Long-Term Care in America: Views on Who Should Bear the Responsibility and Costs of Care
The Associated Press-NORC Center for Public Affairs Research, May 2017
Results from the 2017 Long-Term Care trends poll find that two-thirds of Americans age 40 and older feel the country is not prepared for the rapid growth of the older adult population. The Associated Press-NORC Center for Public Affairs Research survey also finds that at the local level, less than half of older Americans say their community is doing a good job of meeting older adults’ needs for nursing homes, assisted living facilities, and home health care aides to provide long-term care. Additionally, a majority of older adults say they would like the federal government to devote a lot or a great deal of effort this year to helping people with the costs of ongoing living assistance.
To help policymakers, health care systems, and families address this issue, research conducted by The AP-NORC Center examines awareness of older Americans’ understanding of the long-term care system, their perceptions and misperceptions regarding the likelihood of needing long-term care services and the cost of those services, and their attitudes and behaviors regarding planning for long-term care.
Overall, about a quarter of adults age 40 and older are able to correctly estimate the national average monthly cost of living in a nursing home, living in an assisted living facility, and hiring a part-time home health care aide.
While already underestimating the costs of most care, only 15 percent of Americans age 40 and older are very or extremely confident that they will have the financial resources to pay for long-term care.
Overall, older Americans have not done much planning for their future or current needs for ongoing assistance. Two-thirds (67 percent) say they have done only a little or no planning at all for their own needs. About a quarter (23 percent) say they have done a moderate amount of planning, and just 1 in 10 say they have done a great deal or quite a bit of planning.
Americans are confused about how they might pay for any needed care. The source that most Americans age 40 and older expect to rely heavily on to pay for ongoing living assistance is Medicare, which 57 percent say they will rely on quite a bit or completely. However, Medicare does not cover many expenses associated with long-term care, including most care in nursing homes, assisted living facilities, or from home health care aides.
Today, 70 percent of older Americans support a government-administered long-term care insurance program, similar to Medicare, a significant jump from the 53 percent who said the same last year.
Though support for a government-administered program for long-term care insurance similar to Medicare is lowest among Republicans, it still receives majority support. Eighty-three percent of Democrats favor such a program compared to 69 percent of independents and 54 percent of Republicans.
By Don McCanne, M.D.
Americans fear the prospects of long-term care, especially how they would pay for it should it become necessary. This survey reveals that a majority of Democrats, independents and Republicans – 70 percent overall – support a program similar to Medicare as the payment source for long term care.
The nation is ill-prepared for anticipated future needs for long-term care. Currently the most important program to cover these costs is Medicaid, but that requires the indignity of becoming destitute in order to qualify for the program.
Americans are very supportive of our Medicare program and a clear majority supports such a program for covering long-term care. The solution seems obvious; include long-term care under the Medicare program.
Single payer supporters understand that an improved Medicare for all would automatically do this. We should no longer demand destitution for those of modest means as a ticket to long term care.