The number of the Americans who need long-term care is nearly 10 million. Long-term care refers to the aids given to those people incapacitated by poor health, disability, or old-age among other provisions. Such people demand special assistance for them to perform basic and routine activities in their daily lives.
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These incorporate bathing, movements, preparation of meals, and medical therapies among others. It is evident that most of such people attain free assistance from friends, families, and other dedicated relatives. Nonetheless, the government (both state and federal) has established various programs meant to provide the alleged long-term care. There is a considerable spending for specialized long-term care services.
These incorporate nursing services, domestic care, and supported living services. It is crucial to consider such factors in the context of healthcare provisions. Long-term care is expensive for individuals with extensive needs. As at 2006, the annual cost for a private room in a nursing home neared US$70,900.
Concurrently, the pay per hour for a home health averaged US$25. This indicates how such services have become expensive in the American context. These figures translate to $36,500 and $33,300 base rates annually for a four hour home care and private room services respectively. Precisely, the country spent US$194 on long-term care with the nursing home care registering a considerable portion.
Medicaid is one of the prominent financiers of the long-term care. As at 2004, it accounted for nearly 49% of the total funding. Medicaid cares for poor individuals who meet up the eligibility standards. Each state is obligated to govern its own Medicaid programs; however, funding emanates from both the federal and state governments. Each state expects Medicaid to provide nursing home care as well as home health care for the eligible individuals.
These incorporate medical provisions and therapy services. Nevertheless, any state might include personal care in its Medicaid programs. Additionally, all states presently provide home and community-based services in a program that promotes services to a specific and limited number of residents.
DRA (an act) allows states to finance home as well as community-based services. Concurrently, the Medicaid spending on non-institutional care is growing tremendously. Conversely, Medicare program is intentioned to provide health indemnity/cover to individuals aged 65 and above as well as people with disabilities in this context.
In 2004, Medicare funded 19% of national long-term care expenses. Medicare is not designated to fund long-term care services; nonetheless, it grants minimal pay to the mentioned services. In a skilled nursing facility, Medicare pays fully for the initial 20 days and partially in the subsequent 80 days. Additionally, it also funds home health care for homebound individuals demanding amateur professional nursing and therapy services.
Nearly 19% ($37 billion) of the total cost of the long-term care expenditures was funded by ‘Out-of-Pocket Spending’ in 2004. Families of individuals with long-term care needs assume crucial roles in this context. This is true since most of these needy individuals (nearly 83% in 2000) attained their aids in community-based settings where family members contributed significantly. Private insurance institutions equally funded 7% (US$9 billion) of the total cost.
Private insurance sector also finances minimal amount of nursing and home care services. In 2002, insurers paid around US$1.4 billion on claims. Other sources (private/public) registered nearly 6% of the total in 2004. On policy issues, it is crucial to agree that numerous individuals needing long-term care have no insurance indemnities due to poverty. Nonetheless, Medicaid and other organs spend considerably on institutional care compared to home/community-based cares.