WATERLOO -- Maxine Tisdale has cared for her mother for four years, an effort that has the entire family living on a financial edge.

Tisdale's mother is too old to be eligible for another hospitalization policy. When she was hospitalized, Medicare only paid in full for the first 21 days of her rehabilitation.

Tisdale said that's only the beginning: Supplemental insurance through Medicare is a maze she can barely navigate, and often times she ends up paying out of pocket.

"The amount they charge is enormous," she said.

At a forum organized by AARP at Payne Memorial AME Church on Wednesday, health policy leaders spoke of health care costs, quality and access. But the issue that left the audience nodding in agreement and encouraging the speakers with shouts of "yes!" was long-term care for seniors.

Tom Newton, director of the Iowa Department of Public Health, said studies show caring for the elderly in their homes is not only cost-effective, it extends life and the quality of those remaining years.

But yet, he said, the longer people live in today's society, the more likely they are to end up in a nursing home.

"We have lots of folks who could remain in their homes and not necessarily be put in that system," he said. "It costs money to do that, but if you look at the costs associated with it compared to the cost of nursing homes, it's substantially less."

Leaving people in their homes also can tax the caretaker, often a daughter or son. That's why having a system in place for professional caretakers to help supplement the efforts of family is so important, panel members said.

"We're in a sandwich generation. We're not only taking care of children and grandchildren, but we're taking care of our parents," said Dr. N. Joyce Payne, who serves on the AARP board of directors.

The stress of caring for a loved one combined with paying for that care can create disastrous financial consequences. Payne said it is not uncommon for a person's insurance coverage to be ineffective because it only covers $4,000 per month, when the actual cost is $10,000 per month.

As politicians discuss health care reform, Dr. Paul Franke, vice president of medical affairs at Wheaton Franciscan Healthcare, said the country needs to reflect on what health care access means in this country.

"Is health care a right or a privilege? And why do we regulate the price of utilities, but not health care costs? We have a finite amount of resources to spend. How we spend those dollars is a reflection of our values," he said.

Contact Jens Manuel Krogstad

at (319) 291-1580 or

jens.krogstad@wcfcourier.com.