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With the inclusion of Alaskan Governor Sarah Palin on the Republican Presidential ticket and Barack Obama’s equally historic emergence as the standard bearer of the Democratic Party, both national conventions took on a larger than life quality. Now that the battle lines are fully drawn—celebrated veteran vs. upstart elitist; small town values vs. a cosmopolitan sophistication—it remains to be seen whether this election cycle will produce any meaningful conversations about day-to-day issues. The senior healthcare crisis would be a great start.

In a nation in which nearly 50 million people lack health insurance of any kind, most seniors over the age of 65 are nominally covered by Medicare. TheMedicare system has its faults, particularly with regards to affordable prescription drugs. And the system also offers little for long-term care, except under specific circumstances. 

As Americans increasingly live longer lives and with millions of seniors suffering from Alzheimer’s and other forms of dementia, long term care options, such as nursing homes, assisted-living environments and retirement communities, have become increasingly prevalent. The struggle for many seniors is trying to find ways to pay for long-term care.

Wealthy seniors are often able to leverage their homes and other forms of wealth, including pensions and other investments, to buy into retirement communities. These communities extend care as the health status of senior change. Many such communities can cost as much as $100,000 just to buy in. And monthly expenses for various care-giving services can rival and exceed that of monthly mortgage payments. Only a small fraction of Americans have this kind of financial flexibility.

By contrast, the poorest seniors in the country are often eligible for Medicaid. Medicaid allows them to receive long term home and institutional care. While pithy as compared to some high-end senior care facilities, it at least allows them some relative dignity.

But the real tragedy exists for those seniors who often have worked their whole lives, paying into the social security system and who also have some sort of pension set aside for them. They are the ones who arrive at their senior years only to discover that the combination of their pensions and their social security payments generate too much income to be considered for Medicaid—even though they can’t afford assisted living or nursing homes. These seniors literally have to spend themselves into impoverishment before they are eligible for long-term care. And then, it is often too late.

Senior care is a particularly troubling issue for the post-Civil Rights generation of African-Americans, who often earn the same salaries as their white counterparts, while lagging behind in terms of wealth.  Just as many post-Civil Rights Blacks are finally paying a down payment on the American Dream, they find themselves challenged to have to provide elder care—both physical and financial—that most are simply unprepared and unequipped to provide.  

As upper income whites expect to pass their wealth on to their children, many middle class Black Americans, as other Americans who share their financial predicament, find themselves passing their wealth back to own parents, just to help meet their parent’s healthcare cost.

A quick glance at Senator McCain’s website shows little information about long term health care for seniors, which is rather surprising given that the senator is a senior himself. Then again, it’s not surprising—given that the senator could finance his own high-end long-term care by selling one of his seven houses. 

And despite all of Senator Obama’s lofty language about healthcare in general, the senator’s “at-a-glance” position paper on senior issues contains only obligatory language about the need to stop insurance fraud among long-term caregivers. The document vaguely notes that as President, Obama will also “work to reform the financing of long term care to protect seniors and families from impoverishment or debt.”  

No doubt such reform will be a long way off for those senior and their adult children currently helping them to make ends meet. Meanwhile, what awaits them both—to use the senator’s own word—are “catastrophic” circumstances.