Catastrophic Health Insurance: The Pennsylvania Perspective : Hearing Before the Subcommittee on Health and Long-Term Care of the Select Committee on Aging, House of Representatives, One Hundredth Congress, First Session, April 10, 1987, Philadelphia, PA.

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Page 38 - The individual need and the family need have been stated in broad terms, being focused on personal and family strain. Multigenerational involvement is integral to continuity of care. There is general agreement that the societal response to the needs of the individual and the family for continuity of care has been inappropriate and inadequate. The policy response, whether in the private or public sector, has been consistent with previous reactions to human catastrophe. The concern is with economic,...
Page 5 - What am I going to do? How am I going to take care of a small child?
Page 37 - Min DeParle, JD,* is a senior advisor to JPMorgan Partners, LLC, and adjunct professor of health care systems at the Wharton School of the University of Pennsylvania. From 1997 to 2000, she served as administrator of the Health Care Financing Administration (HCFA), now the Centers for Medicare and Medicaid Services (CMS).
Page 37 - What is still needed is legislation that will truly provide the elderly and their families with the "last full measure of security" against the risk of catastrophic long-term care.
Page 17 - These services include skilled nursing, physical therapy, occupational therapy, speech therapy, medical social services and home health aides.
Page 38 - ADL deficiencies. They were the ones who used onethird of all informal and paid assistance and spent more than half of the total outof-pocket expenditures. Furthermore...
Page 37 - Despite extensive data to the contrary, the elderly and their families deny the probability of disability as a normative problem to be anticipated and insured against. In this avoidance of the problem, they are joined by the insurance industry and Government who regard long-term care as a bottomless economic pit.
Page 38 - ... long-term care. Whether we are confronting an Amyotrophic Lateral Sclerosis patient or an Alzheimer's patient, the remaining assets, whether mental or physical, must be actively maintained and conserved as well as maximized. There should be as much concern for the will to live as for the living will. Repeatedly the need for continuity of care has been called a catastrophic need based on both the individual's and family's involvement in long-term care. Indeed, the family invented long-term care.
Page 38 - This 5% may be objectively designated as at-risk of economic catastrophe for the long-term care sector of continuity of care services. That figure is much lower than the 9% of Medicare beneficiaries who are at catastrophic risk for acute care and who use 70% of all Medicare expenditures. As each successive cohort of older people evidences an improved level of functioning, even in advanced old age, this is a manageable societal risk. Should the requirement of five deficits be deemed too harsh, Congress...
Page 37 - New data suggest that long-term care has definable dimensions and that calibrating the need for services in terms of ADL would provide the framework needed to define the insurable risk. It is not a bottomless pit.

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