The long-term care system in our country isn’t on the verge of crisis—it’s already in one. Slowly, but undeniably, it is failing the very people it was meant to support.
I’ve spent nearly five decades working across financial services, health care, and public policy. I’ve served on presidential commissions, sat in closed-door briefings with lawmakers, and helped lead organizations working to meet the evolving needs of aging Americans. This crisis didn’t emerge overnight – we’ve seen it building for decades.
For more than 30 years, commissions under Presidents George H.W. Bush, Bill Clinton, George W. Bush, and Barack Obama all reached the same conclusion: our entitlement programs were never built to handle a rapidly aging population. There were moments when real reform seemed possible—when ideas were on the table and momentum was building. But again and again, the opportunities slipped by with inaction.
Now we’re living with the consequences. By 2036, the population aged 85+ will more than double. We’ll need nearly one million new assisted living units to meet demand, but we’re on pace to build only 40% of that.
Most Americans still don’t understand how long-term care works, what it costs, or how to prepare for it. And the reality is stark: home care now averages $77,792 per year, assisted living $70,800, and a private nursing home room more than $127,000—and those numbers are rising.
