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The conscience cost

How best to provide quality long-term care for Florida's elderly residents is more than a thorny problem. It is "a human and financial crisis in the making," said Insurance Commissioner Tom Gallagher. Gallagher last week broke a Florida tradition _ the habit of waiting until a crisis is full blown to begin trying to address it _ by forming a 31-member Long-Term Care Advisory Panel to study the developing problems of long-term care and devise strategies to solve them.

An important part of Gallagher's charge to that panel was to find ways to make in-home care, often the most comfortable option for the elderly and potentially the least costly, a viable choice for more families.

Today Florida has 196,000 residents over the age of 85. In 10 years that number will approach 350,000. The number of Floridians over 65 years of age is expected to increase almost 300 percent by 2020.

With improved medical care and the aging of the baby-boom generation, the percentage of elderly in the population will grow too quickly for existing systems to meet the demand. Even now, more than 9,000 elderly Florida residents are on waiting lists for community programs and many more face an uncertain future because they can't afford private care but don't qualify for financial assistance programs.

Residents who have the resources to go to nursing homes may spend their days contemplating financial disaster _ the institutions are so expensive they quickly eat up a lifetime of savings. And though many nursing homes provide quality care, there is no guarantee. A study by Gallagher's staff noted that more than 2,000 cases of abuse or neglect were found in Florida institutions last year alone.

Long-term care is not just a concern of the elderly. Many younger people find themselves over a barrel financially when they must pay for the care of elderly parents while still raising children and trying to save for their own retirement years.

The panel, if it is serious about its task, will grapple with difficult questions. What kinds of long-term care options should be available if Florida is to serve adequately its elderly residents? Is a comprehensive state or federally operated system a better alternative than the current mish-mash of programs? How can programs be financed so they are on firm financial footing, yet affordable for families? How can institutional care be improved and regulated so that helpless patients are not abused or forced to endure years of neglect?

Gallagher is to be commended for seeking answers now rather than later. When the panel completes its work, we hope state legislators and Florida taxpayers will be ready to do their part. Gallagher already has a question for those who might be reluctant to confront the growing problem of caring for the elderly: How much will it cost our conscience to ignore another human need?