In January I’ll turn 62, so I can get away with some remarks that might otherwise be construed as indifferent or mean. Like, if you’re a baby-boomer, plan or hope to grow into really old age (say, 65, or so), or have a parent who’s already there, the kidding stops right here: this blog is perhaps something you would benefit from considering. 

As someone who has spent more than a decade associated with long-term care insurance, I want to assure the skeptics that if you live long enough there’s a better than even chance you’ll need long-term care, and that the care you’re given will most likely take place in a long-term care facility, not your home.

Here’s why, and why you really don’t want to lay that cross on the shoulders of a spouse or offspring. By the time you get there, it’s a better bet you’ll win the lottery than that your spouse will be able to lift you, or you your spouse, into and out of a bathtub or truly provide the emotionally and physically fatiguing round-the-clock assistance that decades of insurance statistics and those from HHS conclude are more likely than not going to be necessary. Gender is irrelevant.

And beginning with the 1999 JAMA (Journal of the American Medical Association) report that demonstrated caregivers suffered 63% higher mortality rates for being Good Joe’s, or Janes, every study since comes up with the same evidence: sticking a spouse or child with the stress-laden task is going to age them early; quite literally steal years from their lives. (http://jama.ama-assn.org/cgi/content/abstract/282/23/2215) A 2006 regression-analysis study by the University of Wisconsin/Madison of 1,842 35+ year old care-giving couples manifested a clear association between the care giving and depression and marital discord. (http://jfi.sagepub.com/cgi/content/refs/27/12/1701)  

Please, before you contend you will “never go to one of those places,” understand I’ve heard that line, it’s a self-delusion that you’ll perhaps have zero choice over, and it’s not the point of this note in any case. The points are in the following paragraphs.  I was watching a Bill Moyers Journal program last evening. (http://www.pbs.org/moyers/journal/index-flash.html) His guest was John Bogle, founder of Vanguard Investments and author of The Battle for the Soul of Capitalism. Although I’ve not read the book, via the interview it concerns itself with the terrible misdirection capitalism has taken over the past several years and the peril to all of us the misdirection poses.

Since our founding the United States has gone from an intensely agrarian country, to an urban centered manufacturing society, to one that was service oriented, to one that is now financial service dominated. It is the latter case that is so disturbing to the Wall Street tycoon and that should be as well to each and every one of us.

A few bytes of data describing the financial service orientation might be useful. For starters, 1/10th of 1% of all Americans possess more than half of total US wealth. That’s a greater spread than was the social circumstance that provoked the French Revolution in 1789 and which led to Marie Antoinette losing her head to the guillotine’s basket, a greater spread than has ever existed in US history.

Additionally, according to Mr. Bogle, unless you made — I intentionally did not use “earned” — $129 million last year, you were not among the top-tier hedge-fund managers. Mr. Bogle mused briefly over how much was enough, and deflected the suggestion issued by Moyers that these were “respectable citizens.”

Mr. Bogle, and it is essential to bear in mind he is not some blathering left-wing socialist, he’s the founder of one of the world’s largest financial empires, complained how the private-equity firm managers are taking an average $560 billion out of society every year, while returning nothing to society in exchange. Companies like the Carlyle Group, Blackstone, Cerebrus, and Warburg Pincus buy public entities (have common stock that’s traded on the exchanges) such as Chrysler, Dunkin Donuts, Toys-R-Us, strip them of their various components, trim all the parts of as much overhead as possible, then sell the parts to whoever at a huge profit. An example provided that ties in the earlier nursing home reference is how Warburg Pincus and Carlyle purchased thousands of nursing homes in the United States, cut nursing staff even below state mandated levels, eliminated or reduced severely recreational and rehabilitation programs, ignored principles of basic food hygiene and more, all on behalf of super-sizing the bottom line, so the homes could be dumped for mega gains. In the interim, residents in the homes suffer, many die.

And the kicker: The states have levied fines and have attempted criminal prosecutions, and families have tried to sue, but the entities have been so labyrinth-like structured that there’s no one accountable and no way to pinpoint financial responsibility. Lawyers have ceased trying to sue on behalf of families whose mother or father has perished due to abject neglect and/or physical abuse because the liable party has been meticulously structured so that it rarely has any money to recover. (Either view the interview or read the transcript at http://www.pbs.org/moyers/journal/09282007/watch.html) Or read one of the articles at either http://www.medicalnewstoday.com/articles/83493.php or http://www.nytimes.com/2007/09/23/business/23nursing.html?_r=1&oref=slogin   

So why should any of us really care, and what can we do about it if we decide we will care?    

You may find that you’ve no choice but to place your mom or dad in one of these homes, or you may at some future date have to be placed in one yourself. As Ronald E Sylva, president and chief executive of Fillmore Capital Partners, is quoted in the latter cited article, “There’s essentially unlimited consumer demand as the baby boomers age. I’ve never seen a surer bet.”  Since profit has been everything and regard for the wellbeing of your mom or dad or your spouse or you, and locating any source upon which responsibility can be assigned for mistreatment (Again, READ THE ARTICLE[S]), what ya gonna do?    

That’s Reason #1 why all of us ought to care, a lot.    

Reason #2 goes to the Iraq War, how it’s been funded, and the catastrophic way the Bush and the GOP has mangled our finances. When the United States government borrows money, US citizens have to pay it back. So far, on just hard costs we’re into Iraq somewhere around $1 trillion. The downstream obligations for care of those we sent into harm’s way is estimated to presently exceed another $1 trillion. Since George Bush took office, the national debt has risen from $6 trillion to nearly $9 trillion! And that does NOT count the future obligations we have to the men and women who will need that long-term, and in many, many instances, lifelong psychological and physical care!   Maneuvering the social and financial obligations that are just around the corner may be a Herculean challenge we simply are not up to.

Medicaid is the last resort of most of those who will enter and are presently in a nursing/convalescent facility. Right now the annual cost to the uninsured-non-Medicaid resident exceeds $60,000, and is $90,000 in many of the more expensive areas of the country; not more expensive facilities, more expensive geographic areas. Who’s gonna pay the tab?    

But more generally, as more and more companies are being eviscerated by these vulture private equity managers and more and more Americans find themselves unemployed or underemployed at stagnant or substantially lower wages, as the falling dollar makes everyday goods more and more expensive to the point of unaffordable whacha gonna do?    

Then, nothing we’ll be able to do. Now, however we’ve not yet reached the point of no return.

First of all we have to inform ourselves and our associates of the genuine peril that’s just over the horizon. That may mean turning off the episode of whatever that mindless fluff it is that’s on the television, and devoting the time to some basic research on the fundamentals of macro-economics.

Second, we can follow the recommendations of Mr. Bogle and AARP and others: regardless of party affiliation, make sure your US representative and senator knows that you know what the hell is going on, then insist he or she stress financial accountability in the government and private accountability and strict federal oversight of the private equity companies.  

— Ed Tubbs