An Early Casualty in the Affordable Care Fight

By on November 22, 2013
Bye

ByeFew Americans know that the Affordable Care Act of 2010 had nine ‘titles’ (read: sections) and that one has already fallen by the wayside. Its death was so quiet and so underreported that most people didn’t even know it existed. Trouble is,  it left behind a future problem that needs attention today and almost certainly won’t get it.

Title Nine dealt with long term care for end-of-life seniors and espoused a plan to deal with it more effectively in the future than we are now. Currently healthy seniors age out and end up in nursing homes or extended care facilities where their nest eggs are eaten away, often landing them on Medicaid by the time they die. This is a sad, painful process for them. With the horde of baby boomers on the verge of old age, this is a growing problem and potentially a terrible burden on the state. Other cultures see families handling multiple generations under one roof. It was largely that way here in the 19th century. Now retirement communities and nursing homes are the great growth industry. As one wag once told me, death is supposed to happen off-stage in the US. Shady Acres makes the perfect place.

The ACA plan called for the start of a payroll tax to begin which later help defray these costs when the worker reached that time in retirement. It was a big moneymaker in its early years because it took five years of contributing before you were eligible for benefits. This trust fund built up a lot of money. When the notorious fiscal cliff deal was struck, Title Nine was scrapped. Whether the idea, ascribed to Senator Edward Kennedy, would have worked is unknown. What we do know is that we are back facing a potential crisis at the state level as our society increasingly ages and ends up extending life into the ninth, tenth and eleventh decades at Shady Acres. Right now even the healthiest eaters and best exercisers cannot stop aging as they grow older. Oil of Olay and monkey glands don’t stop the march of time —  the wear and tear on joints, the loss of elasticity of skin, the loss of cells in the brain. We don’t like to talk about it, but this is a problem that will not get wished away very soon.

The next generation is reported to have less saved for retirement than current seniors. Given the perilous state of our current economy the generation after that will likely do even worse. Research about aging is on-going but significant changes in the aging process are a long way off, if possible at all on a mass level. A thoughtful approach to our aging seniors in the US requires a dialog a lot more intelligent than what we hear going on in Washington these days. And it’s a wonder you can hear anything at all over the din of snake oil salesmen marketing their wares in the nation’s capital.

Tom

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