The Depreciation of Care at Home

At the next birthday party for your grandparents or yourselves, consider what the following public policies all have in common:

Medicare pays for many expensive medical procedures that don’t significantly prolong life, but does not cover the costs of custodial care for patients with diseases that can’t be medically treated, such as Alzheimer’s or dementia.

Medicaid is far more likely to pay for nursing home care for the indigent elderly than to pay for home- and community-based services that would enable them to remain in their own homes. While some states do far better than others in this regard, at least 25 states and the District of Columbia cut spending on such services between 2007 and 2010.