated percentage of the general excise tax. Many more questions would need to be answered before any program is implemented. For example: What would be the administrative costs of the program? How would the insurance carrier be selected, and how would it be overseen?
For families already embarked on securing long-term care for their elders, the Legislature is also taking some necessary steps. A pair of bills — SB 358 and House Bill 120 — propose a requirement that long-term care facilities put their inspection reports online.
Hawaii is one of the minority of states that doesn’t provide easy access to such important information. A consumer researching care homes currently has to write to the state Department of Health, pay for copies of the reports and wait at least 10 days to get them.
Often, decisions about a loved one’s care must be made quickly, and in the age of the Internet, this wait seems intolerably archaic. Reports should be readily available, as they are in at least 27 states.
Two other bills deserve consideration, within the constraints of limited state funding that’s available. Senate Bill 103 calls on the state Executive Office on Aging to administer a public education campaign on the need for long-term care financing by households.
This is important, given that many people don’t know that Medicare won’t cover many costs and that Medicaid funds are going to become very tight. It’s good that the bill would encourage a public-private partnership to get the campaign off the ground. Competition for state funds will be fierce.
Finally, SB 106 would allot $9 million for the state’s Kupuna Care program, which helps elderly residents not on Medicaid and assists current seniors with the challenges of self-care within their own homes. The additional $1.8 million for the state’s Aging and Disability Resource Center will help with locating senior services.
If Hawaii is to manage the skyrocketing costs of elder care, various coping strategies will be needed. These bills represent a good start.
