[Congressional Record Volume 142, Number 2 (Thursday, January 4, 1996)]
[Senate]
[Pages S55-S56]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               THE BUDGET

  Mr. SARBANES. Mr. President, just a couple of days ago Ellen Goodman 
wrote a very interesting column entitled ``Bootstraps for Middle-Aged 
Children,'' and she addressed the problem that would confront the 
elderly and their children if the budget is cut according to the 
Republican budget proposal. She made the point that middle-aged 
children may get a small tax cut of less than $1 a day and a nursing 
home bill of $35,000 a year for their parents if some of these Medicaid 
cuts go through.
  Actually, the fact is that Medicaid now pays for 60 percent of 
nursing home care. The elderly are required to use up their own assets 
until they get down to a level where they qualify for Medicaid. These 
are middle-income people who are, in effect, by their health situation, 
forced to use up their assets in order to meet their medical needs, and 
then Medicaid covers for them. If Medicaid ceases to do that, the 
burden is going to come back upon their children.
  I think if people ask themselves carefully, ``Which would you rather 
do, forego a small tax benefit or keep the protection against the 
extraordinary costs of nursing home care?'' they would want to be 
protected against the nursing home costs.
  I ask unanimous consent that this article be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

[[Page S56]]


                      [From the Sun, Jan. 3, 1996]

                  Bootstraps For Middle-Aged Children

                           (By Ellen Goodman)

       Boston.--This one is for Priscilla Parten, the Derry, N.H., 
     woman who had the temerity to ask Lamar Alexander who would 
     care for the elderly if the budget is cut according to the 
     GOP pattern.
       The answer from the presidential candidate, one of the men 
     hawking their wares across New Hampshire was that ``We're 
     going to have to accept more personal responsibility in our 
     own families for reading to our children and caring for our 
     parents, and that's going to be inconvenient and difficult.''
       Happy New Year, Priscilla and open up your calendar. 
     Scribble down two rather large words under 1996: Personal 
     Responsibility. They're going to be the watchwords of the 
     1996 campaign.
       Personal Responsibility is the catchall moral phrase 
     uttered by politicians in favor of removing the guaranteed 
     safety net and parceling the money out in incredibly 
     shrinking block grants to the states. It's the all-purpose 
     ethical disclaimer for those who equate the task of caring 
     for the elderly sick with ``reading to children,'' for those 
     who blithely describe eldercare as ``inconvenient'' or 
     ``difficult'' but character-building.
       To know what they have in mind, get past the P.R. campaign 
     and go to the fine print of the GOP's Medicaid Transformation 
     Act of 1995. That's the Orwellian title for the bill that 
     would ``transform'' Medicaid by eliminating its guarantee.
       From the day Medicaid is block-granted, adult children 
     earning more than the national median income--that's $31,000 
     a year per household--may be held responsible for the bill if 
     their parents are in a nursing home. If they don't pay up, 
     these newly defined Deadbeat Kids may find a lien put on 
     their incomes, their houses, their savings.
       A secret of the current system is that Medicaid, the health 
     program established for the poor and their children, now pays 
     for 60 percent of nursing-home care. That's because nursing 
     care eats up the assets of elders at a rate of about $35,000 
     a year until they are indigent.
       Not surprisingly, the folks calling for Personal 
     Responsibility draw on examples of personal irresponsibility 
     to justify a change that is beginning to make middle-class 
     eyes widen. They point to elderly millionaires who 
     deliberately transfer their assets to the kids in order to go 
     on the dole in nursing homes. They describe deadbeat kids who 
     callously drop their parents at the government door and go 
     off to the Bahamas.


                        the ones who will suffer

       But if and when states begin sending bills to the kids, 
     those folks aren't the ones who'll suffer. Thousands of 
     middle-aged ``children'' of the 3 million elders in nursing 
     homes may have to pay for their parents out of their 
     children's education fund and their own retirement savings. 
     Adult children, perhaps elders themselves, may have to choose 
     between nursing sick parents at home or emptying the bank.
       How neglectful are we, anyway? Despite the bad P.R. we are 
     getting, families do not by and large look to nursing homes 
     for their parents until they are overwhelmed. Elders do not, 
     by and large, go there until they are too ill to be cared for 
     at home. Only one-fifth of the disabled elderly are in 
     nursing homes.
       Daughters and daughters-in-law provide most of the care of 
     elders and they will shoulder the increased Personal 
     Responsibility at the cost of their jobs, their pensions, 
     their own old age. The daughter of a disabled 88-year-old 
     may, after all, be 66 herself. It is their characters that 
     will be built on deteriorating lives. One politician's social 
     issue is another woman's life.
       There is enough guilt in every family to trip the 
     responsibility wire, to push the button that says families 
     should take care of their own. As a political slogan, P.R. 
     passes what Dan Yankelovich calls the ``they have a point'' 
     test.
       But there is an awful lot of Personal Responsibility going 
     around already. As educational loans are cut we are told to 
     be responsible for our own children. As company pensions are 
     fading, we are told to be responsible for our own retirement. 
     At the same time we are to be responsible for disabled 
     parents and even grandparents.
       Dear Priscilla, when the politicians up there start talking 
     about Personal Responsibility, they mean our responsibility, 
     not theirs. The GOP Congress isn't just trying to balance the 
     budget. They want to end the idea of government as an agent 
     of mutual responsibility.
       This is what you get in return for a safety net: a pair of 
     bootstraps, a middle-class tax cut of less than a dollar a 
     day and, oh yes, a nursing-home bill of $35,000 a year.

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