A recent exchange on some Certified Elder Law Attorneys pertained to the Stop Unfair Medicaid Recoveries Act introduced March 6 in the U.S. House of Representatives. This law seeks to end the “estate recovery” right by which states seek recovery from the estate of a deceased Medicaid recipient for the care expenses paid by Medicaid. Most states, including Mississippi, have such laws (although Mississippi’s right to recover against a home may be limited if there are surviving children or grandchildren). The comments included discussion of the inequities in our national health care system, such as the following different treatment of acute illnesses and long-term illnesses.
Why is there a basic right to health care, but no right to long-term care? In the United States, people over 65 generally have a right to medical care, but not to long-term care. Medicare Part A Coverage (which covers hospital visits) is free to people who have worked for at least 40 quarters (generally 10 years). No one in the U.S. (regardless of age and citizenship) can be turned down from medical care in a hospital emergency room because of EMTALA (the Emergency Medical Treatment and Labor Act), which requires hospitals with emergency departments to provide a medical screening examination to any individual who comes to the emergency department and requests such an examination.
Does any similar program pay for long-term care in our country? The answer is NO. In the US, nobody has a basic right to receive any type of care that is classified as long-term care. Why? It’s just how our American healthcare system has evolved over our country’s history, and politicians have not yet figured out that perhaps long-term care should be considered a basic human right (as it is in some countries).
Medicaid planning is used to overcome a discriminatory health insurance system. This distinction between acute care and long-term care means that our American health insurance system discriminates against people suffering from certain types of chronic illnesses, incuding those that routinely result in the need for long-term care, such as: Alzheimer’s disease, Lewy Body dementia, Vascular dementia, FTD (Frontotemporal dementia), and other types of dementia; Parkinson’s disease; Huntington’s disease; ALS (Amyotrophic Lateral Sclerosis), Multiple Sclerosis, Muscular Dystrophy; severe osteoarthritis, rheumatoid arthritis, psoriatic arthritis, or spondyloarthritis; severe spinal stenosis; severe gout; and any other of the dozens of types of progressive neurodegenerative disorders or neuromuscular disorders that result in the need for long-term care. Any person suffering the tragedy of one of these diseases in the U.S. may be ineligible for payment of those costs under our American health insurance system.
Why should someone with brain cancer – tumors in the brain that aren’t supposed to be there – have all his treatment (chemotherapy, radiation, and surgery) covered by health insurance, yet someone with Alzheimer’s – plaques and tangles in the brain that aren’t supposed to be there – must pay for his care out of pocket? In both cases, we are dealing with the care that someone needs because of the disease that person has. How is the differing result “fair?”
Is it an ethical social policy that seemingly arbitrarily distinguishes among these different types of illnesses? Is it an ethical social policy that provides full coverage for most illnesses – whether chronic or acute – but forces Americans with certain chronic conditions (many of them elders) to become impoverished in order to gain access to the long-term care necessitated by their particular type of chronic illness? Is it a surprise that Americans suffering the “wrong type” of chronic illness will want to look for legal ways (such as Medicaid eligibility planning with elder law attorneys) to preserve the efforts of their lifetime in order to protect themselves and their families from this seemingly arbitrary social policy?
As we age, we must consider the costs of health care in our older years and how those costs will be paid. Call us today at 601-987-3000 to set a meeting to discuss how you might pay for your long-term care needs and preserve assets needed for your family’s financial security.