On PBS:'Who Pays for Mom and Dad?'


April 30, 1991|By Michael Hill

THE ESSENTIAL question asked by tonight's edition of the PBS documentary series "Frontline" is whether Harley Gordon is a good guy or a bad guy.

That the correct answer is "neither" and "both" is compelling evidence that the country has not come to grips with how to pay the enormous costs of taking care of its elderly population. "Who Pays for Mom and Dad?" will be on Maryland Public Television, channels 22 and 67, at 9 o'clock.

Chances are you haven't heard of Harley Gordon. He's a Boston lawyer who has carved out a nice little niche for himself in what this documentary describes as "elder law," a fast-growing specialty.

Gordon is shown conducting a seminar on his specialty, selling his book and recruiting potential clients after his speech. The theme of his talk was simple: Here's how you can get the government to pay for your nursing-home care instead of paying for it yourself.

It has to do with that pejorative term "loopholes." Gordon and his colleagues train people to jump through them.

Economic commentator Jane Bryant Quinn gives a predictable and supportable response to Gordon's message -- he is shifting the burden of nursing-home costs from the well-off people who can afford to pay for it to the backs of the already strapped taxpayers.

But the people profiled in "Who Pays for Mom and Dad?" don't come across as rich tax dodgers eager to feed at the government trough. They look like ordinary taxpaying Americans who have come face-to-face with a concept that will undoubtedly become better and better known over the coming decades -- spending down.

That refers to the federal requirement that a person have only $2,000 in assets before the government will pay for nursing-home care under the Medicaid program -- designed to assist poor people -- not the Medicare program which covers health care for the elderly.

So, say you and your spouse have worked all your lives, have a little pension and Social Security, paid for the house and have saved about $50,000 to support you in your old age, hoping to have a little to leave to your kids.

Well, if both members of the family have to go into a nursing home, "Who Will Pay for Mom and Dad?" shows that it probably will take less than a year to wipe out those assets to the point that the government would start picking up the tab. For the average American couple, it takes 20 weeks to reach the Medicaid poverty level.

Gordon shows people how they can shelter their money with children and trusts so that nursing care will not wipe them out. Is that so bad?

But, as Rep. Henry Waxman of California points out, Medicaid was never designed for this. It was supposed to take care of poor people, and every dollar that people shelter from their nursing-home payment is one less dollar for low-income women seeking pre-natal care.

Still, it seems that if the purpose of Medicare was to take care of poor people, it shouldn't be set up to require people to become poor. And often that means not only the person in the nursing home, but a spouse who watches savings dwindle and loses pension and Social Security checks that now go straight to the nursing home.

So should the government start paying for everybody's nursing-home coverage, even those who could afford to pay their bills? That hardly seems fair, and it hardly seems likely since it would cost tens of billions of dollars a year for a deficit-ridden government in the hands of people who aren't about to raise taxes.

Moreover, if the government started paying for nursing homes, would amoral kids start sticking their parents in them just to remove a financial burden while protecting their potential inheritance?

You meet a few people during this hour, families with spouses and parents struggling with Alzheimer's and age, dealing with the guilt and pain that go along with putting someone in a nursing home. At the same time, these people are facing the fact that once the long-term-care vacuum cleaner is hooked up, a lifetime of savings can be sucked up in a matter of days.

The private sector has, of course, moved in with insurance that pays for nursing-home costs if that becomes necessary. The costs, availability and fine print make this a murky and potentially dangerous area.

But it does raise possibilities. Should there be national insurance for this? Should these costs come under Medicare or even Social Security -- the original plan to avoid poverty for our nation's elderly -- instead of Medicaid? Should we bother to protect the middle class?

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