Health care access remains a critical factor for various populations all around the world. However, it is worrying to realize that not all populations can have a sustained access to health. Notable is the fact that long-term insurance is highly priced; hence, only a few populations can afford. Long-term care insurance is clouded by a paradox aligned with the fact that the populations in dire need of such insurance cannot afford it, whereas those who can afford it do not need it. While it is true that health care insurance is a basic need, it is of the essence to point out the fact that not all populations can afford it. A reflection on the United States contexts shows that close to 44 million persons do not have health insurance (Pratt, 2016). Similarly, 38 million do not have adequate health cover. These statistics portray the fact that close to one third of Americans without insurance cover for them and their families.
Lack of an insurance cover impacts negatively on the health of the populations. One of the most comprehensive means through which lack of an insurance cover negatively impacts on the populations aligns with the fact that it impacts negatively on the health seeking behaviors of the populations. Many at times, people who do not have insurance cover do not seek health often as compared to those who are covered. In most cases, uninsured populations forego preventive care such as routine medical checkups and postpone necessary care. Therefore, the uninsured populations are more likely to be hospitalized for conditions that are preventable (Pratt, 2016). Delaying medical care due to fear of medical bills results in increased health care costs for all the populations. This is because postponing care elicits a downward spiral, which increases the health care costs.
The fact that long-term care is costly for a significant portion of the populations has resulted in the development of various notions on how the populations can be helped to pay for long-term care expenses. Buying of private insurance has been proposed as one of the means of helping people pay for long-term care costs. However, private insurance has proven to be similarly expensive (Pratt, 2016). Precisely, private insurance results in additional costs that are expensive. For this reason, there is a need for alternative solutions that would help the uninsured populations to pay for long-term care costs. Apart from the use of private insurance to pay long-term care expenses, there are several ways through which families that cannot afford long-term insurance can be helped.
Public Insurance Approach
More importantly, pubic insurance approach should be adopted as a means of helping the uninsured populations pay for long-term care expenses. The public insurance approach entails the use of public funds to insure all the populations. The adoption of this approach would result in an increase in taxes. This is because the taxes would be used as the sole means of helping the uninsured population access long-term care. This method is recommendable because it would mean that all the vulnerable populations including the disabled would qualify for insurance benefits (Pratt, 2016). In a nutshell, public insurance as a way of helping the uninsured populations pay long-term expenses means that all the populations regardless of their economic capability would qualify for benefits. Deductively, public insurance approach is based on the premise that long term care service provision should not be a private responsibility, but a public responsibility.
Conclusively, public insurance approach as a way of helping the uninsured cater for their long-term care expenses requires an expansion of public financing. Expansion of public financing also calls for a shift in the manner in which long-term care expenses are shared by the society. As previously connoted herein, sharing of the cost burden emanating from public insurance will be reliant on particular financing and tax mechanisms, which will be utilized to generate returns required to cater for the public benefits. A reflection on insurance in the contemporary American contexts shows that close to 50% of long-term care expenses are generated privately by persons using formal care. The other 50% are drawn from the public sector whereby 38% come from state and federal revenues that are paid to the Medicaid program (Pratt, 2016). This analysis shows, that the adoption of public insurance approach would be carried out with ease because the public sector is already catering for 50% of the insurance.
There are various reasons justifying the fact that a public insurance approach would help the uninsured populations cater for long-term care expenses. More importantly, a public insurance approach ensures universal access to health care (Pratt, 2016). Adoption of public insurance approach would mean that all populations requiring long-term care would get access regardless for their economic capabilities. For example, persons ailing from chronic illnesses would not denied access just because of the mere fact that there are not insurable. Through public insurance approach, admission policies that are discriminatory against poor patients will be repealed. In addition, public insurance approach is a recommendable means of helping the uninsured to pay long-term care expenses because it ensures equity. This approach would ensure that all people irrespective of their economic capability would get equal benefit (Pratt, 2016). The current insurance system does not ensure equity as evident by the fact that Medicaid patients receive care that is of a lesser quality than privately insured patients. With the adoption of a public insurance approach, individuals wishing to purchase additional amenities not covered by the public insurance package would still be able to do so.
