Long-Term Medical Expenses
The Need for a New Business Model
Research is needed to discover and evaluate different business models for financing long-term medical expenses. These expenses, also known as independent living services, include personal assistant services, durable medical equipment, long term therapies, and maintenance drugs.
The federal government grants more than $100 million per year to academic and professional research centers to study issues that affect the population of people living with disabilities, primarily focused on policy-related issues There is an enormous amount of data and information about people living with disabilities, particularly related to demographics; barriers and facilitators to employment; the relationship between disability benefits policy, work and economic well-being; and the costs of living with a disability. Despite wonderful laws including Americans with Disability Act that have significantly improved the lives of people with disabilities, the economic well being of most people with disabilities continues to be dismal.
I'm thrilled that many agencies and an increasing number of financial institutions offer services that provide customers with disabilities and their support community with information, advice and guidance that aims to improve their financial health. Expanded use of ABLE accounts and Special Needs Trusts will positively impact the people with disabilities' economic conditions. I'm also thrilled that there is a renewed focus on job development and employment for people with disabilities. However, I do not expect that any of these efforts will significantly 'move the needle' re people with disabilities' financial health.
There is an underlying prevalent paradigm and business model that inhibits significant improvements in the financial health of people with disabilities from occurring. Too many agencies, including Social Security, still defines disability as an inability to work. Too often financing independent living services is only available to people living in poverty. These services must be viewed as investments and not just expenses. These goods and services must be viewed as enablers rather than just ways people with disabilities sustain themselves. Investment in technology that can enable remote assistance and robotic assistance must be viewed as ways of providing better goods and services as well as cutting costs. Provider's advancement should be tied to the advancement of their clients.
There should be many ways to achieve the goals stated above. One possibility may be an Independent Living Services Plan (ILSP) that is a cross between an insurance plan and a retirement plan. Premiums may be paid based on a percentage of a household's annual income. If/When long-term medical goods and services are needed, the ILSP would pay for the services and seek reimbursement to itself from the varied agencies that should be providing the service. Clients would be shielded from the myriad of complexities required to finance services they need. Client's co-pay may also be capped based on a percentage of a household's annual income.
My experience is that the business community is best able to develop innovative, sustainable, scalable and maintainable systems and business models that truly meets and exceeds the needs of its customers. How can we engage experienced business people, entrepreneurs and creative young people to suggest new ways of financing independent living services? What research is needed to prove the viability of any new strategies?