My mother in law is currently living in a nursing home and is paying out of pocket. If she lives longer than her financial resources then it will be Medicaid. My father has Alzheimers and will likely need nursing home care in the future. My folks have long term care insurance but that only covers two years, that's all they could afford. After that it will be Medicaid. I would gladly take responsibility of caring for my own, but my ship would sink almost instantly as would most middle class families.
The world is a ghetto