Covered vs Not covered

[jimtoo]

@Bears54

They could increase the Medicare tax and add a long term care benefit, but I doubt that will happen.

The Medicare tax is already too small. 40-45% of the cost of Medicare already comes from general tax revenue.

[Bears54]

@jimtoo

The Medicare tax is already too small. 40-45% of the cost of Medicare already comes from general tax revenue.

It should cover what it costs, but no one in DC will raise it.

[Wintermute]

Are you talking about the icd10 codes?

There use to a be pdf out there and the pay rate for each code.

[smartpolitics]

@BridgeMaven

I am not an advocate of Canadian health care in general but like the way they handle long term care. The Canadian government evaluates what each resident can afford to pay and subsidizes the rest. So very wealthy people pay the entire bill but the average person only pays part of it. This is much better than our system where a person either pays the entire amount or gets it for free.

I do think your means test idea is better than Medicaid. As you mentioned, Medicaid has a cliff where they either fully cover you or deny coverage altogether

I learned something new. I thought their socialized medicine was limited to healthcare not custodial care

@BridgeMaven

This did not include the cost of the skilled nursing facility which cost me $13,000 per month because Medicare does not cover the cost of a skilled nursing facility except for short term rehab.

Happened to my dad as well. The memory care $7k / mo kicked him out when he had $25k left on assets. The $13k/mo is the retail price for skilled nursing

Elderly care can be so frustrating. Our dad started in a CCRC but he was kicked out for being too much to manage so we found a $7k/mo assisted living

Of course after six years in assisted living and $350,000 spent, we had to find a skilled nursing 50 miles from the CCRC and memory care places

[smartpolitics]

@Bears54

They could increase the Medicare tax and add a long term care benefit, but I doubt that will happen.

Not a bad idea. It might be an expensive rider as LTC is not cheap but neither is hospital care

The issue is it’s a service many people will need but also is very costly; thus while it’s catastrophic, it’s common enough to make it impossible to insure for at least the first two years. The insurability is care needed between 2-20 years as that’s far less common

@Bears54

It could just be a partial benefit, like a few thousand a month to offset the cost. The rich and middle class will be able to keep more of their assets and poor people can still go on Medicaid.

That’s a great idea. The concept is either to help with the cost of long-term care or to encourage people to buy insurance. You could have it where people must have a minimum amount of insurance before Medicaid kicks in or where a consumer agrees to a large deductible or a percentage of assets but whereby the insurance covers a catastrophic decade long event

@Bears54

The moral and legal way around that is to spend your kids future inheritance on them now. People will give their kids a down payment on a home, take them on a nice vacation every year, buy them a large purchase such as furniture or vehicle. You can’t take it with you so you might as well see your kids enjoy it while you’re alive.

Agreed this is ethical. In terms of putting assets in a trust, I think it’s ethical to take care of a surviving spouse or disabled dependent.

It’s great to see your kids enjoy the fruits of your labor.