Life Happens

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Episode Transcript

(00:01):
Welcome to Life Happens Radio with attorneysfrom Pierre O'Connor and Strauss, every Saturday
at eleven am on News Radio eightten and one O three one WGY.
Good morning, everyone, and welcomethe Life Happens Radio, your weekly radio
broadcast that brings you ideas, informationand thoughts to help you successfully navigate through

(00:22):
life, aging as a lifestyle,looking at retirement, planning for retirement,
planning for college education. Last weekwe had doctor Dean Scarletts with us talking
about college and putting out some veryvery useful and interesting information. And today
we're going to flip that and weactually are going to bring you some college
students. So what does long termcare mean to a college student? And

(00:48):
I think the answer for most Andwe have three of his students with us
here today that have done the researchand presented the report and al welcome to
the show. Thanks, thanks somuch, Lou. It's a great privilege
to be here with you again inthe program, and especially to have these
brilliant young students here with us today. And I'm fascinated because you know,
I'm not getting any younger, You'renot getting any younger. And we've been

(01:11):
kicking this can for thirty years talkingabout long term care and how the government
just has not recognized and acknowledged andin fact has run the other way in
many respects when it comes to Medicareand the services that are available to people
for long term care. But howdid this come about that it began you
began teaching and got this into thecurriculum. Well, you know, the

(01:34):
course that the students participated in ais a course called the Health Health Systems,
and within that we analyze every partof the health care system and every
sector. So these students selected thelong term care sector as a sector to
analyze present issues, identifying challenges andneeds, and then also to present solutions

(01:56):
with it. And really I wasI was amazed in the presentation because not
only did it really cover the sectorso comprehensively, but what really their reaction
and presenting the information is this issuch important information. This is the first
time that we really understood these kindof gaps exist in the system. This
is fundamental. Why aren't young peoplelearning about this all the way through?

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And when they said that, LouYou're one of the first people I thought
about, because the idea of publiceducation is so often slanted toward people when
they need the services, not atan early age where they might contemplate on
what might be available. And Ithink most kids, you know, my
kids learned about this because their grandparentsneeded long term care. And I think

(02:42):
most kids learned about it because grandma'sin the hospital and she's got to go
to the nursing home and mom anddead are afraid she's going to lose all
of her money in her house andhow do you protect all those things?
And that first awakening comes in crisis, and you're so right about that.
So this is something that should bean issue, and we talk about it
all the time, but there's sucha small pool of people, the same
people we've been talking to for thirtyyears, that talk about this, and

(03:05):
it just hasn't permeated the general population. So this is so important to get
it out there at the educational levelin college and in the public health program.
So thank you for doing that.Do you want to introduce our students
here this morning? Yes, absolutely, and thank you. So we have
Sue Young Yun, We have HopeWalker and Abamel Morrero who are with us

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today who've done this research and it'svery comprehensive. They've analyzed the workforce issues,
the cost of care, gaps incoverage, a comparative analysis between European
countries and the United States in termsof the relative proportional investment, and long
term care, particularly homely community basedcare. So I think each one can

(03:47):
speak to a point of that.Yeah, I think we all know who
spends the most money and gets theleast result, and that's probably US.
So let's start with you, SueJun. What was your first impression when
when you started to look at theseissues of long term care? UM,
So, when I was exploring theglobal health comparison when it comes to long

(04:10):
term care, UM, United States. Obviously, we promote our country as
like one of the best in medicalcare. Yeah, and so you know,
I expected, um, you know, data set that reflects that that
idea that the United States is oneof the most developed countries in a medical
field. But um, you know, comparing the GDP and UM, you

(04:34):
know, the overall comparison to othercountries, I realized that there are a
lot of UM populations that go ona notice and maybe like they're maybe kicked
off of the long term care leaderon because they can't financially afford it.
And I think that's concerning given thatthe elder population is rising exponentially, um,

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you know, almost every year,and so we're looking at lack of
investment and how that kind of negativelyaffects the senior population. And I personally
come from a neighborhood with a lotof senior population. I mean, my
next door neighbor is a senior,and my downstairs neighbors are all seniors,
and they do require and they doneed these long term care of facilities to

(05:18):
do the work for them so thatthey can live a quality life. But
I think especially in those neighborhoods thatare you know, like economically devastated and
they don't receive a lot of fundingfrom these state and local governments, like
those senior populations, they suffer fromtheir chronic illnesses because they can't afford the

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proper treatment for those Sure, andI hate to tell you, kids,
but Al and I are going toage out and we'll be long gone when
this really hits home. And thisis going to shape the demographics of America.
We've been studying it for forty plusyears and people have been doing it
longer than that. But the issueis the numbers. The number of baby
boomers aging out on a daily basisten thousand a day turned sixty five,

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and now the front edge of thebaby boom wave is about seventy four.
And behind that you have Gen Xwith almost as many people who are going
to come through right behind the boomers. And so you have forty or fifty
years of a swelling population, andnot just over sixty five. It says,
oh, the over sixty five populationis growing. The over eighty five

(06:24):
population is growing faster on a percentagebasis than the over sixty five population because
of medical science and the things thatare happening there. And Hope, let's
turn to you. What was yourperception of this when you got involved.
I would say that my perception ofthis was I expected the solutions to be

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very difficult to find. I thoughtthat maybe it would take a lot more
studying than just coming up with somethingsimple in order to solve the economic problem
per se. But really it justcomes down to insurance and what New York
State is willing to do for theaging population. Yeah, and it's more
complicated than that because the federal governmentright puts a lot of the dollars into

