Pete Buttigieg has a solution that I wish my parents would have had.
When I started reading Pete Buttigieg’s plan outlining long term care options, I was driving to the Portland Airport after spending a weekend snuggling with our newborn granddaughter and playing with her adoring big brother. I was in a warm and fuzzy state. Then I felt myself become breathless and teary as I started reading Pete’s comments on his plan.
“I’ll always remember the social worker patiently explaining to my mom that her best option to cover Dad’s care might be for our family to spend everything that we had until we were asset-poor enough to qualify for Medicaid,” he said. “I am determined to usher in a new era for older Americans that upholds the unshakable promise that every American should be able to maintain a decent standard of living when they retire.”
My experience has shown me that for so many others the situation our family faced decades ago was exactly what Pete and his Mom were confronting when his father became critically ill. We learned the hard way that long term care should not be a privilege for those who can afford it. Long-term care should exist to provide dignity and security whenever it is necessary for whoever needs it and home care should be an option whenever possible.
When I read Pete’s plan this morning I was flooded with memories. But I was aware of something else, too. People sometimes question Pete’s age and experience in how he will have the “right type of experience” to lead our country.
Sitting in that social worker’s office last year gave Pete the experience to understand what people go through at one of the most vulnerable moments in their lives. You can’t put a value on that. It is priceless.
He didn’t have to serve in Congress to come up with a solution. He didn’t have to be 65 years old either. He saw a situation that needs to change and he has offered a strong and reasoned solution based on serious research and investment.
My story and Pete’s might not be yours but I have told mine in detail to make a point. Our crisis started forty years ago with my dad’s out of the blue heart attack changing the future in ways we would never have imagined. Pete’s experience was just last year. It is past time to fix this. It is time to be bold with solutions with dignity and #WinTheEra.
Thank you Pete for having the right values and experience to make the world a better place.
[read in full at Medium.com]
I was not prepared for a social worker to suggest our family spend itself into poverty.
Last winter, after my father entered a hospitalization from which he would never emerge, my mother and I sat down with a social worker to talk about options for the long-term care we thought he might need. I’ll always remember the social worker patiently explaining to my mom that her best option to cover Dad’s care might be for our family to spend everything that we had until we were asset-poor enough to qualify for Medicaid. I remember thinking, “Is that how this works in America?”
It is a fact of life that we and the people we love grow older. With aging can come deep satisfaction and joy — the chance to slow down, travel or play with a new grandchild. It can also bring hardship, as a worker frets whether she has sufficient savings to retire or a husband debates whether to move his spouse to a nursing home.
More and more Americans are confronting the challenges of aging, as shifting demographics intensify a crisis that Washington has neglected for years. As Baby Boomers age, there soon will be more older adults than children for the first time.
By 2050, nearly one in five Iowans will be over 65. Americans are increasingly becoming eligible for Social Security, even as the Trump administration has tried to cut billions from the program.
I am determined to usher in a new era for older Americans, one that empowers them to retire and age with dignity, so that they and their families can see their golden years as a time of security and possibility.
In this new era, we will uphold the promise that every American should be able to maintain a decent standard of living when they retire. A key part of that means ensuring that the 22 million seniors on Medicare Advantage can choose to keep their plans, which is why I will offer Medicare For All Who Want It, in addition to making prescription drugs more affordable.
We’ll ask the most fortunate Americans to pay their fair share, to protect Social Security for the next generation and increase the minimum Social Security benefit. At the same time, 62 million Americans lack a workplace retirement account, and over a third of Iowans have less than $5,000 saved or invested for retirement.
So we’ll create a public option 401(k) to ensure that workers can supplement their Social Security benefits if they choose. Under our plan, a typical American worker could retire with more than $500,000 in that account.
I am committed to making long-term care more affordable, because no family should be faced with the dilemma my family encountered. So we will establish a new, universal long-term care insurance program called Long-Term Care America to provide eligible seniors $90 a day for as long as they need it. For Iowans, this would cut the cost of care by 39 percent for nursing facility services and 57 percent for assisted living services.
We’ll also revitalize the private long-term care insurance market. Through these policies, the public and private sectors will work together to provide comprehensive long-term care insurance while strengthening the safety net for older people with lower incomes.
Our plan will also improve access and quality of long-term care at home and in communities. We’ll mandate that Medicaid cover such care. And we’ll expand the CAPABLE program — which provides a nurse, home repair person and occupational therapist to aging Americans — to make it easier to stay healthy and age at home.
We will honor and support our nation’s caregivers, who are primarily women and disproportionately people of color and immigrants. America will need nearly 8 million new care jobs by 2026, even as these high-turnover jobs involve long hours, low pay and frequent abuse.
So we’ll support Iowa’s 75,000 direct care workers by setting a $15 minimum wage, implementing new work standards and expanding programs to train more caregivers and create ladders for advancement.
And we’ll ensure these workers can unionize, because care jobs should be good jobs.
