and more pro-growth because you have
to have growth and spending discipline
to fix this problem.
AL exec: A recent federal report predicted the Social Security Trust Fund
would go bust by 2037 and Medicare
will consume more than 10 percent of
the nation’s gross domestic product by
2083. What does that say about the future of these programs?
ryan: These reports are just the lat-
est warnings that we have to act and
we have to act soon. We can’t afford
to kick the can further down the road,
and those in Washington need to put
forward some real ideas to get entitlement spending under control.
AL exec: The wellness philosophy
is one embraced by the assisted living business. But can a focus on wellness—smoking cessation programs,
obesity control, more exercise, for
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example—produce enough savings to
really affect the bottom line of health-care costs?
ryan: While not a panacea, emphasizing healthy living and investing
in preventative medicine can have a
positive impact on reducing our health-care costs. Consider that five prevent-able chronic conditions consume 75
percent of our health spending and
cause two thirds of American deaths.
In government programs, the problem is even worse, with chronic disease spending consuming 96 cents of
every Medicare dollar and 82 cents of
every Medicaid dollar.
Innovative businesses have seen
great returns on investments in preventative medicine and we need to
complement these private-sector initiatives with government programs that
are cost-efficient and linked to measurable goals.
AL exec: How do you anticipate
baby boomers will change retirement?
ryan: This demographic realignment is not a temporary phenomenon,
associated solely with the retirement of
the baby boomers, but a long-lasting
shift—and it is more than a problem
just for Social Security or federal government spending. It poses a challenge
to the economy to generate sufficient
resources to support the income and
health needs of a growing population
of retirees.
AL exec: Long-term care costs, particularly the cost of skilled nursing, are
beyond the reach of most families now,
which is why 75 percent of all Medicaid dollars pay for skilled nursing care
in nursing homes. Should the federal
government shift its emphasis from
skilled nursing to home and commu-nity-based care, and if so, how?
ryan: We need to rebalance long-term care services to ensure that individuals and families have a choice
between institutionalized and home-based care. Long-term care subsidies
that favor poor-quality institutions
should be improved to offer a broad,
flexible array of services and supports
that promote personal choice and
control.
Individuals wishing to stay at home
with their loved ones rather than in a
nursing home could use their benefits
for targeted assistance. ❏