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this through the Medicare program and fiftypercent of the Medicaid program. So did
you look at the confluence of governmentforces, especially in New York where you
have not only the state, notonly the Feds, but counties participating in
the cost of all of this,and the taxpayer footing the bill for all
of this, and just the disjointedprogram. Did you did you look at
the different funding streams. Yes,we did look at where the money is

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coming from, but we looked atit in a sense of if a majority
of the people are on Medicaid programs, Medicaid as a managed care plan,
so in New York State, theyautomatically have a set of resources that they
have to supply to someone that's onMedicaid, and if you add long term

(07:54):
care into that, then it's alreadycovered in a sense, there's no need
for necessarily extra funding, maybe justreallocation of funds in order to bring long
term care into that set. Toframe this out for our listeners, and
I've heard you give this definition,so what is long term care? So

(08:15):
long term care really covers the entirespectrum of services that would be associated with
a chronic illness, A disability oftenjust the need for support and what are
called the activities of daily living,eating, dressing, toileting, bathing,
things of that, nate transferring serviceslike that. So long term care is

(08:39):
really situated to try to cover andsupport an individual across that spectrum of need.
And we go back. Nineteen sixtyfive was a seminal year in this
area because that's when Medicare and Medicaidwere both enacted by President Johnson. But
then we had things happen over time, the Olmstead decision, where the government
recognized that people deserve to be takencare of not in facilities, but in

(09:03):
their most independent setting, which formost people is their home. So people,
when I mentioned long term care,oh, the nursing home, I
don't want to go to the well. That's a very small sliver of long
term care. And most long termcare is provided in the home, and
most long term care is provided informally, yes, by children, by spouses,
by other family members before you getto the formal long term care system.

(09:26):
But let's let's turn over to abbamail. And you're going to be going
to med school, understand, Okay, So as a med student and coming
into medical the medical field. Ican tell you that your intology is not
the most popular choice when you goto med school. But how are you
viewing these issues as a rising physician, Well, that's a rising physician also

(09:48):
on a publico advocate. I believeone of the main problems is the lack
of information, Like people are gettinginterested in long term care and basically in
their sixties seventies, where chronic illnessesare starting to arrive on them, and
this is too late. I believewe have the means to provide more information.
Maybe they can see they have optionsto find a long term care insurance

(10:13):
that covers their needs in their turreties, in their forties, where they may
be paying half the premium that theywill be paying in their sixties, in
their seventies, when they're just startingto now look at these options, and
it would be too late if theycan prevent this and then already start to
looking into whole life insurance term insurancethat covers their specifical needs, because everybody

(10:35):
believes there won't have the necessity tobe in the nursing home. Yeah,
I can cover my needs in myhome, but there are certain tasks that
you may need. This all daycare, and you will find yourself in
the position to be in a nursingcare nursing care home. Were you shocked
at the cost of care when whenyou look at it, yes, very

(10:56):
so it startles people unless you're init and you're paying that thirty five dollars
an hour for home health aide andthat's the private pay rate for many home
health agencies. What did you seein our healthcare system? And I call
it an oxymoron the US healthcare system? But what did you see when you
started looking at our country in termsof how we pay for care and coordinate

(11:18):
care versus how it's done in othercountries? Who wants to take that one?
I can take that one, allright? So I did well.
Initially. I began with the GDPshare on long term care comparison by some
countries in Europe versus the United States, So the Netherlands and Norway their GDP

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share was around three point seven tothree point three percent on long term care
versus the United States at just pointfive percent. And while these European countries
they've kind of expanded their at homelong term care programs to make sure that
the seniors are receiving proper care.We've actually reduced cut down on the spending

(12:01):
and the investment on that. Soas a result, more and more senior
population have moved from proactive care toreactive care. What I mean by that
is instead of trying to prevent diseasesearly on through education as Ebmail mentioned,
and you know, insurance coverage andkind of promoting this idea to the general
public that these chronic diseases can beprevented and when you arrive at that point

(12:26):
where you are diagnosed with the chronicdisease, you can be treated at home
comfortably with healthcare professionals. But becauseof this reduction and funding, more and
more seniors they can't you attend totheir regular checkups, they can't attend these
proactive measures. So as a result, their illnesses kind of developed on and

(12:48):
on until they really need like asevere surgical intervention, intervention or be hospitalized.
And now not only the cost hasyou know, increased exponentially, but
their quality of life has also decreasedas a result. Absolutely, And you
talked about the lack of education andthe lack of information, I would flip

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it. I'm a fished cynical person. There is misinformation and disinformation about long
term care, and that bears itselfout in studies that AARP does Every two
years, they do a survey ofseniors and they ask seniors, if you
need long term care, how willit get paid for? And the percentage
of people that say Medicare is sixtyto seventy percent of seniors believe that Medicare

(13:35):
is going to cover their long termcare. Does your research show that it
does? No, it actually knowMedicare coun covered term that's actually lie.
I'll limited amounts of nights, butafter that, after this you'll diverse in
that's covering this cost. That's right. Now we're gonna talk about long term
care insurance. We're going to talkabout the shift to home healthcare and the

