America’s new semi-entitlement

A new semi-entitlement program exists deep within our new health care law. It concerns long-term care, the services you may require when you get old.

By staying alive longer through improved health practices and treatments, we enhance the prospect that we’ll find ourselves still ticking even after our mental skills have declined through Alzheimer’s, dementia or general atrophy of the brain. Or we might find ourselves living longer than people lived before with degenerative, debilitating diseases like Parkinson’s.

We’re not talking about medical care, which would be covered for seniors by Medicare. We’re talking about help sorting your medications, dressing, cooking, bathing and going to the bathroom.

Nursing home care will take all the money you’ve spent your lifetime responsibly saving for your own peace of mind and to bequeath your children. Then, when all that’s gone, nursing home care will make you a ward of the state tapping Medicaid from the deficit-choked federal government and cash-strapped state governments. These costs will only worsen as the abundant baby boomers enter what, sadly, aren’t necessarily the golden years.

Recent years have seen the introduction of private long-term care insurance policies. These policies are not cheap. It can be difficult to figure out just what you need to buy to make a full or significant dent in whatever the per-day costs of the care will be if and when you need it.

It’s unpleasant. You’re not building equity. You’re not earning interest or dividends. You’re merely ensuring that somebody will pay somebody to assist you if you become incompetent.

Now, to this new semi-entitlement in the health care law: The late U.S. Sen. Ted Kennedy, love him or not, was a great leader in the progressive vanguard of public policy. For years he worked on a government long-term care insurance program. It was never to be in the conservative, anti-government era ushered in by Ronald Reagan.

But a government long-term care insurance plan got plugged into this health care reform bill early. As our attention focused elsewhere and as more visible provisions got debated emotionally, and, in some cases, excised, that provision stayed in through the bitter end.

So here’s what you need to know: Beginning next year, employers will be able to choose to offer a payroll deduction to employees for this insurance. If your employer offers it, you will be able to decline it, but only by opting out. Passivity will put you in automatically.

You can buy in individually if your employer doesn’t generally participate through a payroll program.

It’ll probably start out offering a benefit of $50 a day, which will be merely supplemental. You’ll be vested after five years of premiums and three years of work. It’s a worker-directed program, you see. The active employee is getting it for himself.

Ideally, it would help with in-home services to lessen our dependence on tragic human warehousing in nursing homes. As for nursing homes, this long-term care premium could be merged with Medicaid and save the federal government and the states some money.

What you need to do for now is stay keen as to whether your company will participate in this program next year, remembering that you’ll need to be proactive in opting out if your employer participates and you don’t want it. And you’ll need to ponder whether you’d like to make this part of your long-term financial strategy.

More liberal-minded persons will applaud the government’s aid.

More conservative-minded ones will say this ought to be a matter of personal and familial responsibility in the private sector — not government confiscation from your hard-earned paycheck — and that the whole thing is impractical because the government program will collect all the low-income, high-risk participants and run up yet another unsustainable deficit for taxpayers.

As always, both sides could have a point. Our political questions usually aren’t mutually exclusive propositions.

John Brummett is an award-winning columnist for the Arkansas News Bureau in Little Rock and author of “High Wire,” a book about Bill Clinton’s first year as president. His e-mail address is jbrummett@

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