I have some friends who are retired, with good pensions and no major financial worries. They also have decent health care coverage, both through Medicare and through a supplemental state program for which their longtime service made them eligible (those benefits were taken away from employees who had not had twenty five years of work as of the late 1990s, but they were lucky to have that length of service and retain their benefits).
But they have major, chronic health problems and they have been examining life in "assisted living" facilities. While they would definitely need some of these services, given their special and difficult health needs, they would have to pay something like $350,000 for a one bedroom facility (meaning that they would have to sell their house in all likelihood in order to make the down payment) and also pay high maintenance fees for services rendered. They would also be largely isolated from their communities and the political activism that has always helped sustain them as human beings (although of course the possibilities exist that they could develop new community relationship). In reality, their savings and pensions would in all probability largely fall into the hands of the for profit institution for the remainder of their lives, whose overall quality, even with their increased physical security in the event of health emergencies and access to daily care, would be diminished, since life is about social relationships, involvements, interactions with people.
And my friends are relatively well off. Other senior citizens with greater health problems and far less resources are compelled to turn over all of their resources to nursing homes as a consequence of being admitted to such facilities. I know of cases where low income spouses have been compelled to legally divorce their chronically ill spouses in order to protect themselves from the financial liabilities for health and hospital care. Spouses and children of ill senior citizens hiding the assets of their spouses and parents in order to prevent them from reaching the destitute state that institutions require for admittance is commonplace in the U.S. today.
This is yet another horror of capitalism--that is, people are encouraged to fight with each other all of their lives for money and then, in a twist on the classic Jack Benny joke, when they are told by a thief (in
this case the for profit nursing homes and assisted living facilities) "your money or your life," have to think about it.
Along with public health care, day care, and other necessary social services, a flexible public system to provide aid to chronically ill senior citizens should be a high priority for a socially just society. The first call should be to help people live and remain active in their homes and communities to the greatest extent possible--to provide them with the assistance (not charity programs) as a matter of right to live comfortable lives and enlist communities in helping senior citizens. When full-time care becomes necessary, facilities should be available for senior citizens that would permit them to retain their personal property(homes especially) and/or sell such property for themselves if they wish. American capitalism, which glorifies "private property" aka stocks, bonds, commercial real estate, etc, does less than many other societies in protecting the personal property rights of citizens, who must sell their homes to go into nursing homes and can have their homes and small businesses(which are not personal property) in effect confiscated by local and state governments in order to make way for commercial developments In the past this power was usually reserved for roads, highways, and public sector improvement. Today it is being widely extended to developers and gentrifiers, those who will allegedly bring more "ratables" in the form of tax dollars into financially strapped communities.
Through most of the twentieth century, reactionaries mocked social welfare state policies as providing "cradle to the grave" protections. In the U.S., with outrageously high infant mortality rates for a developed country, no real public day care, the complete absence of national health insurance or socialized medicine, and a very limited and inadequate social security system, the journey from the cradle to the grave in the twenty-first century, regardless of all the scientific advances to prolong life and technological advances to make life more comfortable, continues to be a perilous one. And it will become more perilous as long as all citizens except without questioning a capitalist system that exploits them from the cradle to the grave.