Paid for disability care

One thing you can say about the Community Living Assistance Services and Supports Act: It sure is a CLASS Act.

It’s part of Obamacare:

It is a self-funded and voluntary long-term care insurance choice. Workers will pay in premiums in order to receive a daily cash benefit if they develop a disability. … The benefit is flexible: it could be used for a range of community support services, from respite care to home care. No taxpayer funds will be used to pay benefits under this provision. The program will actually reduce Medicaid spending, as people are able to continue working and living in their homes and not enter nursing homes.

I guess it’s like Social Security: conjured as self-insurance, but really paying as you (we) go. And what of the “flexible” benefits? Marketplace Money reports:

The government basically gives you a check, which then you spend. And you can even actually hire a family member, which could be great for family members who don’t have to then choose between going to work and caring for a parent. Of course, at the same there’s a big potential for fraud. I should mention though that you can’t hire your spouse, because apparently the pledge to be there in sickness and health extends to long-term care.

Correction to the Marketplace story. I’m now told by several correspondents that this is not true, that the CLASS benefit is a cash payment, supposed to be about $50/day depending on the extent of disability, to be spent as you like. That’s good to hear. I had thought this was a case of: “it’s really wives’ who absolutely, positively, always must work for free.”

This makes most of this post unnecessary. So instead I’ll just give you a reference to some basic info on the act, and a recent article in Health Affairs on policy issues with long-term care coverage in general. I hope it’s helpful. And thanks to those who wrote correcting the story.

Will Asian sex ratios return to normal?

I read an interesting analysis of sex ratios at birth by Christophe Guilmoto.

As sex identification technology spread through Asia, sex-selective abortion has followed, allowing for greater expression of son preference, and a skewed ratio of boys to girls. The biological average is about 105 boys for every 100 girls, and the most extreme deviation from that now is found in China and Azerbaijan, with ratios of 120:100.

China’s run-up in sex ratios follows a long evolution that saw a decline in female infanticide after the 1950s, followed by a retrenched son preference under the combination of the one-child policy and the collapse of the social welfare system — and enabled by increased access to ultrasound technology.

However, South Korea is a country that apparently reversed course, dropping from over 115:100 in the mid-1990s to near-normal now:

Guilmoto attributes South Korea’s improvement to increased educational and job opportunities for women, made possible by economic development, and anti-discrimination legislation.

He also has some interesting speculation, especially about the effect of a bubble of “surplus” men — many of whom will not be able to marry:

In such a greatly altered demographic environment, having a son who may never marry would soon represent a serious social or economic hazard. It is ironic that the very precepts that underlay the initial demand for sons (and the parallel aversion to daughters) would deal a fatal blow to the patriarchal system.

That might be wishful thinking, but something has to give.