Center for Long-Term Care Reform, Inc.

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Email info@centerltc.com or call Damon at 206-283-7036 for advertising rates.

Interested in the Group LTC market?

LTC Solutions is a firm that specializes in LTCi as a benefit for employees. We are looking for enrollers and sales representatives to help expand our business. Interested in learning how LTCi can be profitable for you or your company?

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Join the Center for Long-Term Care Reform. Help us fight for rational LTC policy reform. Receive our daily email publications. Get a user name and password to our Members-Only Zone. Only $150 per year. Mail your check to Center for Long-Term Care Reform, Inc., 2212 Queen Anne Avenue North, #110, Seattle, Washington, 98109. Contact Damon at 206-283-7036 or damon@centerltc.com if you have questions. Join the team!

READ STEVE'S BIO

Did you miss our well-received CLTCR Webinar: Maximize the Value of WWW.CENTERLTC.COM? No worries! View a recording of this informative Webinar and explore with Steve Moses the Center's multi-faceted, content-rich website.

CHECK OUT OUR BRAND NEW
LTC ALMANAC
(Members Only)

Not a CLTCR member? Get a free trial membership for your sneak peak at our LTC Almanac and Members-Only Zone. Contact us at 206-283-7036 or info@centerltc.com

Read Medicaid Planning Quotes

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Updated: Thursday, May 15, 2008 10:01 AM (Pacific)

Dateline: Seattle, WA--

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LTC BULLET: THE LTC SCORE

LTC Comment: How the Congressional Budget Office (CBO) "scores" proposed legislation helps or hinders passage often inversely to the proposals' merit. LTC tax deductibility is a case in point, after the ***news.***

*** TODAY'S LTC BULLET is sponsored by Claude Thau, a Master General Agent who helps LTCi producers nationwide. Claude is the lead author of Tillinghast Broker World Individual and Group LTCi Surveys. His mentoring skills help you build whichever market suits you best (individuals, executive carve-out, multi-life, affinity, financial institutions, referrals from other professionals, etc.). Claude has been actively involved in the State Partnership movement and has campaigned to allow independent review of LTCi claims. Test Claude by calling 800-999-3026, x2241 to discuss opportunities or emailto:cthau@targetins.com. ***

*** LTC TOUR RESUMES. My second respite from the rigors of the LTC Tour is coming to an end. I'll board a ViaRail train in Vancouver, British Columbia on Sunday, May 18 for the three-day, three-night journey to Toronto, Ontario. Arriving there, hopefully on time, at 8PM Eastern on May 21, I'll bus to the airport, retrieve the Silver Bullet's FJ Cruiser tow vehicle from long-term parking, and head to Cleveland, Ohio for an interview with Long-Term Living, a leading LTC provider trade magazine. Thence on to Jackson Center, the tiny town in Ohio where Airstream built the Silver Bullet, and where our LTC Tour's media magnet awaits my return after three weeks in the loving arms of its mother and a full servicing of all her many systems. Then the Silver Bullet, the LTC Tour, and I will proceed full speed ahead toward Washington, DC where one of our first activities will be to meet with a delegation from the Prime Minister's office of the United Kingdom. They wonder why LTC insurance has not taken off in the U.S.A. and I have a few things to tell them about that. Furthermore, what I have to say is very relevant to the future prospects of the embryonic private LTC insurance market in the UK! Stay tuned for more exciting adventures from the National Long-Term Care Consciousness Tour. ***

*** SUPPORT THE CENTER AND THE TOUR. Traveling the country (especially at the ground level with today's gas prices) to beat the drum for responsible LTC planning and rational LTC public policy . . . IS VERY EXPENSIVE! If you appreciate what we're trying to do, please help. Be part of the solution. Join the Center with a $150 annual membership; or get your organization or company to join with a group membership (negotiable.) Bring the LTC Tour and the Silver Bullet of LTC to your town while the cost is nominal during this year's road trip. We're having a lot of fun and making a big difference. Find out how to get involved: call or email Damon at 206-283-7036 or damon@centerltc.com. He can refer you to Regional Representatives of the Center for Long-Term Care Reform who have already hosted the LTC Tour, scheduled successful programs for the public and financial advisors, and attracted important media attention to our issue AND to their own businesses. Seek their advice. Then if you want to participate, work directly with Steve Moses to plan and accomplish your LTC Tour program. ***

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LTC BULLET: THE LTC SCORE

LTC Comment: The "white knight" for long-term care insurers is tax deductibility. Above-the-line preferably; part of cafeteria plans as a fall-back; or through IRA/401(k) plans at least.

Tax deductibility for LTCI would certainly help. Let's leave aside today the more fundamental issue that the private insurance market will never really take off, regardless of tax deductibility or education efforts, as long as the government pays for the vast majority of home care and nursing home care for middle class and affluent people.

What's holding back tax deductibility for LTCI? Simple. The government figures it would cost too much. How does the government know that? CBO estimates (scores) the cost of every proposal.

Therefore, exactly how CBO schedules LTCI tax deductibility proposals is critical to their prospects for passage. Unfortunately, the methods CBO uses handicap the proposals unfairly.

The following (slightly abbreviated) column by Merrill Matthews, Director of the Council for Affordable Health Insurance (www.CAHI.org), explains how CBO scoring impedes good public policy regarding LTCI tax deductibility.

Read Merrill's thoughtful piece, but don't despair. There is a way to pass all three kinds of LTCI tax deductibility AND finance a much-enhanced education program to encourage responsible LTC planning.

How? Improve Medicaid and cut its cost radically by targeting the program to people truly in need. Use the savings to fund LTCI tax deductibility and public LTC education. You'll have enough left over, no matter how daunting the CBO scores, to improve Medicaid radically for a smaller number of genuinely needy recipients. (For details, see the articles, speeches and reports at www.centerltc.com.)

Furthermore, government and the tax payers will reap the added benefit of Medicaid savings and improved care for all that a supercharged market for private LTC insurance will deliver. CBO's mis-calculations to the contrary, notwithstanding.

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The following column is republished with permission from the author.

And Now You Know...

by Merrill Matthews, CAHI Director

The biggest enemy of moving to a consumer driven health care system may not be those wanting a government-run system, but the way certain federal agencies "score" various pieces of legislation.

Before Congress can vote on a bill, it must get an estimate, or score, from the Congressional Budget Office (CBO) or the Joint Tax Committee of how much money the legislation will cost or save the federal government.

To most Americans, that sounds like a reasonable procedure. Don't most families, before remodeling a room, estimate how much the project will draw from the family budget and whether that's a workable number?

But like so many things in Washington, it's not that easy. Take, for example, the long term care (LTC) legislation that CAHI has supported for several years. The legislation would allow workers to pay their long term care premiums out of their tax-deferred IRA or 401(k) account. Rep. Lee Terry (R-NE) introduced a version of this legislation.

There is a different bill that has been floating around for years -- and going nowhere -- that would create a new tax break for LTC premiums. But it received a very large score, that is, Congress would lose a lot of money. That cost has effectively killed the legislation.

But the Terry bill wouldn't create a new tax break; it simply made LTC premiums a qualified distribution of an existing tax break. It's fair to say that some people would increase their IRA and 401(k) contributions, but both programs' contributions are capped. So the federal government would certainly lose some money, but it would be minimal.

However, the score assumed another factor -- one that drove up the "cost" of the legislation. It asked how much money the government would lose if people bought all of those LTC policies with after-tax dollars. Of course, they wouldn't be buying those policies without the tax break in the first place, so the government wouldn't actually lose a dime on the sales. But that's beside the point. That assumption added a significant cost to the legislation, making it more difficult to move.