On another note, public insurance approach is the most feasible approach in catering for the long-term health care costs of the uninsured populations because it protects against unpredictable costs. Many at times, unpredictable costs emanate from catastrophic events. Through the use of a public insurance approach, all people will be accorded protection from the risk of being rendered poor by catastrophic occurrences. Besides, public insurance as a solution for long-term care expenses is feasible because it would be dependent on taxes that are exclusively set for the sole intent of long-term care. As a result, there would be a dedicated financing for public insurance, which will ensure financial creditworthiness of long-term care. Similarly, public insurance has a guaranteed administrative efficiency (Pratt, 2016). Public insurance is likely to evolve into a large program that has lower administrative costs comparative to the premium amounts remitted. It is also essential to note that public insurance would ensure that insurance costs are spread across all workers. This means that contributions from each worker will be minimized. This shows that public insurance would be relatively cheap when compared to private insurance. This analysis depicts the fact that public insurance is a viable alternative that would be of great help to the uninsured populations who cannot pay for long-term care expenses.
Annuity hybrids is the other alternative insurance solution for families who cannot afford longer-tern insurance. Precisely, families who cannot afford long-term insurance can take an annuity with long-term care riders (Pratt, 2016). By investing their finances in an annuity with long-term insurance rides, families who cannot afford long-term insurance can use such annuities for long-term care. This will be guided by the terms defined by a contract entered by such families when investing in an annuity with long-term riders. The use of annuity hybrids as a means of catering for long-term care expenses has been made possible by the restructuring of Internal Revenue Service (IRS). Changes in the IRS have provided a means through which finances invested in an annuity can be utilized tax-free to cater for long-term care. This alternative offers the populations much freedom on how they can use the health care claims drawn from the annuity. In cases where an individual has not used his or her accumulated annuities, they have the freedom to redeem the amount they had invested in the annuity. Deductively, annuities merged with long-term care riders offer a feasible support that enhances access to long-term care by poor populations who cannot afford long-term insurance. Annuity hybrids as an alternative for families who cannot afford long-term care is however limited by the fact their purchase is done upfront. This means that the annuities require huge upfront payments, which may not be possible for the poor populations.
Apart from using annuities with long-term riders, families who cannot afford long-term insurance can also use annuity in the form of deferred fixed annuity. In this type of annuity, an individual sets aside a specific amount of money determined by the chances of them requiring long-term care. In return, the insurance firm will remit back the claims after the contributor has reached a specific age, particularly the retirement age (Pratt, 2016). The difference between deferred fixed annuity and annuity with long-term care is that the former is not wholly designed for long-term care expenses. Deferred fixed annuity can be utilized for other purposes and cannot mature until an individual approaches retirement age. The most comprehensive benefit of annuity hybrids aligns with the fact that it can be used for long-term care without attracting any tax deductions. In addition, annuity hybrids entail medical underwritings that are not stringent when compared with long-term care insurance. This is evident by the fact that annuities have freedom that allow the beneficiaries to redeem accumulated annuities.
Families who are not in a position to afford long-term care insurance can also take convalescent insurance. Speaking of convalescent insurance, this connotes to short-term care insurance that allow policy holders a certain amount of long-term care coverage for a particular number of days. In most cases, convalescent insurance provides between fifty to three hundred dollars on a daily basis of long-term care insurance for 180 days to one year. The advantage that comes with this form of insurance is that its premiums are often reduced when compared to the premiums charged by conventional long-term care insurance. Another advantage of this kind of insurance is that benefit claims are initiated immediately and have no waiting periods. The only disadvantage with this alternative insurance is that it offers a short-term solution, which may not be cater fully for long-term care expenses.
Self-Insured Group Health Plans
Another alternative resolution to the issue of unaffordable long-term care expenses is through the use of self-insured group health plans. While much has been hypothesized regarding self-insured group health plans, it is important to point out the fact that they refer to health plans whereby an employer provides insurance to its employees. In self-insured group health insurance, the employer takes the full financial risk of offering health care remunerations to its employees. Self-insured group health covers are often confused with full-insurance plans. The two are different in the fact that self-insured group covers exist when employers set aside funds from employees contribution and from the corporation (Pratt, 2016). These funds are then used to pay for claims incurred by the employees. This alternative has been fundamental for various populations who may not be able to afford long-term insurance expenses. Statistics drawn from...
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