Bootstraps for middle-aged children

January 03, 1996|By Ellen Goodman

BOSTON -- This one is for Priscilla Parten, the Derry, N.H., woman who had the temerity to ask Lamar Alexander who would care for the elderly if the budget is cut according to the GOP pattern.

The answer from the presidential candidate, one of the men hawking their wares across New Hampshire was that ''We're going to have to accept more personal responsibility in our own families for reading to our children and caring for our parents, and that's going to be inconvenient and difficult.''

Happy New Year, Priscilla and open up your calendar. Scribble down two rather large words under 1996: Personal Responsibility. They're going to be the watchwords of the 1996 campaign.

Personal Responsibility is the catchall moral phrase uttered by politicians in favor of removing the guaranteed safety net and parceling the money out in incredibly shrinking block grants to the states. It's the all-purpose ethical disclaimer for those who equate the task of caring for the elderly sick with ''reading to children,'' for those who blithely describe eldercare as ''inconvenient'' or ''difficult,'' but character-building.

To know what they have in mind, get past the P.R. campaign and go to the fine print of the GOP's Medicaid Transformation Act of 1995. That's the Orwellian title for the bill that would ''transform'' Medicaid by eliminating its guarantee.

From the day Medicaid is block-granted, adult children earning more than the national median income -- that's $31,000 a year per household -- may be held responsible for the bill if their parents are in a nursing home. If they don't pay up, these newly defined Deadbeat Kids may find a lien put on their incomes, their houses, their savings.

A secret of the current system is that Medicaid, the health program established for the poor and their children, now pays for percent of nursing-home care. That's because nursing care eats up the assets of elders at a rate of about $35,000 a year until they are indigent.

Not surprisingly, the folks calling for Personal Responsibility draw on examples of personal irresponsibility to justify a change that is beginning to make middle-class eyes widen. They point to elderly millionaires who deliberately transfer their assets to the kids in order to go on the dole in nursing homes. They describe deadbeat kids who callously drop their parents at the government door and go off to the Bahamas.

The ones who will suffer

But if and when states begin sending bills to the kids, those folks aren't the ones who'll suffer. Thousands of middle-aged ''children'' of the 3 million elders in nursing homes may have to pay for their parents out of their children's education fund and their own retirement savings. Adult children, perhaps elders themselves, may have to choose between nursing sick parents at home or emptying the bank.

How neglectful are we, anyway? Despite the bad P.R. we are getting, families do not by and large look to nursing homes for their parents until they are overwhelmed. Elders do not, by and large, go there until they are too ill to be cared for at home. Only one-fifth of the disabled elderly are in nursing homes.

Daughters and daughters-in-law provide most of the care of elders and they will shoulder the increased Personal Responsibility at the cost of their jobs, their pensions, their own old age. The daughter of a disabled 88-year-old may, after all, be 66 herself. It is their characters that will be built on deteriorating lives. One politician's social issue is another woman's life.

There is enough guilt in every family to trip the responsibility wire, to push the button that says families should take care of their own. As a political slogan, P.R. passes what Dan Yankelovich calls the ''they have a point'' test.

But there is an awful lot of Personal Responsibility going around already. As educational loans are cut we are told to be responsible for our own children. As company pensions are fading, we are told to be responsible for our own retirement. At the same time we are to be responsible for disabled parents and even grandparents.

Dear Priscilla, when the politicians up there start talking about Personal Responsibility, they mean our responsibility, not theirs. The GOP Congress isn't just trying to balance the budget. They want to end the idea of government as an agent of mutual responsibility.

This is what you get in return for a safety net: a pair of bootstraps, a middle-class tax cut of less than a dollar a day and, oh yes, a nursing-home bill of $35,000 a year.

Ellen Goodman is a syndicated columnist.

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