(13:56):
elephant in the room and now thisis your issue, and that is the
shortage of workers available to provide servicesto people we faces. I'm an elder
law attorney and we work with clientsevery day who are desperate to find that
care. We're going to take ashort break, but when we're going to
come back. When we come back, we're going to talk to these brilliant
students and Alcardalo about their perception theirstudy in what they think. We make

(14:20):
people to do about it. Sostay with us. You're listening to Life
Happens Radio every Saturday morning at eleveno'clock on Talk Radio WGY. We'll be
right back. Do you own abusiness or are you thinking of starting one?
Hello? I'm attorney Teresa Skin.For over two decades, I've worked
with business owners and their companies toform corporations, partnerships or limited liability companies,

(14:43):
draft business agreements, reduce risk andresolve conflicts, and structure business sales
or transfers. At Pierre O'Connor andStrauss, we can help grow your company
and plan for its success and succession. Visit us at PIERO Law dot com.
Life Happens, Be prepared. Hello, Life Happens listeners. We host

(15:05):
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Sign up to learn more at pierolawdot com slash events. That's p
I E r r O Law dotcom slash events. And we're bad.

(15:33):
Well, how back the Life Happensfolks. I'm Luke here are your host
for today and we have some veryvery special guests with me. And this
is a this is a fascinating show. Something different for life happens. We're
fortunate to have Al Kardillo, thedirector of the Homecare Association of New York,
also a professor at the Albany Collegeof Pharmacy Public Health Program, and
he's brought with him three of fourstudents. And we're gonna give a shout

(15:54):
out right now out to the studentwho didn't make it today, Kaylee Stewart.
She's not with us today because she'sacts was selected to give a presentation
at Emory University. So Kayley,we're rooting for you. And it's an
issue, folks, that we talkabout on this show all the time.
It's an issue that in our elderlaw practice at Pierre O'Connor and Strauss,
we work with clients on every day. But what you don't typically see is

(16:15):
academia taking this on in a waythat it's done here, with students going
out and researching the issues of longterm care and the findings. And I
can see in their eyes when Iasked them a question, did you expect
that it would be that expensive?That there's a shock factor when you start
looking at this and people are justanesthetized to this issue because they don't want

(16:37):
to think about at number one,it's your own morbidity. You never want
to think about your own morbidity ormortality. But they're also told that Medicare
is going to cover it. Andso we have long term care insurance and
Ababel you were talking about that earlierthat's available to people. We have someone
that we have on the show thatwe used to co host with, Brian
Johnson, who is with Advisors insurancebrokers, and because his father owned an

(17:00):
insurance long term care insurance agency andhe sold long term care insurance, he
bought his policy at age I thinktwenty eight and he's paying a thousand dollars.
He started out paying a thousand maybeit's two thousand now for a ridiculously
comprehensive policy and that's his premium goingforward. So when you start to buy
this insurance at age sixty, sixtyfive, seventy, now you're talking about

(17:21):
five, eight, ten thousand dollarsa year in premium as opposed to being
able to work it into your workingbudget. So when we look at all
of these issues, we bring itback down to your grandma's house, and
grandma needs a home healthy and yourparents start picking up the phone and calling
home health agencies and they're short ofstaff, so they can't staff the case.

(17:45):
And then your parents start saying,okay, so if we can't get
it through a home health agency,where are we going to find care?
So then they start looking online andthere'scare dot com, and there's all these
sites that have now grown up wherepeople put their names in, and but
you don't know who those people are, and it's kind of unregulated. It's
black market of home healthcare. Andthen they asked their neighbor, oh,

(18:06):
I heard somebody across town just diedand their aids are now available, so
maybe you can get one of themto come in. And it comes down
to that kind of a dilemma thatpeople face. So now, the wage
gap between real work and real wagesand what they perceive as home healthcare and
just stilted wages is something that's beendebated and is one of the budget issues

(18:29):
right now being debated right here inall ways. It is, yes,
the way the wage is a reallycritical issue. Last year there was a
major movement to try to increase thewage levels for individuals who work as home
health aids in the system. Andthat was supposed to be implemented as a
two phase initiative. One increased lastfall, another increase this coming fall.

(18:52):
And even as those are pending,there is discussion about trying to lift the
wages even further. One of thedilemmas is because going back to what you
were saying, Medicaid is such aprimary payer. Anything that you do that
increases of financial support, such asin the wages, goes toward our ninety
four billion dollars medicaid budget. Youknow. So we have a ninety four

(19:15):
billion dollars proposed budget out of atwo hundred and twenty seven billion proposed budget,
so Medicaid is over forty percent ofthe total budget. Really, what
it speaks to is that there needsto be a more structural correction of the
system. And it was clear inthe student's research they were finding it with
the workforce, with the coverages,with a gap between Medicare and Medicaid and

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so on. So let's turn itover to them who wants to take that
issue on and talk about it alittle bit. I will, all right.
So, what we saw during COVID, especially when the pandemic was faked,
was an exorbitant amount of home healthAIDS or healthcare members leaving their jobs,

(20:00):
and a lot of people want tostrictly blame this on COVID, on
burnout, on whatever, when thefact of it is they're not being paid
for the work that they're doing.They're not only like giving out medications and
just checking on Grandma. They're spendingtheir entire day they're there and making relationships
and feeding people and get them upand then taking them to the bathroom.

