MONDAY, Sept. 30 (HealthDay News) -- Worried about how you'll
pay for long-term care in old age? You're not alone.
Harris Interactive/HealthDaypoll released Monday finds that
more than two-thirds of Americans are anxious and uncertain about
how they'll meet nursing home or home care costs should they need
Most people were also wrong about how most of these costs are
covered under the current system. About half (49 percent)
mistakenly thought the bulk of the bill was paid by individuals,
while one-third guessed Medicare. Only 19 percent understood that
the major funder of long-term care is actually Medicaid, the
government agency that covers health services for the poor.
One thing most people agree on: as America ages, the problem of
how to pay for seniors' long-term care will only get worse.
Eighty-seven percent called the situation "serious" or "somewhat
They're right to be worried, said Howard Gleckman, a fellow at
the Urban Institute in Washington, D.C., who focuses on long-term
"This is a huge and growing problem," he said. There are
currently about 12 million Americans in some form of long-term
care, he noted, and that's expected to double within the next 20
It's estimated that most Americans -- more than two-thirds of
those aged 65 and up -- will need some type of long-term care, such
as a nursing home, home health aide or adult "day care" center.
In the new poll, a similar percentage -- 68 percent -- expressed
worry about how to pay for it all.
The problem of how to pay for rising costs of senior care was
not addressed by the Affordable Care Act, or what some call
"Obamacare." And Gleckman said that policymakers have shown no
agreement on where to go from here.
As for the general public, past research proves that few of us
even know how long-term care is currently financed, Gleckman noted.
And the new poll confirms that.
For example, "very few people understand Medicaid's role in
long-term care," Gleckman said. The problem for families is that
Medicaid coverage only kicks in once people have spent down their
assets enough to qualify for assistance.
The other option is for people to plan in advance and buy pricey
private insurance that specifically covers long-term care. The poll
found that 64 percent of Americans think "most people" should buy
long-term care insurance.
But thinking that something sounds good, and actually doing it
for yourself are two distinct things, Gleckman pointed out. Based
on current statistics, less than 8 percent of U.S. adults have
bought long-term care insurance, he noted.
In the new poll, 79 percent said they supported the notion of
tax breaks that would help people purchase long-term care
insurance, with similar numbers of Republican and Democrat
respondents in favor of such a move. Whether any tax perk would
actually encourage more Americans to invest in private insurance is
the big question, Gleckman said.
With the age of the average voter steadily rising, "how we will
pay for long-term care in the future is likely to become a huge
political issue," added Harris Poll chairman Humphrey Taylor. "The
cost is already well over $200 billion and is almost certain to
grow rapidly as many more baby boomers grow older."
Just last week, the federal Long-Term Care Commission -- an
expert panel established by Congress -- issued recommendations on
how to improve the delivery of long-term care.
"Where they couldn't reach any consensus at all," Gleckman said,
"was how to finance it."
But in the new poll, he noted, the public showed a surprising
amount of agreement on some financing options. Over two-thirds were
in favor of a "new government program" to help out. Even among
Republicans, half liked the idea -- which was particularly
striking, Gleckman said.
Another expert in long-term care said the poll shows that
Americans are becoming more aware of the issue.
"Most Americans now will live for some years with an inability
to take care of themselves due to the illnesses associated with
advanced old age," said Dr. Joanne Lynn, director of the Center for
Elder Care and Advanced Illness at the non-profit Altarum
"This will be the most expensive part of most of our lives,"
Lynn said, "yet insurance does not cover it -- at least not until
the person has spent down to poverty, when Medicaid will pitch
She added that "very few" Americans can save enough money to pay
for long-term care in their final years. "It's good that most
Americans are beginning to recognize the need for some public
support," she said.
According to Gleckman, the financing solution does not have to
be strictly "private" or "public," but could involve some mix.
One possibility, he said, is a program where private insurers
sell long-term care coverage "under the auspices" of the Medicare
program -- similar to the current "Medigap" system, where older
adults can get supplemental private insurance for services that
Medicare does not cover.
Everyone agreed that the long-term care problem is only going to
get more complex in the years to come. Not only will there be more
elderly Americans in need, there will also be fewer family
"Lower birth rates mean there are going to be fewer and fewer
adult children available to provide care," Gleckman said.
The baby boomers who are caring for an elderly parent, or have
in the past, already know the shortcomings of the current system,
according to Lynn.
"Their frustration should fuel real reforms," she said.
Harris Interactive/HealthDaypoll is based on interviews with
2,013 adults who were surveyed online between Sept. 10-12.
There's more on issues surrounding long-term care at the
U.S. Department of
Health and Human Services.
For more details on the poll, visit