And because these scores usually look only 10 years out, they didn't capture all the future savings to the Medicaid program, which would be paying out less for long term care.

I can't tell you how many times good legislation has been thwarted by bad scores and bad legislation has been boosted by good scores. . . .

Scoring will also be a huge hindrance to Medicare reform. Almost any market-oriented Medicare reform envisions paying providers a reasonable fee for their services. But Medicare price-controls most of those fees now. So the score for market-oriented reforms almost always looks more expensive than the status quo -- even when everyone knows that the current system is unsustainable and the proposed legislation would be affordable.

So while we can count on the usual suspects opposing good health reforms, the biggest hurdle may come from those who can't count.

Source: Health Care Central, May 6, 2008, www.cahi.org

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Updated: Wednesday, May 14, 2008 11:18 AM (Pacific)

Dateline: Seattle, WA--

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THE ZONE UPDATED WITH NEW COST OF CARE DATA

LTC Comment: We update the Center for Long-Term Care Reform's "Members Only Zone" every time new cost of care data is released.

Go to "Long-Term Care Cost Surveys" at http://www.centerltc.com/members/ltccostsurveys.htm, enter your user name and password, and you'll find:

(1) links to the latest cost of care data reported, and for comparison
(2) links to cost of care data for the past few years.

The latest survey comes from Genworth Financial. A summary and some highlights from the AHCA / NCAL Gazette follow.

You've doubtlessly seen this data reported elsewhere already. Our purpose with today's LTC E-Alert is to remind Center members that you can always find the latest cost of care data in The Zone.

And while you're there, check out the many other features of The Zone, such as:

(1) The Almanac of Long-Term Care,
(2) Links to all the annually updated Medicaid and Medicare numbers,
(3) Documentation on the government programs' "unfunded entitlement liabilities," and
(4) Reasons Why Veterans Should Not Depend on VA Benefits for Long-Term Care.

Not yet a member of the Center for Long-Term Care Reform? Don't have access to The Zone? That's easily remedied. Contact Damon at 206-283-7036 or damon@centerltc.com. He'll have you enrolled in the Center with your personal user name and password for The Zone in a flash. Individual membership is $150 per year or $12.50 per month. Group or corporate memberships, entitling everyone in your organization to all the benefits of Center membership, are negotiable.

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Study finds increases in nursing home, assisted living costs; Nursing home costs up 17 percent from 2004. By Eileen Alt Powell, The Associated Press. Apr 29, 2008 1:00 PM EST

In its 2008 Cost of Care Survey, released yesterday, Genworth Financial reports that the average cost for a private room in a nursing home is now $209 per day, or $76,460 a year. The average annual cost in 2004 was $65,185. Alaska had the highest cost last year at $515 per day while Louisiana had the lowest at $125 per day.

The cost for assisted living facilities averaged $36,090 nationally, up 25 percent from $28,763 in 2004. New Jersey had the highest average cost at $4,921 per month, while Arkansas had the lowest, at $1,981 per month, according to the study. Read article.

* The 2008 Cost of Care Survey can be found here (click on the survey on the right side of the page)

* Access Genworth's other new report: 'A workforce to care for our aging'

AL: Alabama annual nursing home costs increase by 14 percent to $57,591 By Jimmy DeButts. Birmingham Business Journal. Apr 29, 2008. Read article.

* NJ nursing homes cost 25 percent more than national average Newsday:

http://www.newsday.com
http://www.bizjournals.com

* Miami nursing home care up 28 percent since 2004 South Florida Business Journal http://www.bizjournals.com/southflorida/stories/2008/04/28/daily22.html

* Nursing home costs creep up in Utah, By Lesley Mitchell. Salt Lake Tribune

"The cost of long-term care in Utah and other states has been climbing in recent years right along with the cost of health care," said Dirk Anjewierden, executive director of the Health Care Association. Rising costs and labor shortages have affected long-term care. "Just try to find a nurse right now," he said. http://www.sltrib.com/ci_9101554

Source: AHCA / NCAL Gazette - Wednesday, April 30, 2008

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Updated: Tuesday, May 13, 2008 10:01 AM (Pacific)

Dateline: Seattle, WA--

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LTC DISCONNECT

LTC Update: Enjoying your respite from the Center's daily publications? I sure am. But don't think we're snoozing. I'm in Seattle for my second R&R from our 2008 LTC Tour. Nevertheless, Damon and I are working hard on preparations for the next leg of the Tour. I'm headed toward the Central East next, including DC, Maryland, Virginia, West Virginia, Pennsylvania, Delaware and New Jersey. Your LTC Tour updates from the road will resume soon. In the meantime, we'll touch you with the occasional e-message like this one.

LTC Comment: According to the following national survey, running out of money is right up there with losing one's health as the biggest worry in later life.

So, insuring against that risk must be a slam/dunk estate planning decision. Yeah, right!

Go figure. Are consumers stupid? Are LTC insurance producers incompetent? None of the above.

The real answer is simple. Government has paid for most expensive LTC, such as it is, for 43 years. That put the public to sleep about the risk. The only people waking up and buying LTCI have been through a wrenching experience with a loved one. Wait for all the parents of baby boomers to require LTC and the market will finally improve.

But the waiting game is for suckers. The better strategy is proactive. Advocate public policy to target government financed LTC to people truly in need. Use the savings to incentivize LTCI and reverse mortgages for people with wealth to protect or use. Everyone wins because the more private money in long-term care, the better the access, quality and diversity of care for everyone, rich and poor alike.

Side note: the sponsor of the study described below is the National Association of Professional Geriatric Care Managers ( NAPGCM, www.caremanager.org). It's a fine organization but for some unaccountable reason has always been connected at the hip to the National Academy of Elder Law Attorneys (NAELA), the trade association of the Medicaid planners.

Talk about strange bedfellows. NAPGCM and its members depend entirely on private LTC financing to survive and provide the critical service they offer. NAELA and its members' cash cow is artificially impoverishing affluent people to qualify them for welfare-financed LTC, which never pays for geriatric care managers.

Oh well, I learned long ago not to expect rational behavior from stakeholders in the long-term care system. Present company excepted, of course.

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Geriatric care managers association releases results of consumer survey

Consumers' top concerns include losing their physical or mental health and not having sufficient finances to support themselves or their spouses/partners later in life

(5/5/2008)

TUCSON, ARIZ.-The National Association of Professional Geriatric Care Managers (NAPGCM) recently surveyed 2,075 U.S. adults 18 years of age and older about elder care and aging issues.

Highlights of the survey results:

* While losing their physical or mental health was the top-rated consumer concern overall (83%), at a close second (78%) was not having sufficient finances to support themselves or their spouses/partners later in life.

* A relatively high percentage of consumers (71%) were concerned about having to leave their homes or losing their independence.

* Losing a spouse/partner and/or having to live alone weighed heavily on the minds of many of the respondents (66%) as did a spouse/partner having to care for a person if he or she was to become frail or was dying.

* Other major concerns noted were losing the ability to drive (65%) and having to care for a spouse/partner as they became ill or were dying (58%).

* Overall, 32% of respondents were at least familiar with the roles and responsibilities of the geriatric care manager profession.

Source: Long-Term Living E-News, 5/7/8

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Updated: Monday, April 28, 2008 12:17 PM (Eastern)

Dateline: Lakeview, Ohio--

(LTC Tour Mile 10,450; State #13)

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LTC E-Alert #8-043: LTC Tour Goes International

LTC Comment: This morning, I'll drop off the Silver Bullet at the Airstream factory in Jackson Center, Ohio. Home to momma for the trailer. Fitting, with Mother's Day so close. A full servicing will be done.