(20:22):
And let's face it, it's it'snot pretty work, it's not easy work.
It's a labor of love. Theysit home for me during during the
pandemic because everybody was short of employees. And I was driving somewhere and I
stopped in front of a Burger kingand I looked up at the sign and
I said, eighteen dollars an hourto flip a burger When the people that

(20:45):
were taking care of human beings ona day to day basis and providing them
with human care and all the needsthat they have were getting. We're making
at that point, I think fourteendollars an hour, and that's the wage
gap. So if you had achoice, hope between flipping a burger and
being hands on caregiver for somebody fromeight hours. What are you going to
do? I'm honestly, I'm goingto choose working at burger king when there's

(21:07):
an honest answer, when there's ajob that's going to pay me a livable
wage and give me the benefits,versus maybe doing something that I really truly
care about but not being able tolive off of that, I'm going to
choose what I need to do,which is make money. So how do
we fix this problem? I mean, that's a big question. We'll get
into that in the rest of theshow. But in addition to the worker

(21:32):
shortage, we have a finance shortage, and we have a disparate system that
just doesn't coordinate any of the financingstreams. And we worked on a program
out twenty some years ago called aCompact for Long Term Care, which was
designed to do just that. Youget a private insurance, you get a
public insurance, you could use Medicaid, you could use your own money,

(21:53):
and you could put it towards thecost of care, just for long term
care. That didn't get any play, And did you look at politics and
how it impacts this at all?In the system I would say we tried
to strictly focus on the problem athand and an easy solution to it because

(22:14):
of how messy politics does get.But politics obviously placed into everything. You
meet a lobbyist, yet I knowAl's a lobbyist very well. And it's
it's like a feeding frenzy and you'vegot a limited amount of corn in the
trough and everybody wants to get theirnose in and get their money out of

(22:37):
the trough. And that's how politicshelp shape policy. And unfortunately, what
I've found is the government's cycles areso short now, they're one year cycles
that you can't say, oh,we have a five year plan or we
have a ten year plan. Thefive year plan is gone in a year.
You know, Governor Cuomo had aplan, a plan on aging and
it died with COVID. And Iwas on a Governor's task for us on

(23:00):
long term carey form in nineteen ninetysix and we had a plan that was
supposed to last ten years. Itlasted about six months. It never got
picked up. And politics is wherethe money comes from from Medicare and medicaid,
and it doesn't really hit the streetwhere it needs to hit. Loud
to your point. In this year'sbudget, recognizing that there's a crisis in
hospitals and nursing homes and other locations, the governor proposed a five percent increase

(23:23):
in the rates and the legislature hasproposed a ten percent increase on top of
that. Getchwas sector is left outof that increase, the home health sector.
So going to the points that everybody'sbeen making at the table about wages
and about support in the system,if you're going to if you've already got
issues of competition and wage pressure,and you're going to increase the funding substantially

(23:48):
to the facility based sectors, whichthey need, you can't omit the home
care sector from that same equation.We've been trying to get the legislature to
respond and to add those funds tothe budget, and also the governor to
support that. And that's you know, that's because there is no big money
behind it, and that's what getsyour seat at the table in the political

(24:11):
world. It's families that are strugglingmightily, and there should be a families
union. I mean, the familiesshould unionize themselves and band together in this
policy. So we now have amaster plan on aging for New York Governor
Hockles. Senator Jilibrand just announced hermaster plan on aging for the federal government.
A lot of master plans and albameo, how do you see them looking

(24:34):
at this comprehensively. Is insurance evengiven the respect and the credence that it
should be given in this discussion.I don't. I don't. I don't
think so anybody else. And ifyou had to go out and buy a
policy today, would you buy longterm care insurance? So I don't.

(24:56):
For stars, I don't think there'san offer information for us to buy a
policy, go out and baas.There's certainly a lot of vendors torn to
send those ballassies, those whole lifeinsurers. But I believe there's very little
information about how we can benefit inour twenties and maybe onaris to get a
long term curve insurance. And Iknow you look at other countries and we're

(25:21):
gonna have to take a break,but when we come back, social insurance
is something that has been discussed inthis country. Medicare back then, it
was a Medicare part forget D thatwas going to be a long term care
program. The Class Act. Wehad as a social insurance program, and
none of them have been able tostick because they haven't been able to work
the finances. And that's where wefall down. But other countries have and

(25:41):
we're gonna come back and talk aboutthat. And we're very fortunate today,
folks, to have with us somestudents from Albany College of Pharmacy, School
of Public Health and al Cardillo theirteacher, and we're talking about long term
care from a student's perspective. They'vedone the research. We're gonna lay it
out for you in the second halfof the show, So stay with us.
As always, you're listening to LifeHappens on Saturday morning at eleven here

(26:02):
on talk Radio WGY. We'll beright back after the news WGY News.
I'm Pauline lu. Police and fireofficials in the city of Schenectady are continuing
to investigate a major fire at amulti family house on then Vrankin Avenue yesterday
that left nineteen people homeless. TheRed Cross is stepped in to help the

(26:26):
families with shelter, food, andclothing. Officials say the fire is being
investigated as a possible arson. Aninvestigation is also continuing into the cause of
a fatal fire in Renstler County.One person is dead and four homes were
damaged or destroyed at the Hanley MotorHome Park on Columbia Turnpike in the East
Greenbush Thursday. The name of theindividual hasn't been released yet. A new

(26:49):
poll shows many New Yorkers are planningto leave the state. Scott Pringle reports
as Siena College survey shows twenty sevenpercent saying they'll leave New York within the
next five years. Poster Don Levythat sentiment that doesn't mean they're packing their
bags, but it's certainly something thatpolicymakers need to take a look at,
because that level of exodus would havea dramatic effect on the economic vitality of

