Why are the costs for nursing care and long-term care beyond what is affordable?

As long as we continue to believe, as a country, that it's okay to make a profit off the sick and the elderly, the costs will be exorbitant.

I did quit my job to care for family members. I paid off my home in 2005, I'm 58, and do commissioned artwork from home (which is not nearly enough to pay for anything.) I'm full time with Mom here, 92, multiple medical concerns, but still a sharp lady. All utilities and auto costs are approx. $900 a month. Prior excursion to care for younger sister (bone marrow transplant) out of state cost me the 401K to keep my house and leave the state. For now we are ok. Mom's SS of $1300 pays her seven doctors, meds, and personal needs. She has no assets, qualifies for NADA. I own the house (all 1100 sq ft) so I'm out as well. We can drive to docs, we have groceries and electric. I consider that quite an accomplishment considering the circumstances. Since the beginning of time, people age, become infirm, die. Family members in a group took turns taking care of them. Only in this our MODERN ADVANCED society do we have unimaginable financial burdens to continue our lifestyle of 'privilege'. I say that with a smirk, because it's been five years of full-time no-real-income, no
'respite' and no-projected-future-for-me-lifestyle. I just CANNOT consider delegating my Mom to government-paid stressed-out strangers in a warehouse-style facility ! What if she's thirsty but can't find the word? She's embarrassed to no end if the poops her pants- and it's just us here ! Every time I get frustrated, every time I want to pull out my hair over an old story about my ex-husband that goes on repeatedly EVERY day...(at breakfast !!!) and how much she hates him, and how much she hates her father, and blah, blah, blah...I envision her alone and afraid with (maybe even kind) strangers, with (like you described) several people in a room (when she is afraid of anyone coming into this house...) I put on my big-girl pants, suck it up and move on to another day. ALL 63 million of us here in the US of A need to start emailing our congressmen. (Not just me, thank you.) Generations of folks who have not paid into the system get more 'assistance' than those of us who pay taxes. I will leave this adventure (fourth family member cared for) with the hope that these years have galvanized experiences in me that will somehow benefit my ENTRY BACK INTO THE WORKPLACE IN MY SIXTIES.

It has nothing to do with the physical building, and little to do with the number of patients in a room, and everything to do with paying all the workers. If you have 60 patients in a facility that must be staffed with 2 or 3 RN'S 24/7 (not just on call but actually working there, awake) all of a sudden you don't just have 3 x $85,000/yearly salary PLUS health ins, pensions, union benefits, paid time off which must be covered by another nurse, etc. Their actual reimbursement takes up what is paid by about 5-6 residents. Then there's all the LPN's, health aides, maintenance staff, laundry staff, professional chef & kitchen staff, marketing staff & office helpers, just add up all those workers' paychecks and you start to realize how it costs $90,000 a year. Plus they have to have insurance, keep the roof from leaking, and maybe update their furnace & air conditioning every so often. My wish is not that the government would pay for a billion people's bills every year, but that every single teenager was taught every single year in school, to Save Save Save and get their financial Priorities straight. It IS possible to get your education and buy a modest home AND do ALL of that without ONE PENNY of government handouts. I've done it and my kids are doing it. It's called WORK and Living Within Your Means. No one needs a $10,000 vacation every year, two Big Screen TV'S and a 3-car garage. Your kids want an I-phone? Let them work for it. They want to drive your car? Let them pay for it. You want to retire at 65 with another 40 years of luxury? I hope you planned & saved for that Priviledge, because No One has a Right to steal MY hard-earned & SAVED money which I have crimped and saved for my own "retirement" (which won't come until 70 and won't be anything fancy). Buy LTC insurance and buy the inflation riders. Keep yourself healthy. Don't waste money on frivolous crap you can't live without. If everyone did this, we would still have a few that by reason of being extremely disabled, or severe disease would require government help. But by far, there are too many mooches living off gov't who are setting a huge bad example and the cycle just continues.

