In the frayed, porous net that is America's health care system, dementia sufferers are especially susceptible to falling through. With early-onset dementia in particular, the financial stresses can be devastating, and federal programs inadequate. It can drive patients, their spouses and even their adult children to bankruptcy.
Our health care debate is focused largely on what portion of the burden individuals should shoulder and what government can or should do. Dementia is a condition that can strike anyone approaching retirement age. The amount of care, and the expense of covering it, escalates as the condition progresses.
Should spouses and relatives be shouldered with the entirety of the crushing financial burden? Dementia patients shouldn't have to put their families through that before qualifying for federal help.
The economic impact of this condition was explored in heartbreaking detail by the Post-Dispatch's Michele Munz on Sunday. The fourth part of the important six-part dementia series, "Stolen Future," examines the financial toll it has taken on Lonni Schicker, 63, and her son, Dan Schicker, 32, as they fight to stay above an avalanche of medical bills and navigate gaps in federal health coverage of dementia.
It's a story of a mother and son trying to help each other through the labyrinth of debt that has ensnared them both as her condition worsens. "I'd rather me be stressed than her," Dan said. "I've sold my game systems more times than I can count. I'll sell some furniture. I'll just do what I can to make it."
Poverty should not be the point at which federal help kicks in. But as the story explains, Medicaid, the federal health program for the poor and disabled, can have high out-of-pocket costs for dementia patients — Lonni was paying $1,500 a month at one point — and only covers nursing home care after income and savings are exhausted. Unless you have the foresight and means to purchase a long-term care policy, you're literally required to drive your family into financial destitution to qualify.
And even upon qualifying for Medicare, the federal health care program for older Americans, coverage doesn't include assisted living or long-term skilled nursing home care, which is often what dementia patients need most.
Some spouses of dementia patients turn to divorce as a strategy for getting the needed care without financially decimating the rest of the family. No one should be forced into that kind of drastic action just to cover bills.
Medicaid and Medicare coverage of these gaps can't just be turned on like a faucet. It needs to be factored into the rest of America's health care debate along with other costs and priorities. But this is a systemic lapse that is imposing pain across generations. It deserves to be a priority as lawmakers refine the scope of federal health care coverage.
REPRINTED FROM THE ST. LOUIS POST-DISPATCH