In the meantime, I'll head north, do a program and media interview in Findlay, Ohio, proceed to Detroit to meet with two Regional Representatives of the Center, and then cross the border into Canada. (At that point, I'll be offline for awhile, so no more LTC Bullets or LTC E-Alerts temporarily and little or no email.)

On May 1, I'll board a ViaRail train in Toronto for a three-day, three-night journey to Vancouver, British Columbia. This is the start of my second return home to Seattle for rest and relaxation after the rigors of the LTC Tour. A much-needed break.

But, why not make the most of the train trip professionally? I plan to interview fellow passengers informally on how their countries handle long-term care service delivery and financing. Although Canadians will be on board the Toronto-Jasper-Vancouver run, I anticipate I'll also share tables in the dining car and chat in the "dome" car with people from all over the world.

So, in a couple weeks, when I come back online regularly, expect an essay about what I learned over there about how the other side handles LTC. In the meantime, I'll be catching up on professional reading, updating the "Almanac of Long-Term Care" in The Zone, and planning the next exciting stretch of the National Long-Term Care Consciousness Tour.

If you miss your daily dose of information from the Center for Long-Term Care Reform, may I suggest this would be a great time to explore the wealth of information at www.centerltc.com? You'll find archives of all the LTC Bullets, links to "articles, speeches and reports," information on the LTC Tour including how to get involved and much, much more.

See you soon, but for now . . . hasta luego. Oops! Wrong border.

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Updated: Friday, April 25, 2008 1:19 PM (Eastern)

Dateline: Clarksville, Indiana--

LTC Tour Mile 10,150; State #12--

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LTC TOUR AT CHURCHILL DOWNS

LTC Comment: The Silver Bullet of Long-Term Care visited Churchill Downs in Louisville, Kentucky yesterday. The 134^th running of the Kentucky Derby will take place on May 3 at that venue. What better place could there be, I thought, to point Center members and readers to "The LTC Triathlon: Long-Term Care's Race for Survival."

That's a study I conducted documented in a report I published on December 7, 2000. "The LTC Triathlon" analysis is more relevant and important today than it was back then. So, in the YouTube video at http://www.youtube.com/watch?v=A3H_1Xhe9Gw , I encourage you to look up the report at http://www.centerltc.com/pubs/triathlon.pdf and read it.

To pique your interest, the "LTC Triathlon's" Executive Summary follows below. But first, check out these photos depicting progress of the Center for Long-Term Care Reform's National Long-Term Care Consciousness Tour.

Here's a map of the United States with the LTC Tour's route indicated in black lines. The solid line shows the Silver Bullet's itinerary. The dotted line indicates where I flew in to do presentations: from Greensboro, NC to Chicago for the American Medical Association and from Memphis, TN to Miami for the Dade Association of Health Underwriters "LTC Expo." The second picture shows the LTC Tour map positioned on the Silver Bullet of Long-Term Care.

Although the LTC Tour has racked up over 10,000 miles and touched thousands of lives with our message of responsible LTC planning and rational LTC policy, we've only just begun! The best is yet to come. After some R&R back home in Seattle, I'm taking on the nation's capital, the mid-Atlantic states, the Northeast, the Midwest, and before we're done, the West.

Check out the LTC Tour's "Calendar" at the top of www.centerltc.com. Read how you can participate as a "Regional Representative" of the Center: http://www.centerltc.com/Regional_Rep-Sponsor_Level.htm. Get your company involved as a Platinum, Gold or Silver sponsor with signage on the Silver Bullet and recognition in our elegant presentation package: http://www.centerltc.com/LTC_Tour_Sponsor_Packet.pdf.

If you're happy with the current condition of long-term care service delivery and financing in the U.S. . . . if you're protecting more people from the risk and cost of LTC than you can handle . . . if you think the public needs no awakening about LTC . . . if you think government can go on paying for most LTC, then ignore this appeal.

But if you care about fixing LTC, get involved, help the 2008 LTC Tour succeed, join the Center, sponsor the Tour, donate your time to organize events and reach out to the media. That investment will pay dividends: for your clients, for your country, and for you.

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Executive Summary of "The LTC Triathlon: Long-Term Care's Race for Survival," by Stephen A. Moses, Center for Long-Term Care Financing, December 7, 2000, http://www.centerltc.com/pubs/triathlon.pdf, footnotes omitted

Our parents and grandparents fought two great wars to make the world safer and more free for us. They struggled through the Depression, scrimped and saved, so we could enjoy greater prosperity. For the past 35 years, however, we have rewarded their long, hard efforts with an inadequate long-term care system based primarily on institutionalization and welfare financing. Most would agree, we owed our "Greatest Generation" better treatment. Surely, no one believes the current system can meet future needs. Our challenge today is to find and finance a better way of providing long-term care before the clock runs out on us baby boomers leaving an even bigger problem for the next generation. We must not fail our children as we let down our parents and grandparents. The clock is ticking. We're in a race, a race for survival, the LTC Triathlon.

Despite the most benign economic conditions in United States history [we know now the "internet bubble" was about to burst], America's long-term care service delivery and financing system is a tragic mess. Seven major nursing facility chains have declared Chapter 11 bankruptcy. Consequently, between 10 and 20 percent of all nursing home beds in the country are in bankrupt facilities today. Hundreds of home health agencies have gone under financially. Many new assisted living facilities are filling far more slowly than anticipated. Long-term care stock prices are down precipitously. New capitalization by debt or equity is almost non-existent for publicly held companies. Caregivers are in desperately short supply, whether they are low-wage nurses' aides in long-term care facilities or unpaid friends and family in private homes. Formal long-term care services are too expensive for most Americans to afford, but Medicare and Medicaid pay too little to assure quality home- or nursing home care. Litigation against nursing homes and assisted living facilities for providing allegedly poor care is on the rise and is driving liability insurance premiums through the roof. Only seven percent of seniors and virtually none of the baby boomers own private insurance that could help them with the catastrophic cost of long-term care. America's gigantic and rapidly aging baby-boom generation guarantees that the challenge of long-term care will become greater and far more expensive with time. As of now, we are losing the long-term care race.

What is wrong and how can we fix it? That depends on whom you ask. The government blames providers. The providers blame government. Who's right? Probably both positions have some merit, but the government has the biggest bullhorn so its point of view often prevails in the popular and academic media. No one gives much attention or credence to the private sector components that struggle, against ever-increasing odds, to build, operate and maintain the long-term care service delivery system. The purpose of this study was to listen to a sample of the Financiers, Providers and Insurers of long-term care, give their point of view a voice, and begin the search for a better way. We asked 119 telephone interviewees four open-ended questions to find out their opinion regarding what is wrong, who is at fault, what should be done, and how.

We tapped into a gusher of anger and frustration directed primarily at the public programs that finance most long-term care in the United States: Medicare and Medicaid. (To help the reader find what our respondents had to say, most of the direct quotes in the report are highlighted.) For example: "Medicaid does not cover costs" and "There is no question the nursing home sector was killed by Medicare cuts." The government demands "Ritz-Carlton care for Motel 6 rates" and simultaneously enforces an "unprecedented regulatory Jihad." Although assisted living providers depend far less on government than do nursing homes and home health agencies, they too are tempted by and frightened of public financing. What should be done? According to our respondents, government financing is necessary but not sufficient. It must go only to the needy with private funding and insurance for all others. Most respondents agreed that (1) excessive government involvement caused many of our long-term care problems, (2) increased public financing is not the permanent solution, (3) past public financing impeded the growth of private financing alternatives, and (4) long-term care insurance is the most promising answer for the future. Such was the thrust of their analysis and recommendations.