While no one wants to broach this subject, I have with my children as I look to the future. At age 75, I want no further treatments to extend my life. I want palliative care only. I work with the elderly and have for 30 years and I was caregiver for both my parents who have passed away. I have seen what chronic illness does for people and their families. My children cannot care for me, and and we have no means of paying for corporate medical costs of AL or NH. In fact we would be lucky to pay to co-pays etc of Medicare that are being proposed for baby boomers. This is a quality of life issue coupled with financial one. Not easy and my view does not mean true for others. However, we cannot continue down this path.

Hey, koufax, I sincerely hope you have seen that my comment is primarily a lot of helpful information that is relevant to the original question. There is also another question behind the OP question-- a huge ripple effect with everyone's decisions affecting everyone else. Unfortunately the sheer numbers of people living irresponsibly, threaten the honestly earned homes & security of the dwindling numbers who are responsible. When it comes to older age, or unfortunate early disability, those who have been responsible will fare much better, due to their own efforts. I believe that 5-year lookback for Medicaid should be 40 or 50 years. The huge costs of NH could easily be paid by those who have $2,000/month mortgages, $1,000/mo car payments, and other luxuries, for 40-50 yrs when they could have lived more exonomically, and bought LTC ins. I have that same sticker shock over NH costs, as expressed by the OP. Nobody who has worked like crazy all their lives seems to know that 30-40 years of senior life could cost so much. Yet NH are flourishing, they have waiting lists and are full to the gills. Their "product" is flying off the shelves so fast--if it were too expensive we would see empty rooms wouldnt we? So the problem is not the nursing homes, they are priced correctly &competitively. It is the same problem as hospitals--there are too many people there who are using the product who don't pay full price (Medicaid), and the self-paying folks pay the difference. Its either that situation, or the NH does not accept Medicaid, they only take private pay (and these places have wait lists a mile long). Nobody in WashDC can seem to do anything to control the costs. There are not enough rich people to tax, to pay all these bills. So it is just up to us common folks to save more & more for our own needs, and the pain we feel is not that I am "ranting," it is that all of us realize we can't be living it up, we gotta be saving an incredible amount of money for those senior years--and if you're not going to be responsible & work & save, you're costing everyone else. Just like the bad drivers on the road who increase the costs for the good drivers.

Assisted Living does not provide nearly as high a level of care as a Nursing Home. The NH will have RN's on 24/7, more aides and an actual MD on staff. You can get a private room only in a private pay nursing home.

Just a quick note, my income tax in NZ, Australia and in Holland was about 4%-10% more than I paid in the US and we have just returned to the US 3 years ago to take care of my aging parents, so very recent numbers. However I never worried about bankruptcy due to healthcare costs, and what we did get was fair and equitable. The insurance companies and corporations make the money on our healthcare, which include pharmacuticals, and other vested interests If we did not have the insurance companies sitting inbetween us and our providers then the costs would not be so high. The Affordable Healthcare Act is a farce and is not an example of anything except business as usual.

Is your father a veteran ? If so aid & assistance may be available.

While I don't disagree with other comments, I think StarGazer summed it up very succinctly. Mallory also makes some very good points about consumerism and the lack of money for old age care.

People are living longer and developing more health problems, some of which are beyond the ability of caregivers to manage at home. Commercial providers see a need, move in, and establish a foothold. Some attorneys have focused on asset management specifically designed to open up Medicaid qualification for people, enlarging the pool of potential facility residents. Elderly folks bring in dollars for commercial enterprises.

But it's not just the elderly who are becoming profit centers. As individuals, we are as well. Think about all the data being collected on us, whether we're caregivers or not. If you read privacy policies and terms of service for websites, you'll find references to data gathering, third party use, etc., etc.

People and our data are the hot commodities now. Marketers want that data, and they get it.

Well welcome to the healthcare industry. If you do not take good care of yourself before you get older, then you will probably need services. No one wants to pay at the end of their lives, but leave him where he is since funds are low. It is expensive because you have to pay all the professional people who went to school to get an education and probably are still paying for their student loans (like me).