The problem that we as elder law attorneys face is when someone suffers from a long term illness such as Alzheimer's, Parkinson's disease or stroke. In those situations, not only does the ill individual or their family have to be concerned with the medical aspects of the disease, but as well with the numbing financial costs. I like to tell the story of the time I was trying to impress a woman from Denmark with what I did for a living. When I told her that I helped people with long term illnesses attempt to protect their finances, she looked at me like I had two heads. It was simply incomprehensible for her to understand how illness and financial ruin can go hand in hand.

Our President has done an excellent job at dividing the country and turning various factions against each other. We actually have people out there railing against ill seniors for having the nerve to ask younger taxpayers to assist them in their time of crisis. Unlike other cultures where the older generation is venerated, that type of honor is now being discouraged in this country by many people more concerned with the growing cost of caring for people who have done nothing but work hard and contribute to the system, but now have the gall to live longer than was expected.

The president suggests that, much like the Social Security system, health care should be privatized. That is a suggestion that will go far towards pleasing pharmaceutical and insurance companies. Those companies are already doing very well with Medicare Part D, which is an attempt to privatize the Medicare program. Now, the president suggests that rather than having national health insurance, people should be encouraged to purchase long term insurance. On its face, this is a sensible idea. However, there are some realistic problems. Studies show that only about 20 percent of seniors can either (a) afford to purchase a policy or (b) would be medically qualified for a policy. As it stands now, thanks to the draconian new Medicaid law, for a policy to be worthwhile, it should cover five years' worth of care in an institution. It should also cover the cost of home or assisted living care. That means the policy should cover a minimum of $250 a day and probably more. The private rate of many nursing homes on Long Island is over $400 a day. The cost of these policies is high. Additionally, even a hint of medical problems is going to make the cost higher, or cause the individual to simply be rejected. If at some point you have mentioned to your doctor that sometimes you have trouble finding your keys in the morning and your doctor makes a note in his or her files, you most likely will never be accepted for coverage.

Even the courts have become sympathetic to the problem. Whereas in the past, a guardian of an incompetent person might have a difficult time convincing the court to allow Medicaid planning, now the courts readily agree that that incompetent person should have the same rights to do Medicaid planning as a competent person would. Guardianship proceedings regularly allow for the guardian to do Medicaid planning. Some of our higher courts have been emphatic in allowing the planning. They have pointed out that since there is no workable system, people with serious medical illness have no choice but to do Medicaid planning.

Those that rail against the "artificial impoverishment" tactic have yet to offer any viable alternative. It seems to me that the only sensible thing would be national health insurance. And yet, the emphasis in this country at the present is not to look to the government for help, but rather to look towards large, uncaring private companies to offer us services that will reap them large benefits. I am not suggesting that profit is a bad thing, I simply believe that, at least as a by-product of their profits should come a responsibility. I also believe that our government has a primary responsibility to care for the individual. The multibillion dollar corporations seem well prepared to take care of themselves.