With an increasing elderly population, the need for nursing home services will definitely increase. However, the number of Medicaid recipients probably will increase also. Even though revisions to Medicaid have occurred, reimbursement rates are still inadequate. Realistically, the government cannot afford to totally fund the care of the elderly. Plans to curb the costs of long-term care, such as private insurance and preadmission screenings, appear to be necessary. Perhaps some rationing of care will be necessary. If so, we will have a whole new set of problems with respect to ethical and moral issues.