The ACA’s Medicaid expansion did not make coverage of long-term care necessary unless the person receiving long-term-care services received an income-related subsidy.
“You will not pay for health insurance,” says Dr. J. Andrew Zee, professor of medicine and medical director at Boston Veterans Affairs Medical Center. “There could come a time when it becomes appropriate to pay for medical services. I’m not sure we’ll ever be in that situation, but it’s a matter of when, not if.”
And what if there is a crisis with long-term-care patients who cannot afford care?
It’s a common argument that insurance will pay for long-term-care services for a patient — until it comes time for a crisis at home or in the employment market when premiums rise and coverage costs skyrocket.
But that’s not the case, says Zee.
“We don’t pay for emergency room treatment for a hospital accident,” he says. “People do in some cases pay for services other than ER.”
And while premiums may rise higher, there’s no evidence to suggest that the increase will drive people into bankruptcy, Zee says.
“You have to understand the financial realities of where you are in life. You have to understand that the people who would be going bankrupt from long-term care have fewer assets because their costs are driven high by their inability to pay premiums,” Zee says.
Readers may want to consider this example: An 82-year-old single man who is living with dementia. He has a doctor that won’t be able to afford the care, says Paul H. LaPointe, professor of obstetrics/gynecology and director of the Center for Family and Community Medicine at Northeastern University Boston.
Hospitals offer less expensive care, including mental health treatments. A single, low-income person who can’t afford the care, can find a doctor. There’s nothing to stop a hospital from charging $10,000 per day for a single hospital stay, says LaPointe.
LaPointe says that single-payer is a good option for the majority of patients. There is no requirement on where a patient will go for care, and the government could easily be responsible for a portion of the costs.
Medicare is also more likely to provide more affordable care than private insurance, he says.
Medicaid also gives coverage to those who cannot afford private coverage,
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