and estimates suggest that the demand for long term care among the elderly will more than double in the next thirty years. (Feder, Komisar, and Niefeld) This growth will exacerbate concerns about balancing institutional and noninstitutional care, assuring quality of care, and most importantly adopting and sustaining financing mechanisms that equitably and adequately protect the elderly who need long-term care.Medicare, the federal governments health insurance program, finances acute medical care for nearly all elderly Americans over the age of sixty-five. However, very few long-term care services are covered. Medicare finances long-term care only partially through its limited skilled nursing facility (SNF) and home health benefits. Despite recent growth in spending on these benefits, much of the SNF and home-care paid for by Medicare remains short-term rehabilitative care, often related to a hospital stay or outpatient procedure. Medicare covers SNF care for up to 100 days following a hospital stay of at least three days. For homebound persons needing part-time skilled nursing care or therapy services, Medicare pays for home health care, including personal care services provided by home health aides. (Feder, Komisar, and Niefeld) All that is not covered, the elderly are expected to cover with savings, private insurance policies, and financial support from family and friends.About 7 percent of long-term spending is financed by private insurance. This is a combination of health insurance and the relatively new long-term care insurance. Although the number of people buying private long-term care insurance is growing, as of the end of 1996 fewer than five million policies had been sold. (Coronel) The problem lies in the high premiums. Most elderly people are on a fixed income, and the cost of long-term care coverage is simply not affordable. This is where the real financial strain comes in. Next, personal savings and assistance from family ...
