HEARING - U.S. Senate Special Committee on Aging

77
ing home, or a hospital, or at home with extra care-that you can
do so with dignity. We want to step up and make it possible for
people not to be flat broke in order to be certain that they are
going to have that kind of help.
Can you provide for the committee, on the basis of actuarial calculations,
at some threshold what it would cost-not necessarily
Bowen's $2,000, which is a small threshold-but at some threshold
where Americans could be assured that they get this catastrophic
protection in nursing homes or at home and what it might cost; because
that is exactly what the voters and the taxpayers want to
know when we have a bill on the Floor. Additionally, what are we
going to have to know if we expect to pass a bill-and we do expect
to pass some type of bill.
Mr. SHAPLAND. Let me make sure I respond to your request. I
want to respond to your request, so I have to make sure I understand
it.
There are lots of figures available on what the current expenditure
for nursing home care cost is; how much of that is being paid
for by Medicare and Medicaid and how much is being paid out of
people's own pockets. If that is the kind of number you are looking
for, how many billions of dollars people are having to put out of
their own pockets for nursing home costs today, I can give you that
figure real easily, and how much of that is being paid for by Medicaid
and so on.
Is that what you are looking for?
Chairman MFiLCHER. Let us put the second part in. There is the
threshold where somebody such as Mrs. Fish's mother has utilized
$10,000 of her savings-the mother's savings-and at that point,
either the nursing home or the home health care assistance is
going to be covered.
Mr. SHAPLAND. I would like to make a suggestion. Insurance
companies do not have those kinds of numbers.
Chairman MELCHER. Well, now, wait a minute.
Mr. SHAPLAND. But somebody does that you can obtain them
from and that is the Health Care Financing Administration.
Chairman MELCHER. Well, you can generate them, can't you?
Mr. SHAPLAND. No. You are talking about Government figures.
Chairman MELCHER. How can Mutual of Omaha offer a good insurance
plan that I can buy for so much a month that is going to
keep me whole if I have to go into a nursing home-you have some
figures on that, or you would not have a basis for charging, what
the policy costs.
Mr. SHAPLAND. But I thought the question had to do with people's
incomes.
Chairman MELCHER. No, not people's incomes.
Mr. SHAPLAND. I thought you said how much would it cost on a
spend down basis.
Chairman MELCHER. A threshold of $10,000 being spent. The
Bowen proposal says spend $2,000, and we are going to pick up
some extra protection for you. I am saying spend some figure-I do
not care what figure you use, because it does not make any difference
whether it is $7,000, $8,000, $5,000, $10,000.