She entered the nursing home as a private patient, spending her own funds until they were exhausted. Thus she qualified for Supplemental Social Insurance and Medicaid. Of course this means she will have no estate to pass on to me or to my children, but I see no injustice in this arrangement. I certainly don't feel resentful that my mother's savings (not mine, which are mercifully intact for my own rapidly approaching retirement years) were used up before the government-which is simply a shorthand way of saying the community of tax payers-took over. I'd very much like to know how other Swarthmorans feel about this issue.
Judith Asch-Goodkin '55
Westfield, N.J.
Who should pay for long-term nursing home care for a middle-class aging parent with middle-class children? The articles imply that the only reasonable and responsible option in this situation is to view the assets of the parent as "family" funds and to arrange for the transfer of these assets to other family members (typically adult children) so that the aging parent will qualify for Medicaid-paid (taxpayer supported) long-term care.
A number of other views of this situation-including the views held by some elder-law attorneys-were not reflected in the Bulletin. One view is that each individual should use his or her own assets to pay for long-term nursing care, even if no money remains to pass on to the next generation. Another view is that present law should be modified to permit an elderly person in need of long-term care to retain a modest amount of assets. (In most states at the present time, an unmarried nursing-home resident wishing to become eligible for Medicaid may have no more than $2,000 in countable assets.) A third approach stresses the practical problems and consequences for the person who is divesting-including periodic evaluations that may intrude on the person's sense of privacy as well as possible discrimination in admissions and differences in the quality and location of care. Finally, poorly drafted federal legislation that became effective Jan. 1 attempts to criminalize the disposition of assets for the purpose of obtaining Medicaid eligibility. The effect of this new law will be to make divestment more complex.
Looked at from a broader perspective, Medicaid obtained by divestment consumes public resources that might otherwise be available for the desperately needy, especially poor children, or other high priority public programs. Our particular concern relates to children in poverty. Recent research has established that the number of children growing up in poverty is growing at an alarming rate, a rate that can be expected to grow even faster owing to recent "reforms." At the same time, elderly beneficiaries represent only 11 percent of total Medicaid beneficiaries, but their share of program payments is 31 percent of the total-and growing larger each year. Therefore increased Medicaid use by the middle class only accelerates the decline in medical assistance and related public programs for poor children.
The articles also fail to make clear that the assets that are being divested are not "family funds." They belong to the aging person, not to his or her family. The aging person (assuming legal competence) is the sole person with the right to make all decisions about the transfer of assets. Lawyers have the professional duty to ascertain their clients' independent wishes and to make clear to all concerned that there may be a conflict of interest between the objectives of the client (the aging parent) and those of other family members. We suggest that a future Bulletin tap Swarthmore's creative alumni for a serious discussion of a new national policy for long-term health care financing that does not strip the frugal elderly of their life savings, does not encourage their adult children to believe that they have some priority claim to their parents' assets, and does not functionally restrict future efforts to deal with the problems of the unconscionable number of children growing up in poverty.
Elizabeth Stern Uhr '52
June Miller Weisberger '51
Madison, Wis.
The editor welcomes communications from readers who would be willing to participate in a future article on this topic.
There are two reasons that the College should not brag about "doing very well indeed" by Big Macs and the like. One is that you are skirting the nutritional questions that should concern alums of all ages. Against this, of course, you could note that when McDonalds opened in Moscow it gave Russians a chance to eat meat of higher quality than they were getting elsewhere, and that McDonalds' standards of cleanliness are at least equal to those of Disneyland.
But I'm more bothered by a financial detail: "`the idea that McDonalds was building substantial value in real estate and that the franchisee was on the hook to lease property ... for a much longer period than it would take McDonalds to pay off its real estate purchases.'" I admit that economics was my worst subject at Swarthmore, but the phrase "on the hook" (like a side of beef?) seems to point to "gouging."
I acknowledge that McDonalds, thanks mainly to Mrs. Ray Kroc, has set a fine example for other corporations, for instance with its Ronald McDonald houses. But when my class agent bids me to dig deep for the Alumni Fund, taints like that in the $640 million endowment make me wonder whether there aren't needier causes to assist.
John Ridland '53
Santa Barbara, Calif.
Many of us would like to think that Swarthmore fostered an ethic of considering the consequences of our actions. While the school teaches us in the Quaker tradition to be enlightened, responsible members of the human family, how does the school itself do business? What are the consequences of helping to finance the ascendance of the McDonalds Corporation? Destruction of Brazilian rain forests for corporate cattle ranches to export cheap meat? Infusing the American diet, especially that of lower-income people, with high-fat, salty junk food-then aggressively exporting our culinary misfortune all over the world? Paying employees wages they can't live on and lobbying against any raise in the federal minimum wage?
You wrote, "according to ... one of Swarthmore's [financial] advisers, the McDonalds investment is an example of the long view taken by the College's money managers." Is this truly the extent of Swarthmore's vision?
Richard Figiel '68
Trumansburg, N.Y.
The route I envisage is similar to that advocated by the authors but would contain material disincentives to drug use. Suppose drugs were made available inexpensively but only by prescription. These prescriptions might be easy to come by but would automatically disqualify the holder from any occupation involving public safety or high-level decision-making-perhaps even a driver's license. The restrictions might even vary according to the drug.
This would decriminalize drug use, but make it socially inconvenient. Presumably drug use would cease to be "cool" under these circumstances and social pressure would tend toward abstention. This policy could be coupled with a public health program to help people break their addictions, such as Bertram and Sharpe proposed.
Sifford Pearre Jr.
Halifax, Nova Scotia
The Bulletin welcomes letters from readers concerning the contents of the magazine or issues relating to the College. All letters must be signed and may be edited for clarity and space. Address your letters to Editor, Swarthmore College Bulletin, 500 College Avenue, Swarthmore PA 19081-1397, or send by electronic mail to bulletin@ swarthmore.edu.
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