(27:14):
the state. He says. Sixtyseven percent say the state is not affordable,
but one third say it's not aplace they can afford to retire,
and about half of respondence rate NewYork is fair or poor when it comes
to safety. Scott Pringle News Radioeight ten and one h three one WGY
Opposition to New York City's pushed toput a casino in Times Square is growing.
Natalie Migliori has more the Broadway Leagueis one of fourteen local groups that

(27:38):
are part of the No Time SquareCasino coalition. We are not opposed to
a casino in the city of NewYork or down state as they call it.
We just don't believe the right locationis Times Square. Broadway League president
Charlotte Saint Martin says Time Square isalready packed. The last thing we need
is more congestion in Times Square.Officials have previously said they want part of

(28:03):
the money from a casino in NewYork City wherever it goes, to go
towards funding the MTA. I'm PaulineLow News Radio eight ten and one oh
three one WGY, the Capitol region'sbreaking news, traffic and weather station.

(28:30):
The good old days when sixty fourwas old. You guys know this song,
the Beatles song Will You Still NeedMe? Will You'll Still Feed Me?
When I'm sixty four? That waswritten back in nineteen sixty five about
when Medicare and Medicaid were passed,and back then people died a lot younger.
So we have a population issue thatis going to shape this country's economics.

(28:53):
It's going to shape our GDP,it's going to shape our workforce.
For the next fifty plus years.And we have with us in studio today,
three students studying these issues and studyingthem our country. What's being done
in other countries? Where do weget it right and where do we get
it wrong? And let's start outwith you, Sueyan, and you're the

(29:17):
international side of the research here,and you've done studies on other countries.
What strikes you about our population,how we're handling it versus the rest of
the world. I mean, ingeneral, the United States population is huge
compared to other countries that I've lookedat, which are basically you know,
Western Europe countries, Nordic countries andyou know Republic of Korea because I'm from

(29:42):
there. And with the increasing elderpopulation, I am not seeing, you
know, coverage that reflects the increasingpopulation, and the costs of long term
care is like increasing exponentially, andcompared to other countries where they do have
universal healthcare system where people are ableto receive not only reactive and preventative I

(30:07):
mean curative care, they can alsoreceive you know, preventative care and regular
health checkups like personal experience. Igo to a dental office in Germany and
I am in there for about twentyminutes. I don't have you know,
co paid. I don't have topay all of these like you know,
extra extra costs after my care.And it applies the same to the seniors

(30:34):
who need all of these checkups forchronic diseases. And in the United States,
you really do not really have thataccess. You know, a lot
of the populations they are not awareabout what kind of you know, coverage,
the Medicare offers and Medicaid offers.And given the increasing population, the

(30:59):
the coverage the insurance of long termcare isn't really reflecting that too. So
and in our state, the numbersare even more stark because New York is
facing an outmigration of young people,working age people who are paying taxes and
filling the workforce, and a startlinggrowth of our senior population, which is

(31:22):
growing at a much much faster ratetwenty nine percent. I think by twenty
thirty five we're going to increase ourover sixty five population and by three percent
the under sixty five population. SoNew York has a bigger problem than most.
And in looking at these issues,and hope I'm going to come back
to you when you started looking atOh my god, I'm part of this

(31:44):
system. Now, how old doyou hope? I'm twenty two, twenty
two, god bless you so andtwenty two. Looking at the issues of
aging is something probably why our educationalsystem doesn't really focus on it, because
it isn't something that's on the topof mind. Has your perception changed since
you did this study? Absolutely?I would say when I was even a

(32:07):
year ago, when I thought aboutlong term care, I typically thought of
my great grandparents and my grandparents,and thinking of the over sixty five population,
and I'm like, oh, well, they've got money, they can
pay for that, you know.But truly it's best to invest early in
this because currently the only real planI say that in quotations is you're on

(32:31):
Medicare. They pay for a hundreddays maybe right like maximum, and then
you're out of pocket cost until youget to the point where you can't afford
it and you're forced into applying forMedicaid, and at that point you have
lost all of your assets. Alreadyyou're living in a way where you never

(32:53):
thought you would have to because youworked so hard for so many years,
just for the next ten years tobe living on nothing to be bankrupt,
right exactly. In fact, andwhat about the cost. In New York
State, the median cost of ayear of long term care is about one

(33:17):
hundred and fifty thousand dollars, andthat's going up, I can tell you
every year, and it seems likealmost every month. And we're seeing clients
every day that are writing checks tonursing homes for seventeen or eighteen thousand dollars
per month. And I'm no mathematician, but that's over two hundred thousand dollars

(33:37):
a year. And most people don'thave that in savings, right, And
you're not I mean, you're notworking. You've already worked your entire life.
Why are you? Like, whatare you going to do now?
And your three thousand dollars SOL securitybenefit or your two thousand dollars SOL security
benefit isn't going to cover that seventeenthousand dollars nursing home bill, so you're
depleting your assets. Another fact thatthat we also don't see is that the

(33:58):
eight hourish estate of person on thesenursing homes is two and a half years,
So that's roughly more than three hundredthousand dollars. I know a lot
of people that don't have this amount. And this is way before the amount
of time that your your family istaking care of you, before you say
and it is a difficult thing tosay, all right, I wanted to
go to a nursing home. Sothere's uh, this all their costs that