If more private financing is the key to a solution, however, why haven't private financing and insurance played a larger role already and what should be done to effectuate such a result? We heard many opinions, but little agreement. The Financiers, who provide capital for the industry, have depended traditionally on Medicare and Medicaid to cover their cash flow requirements. They know little about private financing sources such as long-term care insurance. The Providers, who offer services directly to the public, either relied heavily on public financing in the past, had little or negative experience with private insurance, or both. The Insurers, who try to protect people against a risk about which most Americans are in denial, do not understand the Providers' problems or trust their intentions. Each of these groups has different challenges, different stakeholders, and different priorities. Each group, by its own report, lacks a long-term vision for its business. Each pursues its own private interests and public policy objectives independently, and so far, less effectively than all would prefer.

Nevertheless, all three groups are in agreement that a better understanding of each other's businesses could advance their own, their clients', their customers', and America's interests. They share a common purpose to pursue long-term care policy that is less dependent on government and more reliant on private financing. A near consensus prevails among the Financiers, Providers and Insurers interviewed for this study that, toward the goal of better coordination and cooperation, more industry-cross-cutting conferences, publications and speeches are highly desirable. The problem is where to start and how to begin. Most respondents stated that making such a beginning would be a difficult and thankless task. Nevertheless, the Center for Long-Term Care Financing would like to try. We will distribute this report widely in order to encourage mutual understanding of the challenge. We hope to convene an "LTC Summit" conference in 2001 to facilitate a conversation between long-term care financiers, providers and insurers. We will speak and publish widely on the importance of communication and cooperation between the primary private sector stakeholders in long-term care. And we will encourage and assist the major long-term care trade associations to unite in the identification and pursuit of mutually beneficial public policy initiatives.

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Updated: Thursday, April 24, 2008 12:55 PM (Eastern)

Dateline: Frankfort, Kentucky--

(LTC Tour Mile 10,500; State #11)

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LTC BULLET: LIVIN' IN ALUMINUM

LTC Comment: Broker World magazine captures the LTC Tour's first quarter, after the ***news.***

*** CAPITOL NEWS: Check out the Silver Bullet of Long-Term Care at the State Capitol building in Frankfort, KY ***

*** LTC TOUR $: If you appreciate the LTC Tour and enjoy following our progress, please help support the Tour and the Center. Become an individual member ($150 per year or $12.50 per month) or a corporate member (negotiable). We want to carry the LTC Tour's message of responsible long-term care planning and rational LTC public policy all across this land. We're doing it, but we need your help. Please pitch in. Join the Center, and if you have the time and inclination, join the Tour by helping to plan events in your area. Help us make a difference. Contact Damon at 206-283-7036 or damon@centerltc.com. He'll explain the opportunities and put you in touch with me if you want to get involved. ***

*** SUBSCRIBE TO LTC BULLETS. Please encourage your colleagues to fill out the simple online subscription form at http://www.centerltc.org/bullets/subscribe_to_bullets.htm . Subscriptions are free to everyone for the first month. After that, we'll ask you to help support the cause: rational long-term care public policy. ***

*** REFERRALS. Thank you for reading the Center for Long-Term Care Reform's latest "LTC Bullets" newsletter. If you know someone who would be interested in this publication, please recommend us by clicking here http://www.centerltc.com/bullets/recommendus.htm. If you have received this edition as a forward, and would like your own subscription, you may subscribe here http://www.centerltc.com/bullets/subscribe_to_bullets.htm. Thank you. ***

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LTC BULLET: LIVIN' IN ALUMINUM

LTC Comment: Sharon Chace, editor of Broker World, invited me to report once a quarter on progress of the Center for Long-Term Care Reform's National Long-Term Care Consciousness Tour. This month's issue of the magazine contains my first update.

Broker World doesn't publish online, so don't miss future updates: subscribe here for a mere $6 per year! http://www.brokerworldmag.com/2004/order/formOrder.asp

To watch and hear Antsy McClain sing "Livin' in Aluminum," go to http://www.youtube.com/watch?v=WcTeEEzHxgQ&feature=related.

Now, here's the article, republished with permission:

The LTC Tour Update . . . "Livin' in Aluminum" -- The First Quarter
by
Stephen A. Moses

In late December '07, I purchased a new 16-ft. Airstream trailer and a Titanium-Metallic Toyota FJ Cruiser in Tampa, Florida and began the Center for Long-Term Care Reform's 2008 National Long-Term Care Consciousness Tour.

I'm living in this "Silver Bullet of Long-Term Care" as I work my way around the country: six regions for two months each starting with the Southeast in January and February, and moving to the Southwest, Central East, Northeast, Midwest and finally out West late this year.

The purpose of our LTC Tour is to raise awareness among the public, legislators, policy-makers, and the media about the importance of responsible long-term care planning and public policy. Toward that end, I'm working with regional representatives of the center and major corporate sponsors of the LTC Tour all around the country to schedule and deliver speeches, meet with public officials and print reporters and appear on radio and TV shows.

So far the media interest has been exceptional and audience feedback wonderful. For example, in Chattanooga, TN, all three television networks had me and, in one case, the Silver Bullet, on the air. A public forum brought out a large audience eager to learn how to prepare for the risk and cost of long-term care. The Nashville-based Tennessean newspaper did a big story, as well. Representatives from TennCare (Tennessee's Medicaid program) met with Regional Representative Phyllis Shelton, LTC Consultant, Hendersonville, TN, and me and to hear our analysis and recommendations.

In Florida, I spoke to groups of financial advisors and insurance agents, did two radio shows and a "podcast" for a magazine.

In North Carolina, I addressed 300 nursing home providers in Greensboro and I delivered the Shaftesbury luncheon speech at the John Locke Foundation in Raleigh celebrating publication of my latest report: "Long-Term Care Financing in North Carolina: Good Intentions, Ambitious Efforts, Unintended Consequences," sponsored by the John Locke Foundation (http://www.johnlocke.org/site-docs/policyreports/NC_LTC_finance.pdf ).

While I'm living and traveling full time in the Silver Bullet, I'm not tied down to it. I parked the rig for several days and flew to Chicago to deliver a speech to a committee of the American Medical Association that is planning the AMA's policy position on long-term care financing.

Early in February there was a stopover in Knoxville, TN, to affix logos of the LTC Tour's major corporate sponsors. Platinum, Gold and Silver sponsors receive signage on the Silver Bullet and recognition in the presentation packet to be distributed at major events.

Mid-February took me to Columbia, SC, to speak at the South Carolina Association of Health Underwriters "Day on the Hill" annual lobbying campaign and on to Atlanta, GA, where I spoke to the Atlanta Association of Health Underwriters, met with a Wall Street Journal reporter, and addressed BRAMCO, a brokers' group.

Finally, I attended the Long-Term Care Insurance Producer's Summit in Atlanta, GA, before heading home to Seattle to enjoy a two-week respite for this weary road warrior. But I was back at it March 16 to 19 at the Intercompany Long-Term Care Insurance Conference in Jacksonville, FL, where the Silver Bullet of Long-Term Care was prominently displayed at the entrance to the conference hotel.

Would you like to take part in the National Long-Term Care Consciousness Tour? Read all about it at www.centerltc.com. I'll provide updates on the LTC Tour's progress once quarter in Broker World..

Help us stir up interest along the way!

"Livin' in Aluminum" is a song about an Airstream trailer searchable and viewable on YouTube.

