Medicaid/Nursing Home Care
The overall philosophy is reasonable measures with scientifically verified results.
- Encourage long-term care insurance to insure the "family obligation" described below.
- Move Nursing home care from Medicaid to Medicare
- Weighted formula of assets to qualify - look at assets over past 5 years
- If unmarried all income dedicated; if married 1/3 combined income dedicated
- Qualify if 1/2 of assets (using the weighted formula) will not support nursing care for 48 months (based upon average pay rate)
- If qualify, settle up immediately - set up trust account for 1/2 of assets to support care; that is used first for as long as it lasts (family gets back 1/2 of what is not used, if any); coverage begins after those funds are exhausted.
- Family keeps 1/2 (when no spouse)
- If husband and wife situation where only one requires care - the family dedicates 30% of assets (including residence) (using 48 month/average pay rate formula)
- State licensing of health care at all levels, minimum standards and harsh penalties for theft/abuse/neglect while providing such care. In particular, review home health care issues.
Goals: Quality care; balanced cost between family and government
Reasons: Too many families are forced to use all assets or undertake lifetime transfers to children etc. Three year look-back led to strange planning; the new 5-year look-back may be too harsh. Saving 1/2 (or 70% if married) of family assets seems fair. By isolating nursing home care, we can focus on the needy who need medical care and how we can best provide it.
"I don't believe in government for special privilege. Our resources should be used for the benefit of all the people." -Harry S. Truman