Coffee or Care? Your Choice

You’re a baby boomer, or a recent graduate, or maybe, a newlywed. You’re sorting out your future, worried about the pressures of new circumstances, concerned about finances. And then there’s your mother. Or son. Or sister.No one lives in a vacuum. We all have ties binding us to loved ones across the generations, and for many, these ties mean that we must lend a helping hand, or provide full-time care. Sometimes, the needs are multiple: Your mother-in-law’s health is in steep decline, just as your grown son gets a difficult diagnosis — or the health issue is your own, and caring for your family means caring for yourself.[IMGCAP(1)]Right now, America is talking a great deal about reforming its health care system. Both the administration and Congress are formulating plans and planning to make changes. This is heartening and bodes well for our shared future. Strengthening and securing our health care safety net, and exploring paths to universal access, will be a real improvement for everyone in the country.But so far, a fundamental piece is missing from the discourse: For these efforts to be a true success, Congress must also incorporate long-term supports and services in any reform package. These kinds of services run a gamut of possibilities: housing, medical care, transportation, nutritional guidance, spiritual counseling — all are ultimately crucial to the well-being of those with long-term health needs. High-quality, affordable support systems, whether they’re in an institutional setting or your family’s spare room, are not a luxury, nor should caregivers have to struggle to provide them. They are a central, cohesive element of a functioning, healthy society.And yet caregivers often do have to struggle to provide long-term support, and the Medicaid system is placed under enormous pressure in the process. It’s an old, familiar problem to anyone who has ever had to take care of someone they love — a problem that could be greatly alleviated if a mechanism of supplementary insurance were in place, providing a pool of funding for Americans with long-term health needs.Such a mechanism is precisely what will be established, if Congress passes the Community Living Assistance Services and Supports Act. The CLASS Act would establish a voluntary disability insurance program, specifically geared toward adults with long-term care needs. For less than the price of a daily cup of coffee, individuals could choose to make a regular payroll deduction of $88 a month, joining an insurance program that would increase their choices in meeting any long-term needs they may have, and easing much of the pressure currently on the Medicaid program. Moreover, this legislation would empower each individual to choose his or her own doctors and services, rather than limiting participants to government-approved options. No two American families are alike, and neither are their needs. Whether the benefactor is long-retired and facing a shrinking savings account, or struggling with disease and mounting medical expenses, this bill is a sensible, middle-of-the-road solution — a unique form of public sector oversight built on a foundation of personal responsibility — that would give benefactors and their families real choices at a time in their lives when being able to make good choices is crucial.Finally, the CLASS Act will not only assist individuals with long-term care needs, it will also provide an important tool for maintaining American productivity, enabling individuals with disabilities to remain in the work force and reducing the absenteeism of working caregivers. As the baby boomers age, we must be honest about the very real stress their numbers will place on our already-strained social safety nets. Some 78 million Americans will join the ranks of the retired by 2030. In educating them about, and engaging them in, the process of providing for their own long-term health needs, we’ll be serving not only the boomer generation, but the American economy as a whole. It’s too easy to see our own needs and those of our family in isolation, as we struggle to get by day to day — and policymakers are no different from the rest of us. We as a country, and our elected officials, need to learn to take a broader view, one that acknowledges that every American has a family, and every family has health care needs. Passing the CLASS Act will be an essential step toward meeting those needs now, and long into the future.William C. Daroff is vice president for public policy and director of UJC/Jewish Federations of North America’s Washington office.