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IN THE MAIL: How to fix the crisis in long-term care

MINNEAPOLIS -- Regarding the Herald's story, "Nursing home woes" (Page A1, May 4): Seventy-seven million baby boomers provide an undeniable demographic point; the stakes are huge. As state Sen. Becky Lourey, DFL-Kerrick, says, the current situati...

MINNEAPOLIS -- Regarding the Herald's story, "Nursing home woes" (Page A1, May 4):

Seventy-seven million baby boomers provide an undeniable demographic point; the stakes are huge. As state Sen. Becky Lourey, DFL-Kerrick, says, the current situation is a "train wreck" owing to the tough economic times, an aging population -- and the fact that two-thirds of the nursing home beds are paid for by public money.

Two-thirds.

When Minnesotans can ignore the risk of long-term care, avoid the premiums for private insurance, refuse to use the equity in their home via reverse mortgages and qualify easily for Medical Assistance if and when long-term care becomes necessary, we should not be surprised that they neither plan, save nor insure for long-term care, and that they end up on Medical Assistance by default.

When nursing home workers can make more money working with soda pop and fresh vegetables at McDonalds, it's no surprise they'd prefer that to working with blood and feces at a care facility.

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"We're looking for a better plan," Lourey said in the story.

Here's one: The agonizingly frustrating irony is that the whole problem of long-term care financing is so easy to fix. Simply extend the transfer of assets "look-back period" to capture a more reasonable planning horizon (say, five years instead of three), and require that home equity be consumed for long-term care by means of a reverse mortgage before Medical Assistance eligibility is granted.

That strategy encourages people to use their home's value to stay at home and delay or prevent Medical Assistance dependency.

In our current long-term care system, efficient estate recoveries are critical. They are the only financial leverage the system has to encourage people to prepare to pay privately for long-term care.

Finally, stop the current system of rate equalization. It's price fixing pure and simple. It doesn't work.

Saving Medical Assistance is a fairness issue. Political parties and ideologies don't matter. What's important is that scarce public welfare resources go to people in need and that others -- who are affluent, healthy and young enough -- plan responsibly for long-term care.

Let's all pull together, whatever our political preferences, to save Medical Assistance for people in need and encourage responsible long-term care planning for those who are able.

Richard Schafers

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