(34:22):
we are also looking at, butthey're there. Maybe your family are costing
them before you do. Yeah.AIRP does studies on that as well.
What an average caregiver child spends peryear in caring for an aging parent.
It's like seventy five hundred dollars outof their paycheck, out of their own
pocket. So it's hitting the generationsall the way down. And how do

(34:45):
they do it in other countries soyoung? How did they solve this problem?
When do they start paying insurance,start their other programs unlike ours where
our public health system requires impoverishment forhealthcare. Well, exploring the insurance policy
specifically in the United States, alot of people are on private insurances given

(35:06):
by their employers. So you know, in European countries you have universal healthcare
system where you can you know,receive coverage from the federal government or um
other you know, public sectors.Uh, you know per se, and
to put this into perspective, theUnited States are economics is very similar and

(35:27):
often compared to a lot of theother you know, Western European countries where
you know, there's there's a lotof spending, there's a lot of earning.
But despite that, only fifteen percentof the United States senior population are
um you know, in the longterm care system, you know, receiving
care, compared to Norway or Sweden, which they're at like twenty eight thirty

(35:47):
three percent, Lithuania at sixty fivepercent of seniors over the age of eighty
being able to receive these care.And the I think the most crucial difference
when it comes to these things isthat the lack of investment from uh,
you know, government officials and otherpoliticians who kind of put this long term

(36:08):
care insurance coverage to the back burnerand they look at other things like military
spending, defense spending, and youknow, even like medical technology. I
mean, the United States we canoffer a lot of medical you know,
new innovative medical technologies and interventions.But despite all of these really great improvements,

(36:29):
we are not addressing the the biggerissue, which is the increasing senior
population and the fact that all ofthem, you know, or most of
them have some sort of condition thatthey want to take care of and they
wanted to take it take care ofit at home, you know, with
their family members, but they can'tdo that because one, they don't have

(36:50):
the access to that information early on. There is lack of public awareness.
I mean I was not aware ofthis, you know, before coming into
college and doing this research. Andalso, um, you know, the
lack of insurance and I mean insurancepolicy itself is like a huge mess in
my opinion here, because you know, let's say you have no idea what

(37:10):
you're doing. You're like, I'meighteen. So let's say I try to
go on to this research hunt oflet's you know, invest on long term
care early on, because I thinkthat's a good idea so that I can
you know, you know, covermy cares later on in life. And
I go onto internet and I,you know, do some digging. There's
just so much information and I don'tknow which one's accurate. I don't know

(37:32):
who to call to ask about myquestions. I don't I don't have any
of these resources or you know,better to say, like, there's a
lot of resources but I don't knowhow to translate them. And I think
that's the that's one of the biggestproblems in the United States is because a
lot of people don't know these terminologies. There's just so much information. When
you try to look into it,you already have you know, first senior

(37:53):
population chronic illnesses that you have totake care of immediately, but you just
don't have to lunch to do that. And the reasons that you just articulated
are the reasons that my profession exists. You would not need an elder law
attorney. There would be no suchthing as elder law if the system worked,
if people could get the answers,if they could get the services that

(38:15):
they needed, if the system work. But we end up being that last
stop on the highway when the crisishits. Some people get foresighted. We
try to educate here on the radioand our seminars and webinars to teach people
to get out in front of this, to do the planning while you're young
enough to do it in an effectiveway. One of the insurance products that

(38:37):
has really grown up and has becomea viable alternative for people at younger ages
is actually life insurance. That nowlinks long term care to it, and
that's actually taking over the market.Traditional long term care insurance has turned down
quite a bit, and you canbuy an insurance policy now that if you
have young children and you die prematurely. Let's face it, insurance is risk

(39:00):
management. So death and disability arethe two risks that you have. And
if you die soon and early,then your college education for your children gets
paid. But if you can lastthroughout that time period and you need chronic
care long term care when you getolder, you can tap that money to
pay for your long term care.So the insurance industry has adjusted. I

(39:20):
don't know if you've looked at anyof those life policies that layer in long
term care benefits, but that's wherethe insurance market is going. And that
allows people at much younger ages toget in because a lot of people,
once you get married, you havechildren, you're going to buy life insurance.
So I think that is the firsttime now that people will get serious
about this. Lou One of thethings, and you were having fun with

(39:43):
it earlier in terms of some sixtyfour you know like that, and I
am yeah. But I think oneof the things that when we look at
the coverage system, and there aresuch fragmentation in our coverages between what Medicare
covers, what Medicaid verse, whatcommercial policies covers. When long term care

(40:04):
insurance is origin available any more compliment, it's it's but I think one of
the things that we are often speakingto is the fact that Medicare the benefits
were established in nineteen sixty five.It's never been modernized to what the changes
have been from nineteen sixty five lifespanand needs to today commer Actually, it

(40:24):
got taken off the rails in nineteenninety seven and the Balanced Budget Act.
I did a paper on it.I have it if it'd like to see
it. But Editcare used to payfor thirty five hours a week of long
term care in home, hands oncare and CHA certified home health acause these
were flourishing because they had a steadypayment, that's true, and they were
integrated into the system. And notonly was it a home healthy, it

(40:46):
was a whole team of people underthat program. You got physical therapy,
you got occupational therapy, you gotour end care all coordinated with your long
term care. And they balanced thebudget. Last time they did it was
President Clinton and New Gangridge. Andpart of what they did was stripped out
home care out of Medicaid. Theytook it and cut the home care budget

