The running scandal of long-term care insurance

I have been privileged in my life to make a friend of Martin Kenneth Bayne (right).

He was known as Mr. Long-Term Care back in the 1990s, an advocate for properly-drawn long term care insurance.

He entered this role due to Parkinson's Disease, and it has had its way with him. He has been in nursing care for several years. I seldom hear from him any more.

But when I do hear from him I can expect rage concerning his treatment and the failure of the insurance industry to protect anyone.

Martin ascribes this to insurers' greed. But I would argue that the cost of treatment, combined with the substantial risk you or I will wind up in this position, means the private market just can't write such a policy.

The premiums on a policy guaranteeing us quality care for however long we may need it would be too high to bear. And anything else is a scam.

Today's New York Times has an online forum with attorney Vincent Russo, who praises a New York plan that can protect assets by switching you to Medicaid when your benefits expire. But your income still goes away.

The cost of care is just too high to insure. In New York it's $317,000/year. And as Martin has told me many times, that's not very good care. He has been in a nursing home for almost five years now. Do the math. Before that he had a visiting nurse for nearly a decade.

Nursing, machines, facilities, it all adds up. Too many care systems today are run as real estate plays, and the patients are seen as a cost to be minimized.

I have sought to reassure Martin concerning the benefits of technology, how it can lower the cost of care while increasing its quality. This blog owes its life to those discussions.

But until we can pay line workers a decent wage, and provide financial incentives for quality, not just cost-cutting, it's not enough.

With 79 million of us now headed past our warrantee expirations, the cost of caring for us is about to explode. It's a ticking bomb under the economy, and the free market does not have an answer for it.

The best I can come up with is a federal pool paying for federalized care into which everyone above a certain age must pay, with the taxpayers making up the losses. That doesn't sound good to me, either.

As Seal said, Martin, I may not know what you're going through, but time is the space between me and you.

For most of us, it's the only space.