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What This Survey Said About Paying for Long-Term Care

Most Next Avenue readers polled believe it should be a public policy issue

By Denise Logeland and SCAN Foundation

Paying for long-term care is a nonissue in America, judging by the content of this year’s presidential campaigns. But the results of a nonscientific survey of Next Avenue readers give a different picture.

About 6,500 readers took part in the online survey last October. Of those, only 24 percent said that they were “extremely” or “very” confident they’d be able to pay for the supports and services they are likely to need as they get older. Another 39 percent called themselves “somewhat confident.”

Long-term care costs, on average, will total $91,000 for a man and $182,000 for a woman turning 65 today, according to the U.S. Department of Health and Human Services in a briefing last July. Any one person’s costs could be lower or higher than that.

Families typically pay about half of these expenses out of pocket and that’s something the majority of survey participants would like to see changed.

Seeking Another Long-Term Care Model

Most said they would favor some type of public policy solution to help families meet long-term care costs; 55 percent said they strongly favor this and 28 percent were somewhat in favor of it.

The survey did not ask about a specific policy solution, but it did offer examples to clarify what was meant by a “policy” approach to the problem of long-term care costs; that included tax breaks to encourage more personal saving and a government-managed long-term care insurance program.

Most survey participants have not purchased long-term care insurance from a private company: 29 percent said they own this type of insurance product. In survey comments, many people explained that they have investigated long-term care insurance and decided it wasn’t a feasible solution for them.

Cost Too High

The most common reason cited: prohibitive cost. Other concerns included the risk that long-term care insurance premiums will keep rising after they’ve purchased a policy and eventually become unaffordable and being declined for coverage due to health conditions.

“I looked into long-term care insurance,” one survey respondent said. “For me, it was not affordable. For my wife, she could not pass underwriting, so the cost was irrelevant. I’m of the opinion that there’s not much we can do other than take care of our health.”

Survey comments touched often on the idea of personal responsibility with regard to aging and the need for long-term supports and services. But responsibility means different things to different people, as the following comments demonstrate:

In Their Own Words

“I have a long-term care policy which will provide $250 a day for five years if necessary. I ride my bike 6,000 miles a year and eat my veggies. I believe in individual responsibility as well as insurance for my well-being.


“When my mother was in assisted living we spent $4,300 per month out of pocket while 69 members of her posterity were working full-time paying taxes. Something is sorely out of whack!

“I don't agree that the government should pay for someone's living expenses if they didn't plan or prepare for it during their lifetime. The government cannot afford to support people, especially in the large numbers of us who are turning 65 each day. Medicare should only be utilized for health care — not living care.

“My 87-year-old mom made preparations during her lifetime to take care of herself when she needed ongoing care. She took care of my dad at home until his death at age 84.

We moved to be near family and that is a trend that seems to be popular. It is hard to move from familiar surroundings but children need to work, so it is up to the retirees to move if that is an option.

“I have not been able to save. Insurance and prescription costs have been terrible. I don't see any point in trying to get the government to pay or make insurance companies pay when insurance companies will spread the cost to the public. I assume that my [costs in] retirement (if I get to have any now) and my medical bills are my responsibility.

"I'd like to see a community response. I’d like to live in a co-housing or village environment in which we care for each other, and possibly hire some outside help for the elderly so that we can stay at home.

Share the Pain

No single solution to long-term care costs emerged from the survey results, but participants made it clear that they want to see more cost-sharing.

Asked how responsibility for long-term care costs should be divided among a set of five possible entities, majorities of survey participants assigned “moderate,” “large” or “very large” responsibility to: themselves as individuals (73 percent), health insurance companies (78 percent),  Medicare (83 percent) and Medicaid (68 percent).

The one entity that they least wanted to make responsible for long-term care costs is the one that bears so much of those costs today. Only 23 percent of survey participants assigned moderate or greater responsibility to family members.

Denise Logeland is a writer and editor in Minneapolis who has covered business, health and health care. She is the author of Next Avenue's ebook, 10 Things Every Family Should Know: Aging With Dignity and Independence. Read More
By SCAN Foundation
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