(41:06):
in Medicare in half. Yeah,right, Half the agencies in the country
closed in that episode. What theydid was they changed the way services were
reimbursed from pain for the services thatwere provided to simply to giving a bulk
payment over a period of time,which really doesn't cover all of what's needed,
but risk shifting which continues to thisday, and managed long term careacter

(41:27):
but on the commercial side too.The last time there was any meaningful action
and general private health insurance covering homehealth services was in nineteen seventy two.
So here we are. The systemin the world are entirely different from nineteen
sixty five, and Medicare in nineteenseventy two, and commercials. We're gonna
take our last break and then we'regonna come back, and I want to

(41:50):
talk a little bit about the confluenceof healthcare and long term care and why
there are two separate and distinct systemsand how they might be coming together.
So we're gonna come back and talkabout that and how it affects you,
because if you read the paper,and I still have paper paper. I
read it online too, but Ilike the feel of a newspaper. Times

(42:10):
Union does some good stuff, Andin March thirty first they had an article
about the hospitals locally Albany med SaintPeter's having the longest emergency room waiting lines.
And this trickles down all the waythrough the healthcare system because now for
a lot of seniors, they're notgetting the care they need, so they
use the er as their primary careand that just backs up the whole system,

(42:31):
makes it unprofitable. That we've gota real mess there. So we're
gonna come back and tackle that anda lot more. Stay with us.
You're listening to Life Happens Radio onTalk radio WGY. We'll be right back
for this short break. When youhire Pierre O'Connor and Strauss, you get
a team of attorneys with over twohundred and eighty years of experience who counsel
people through all of life's challenges.We help families navigate through the ever changing,

(42:53):
in difficult rules of Medicaid and longterm care. We design plans that
allow our clients to aid with dignityand financial security. It's what we do
every day. Protect your life savingsand get the care you need. At
Pierre connoran Strouse, we deliver peaceof mind, Life Happens. Are you
prepared? Would you like to meetwith our attorneys for your own planning?

(43:19):
We offer free consultations by phone,video conference, and in person. Call
Pierre O'Connor and Strouse at five oneeight four or five nine twenty one hundred,
or visit piero law dot com.Hey Jude, take us a song,

(43:46):
then make it better. Remember toletter you're listening to Life Happens.
We're back and we're talking to threestudents at the School of Public Health at
Albany Pharmacy, College of Pharmacy andAlcardillo, their instructor and the head of

(44:07):
the Home Care Association of New YorkState. We're talking about long term care,
what it means to a college student, how their studies of the long
term care issues have shaped their thinking, and what they think we might be
able to do about it. Andat the close of the last segment,
I talked about healthcare and long termcare, how they don't work together terribly
well, and some things that aremaybe innovating to make them work a little

(44:30):
bit better. But hospitals are wheremost of us receive emergency care. They
are now twenty four hour units whereyou can go and get other kinds of
things, but if it's a seriousissue, you're going to the hospital.
And right now we have long waitinglines to get into an emergency room.
And a lot of the reason wehave those long waiting lines is because of
people who are elderly, who havechronic conditions, who end up in the

(44:54):
er and maybe don't even need tobe there. So when you're looking at
healthcare and health insurance and long termcare and long term care insurance, the
United States has a terribly fragmented system. I'm guessing other countries unify that system
a little bit. Yes, theydo, so, yeah, and so
just tell us about one good exampleof that. So for example, uh,

(45:15):
you know, based on my personalexperience kind of back in South Korea,
you only need to visit the emergencyroom if you are in an emergence
situation. Let's say you suffered daytrauma and you're unconscious. You were brought
in to the hospital's er by theambulance, and by the way the ambulance,

(45:35):
you know, you don't have topay four or five thousand dollars for
that because it's covered under your insurance, and you know, you receive your
emergency care and you are discharged,you know accordingly, you know, compared
to here, because as you mentioned, there is a huge, you know,
fragmentation in the system. The eldersin the United States, they visit

(45:55):
the emergency room because they're frustrated withhow they're being treated with their conditions.
So a mail, you are goingto be a doctor, going to go
to med school. Primary care issomething that is very important to people,
But trying to call your doctor,get them on the phone, it's impossible
today for most people. How doyou see primary care playing into this well,
in my experience, a lot ofdoctors are being accessible to their to

(46:24):
the people that are in need.But a lot of people don't want to
assess the primary care practitioner because theyassociate costs with this, Like right now
I don't need to go to thedoctor, but maybe that doctor knew your
conditions beforehand. You go into ther you can get sent to the right
facility and ear costs a lot.A lot of the services that emergency services

(46:45):
cover are very costly. So ifpeople knew the importance of having that connection
with the primary care practitioner can savethem time as you could potentially save their
life. I'm going to say somethingand want you to react. We don't
have a healthcare system. We havea sick care system. Accurate. What
do you think? I completely agree. I think that primary care is completely

(47:09):
underlooked and education and primary care isvery preventative to people getting sick, and
we tend to focus on if you'resick, we do this, not how
do we prevent you from getting sick? Yeah, and I've seen a shift
to wellness. A lot of insuranceplans offer incentives for wellness, but most
of those are people who are workingin their thirties and forties to stay well,