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Updated: Wednesday, April 23, 2008 11:50 AM (Central)

Dateline: Nashville, TN--

(LTC Tour Mile 9825, State #10)

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MEDI-CAN'T

LTC Comment: People and groups who claim to care about aging Americans often insist that Medicare is a magnificently successful program. But it only seems so if you blank out the program's dismal financial condition and hopeless future.

An important message of the National Long-Term Care Consciousness Tour is that Medicare can't continue propping up Medicaid-financed long-term care. As Medicare retrenches from its heretofore generous funding of nursing home and home health care, the Medicaid LTC safety net will fray, then break. That will hurt not just the poor, but the middle class, for whom Medicaid has been the principal payor of long-term care.

Here's more evidence about the Medicare's likely future. Following is the abstract and conclusion of Joseph Antos, "Medicare's Bad News: Is Anyone Listening?," Health Policy Outlook, AEI Online, April 16, 2008, http://www.aei.org/publications/pubID.27825/pub_detail.asp. The remainder of the paper is well worth reading.

"Medicare is in serious fiscal trouble, but no one seems to be paying attention. The Medicare trustees recently issued their annual report, and the news is not good. If current trends continue, Medicare's Hospital Insurance (HI) trust fund will be depleted in 2019. To make good on the health care benefits promised to Americans, future generations face a tax bill of $85 trillion (measured in today's dollars). That makes the mortgage bailout, which is unlikely to cost more than $1 trillion, look like chicken feed. Why are we ignoring a calamity that will affect every American? What can we do to avoid fiscal disaster? . . .

"Conclusion

"Unlike the mortgage crunch, Medicare's fiscal crisis does not seem real to most people. Medicare seems to be functioning adequately now, the trustees' estimates are difficult to truly understand, and the average American is more worried about gasoline prices than about the uncertain promise of government health benefits in old age. No wonder politicians have been unwilling to take the kinds of actions necessary to reform the program--the next election is always just around the corner, and without a palpable sense of crisis, the public would not back such policies.

"The trustees' report clearly demonstrates that it will soon be difficult to ignore Medicare's problems. If recent trends in spending per beneficiary continue, the influx of the baby boomers will rapidly drive up program spending. Left unchecked, Medicare will drain money from the budget, making it increasingly difficult for Congress to find the means to fund other urgent policy priorities.

"Joseph Antos is the Wilson H. Taylor Scholar in Health Care and Retirement Policy at AEI. Research assistant Tal Manor worked with Mr. Antos to produce this Health Policy Outlook."

Our thanks to friend-of-the-Center and LTC expert Terry Savage (www.terrysavage.com), the nationally syndicated financial columnist of the Chicago Sun-Times, for bringing this article to our attention.

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Updated: Tuesday, April 22, 2008 2:01 PM (Central)

Dateline: Nashville, TN--

(LTC Tour Mile 9825, State #10)

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LTC BULLET: LTC MYSTERY TOUR IN CAIRO AND ATHENS

LTC Comment: The Center for Long-Term Care Reform's National Long-Term Care Consciousness Tour took a detour yesterday to the LTC Pyramid and the LTC Parthenon. Check it out after the ***news.***

Don't miss our YouTube video interview of industry leader Claude Thau at http://www.youtube.com/watch?v=EdD6WAqR_Aw. ***

*** TO SPONSOR AN LTC BULLET of your own, contact Damon at 206-283-7036 or damon@centerltc.com. ***

*** GREAT DEAL. For a free subscription to "Long-Term Living" (formerly "Nursing Homes" magazine), go to www.ltlmagazine.com . I've published in and been written about in this excellent trade journal for many years. To follow the LTC provider industry, it's a must-read. Go to the link, click the "New Subscription" button, "continue" to the subscription form and you're on your way. ***

*** The latest update to our series of pictures of the Silver Bullet of Long-Term Care at state capitol buildings is here. Check out the Silver Bullet at the Tennessee State Capitol and other capitol buildings. ***

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LTC BULLET: LTC MYSTERY TOUR IN CAIRO AND ATHENS

LTC Comment: Welcome again to LTC-TV. We have several new YouTube videos for you to watch. To find them, go to http://www.youtube.com/user/LTCconsciousnessTOUR.

Here's a synopsis of what you'll discover there:

THE LTC PYRAMID: The LTC Tour took a side trip to Cairo, Egypt for a visit to the pyramids. Well, not exactly. The "pyramid" in the video at http://www.youtube.com/watch?v=ivbmlKo3n98 is actually an event venue in Memphis, Tennessee. I used it as a prop to make an important point about the "Pyramid of LTC Financing." To wit, the LTC financing pyramid is upside down. Most nursing home and home health care in the United States is funded by Medicaid, Medicare, spend-through of Social Security income by people already on Medicaid, other income, and other government programs. Only a small amount comes from asset spend down. LTC insurance accounts for a tiny fraction of the total. No wonder America's LTC system is a mess. Let's turn the pyramid right-side-up. Most LTC financing should come from private insurance. Then savings and home equity should be tapped for those who fail to insure. Close to the tip of the pyramid, government safety net programs should provide high-quality long-term care for people truly in need. Under such a system, everyone would have access to top-quality LTC at the most appropriate level.

THE LTC PARTHENON: After Cairo, we moved on to the Parthenon, on the Acropolis, in Athens, Greece. Well, not exactly. The "Parthenon" in the video at http://www.youtube.com/watch?v=CVSDYGTfksQ is actually a full-sized replica of the classical structure. It was built for the 1897 Tennessee Centennial Exposition in Nashville, TN. I used it as a prop to make a wish I hope you'll all share.

THE LTC SUMMIT VIDEOS: At the 2008 LTCI Producers Summit in Atlanta, Georgia in February, we "filmed" a series of interviews with LTCI industry leaders. Technical difficulties prevented our bringing these videos to you until now, although a few were posted earlier. Check them all out at http://www.youtube.com/user/LTCconsciousnessTOUR. And while you're there, subscribe to our YouTube channel so you won't miss a single new video as we post them in the future.

LARRY THOMAS, Chief Marketing Officer for Equitable Life and Casualty, talks about his passion for long-term care planning and the reasons his company has supported the Center for Long-Term Care Reform for many years. "You've been a lone voice out there in the wilderness, fighting for us," says Larry Thomas about the Center.

TOM RIEKSE, SR, Managing Partner of LTCI Partners, a Silver Sponsor of the 2008 LTC Tour. Mr. Riekse talks about how he got involved in the long-term care field 19 years ago and why his company supports the Center for Long-Term Care Reform and our National Long-Term Care Consciousness Tour. "We think public awareness of the problems and the inability of our government to handle those problems and the passion, Steve, that you bring to this thing is important to us and so we financially support you," says Tom Riekse, Sr.

MARK RANDALL of GoldenCareUSA, the 2008 LTC Tour's "coordinating sponsor," interviews Center president Steve Moses about the allegory of "The Elephant, the Blind Men and Long-Term Care." Steve uses this analogy to introduce his two-hour mini-version of the Center for Long-Term Care Reform's "LTC Graduate Seminar." The LTC Grad Seminar has been a hit at meeting after meeting around the country on the LTC Tour.

TODD ANDERSON, Vice President for Marketing, GoldenCareUSA, the 2008 LTC Tour's "coordinating sponsor" discusses his start in LTC insurance and why his company supports the LTC Tour and the Center for Long-Term Care Reform. "We need more people like yourself out there looking at the big picture. I remember one of your articles about the bankruptcy of America with the boomers coming in. That's why we've been a sponsor of the Center for many years."

