I received and email from the SCAN Foundation with a list of “10 things you should know about aging with dignity and independence”.  The list is an eye-opener… and a real bummer.

Here are some of the very interesting points from the email which will make you think about your plans for getting old…. or make you want to join the Hemlock Society.

70 percent of us who reach the age of 65 will need some form of care or services for an average of three years.

Research shows that 43 percent of Americans over the age of 55 have less than $25,000 saved for retirement.

In 2011, nursing home care cost an average of $78,110 a year for a semi-private room.

Assistance at home, such as a visit from a home health aide, costs on average $21,840 a year.

Only short-term rehabilitative care at home or in a nursing home is covered by Medicare. [note: Long-term care is not covered by Medicare.]

Medicaid pays for about half of all nursing home or home care services. However, should you need care, the only way to qualify is to spend nearly all of your assets. The nest egg you’ve worked hard all your life to build must be spent to qualify for help.

In 2010, spending on supportive services for adults age 65 and older was estimated to be $182 billion, and projected to increase to $684 billion by 2050. Such projections threaten both state and federal budgets.

Today, over 12 million Americans rely on these services and supports, with 58 percent of those individuals over the age of 65.  By 2050, it is predicted that this number will more than double, with 27 million Americans relying upon long-term services and supports.

Less than 10 percent of adults actually have purchased a long term care insurance policy.  According to experts, few people purchase it because it is expensive, rates have historically increased rapidly, and potential buyers can be denied coverage due to pre-existing conditions.

Despite the recognition of a looming crisis in caring for aging Americans, little has been done in the past 40 years to address this problem and create a healthy network of supports and services allowing Americans to age with dignity in the place we call home.

The federal health reform law created a number of opportunities to help older people and adults with disabilities remain in their homes and communities. It includes programs to help states provide more in-home care to low-income adults in need and ways to help those living in nursing homes to return to their homes and communities.

This last statement refers to one part of the Affordable Care Act which is actually on its deathbed. The Community Living Assistance Services and Supports (CLASS) program was to be a voluntary long-term care insurance plan which working people could pay into through deductions from their paychecks.  The money would  go into a government trust and could be used by CLASS participants to pay for in-home help when they are old and infirm.  The idea is to get people to put money aside for their long-term care needs so they don’t end up in a state-supported nursing home.

Sorry for the bummer news.  Enjoy your day!

Growth in U.S. Health Spending Remains Slow in 2010

U.S. health care spending experienced historically low rates of growth in 2009 and 2010, according to the annual report of national health expenditures (NHE). The low rate of growth means Americans got less health care than in previous years. The report notes that U.S. health care spending grew only 3.9 percent in 2010, reaching $2.6 trillion or $8,402 per person, just 0.1 percentage point faster than in 2009.

Should the Affordable Care Act (Obamacare) get credit for this slow growth?  Or is it that Americans, so many of them with lousy health insurance with high deductibles – or no health insurance – are afraid to go to the doctor? Nobody knows the answer to this question, but the slowing growth of health care expenditures is a good thing for government budgets and employer-based health insurance premiums.

Marilyn Tavenner, acting CMS administrator thinks the actions of the Obama administration should get some credit. “We have worked hard since the passage of the Affordable Care Act in 2010 to lower health care cost growth,” said  “We believe that the tools in health reform will help keep health care cost growth low while improving the value of care for consumers.”

Findings from the report include:

• Household health care spending equaled $725.5 billion in 2010 and represented 28 percent of total health spending, slightly lower than its 29 percent share in 2007.
• Growth in total private health insurance premiums slowed in 2010 to 2.4 percent from 2.6 percent in 2009, continuing a slowdown that began in 2003.

• Retail prescription drug spending (10 percent of total health care spending) grew only 1.2 percent to $259.1 billion in 2010, a substantial slowdown from 5.1-percent growth in 2009 and the slowest rate of growth for prescription drug spending recorded in the NHE.

• The federal government financed 29 percent of the nation’s health care spending in 2010, an increase of six percentage points from its share in 2007 of 23 percent, and reached $742.7 billion. Part of that increase came from enhanced Federal matching funds for State Medicaid programs under the American Recovery & Reinvestment Act which expired in 2011.  Medicare spending grew 5.0 percent in 2010, a deceleration from growth of 7.0 percent in 2009.

• Medicaid spending increased 7.2 percent in 2010, slowing from 8.9-percent growth in 2009.

• The state and local government share of total health spending declined from 18 percent in 2007 to 16 percent in 2010 and totaled $421.1 billion, in part due to the temporary assistance in the Recovery Act.

• Hospital spending, which accounted for roughly 30 percent of total health care spending, grew 4.9 percent to $814.0 billion in 2010, compared to growth of 6.4 percent in 2009.

• Private businesses financed $534.5 billion, or 21 percent of total health spending in 2010, down from a 23-percent share in 2007.

Information in this report can be accessed at the following web location:

http://www.cms.gov/NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp#TopOfPage

I got a call last week from a woman who has a health insurance policy with a $100,000 lifetime coverage limit. This means the insurance company won’t pay any more than $100,000 in insurance claims for this lady, who is 61 years old.  When the limit is met, the insurance policy is canceled – and this lady will have no health insurance.

Jane (not her real name), got this policy a few years back when her husband retired and went on Medicare.  Jane needed to get individual health insurance and wanted to keep her monthly premium  low.  So she “took a chance” (as she said) and signed up for a policy with a fairly low lifetime limit of $100,000.

Jane told me she had always been healthy, so she figured she wouldn’t need more than $100,000 in medical care over a six year period until she would get Medicare.  She said she was hiking Mt. Lemon one weekend and the next week she was in the hospital having triple bi-pass surgery….and worrying about her health insurance.

If Jane’s medical bills exceed $100,000, she will no longer have health insurance. She wanted me to help her get new coverage. Unfortunately for Jane, she is probably un-insurable with her recent medical history and her pre-existing heart condition.  I gave Jane a list of things she can do to see if she can get health insurance  – but I think she is in big trouble.

I told Jane that the Affordable Care Act (aka “Obamacare”) requires lifetime limits for health insurance policies be raised each year until there will be no limit in 2014. The minimum coverage limit this year is $750,000. But the law applies only to plans sold after September 2010. Jane bought her policy two years ago, so it should be exempt from the new requirements… meaning she is out of luck.

A 2009 report by Price Waterhouse Coopers (PwC), a major accounting/consulting firm, looked at the impact of lifetime limits on individuals, insurance premiums, and Medicaid.

Findings from the study:

In 2009, 55 % of people who got their health insurance from employers were subject to lifetime limits, and this number was growing as health insurance premiums continue to rise each year.

The most common lifetime limits on health insurance policies were $1 million or $2 million in 2009.

20,000 to 25,000 people hit their lifetime limit in 2009 – meaning they no longer had health insurance, even though they were employed. The study projected that over 300,000 people would hit their lifetime limits by 2019 because of rising health care costs.

Increasing lifetime limits from $1 million to $5 million would increase premiums by only $3 per month, or .6% for an individual. Family plan premiums would rise by about $8. Increasing limits to $10 million would increase premiums by one-tenth of one percent according to the study.

Because many people who lose their health insurance end up on Medicaid, states would save $1 billion in 2010 if lifetime limits were raised or eliminated.

So it is clear that raising (or eliminating) lifetime limits will save the government money and will protect the health  and finances of working people –  and people like Jane.

This is one more example of how the Affordable Care Act is helping people while saving the government money.  So why do Republicans want to repeal it?