Vice President Hubert Humphrey once observed that “the moral test of government” is, in part, how we treat “those who are in the twilight of life, the elderly.” My administration will meet that moral test and ensure every aging American has respect, dignity and belonging.
by Ed Dolan – Oct 16, 2019 (NiskanenCenter.org, abridged)
The Democratic Party is at risk of falling into a trap on health care — a trap called “Medicare for All.” But at the Democrats’ October 15 debate for presidential candidates, Pete Buttigieg offered a plan that could allow a timely escape.
Buttigieg began by characterizing his plan, Medicare for All Who Want It (M4AWW), as one that “trusts you to make the right decision for your health care and for your family. Unlike the purist form of Medicare for All promoted by Elizabeth Warren and Bernie Sanders, Buttigieg maintained that his plan could be “delivered without an increase on the middle-class taxes.”
The key to making this work will be to implement M4AWW in a way that is biased neither toward the public nor the private option. Many observers see the coexistence of traditional Medicare with Medicare Advantage as a model. Over the past ten years, the share of Medicare beneficiaries who have opted for Medicare Advantage has increased steadily, from 23 percent to 34 percent. Although originally a Republican idea, over time it has grown in popularity among Democrats. Medicare Advantage is not perfect, but commonsense reforms with bipartisan appeal could improve it. Presumably, lessons learned from Medicare Advantage would be applied during the process of turning M4AWW from a campaign position into actual legislation.
Under M4AWW, Medicaid would remain the principal source of coverage for people with low incomes. Two changes would broaden Medicaid coverage. First, people who do not currently have coverage and who live in states that have not expanded Medicaid under the Affordable Care Act (ACA) would be automatically enrolled. Second, states would no longer be allowed to impose work requirements.
For people above the Medicaid cutoff but below Medicare age, M4AWW would use the same basic tools to ensure affordability as does the ACA. Under M4AWW, premium supports would be structured so that no one would have to pay more than 8.5 percent of their income, while people with the lowest incomes would pay no premiums. At the same time, the plan would restore and expand the ACA’s system of cost-sharing reductions in order to ease the burden of deductibles and other out-of-pocket expenses for low-and middle-income beneficiaries. Affordability would be further enhanced by basing the public option on “gold” rather than “silver” ACA coverage.
The combination of premium subsidies, cost-sharing reductions, and Medicare reform would mean that low-income beneficiaries would have their health care costs covered in full, while those who could afford to do so would make reasonable contributions to the cost of their own care. In that regard, M4AWW closely resembles an approach to reform known as universal catastrophic coverage (UCC). It also resembles another UCC-like plan, the Medicare for America bill drafted by Democratic Reps. Rosa DeLauro of Connecticut and Jan Schakowsky of Illinois, and endorsed by presidential candidate Beto O’Rourke. In the committee rooms of Capitol Hill, it ought to be possible to reconcile the two proposals.
Under M4AWW, people who are offered coverage by their employer but don’t sign up because it’s too expensive will be able to enroll in the public option and receive the income-based subsidies that would help guarantee affordability. That would be an improvement over current rules, under which employees who are offered coverage but reject it in order to seek coverage on the ACA exchanges usually do not qualify for income-based premium subsidies and cost-sharing. Furthermore, M4AWW would essentially end job lock. The public option would provide a reliable backup for workers who changed jobs or move to self-employment.
M4AWW would be especially beneficial for low-wage employees. The latest data from the Kaiser Family Foundation show that the average premium for employer-sponsored family coverage now exceeds $20,000 per worker, with the employee paying an average of $6,015 of that. Since M4AWW includes a premium cap of 8.5 percent of income, it would offer a better deal to any family with income of less than $70,000 per year. That is well above the median annual wage of $47,000.
What’s more, Buttigieg is right when he says that his plan is “what most Americans want.” The latest polling by the Kaiser Family Foundation finds that a slim majority of voters, when asked directly, say they favor Medicare for All, but it also finds that they lose their enthusiasm when they are provided details of Sanders’ version of that plan.
Tellingly, 55 percent of all voters, including 66 percent of those who say they favor Medicare for All, think, wrongly, that Sanders’ plan would let them keep their current insurance. If they are asked their opinion of a plan that would eliminate private insurance companies, 58 percent oppose. Fully 60 percent oppose Medicare for All if they are told it would replace the current versions of traditional Medicare and Medicare Advantage. In short, if we believe the polls, Medicare for All is a political dead end.
Pete Buttigieg seems to get this. He understands that 89 percent of voters say it is very important to cover all Americans, compared with just 38 percent who think it is very important to eliminate private insurance companies. Whether or not he ends up with the Democratic nomination, his approach to reform should not die with his candidacy. Whoever prevails in the primaries, and whatever they call their health care plan, they should offer something in the general election that more closely resembles Medicare For All Who Want It rather than Sanders-Warren-style Medicare for All.
[read in full at NiskanenCenter.org]