Pepper Commission Report: Hearing Before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, One Hundred First Congress, Second Session on Recommendations of the Pepper Commission Regarding a Public Program for Long-term Care Services, June 14, 1990, Part 2

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Page 89 - Instead, benefits are often triggered based on the need for assistance in personal care functions such as bathing, walking, and dressing. In addition, they provide inflation protection against future long-term care costs. We will see a continued trend toward more comprehensive and liberal benefit provisions as the market place becomes, more competitive. The recent introduction of employer-sponsored plans is particularly promising. These employee pay-all plans offer the opportunity to reach a large...
Page 91 - Given today's fiscal realities and competing national priorities, we cannot expect the public sector to continue to take on such an enormous and unwieldy financial responsibility. Instead, HIAA believes that public policy should be targeted toward finding ways to more effectively use the private resources already being spent for this care, thereby reducing future public long term care expenditures. Those who can afford to protect themselves should be encouraged to do so. It is not the role of government...
Page 89 - More importantly, the products themselves are changing. The earlier products tended to be more limited. For instance, they covered only stays in a nursing home and then only following a hospital stay. But virtually all the newer products offer coverage of nursing home and home health care, without institutional gatekeeping mechanisms like prior hospitalizations.
Page 103 - Bower's 1986 report on catastrophic illness which called for a $100 credit toward the purchase of long-term care insurance. Although a nominal amount, the report concluded that the educational effects of such a credit far outweighed its monetary value by educating consumers about an important issue and as a result, would help to change attitudes as well. The LifePlans analysis indicates that a 10 percent premium subsidy, which on average approximates a $100 credit, would cost about $174 million....
Page 171 - ... risk. Public opinion surveys show widespread public support for using the Social Security wage tax to fund long-term care, even by those individuals who would be paying the higher tax. Those considerations must be weighed against future projections for solvency of the Medicare Trust Fund, however. Social Security taxes could be augmented by other taxes, such as the surtax on gifts or inheritance transfers. We suggest consideration of a sliding scale on all such income transfers, with no exclusions....
Page 19 - Burdensome cost-sharing requirements (eg, burdensome deductibles and coinsurance) should be avoided because they disproportionately affect the sick and the poor. The public, through the federal and state governments, should subsidize the cost of health care coverage for individuals with lower incomes and should fully finance health care coverage for the poor. Any financing method should preserve the dignity of the individual, regardless of his or her income level.
Page 129 - Policyholders who drop their policy, perhaps to buy a better policy, are typically out of luck. We believe that policyholders who drop their policy after a certain amount of years of paying premiums should be eligible for some sort of compensation (eg . a cash refund or a reduced benefit) , since early year premiums are used to subsidize later year risks. The private market is not well suited to insuring the longterm care needs of people under age 65.
Page 87 - All elements of society ~ individuals, families, volunteer organizations, employers, and insurers must also play a vital role. o There is a growing and critical role for private insurance to provide a better means of financing longterm care for those who can afford to protect themselves . o There is a continued and indeed, greatly improved role, the government can play in financing long-term care for those without adequate resources to protect themselves. o There continues to be a critical government...
Page 147 - It reinforces and supplements the care provided by family members and friends and maintains the recipient's dignity and independence, qualities that are all too often lost in even the best institutions.

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