If Maine has had a long-term strategy for dealing with elder care financing, it has been this: not dealing with it.
Every nursing home operator loses money on every Medicaid-funded resident. That cost is passed on to the private-pay patients who subsidize the others.
This is not sustainable. Private-pay patients cannot shoulder the entire rising cost of long-term care. Nursing homes are closing because they can’t rely on finding enough patients who can pay more than their share just to keep the lights on.
This is especially true in economically depressed rural areas, creating hardship for elders and their families when they have to go far from home to find an open bed.
And, as our boomer-heavy aging population moves from middle age to old age, these problems will get worse, not better.
A legislative task force is working this fall to understand this complex, multifaceted problem, which touches nearly every family in Maine.
The panel will find no easy solutions, but it should be able to set a direction that will prevent the system from collapse.
An obvious solution would be to increase the Medicaid rate so that nursing homes are not losing money on every state-funded patient. That would have immediate results and would also give the state more time to institute long-term improvements that would make a difference in the long term.
One strategy involves creating support structures that keep people living independently in their own homes longer, relieving the pressure on long-term care.
That could include the AARP’s Livable Communities program, which encourages municipal planning efforts that make it easier for seniors to live independently. Pedestrian-friendly street design, mixed-use development that lets people live near shopping and other services without a car, and housing for people of all ages to prevent isolation helps people stay healthy longer and reduces the need for nursing home care.
And the state should not focus all its efforts on the elderly. Maine should be trying to make the state more economically attractive for younger workers so that the number of people who need help stays in balance with the number of people who can provide it.
The legislative commission is posing the right questions, and the commission should be able to report back next year with concrete plans to address the long-term care crisis. The state cannot put off dealing with this problem any longer.