by: Begley Law Group

by Thomas D. Begley, Jr., CELA

This article continues the discussion of special problems for the elderly.  (Here is a link to Part 1.)

  • Long-Term Care. About 70% of Americans will require some form of long-term care be it home care at $28 to $30 per hour, assisted living at $6,000 to $12,000 per month, memory care units at $16,000 per month, or nursing homes at $12,000 to $18,000 per month.  Only about 6% of Americans have long-term care insurance.  Expenses of long-term care will wipe out most families very quickly.


  • Hospital and Doctor Care. The Affordable Care Act covers approximately 23 million additional individuals.  It does not cover the cost of long-term care.  That number would be much larger except that 12 states refuse to expand Medicaid eligibility to their states.  Despite efforts by the Trump Administration and Congress to weaken the law, the enrollment has remained fairly stable.  The Affordable Care Act, or Obamacare, was merely not health reform, it was insurance reform.  Much of the legislation was designed to protect insurance companies.  A better solution would have been a single payer health care system.  This would have been much more efficient for doctors, hospitals, and other health care providers.  Essentially, it would be Medicare for everybody.  Individuals would still have the right to choose their own health care providers, but all bills would be paid by an agency of the federal government.  There would be no out-of-network provider problem.  The federal government would not control the care, simply the payment. Another factor contributing to rising health costs is that the federal government is not allowed to negotiate prices with pharmaceutical companies under Medicare Part D.  Other agencies of the federal government, such as the Veterans Administration, are able to negotiate prices and receive significant discounts.


  • Transportation poses special problems for senior citizens living in the suburbs.  The suburban lifestyle is based on the automobile, and once the elderly can no longer drive, their ability to live independently is curtailed by a lack of public transportation in suburban and rural areas.  Public policy should favor the development of multi-modal transportation systems that are highly inter-connected.


  • Housing is the largest category of consumer expenditures for households age 65 and older.  Expenditures for age 65 years and older break down as follows:[1]


Age 65-74       Age 75 and older


Housing                                          32.4%                    36.5%

Transportation                                17.1%                   13.9%

Food                                               12.9%                      11.9%

Health Care                                    12.2%                    15.6%

Cash Contributions                         10.8%                  13.7%

Entertainment                                  6.1%                     4.4%

[1] The Bureau of Labor Statistics, https://www.bls.gov/opub/btn/volume-5/pdf/spending-patterns-of-older-americans.pdf.