We hope you enjoy "LTC TV." We'll bring you more video interviews with industry leaders and more coverage of the National Long-Term Care Consciousness Tour as time goes on.

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Updated: Monday, April 21, 2008 11:48 AM (Central)

Dateline: Memphis, TN--

(LTC Tour Mile 9590, State #10)

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LTC EXPO

LTC Comment: The National Long-Term Care Consciousness Tour took a detour to Miami, Florida last week.

I joined the Tour's national PR and marketing consultant--author, speaker and LTCMonth.com founder Marilee Driscoll--to deliver a one, two punch at the Dade Association of Health Underwriters' annual "LTC Expo."

After two hours of my mini-LTC Graduate Seminar, Marilee batted clean-up with a well-received luncheon address.

Read the excellent evaluations of our Miami program which follow below. If you haven't yet made plans to have the Center's 2008 LTC Tour visit your town, start now! We have a sponsorship opportunity to fit all budgets. Check out the details at the top of www.centerltc.com. Then contact Damon at 206-283-7036 or damon@centerltc.com. He'll fill you in on all the opportunities and refer you to me for scheduling.

One way to support the LTC Tour is to become a Regional Representative of the Center for Long-Term Care Reform. Details at http://www.centerltc.com/Regional_Rep-Sponsor_Level.htm.

The Center's Miami Regional Representative, LTC Specialist George Braddock, CLTC, chaired this year's LTC Expo and brought me in from Memphis for my second stint in Miami under his management. Great work, George!

Special thanks to George's mother, Ruth Braddock, author of the book "Julia's Daughters" about women's contributions to Miami's history, for giving me such a warm welcome and putting me up in her home for two nights.

And thanks to Dade Association of Health Underwriters President Doug Jacobs for his strong support and generous hospitality.

But thanks most of all to the AMGs (altruistic, masochistic, geniuses) who attended the program. They struggle daily to convince a public in denial that long-term care is a personal responsibility for which they must plan.

We greatly appreciated the wonderful feedback they delivered in response to our two-hour LTC Graduate Seminar. A sample of that feedback follows.

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Robert Newman: "Steve Moses really delivers a great educational seminar on LTC."

Cornelia Philipson: "Great presentation. Depth & breadth of knowledge on the LTC crisis is amazing. Thank you!"

Sandeo Kaskel: "It's a pleasure to learn the history of LTC from someone who is objective and who sees the broader picture."

Jean Ritter: "Stephen was a refreshing source of new information. Great new tools for marketing LTC."

Leni Cohen: "My experience as V.P. of long term care sales has put me in front of thousands of consumers each year. Your description of consumers living in a 'lookback' world of government taking responsibility is always part of their belief system. You have hit the 'nail on the head.' You have made it easier for me to explain this to my agents."

Holmes Braddock: "Very good and insightful - too bad you can't be on TV and/or radio regularly." (Mr. Braddock is Regional Rep George Braddock's father and a highly regarded institution in the Miami insurance marketplace.)

Ken Gamelin: "Very insightful & enlightening presentation."

Jim Moore: "Fantastic presentation! It's always easy to look back at what happened, but very difficult to see what's coming."

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Updated: Thursday, April 17, 2008 12:51 PM (Eastern)

Dateline: Miami, FL--

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LTC Tour Update: I'm in Miami to speak at the Dade Association of Health Underwriters' annual "LTC Expo." The LTC Tour's national PR and marketing consultant, Marilee Driscoll, will deliver the luncheon address. Then I'm on for two hours with the "LTC Graduate Seminar." Thanks to the Center's Miami Regional Rep for arranging this excellent opportunity. Don't worry about the "Silver Bullet of Long-Term Care." The LTC Tour's media magnet and my home on the road is safely ensconced at a campground back in Memphis adjoining Elvis Presley's Graceland mansion. Rock on!

LTC Comment: The key message of the LTC Tour is that people must plan for LTC looking forward, not backward.

Look at LTC planning through the rear-view mirror and you'll see government-financed nursing home care.

But, look through the windshield and you'll discover a brick wall of fiscal reality rapidly approaching that will end government LTC financing for the middle class and force much more personal responsibility in the future.

What I predict is that Medicaid will make eligibility much harder than ever before and Medicare/Social Security will be gradually means-tested so that most baby boomers won't qualify for full benefits within a decade or two.

The evidence mounts every day as our latest economic recession looms more ominously, tax receipts dwindle, and welfare rolls escalate.

A couple days ago, Presidential candidate John McCain proposed means-testing Medicare Part D. Of course, Medicare Part B premiums are already higher for higher income people.

The presidential campaign debates have mostly ignored unfunded entitlement liabilities. No matter who is elected, that $102 trillion hole in public financing will be front and center, compelling attention in the next administration.

And it looks like the bottom is already falling out from under Medicaid. Look at these links, following below, as provided in the "SPN Medicaid Exchange" e-letter for 4-16-2008.

By the way, if you want to follow developments in health and LTC public policy, that newsletter is a great resource. Subscribe at http://www.ncpa.org/sub/. Every issue cites the Center for Long-Term Care Reform, usually several times.

For example: Where in the Heck is Steve Moses This Month? Steve and the Silver

Bullet have been hitting several state capitols this month.

http://www.centerltc.com/TourPictures/Silver_Bullet_at_State_Capitols.htm

Also, read Steve's analysis of a long-term care proposal being introduced in New York. http://www.centerltc.com/pubs/NY_Compact.pdf

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States Struggle with Medicaid Costs

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o House Report Stirs Tempest over Proposed Medicaid Cuts

o Colorado: Medicaid Rules Could Slash Funds to State's Hospitals

o Georgia: Medicaid Cuts Could Shut State Hospitals

o Heartland Institute: A Three-Part Plan for State Health Care Reform

o Illinois: Comptroller Says State's Medicaid System is Broke

o Kentucky: State Could Lose $1 Billion in Federal Medicaid Money

o Massachusetts: Health Care Cost Increases Dominate Budget Debate

o Massachusetts: State Health Plan Underfunded

o Mississippi: Panel Passes Higher Cigarette Tax as Solution to Medicaid Shortfalls

o Rhode Island: State to Apply for Medical Records Funds

o Viewpoint: Unpredictable Pricing Complicates States' Health Reform Programs

o Vermont: States Worry About Medicaid Funding

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Updated: Wednesday, April 16, 2008 11:46 AM (Central)

Dateline: Memphis, TN--

LTC Tour: Mile 9,425, State #10

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LTC BULLET: HOW TO CURE LTC

LTC Comment: "Three Cures for What's Ailing Long-Term Care," after the ***news.***

*** FEEDBACK from Steve Moses's 2-hour LTC Graduate Seminar presented yesterday to the Central Arkansas Health Underwriters Association:

"I have never sold LTC coverage but your presentation convinced me there is a need! In fact, I need to buy myself and family members should buy also!" Alanna Scheffer

"What an eye-opening presentation. You are obviously an expert in the field. Thank you for taking the message across the country." Helen Todd

"Very enlightening. I had no idea how this all came about!" Maxine Fricioni

"Thanks for turning on the head lights as we look out the windshield [and not the rear-view mirror] of the LTC car." Michael Ferguson ***

*** GET THE SAME COURSE FOR YOUR MEMBERS. Thanks to the financial support of our LTC Tour coordinating sponsors, we're able to make the 2-hour LTC graduate seminar available free of charge to NAHU and NAIFA chapters all across the country. Check with Damon at 206-283-7036 or damon@centerltc.com to schedule your event. Pick a date when the Silver Bullet of Long-Term Care (and I) will be in your area. Consult the LTC Tour's calendar, schedule and itinerary at the top of www.centerltc.com, specifically http://www.centerltc.com/TourCalendar/General.htm#April. Scroll through the months until you find your state (listed by region right below the month). Then look for an open date that fits within the dates and locations already scheduled. ***

