May 24, 2022

Millions of people—most of them seniors on fixed incomes—need in-home nursing care or personal assistance. Unfortunately, with minor exceptions, in-home care is not covered by Medicare or Medicaid. Some long-term care insurance policies might cover it. For the most part, Americans must pay out-of-pocket for the care they receive at home—and that care can be quite expensive.
Last month we talked about the high cost of private pay care, which is what we offer at Wellspring. That post explained the factors that go into the cost of in-home care. This month we want to focus on what consumers can do about it.
David vs. Goliath
On one side of the cost equation are the millions of family members who are beside themselves trying to figure out how to get high-quality, affordable care for their loved ones. On the other side is the health care industry, which is focused on streamlining operations and making a profit, turning too much of our health care into transactions. (It’s also struggling with a severe staffing shortage that’s causing many agencies to turn people away.)
The result: individuals and families who must deplete their savings to pay for needed care. People who must choose between that scenario and a long-term care setting, which also is overwhelmingly private pay and even more expensive.
We hear these stories all the time, and we believe that consumers need to start telling them to their politicians and policymakers. “I’m fearful that our society has been blindsided by the tsunami of aging and, more importantly, what it takes to take care of older adults,” says Sheila McMackin, MSW, LCSW, the founder of Wellspring Personal Care. “Resources are tight, and nobody seems to have their thinking caps on about making things better.”
Consumers are the ones feeling the greatest pain, and the situation will only get worse. “If consumers don’t organize and make their voices heard, we see little chance of politicians getting educated and making change happen,” says McMackin.
So, what can consumers do? Start in your own community. McMackin offers some specifics:
- Call your local elected official and tell them your story: Mom is on a fixed income; she wants care at home and doesn’t need a nursing home; there’s a nine-month waiting list for help at home.
- Ask or find out what your state is doing to increase the number of people going to nursing school and into the health care professions. What will the situation be like when you’re 75 and need care?
- Get educated. Learn about private equity investment in health care and its effects on the cost and quality of care.
- Contact your state’s hospital association, medical association, and other health care groups. They should all have this on their priority list.
State governments can do more to ease this financial burden for their constituents
McMackin believes politicians are the place to start. “I do think they listen to consumers and state policymakers. But they’re in their silos and they don’t often have their fingers on the pulse of what consumers are dealing with. People are crying out for care, yet I don’t see any local or national level of commitment or people talking about it.”