Stephen Moses, one of the leading experts on long-term care in the U.S., says the nation can dramatically improve the quality of our health care system if we could get rid of the loopholes that allow nearly everyone to qualify for Medicaid coverage. The current system encourages few people save for long-term care because it is widely accepted that the government will pick up the tab. While this may be true, government control limits innovation and leads to worsening health outcomes.

Moses, and the Paragon Institute released their latest report on the problems with long term care in the U.S., called Long-Term Care: The Solution. In October 2022, Moses and Paragon outlined the problems in Long-Term Care: The Problem.

People prefer to live out their final years in the comfort of their own home but surprisingly, many of the elderly end up in institutional care. That is no accident. Medicaid is the largest payer of long-term care, and one reason is because you don’t have to be impoverished to qualify. This has put a huge strain on the federal budget, on Medicaid reimbursements and significantly compromised the quality and supply of care. Few innovations exist because there is little presence of a free market. As a result, institutional care has become the “go-to.”

This podcast begins with a discussion on Medicaid loopholes, the response from Congress, whether a solution is workable immediately, and how special interests might respond to closing off loopholes. The conversation then turns to why the public needs to be better educated on long-term care. The idea that it must be debilitatingly expensive isn’t true.