*** GET THE FULL DOSE. Alternatively, you can sign up for the full eight-hour LTC Graduate Seminar and watch it online at your leisure. First, watch a free 30-minute Webinar that describes the course at http://www.centerltc.com/WebinarAnnouncingLTCGradSem.wmv. Allow a couple minutes to download. Learn even more about the new online LTC Graduate Seminar at http://www.centerltc.com/LTC_Grad_Seminar/online.htm. Questions or comments? Contact the Center for Long-Term Care Reform at info@centerltc.com or 206-283-7036. You can get the full LTC Graduate Seminar webinar AND a whole year of membership in the Center for Long-Term Care Reform for only $225. Based on the feedback from past attendees and Center members, that is an investment you should recoup very quickly as you help many more people protect themselves against the risk and cost of LTC. ***

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LTC BULLET: HOW TO CURE LTC

LTC Comment: Want to read a succinct report that sums up the problem with long-term care financing policy and proposes the right solutions? Here's your chance.

Lewis Andrews and Natalie Kindred of the Yankee Institute for Public Policy in Hartford, Connecticut delivered the goods.

Read their April 2008 report "Three Cures for What's Ailing Long-Term Care" at http://www.yankeeinstitute.org/files/pdf/82463_Yankee_Three_Cure_Study.pdf.

The "Executive Summary" follows, but here's the bottom line. To fix LTC: (1) give Medicaid back to the poor; (2) promote private LTC insurance; and (3) encourage the use of home equity to fund LTC. Right on!

Thanks to Center member and supporter Tony Stratidis of Marsh PCLIS for bringing the published report to our attention.

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Executive Summary of "Three Cures for What's Ailing Long-Term Care" by Lewis Andrews and Natalie Kindred of the Yankee Institute for Public Policy in Hartford, Connecticut (www.yankeeinstitute.com)

Already spiraling toward financial crisis, Medicaid is facing a challenge of unprecedented proportions in the years ahead. Because of the tremendous cost of long term health care (LTC) and Medicaid's porous eligibility structure, too many citizens obtain full coverage for their institutional long term care. The financial strain this practice imposes on Medicaid threatens the very future of the program.

That one must literally become poor in order to be eligible for Medicaid is a misconception. People can become eligible for nursing home care under Medicaid as long as their income falls under the cost of nursing home care. In fact, they can retain an unlimited number of exempt assets, including their homes.

Because Medicaid reimbursement rates usually fall below the actual cost of care, the poor, who rely solely on Medicaid for their long term care, receive a reduced quality of care.

As long as Medicaid's eligibility loopholes allow people to feel insulated from the often staggering costs of long term care, which can total hundreds of thousands of dollars, individuals have no incentive to prepare for long term care financing.

Aging baby boomers represent a massive uptick in long term care demand, expected to test the limits of Medicaid in the decades to come. This is especially true in Connecticut because of the state's disproportionate number of older citizens. Demand for long term health care services in Connecticut is expected to jump 30 percent by 2030.

The consequences of Medicaid overuse will only balloon as baby boomers enter retirement and beyond. Now is the time to reform Medicaid and to offer solutions to the long term care conundrum.

This study describes the problems posed by long term health care financing to both individuals and the Connecticut economy as a whole. Three practical solutions are proposed:

1. First and foremost, the disincentives to taking personal responsibility for long term care financing must be eliminated. To do so, policymakers must reform Medicaid eligibility to prevent overuse by citizens for whom this program is not intended.

2. Once Medicaid eligibility is tightened, individuals will inevitably seek alternative methods of long term care financing. For those who are able, long term care insurance represents an affordable and viable solution to preparing for long term care. Policymakers and private insurance companies should publicize and promote information on long term health care insurance.

3. Converting home equity into a source of long term health care financing is another option available to consumers. Using reverse mortgages, long term care consumers may remain in their homes (health permitting) while enjoying an adequate flow of funding for their expensive health needs.

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Updated: Wednesday, April 16, 2008 11:42 AM (Central)

Dateline: Memphis, TN--

LTC Tour: Mile 9,425, State #10

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LTC BULLET: HOW TO CURE LTC

LTC Comment: "Three Cures for What's Ailing Long-Term Care," after the ***news.***

*** FEEDBACK from Steve Moses's 2-hour LTC Graduate Seminar presented yesterday to the Central Arkansas Health Underwriters Association:

"I have never sold LTC coverage but your presentation convinced me there is a need! In fact, I need to buy myself and family members should buy also!" Alanna Scheffer

"What an eye-opening presentation. You are obviously an expert in the field. Thank you for taking the message across the country." Helen Todd

"Very enlightening. I had no idea how this all came about!" Maxine Fricioni

"Thanks for turning on the head lights as we look out the windshield [and not the rear-view mirror] of the LTC car." Michael Ferguson ***

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LTC BULLET: HOW TO CURE LTC

LTC Comment: Want to read a succinct report that sums up the problem with long-term care financing policy and proposes the right solutions? Here's your chance.

Lewis Andrews and Natalie Kindred of the Yankee Institute for Public Policy in Hartford, Connecticut delivered the goods.

Read their April 2008 report "Three Cures for What's Ailing Long-Term Care" at http://www.yankeeinstitute.org/files/pdf/82463_Yankee_Three_Cure_Study.pdf.

Thanks to Center member and supporter Tony Stratidis of Marsh PCLIS for bringing the published report to our attention.

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Executive Summary of "Three Cures for What's Ailing Long-Term Care" by Lewis Andrews and Natalie Kindred of the Yankee Institute for Public Policy in Hartford, Connecticut (www.yankeeinstitute.com)

Because Medicaid reimbursement rates usually fall below the actual cost of care, the poor, who rely solely on Medicaid for their long term care, receive a reduced quality of care.

The consequences of Medicaid overuse will only balloon as baby boomers enter retirement and beyond. Now is the time to reform Medicaid and to offer solutions to the long term care conundrum.

This study describes the problems posed by long term health care financing to both individuals and the Connecticut economy as a whole. Three practical solutions are proposed:

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Updated: Tuesday, April 15, 2008 12:21 PM (Central)

Dateline: Little Rock, AR--

LTC Tour: Mile 9,250, State #10

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LET SLEEPING DOGS (NEW YORK LTC COMPACT) DIE

LTC Comment: I did a briefing on LTC financing public policy for the Arkansas Insurance Department yesterday. One of the attendees asked if I'd heard of a proposal being pushed by the elder law bar in New York called the LTC Compact.

I said I'd not only heard of it, I'd done a comprehensive study and published a report about it. Bottom line, it's a bad idea pushed by Medicaid planners trying to salvage their practices by overwhelming publicly financed long-term care. If implemented, it would ruin any market for responsible long-term care planning.

"Thanks," my listener said, "I thought that proposal gave off a fishy smell."

Read the Center for Long-Term Care Reform's report titled "The New York Long-Term Care Compact Proposal: Update, Analysis and Recommendations" at http://www.centerltc.com/pubs/NY_Compact.pdf.

Seriously, you need to read it. The New York Medicaid planners have written to all the State Insurance Commissions pushing that proposal. This is not the first time I've been asked about it on the LTC Tour by state staff who've been urged to implement the LTC Compact.