(47:31):
counter steps, you know, nutritionalguidance, but seniors don't really have
that level of service. One areathat show some promise, I think is
Medicare advantage plans because they've the federalgovernment has loosened up the things that they
can spend money on, and someof it is now wellcare. Did you
look at the developments in Medicare andMedicare advantage From my experience, I say

(47:57):
a lot of the things they arecovered are not really related. Also,
I think they're they're they're getting likeout of the line of what really can
help the person's health because right nowthey're focusing on other things. By Barbara
Shore, covers do your piety ofcovers, and I mean that that that
has a cost, and that costcan be better concentrated in other services that

(48:22):
who potentially really help the pensions thathope One are the things also that's coming
in and came in COVID changed alot of healthcare, and it changed a
lot of insurance plans. And tellthe medicine and technology has become part of
healthcare. It's ingrained. Now tellthe medicine do you see that helping to
solve this issue of long term care. So, given the fact that long

(48:45):
term care is commonly accessed by seniorpopulation, mainly baby boomers and you know,
maybe a generation up or two,they don't have the you know a
lot of them struggle with basic technologiesduring you know, living their daily life.
So this whole telemedicine and this newhealth technology can be overwhelming for these

(49:06):
senior populations. But the problem thatwe're facing is that the lack of education
part where we're not addressing that issuepublic publicly. No politicians are coming forward,
and you know, or you know, healthcare professionals are given the opportunity
to come forward to the general publicand you know, really informing them about
these technological innovations and options that theycan you know, explore and kind of

(49:30):
choose for themselves. And so alot of seniors also because of that,
goes unnoticed and their care is diminishedand you know, their quality of life
is diminitial as a result. You'llbe happy to know that one agency in
New York that does take this seriouslyis the State Office for Aging. And
Greg Olsen and Rebecca Prevy have beenguests on this show a number of times.

(49:50):
They have innovative programs they're supporting acrossNew York State. It's on a
county by county basis and also ona statewide basis, but they're looking at
integrating those types of things that theyhave some great statistics that if an Office
for Aging serves an elderly individual,their typical budget for that individual is just
over seven thousand dollars a year,and they prevent that person from needing long

(50:12):
term care and going on Medicaid ata cost of one hundred and fifty thousand
dollars a year. So there isfortunately some bright lights out there. And
I think it was President Bush Seniorthat said the thousand points of light.
They're out there, but how doyou connect them and how do you pull
it all together? What do yousee as getting people aware of these issues?

(50:35):
How can we bridge the gap?I think one of the main things
that we need to look at educationwise is being upfront about what we wanted
to cover and using terms that everybodycan understand. I'm twenty two and if
you would have looked at me sixmonths ago and asked me about a managed
care plan or an arissa plan orlong term care, I would have had

(50:59):
no idea what you were saying.Yeah, and most adults don't, right,
And even if even if you haveit. I work in a pharmacy.
I have people that come in andthey ask me about their insurance plan
and I'm like, if you don'tknow, I don't know. Like I'm
trying to my best to help.But education is really where we need to
put our focus. How do othercountries handle it. Let's go to Sue

(51:22):
Young. Well, I think youknow, education can come from a lot
of different sources. It's not justschool where you can access this public health
you know information, and I thinkum other countries they invest a lot in
advertisement, so they you know,put these public kind of uh you know
here, here are these programs thatare out there that can help you with

(51:42):
you know, your long term care, and we're going to advertise it to
you through radios and TV so thatyou're aware. You hear it constantly,
and you know it's kind of likeingrained into your brain and you're like,
okay, let's just you know,do some research on my own and the
information as accessible. Now, ifyou could think of an industry that advertises
at that level where you can notsee their commercials every day everywhere. Look,

(52:05):
can you think of an industry beingpharmacy students? It's a it's a
layup. That's a trick question.How many drug ads? I mean,
yeah, big pharma. Why arethey on TV all the time? Why
are they always so happy in theircommercials? They just scared or treated it?
And it's because they have the money. It's the allocation of resources,

(52:29):
which you were talking about earlier.How do we take this issue seriously?
How do we educate people a mail? How do we get this into the
mainstream medical system. Yeah, butdo we have to go back to the
community base services. I believe thatthis is where we can actually help these
people get healthier. The brock spreadsroom that so be trying to trying to

(52:49):
get everybody together on the serves toconfuse people. If you go back to
the community base local from local,we can get more directly to us person.
Now, CBS is a big playerin this game. What do you
think about the drug stores and thepharmacies playing a role because they see these
people are handing out the medications orhanding out the prescriptions. Is there a

(53:12):
role for pharmacies? I think thatso. One of the great things about
pharmacists is they're one of the onlyhealthcare providers you can go to for information
and advice that you don't technically haveto pay. You can walk right into
a pharmacy and ask them questions andthey'll help you, no appointment necessary.
But I think along with pharmacies,we're going to run right out of time.

(53:36):
And I don't want to cut youoff, hope, but I'm sorry,
I have to be got about fifteenseconds left. Al Kardillo Abbamail Sue
Yan and Hope. Thank you forcoming in today. This has been a
fascinating show, and thank you allfor listening. I hope you learned something.
I know I did, as Ido every week here on Life Happens.
Join us next week at eleven onw g Y. You've been listening

(53:59):
to Life Happens Radio with Pure O'Connorand Strauss. For more information or to
contact pure O'Connor and Strauss, visitpurolaw dot com or call five one eight
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Happens on NewsRadio eight ten and oneoh three one WGY w g Y AM

(54:23):
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