I just read an article that indicated part of the health care reform bill is automatic enrollment in long term care insurance, unless a worker opts out. It doesn't say if this will be a government program, or private insurance. Either way, in the era of Generation Greed leading up to an institutional collapse (public and private alike), a scam is possible if not likely.
Insurance businesses could make optimistic assumptions about returns on investments and future costs, paying campaign contributions to allow those assumptions to be made, allowing more profits and executive bonuses — but leaving no money available to pay for long term care when younger generations, who had paid in, need it. As in private pensions. Governments can use the same assumptions to pay out plenty to today's seniors while charging them less, to become popular. This would leave today's middle aged and young with a choice of either forgoing benefits they had been promised, and facing deprivation in old age, or taxing their children into poverty. As in public employee pensions, and Social Security.
There seems to be this idea that what we have are technical issues, to be adjudicated by wonks, rather than culture issues, to be challenged by those willing to call out the entitled. We're in an era in which neither actuaries, nor accountants, nor bond raters, and certainly not brokers, promoters, lobbyists and politicians, can be trusted.
Do you really want to give thousands of dollars to a private company in the hopes that it will meet your needs 20 or 30 years from now? The United States of America? My generation has already been promised that a deal passed in 1983, which raised regressive taxes and cut future benefits, would "save Social Security." Now it will have to be saved again. We were told one pension enhancement for today's public employees, and those retired, would cost nothing, but already taxes are higher than a decade ago, the pay and benefits of younger and future public employees has been cut, and public services are about to be gutted, to pay for those unjust (relative to what most people get) pensions.
Those who control our institutions, Republican and Democrat, liberal and conservative, seem incapable of even elightened self interest. So before less powerful people are tricked into paying more into our institutions, public or private, in exchange for promises, the reality of past promises needs to be admitted and confronted. What would it mean if today's Senators and Representatives make a solemn pledge, collect the money, distribute it to the people that matter, and then pass from the scene along with their generation? Would those that were left, great rationalizers all, say that whatever happens to those coming after is due to circumstances beyond their control?
I see health care reform as a way for those who are paying right now, younger generations, to get something right now, a guarantee of health insurance. Because I have no idea that under the current arrangements Medicare would be available to them later when they need it in any event. A mandated long term care insurance program could reproduce that generational equity. And no matter how equitably its initial design, it would likely be raided in short order by those out for themselves.