Most recently, the "nAliens" (NAELA is the National Academy of Elder Law Attorneys, the Medicaid planners' trade association) have misrepresented the LTC Compact and my opposition to it in their yellow e-journal "Eye on Elder Issues."

What can I say? The people with all the money and power are the ones who make LTC free after the insurable event has occurred by loading the financial liability onto the Medicaid program and taking a cut for themselves.

The purveyors of responsible long-term care planning have to be AMGs (altruistic, masochistic geniuses) to survive selling a product (LTCI) the government gives away with such a hefty "commission" to the Medicaid planners.

The LTC Compact is dead. Our study and report administered an honorable coup d' grace. But the Medicaid planning bar just won't give up. So keep an eye out for signs of life. Send the Center's LTC Compact report to your Insurance Commissioners with a message to watch out for appeals on the LTC Compact's behalf from New York Medicaid planners.

It's not enough to let this sleeping dog lie. Kill it! Good long-term care public policy depends on it.

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Updated: Monday, April 14, 2008 12:03 PM (Central)

Dateline: Little Rock, AR--

LTC Tour: Mile 9,225, State #10

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LTC TRAILER TRASH?

LTC Comment: Okay. I know what some of you are thinking. Steve Moses is driving around in that "Silver Bullet of Long-Term Care." But, bottom line, isn't it just a trailer? Isn't he staying in trailer parks? Do we really want to market to trailer trash? How's that going to advance the cause of long-term care planning? Let me bring you doubters some enlightenment.

First of all, the "Silver Bullet of Long-Term Care" is an Airstream. Airstream is the Lexus of travel trailers. Think of it as a land-based parallel to the MetLife blimp for publicity. Click here http://www.centerltc.com/TourPictures/Silver_Bullet_at_State_Capitols.htm for pictures of the Silver Bullet in front of several state capitol buildings. I've conducted major studies of the long-term care financing systems in two of those states (FL and TX). Read the reports at http://www.centerltc.com/reports.htm. One of the LTC Tour's chief goals is to influence long-term care public policy at the state level.

Second, if you're thinking "trailer trash" and "trailer parks" when you think about the LTC Tour, think again. Today's Recreational Vehicle (RV) culture is something to behold. The "RV Parks" are often resorts in idyllic settings with pools, hot tubs, saunas, stores, recreational equipment, boats, bikes, etc. available. And the RVs themselves? Motorized palaces costing hundreds of thousands of dollars each and carrying all the comforts of home. Here's a picture of a millionaire's row at the lovely wooded park where I happen to be staying in Little Rock, Arkansas: http://www.centerltc.com/TourPictures/BigRigs.JPG . I didn't ask but those four rigs could easily be worth $1,000,000.

(I'm in Little Rock to meet with the Department of Insurance today and to give a 2-hour version of the LTC Graduate Seminar to the Central Arkansas Health Underwriters tomorrow.)

Third, the people driving around in those mobile mansions are prime candidates for long-term care planning. They have money; they're newly retired or semi-retired; and, judging by how they constantly query me about the "Silver Bullet" and its sponsors' logos, they have the interest and time to talk about long-term care. They probably won't buy "on the road," but I'm not selling. I'm just getting a lot of people thinking about the importance of planning for long-term care. When they come home from the road, you sell them the coverage they need. Even if they're "full timers," their rigs are registered someplace where they'll show up sooner or later.

So far, I've only talked about the lives we're touching at the RV Parks. But, as I drive from city to city, people pull up beside the Silver Bullet frequently and ask what it's all about. Rubber neckers stare at the Airstream, bedecked with the logos of major American corporations. It doesn't take them long to see the "2008 National Long-Term Care Consciousness Tour" signage and put two and two together. Maybe each sighting is just one more feather of awareness, but enough feathers and you eventually break the camel's back of denial about long-term care risk and cost.

Finally, the Silver Bullet of Long-Term Care has been a magnificent "media magnet." It draws the attention of TV, radio and print coverage to the LTC Tour. That's how we'll expand the LTC Tour's reach to millions of people before we're done.

So, my friends, that's the story on the Silver Bullet. We still have room on the Bullet for a few more major sponsors. The LTC Tour Sponsors Packet at http://www.centerltc.com/LTC_Tour_Sponsor_Packet.pdf explains all the benefits and costs of Platinum, Gold, Silver and other sponsorship levels. Don't let your company fill the blank in this question I hear everywhere I go:

"Why isn't your company name here represented on the Silver Bullet?"

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Updated: Friday, April 11, 2008 12:00 PM (Central)

Dateline: Little Rock, AR--

LTC Tour: Mile 8775, State #10

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LTC BULLET: HOST THE LTC TOUR: A DO-IT-YOURSELF GUIDE

LTC Comment: Our LTC Tour is a big success and most of America still lies ahead! Want to join the fun, get some publicity, make new contacts, help more people? How to do it, after the ***news.***

*** MORE LTC TOUR VIDEOS: Damon has added a bunch of new videos to the LTC Tour's YouTube channel. Check 'em out at: www.YouTube.com/LTCconsciousnessTour. You'll find the Silver Bullet of Long-Term Care at the famous Biltmore mansion in Asheville, NC with a hopeful analogy explained. You'll see Steve Moses interview Tennessee State Representative Ferguson about his passion for good LTC public policy. Watch Steve and Center for Long-Term Care Reform Regional Representative Phyllis Shelton horsing around for the camera. Catch Steve being interviewed on the early morning TV show "ThisNThat," thanks to the PR efforts of Regional Rep Gail Lindsey and her associate Jason Hillner. These videos will give you a taste of the LTC Tour. Read on for how you can get involved directly. ***

*** CORRECTION. Yesterday's "LTC E-Alert" cited David Landwehr as the author of an article which expressly permitted republication: "You are welcome to use the free 'LTC Elerts' to educate your members." Turns out that, although there was no indication in the publication itself, the piece was actually ghost-written by Marilee Driscoll. Marilee Driscoll is a Gold Sponsor of the LTC Consciousness Tour. You can find information on her "Ghost Written Press Release" program, along with other products, at www.LTCsalesTools.com. ***

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LTC BULLET: HOST THE LTC TOUR: A DO-IT-YOURSELF GUIDE

LTC Comment: The purpose of our 2008 LTC Tour is to promote responsible long-term care planning and rational LTC public policy. Read all about the Tour at the top of www.centerltc.com.

If you've been following the LTC Tour's progress, you know we've received wonderful media coverage (TV, radio, and print). My presentations to groups of financial advisers, LTCI producers, policy makers, and the public have received rave reviews. (See the end of this LTC Bullet for the latest examples.) Regional Representatives of the Center for Long-Term Care Reform who have already sponsored the LTC Tour in their local areas are very happy with the results.

HOW TO BRING STEVE TO YOUR EVENT AT NO CHARGE (Sweat Equity Required)

Now, I'd like to get even more people involved in planning LTC Tour events. If you can schedule an opportunity for me to meet with a reporter, speak to a group of 25 or more people, or visit with a policy maker (state legislator, Insurance Commissioner, Medicaid Director, etc.), I (Steve Moses) will do the program at no charge. The only catch is that you must arrange a date, time and location that fits the LTC Tour's schedule. That means I pull up in the Silver Bullet of Long-Term Care, do the event, and get right back on the road.

WHEN WILL STEVE BE IN YOUR AREA?

To find out where I'll be when, check the LTC Tour calendar frequently at the top of www.centerltc.com or go directly to http://www.centerltc.com/TourCalendar/General.htm#April.

ATTENTION LITTLE ROCK, MEMPHIS AND MIAMI

For example, I'm in Little Rock, AR through April 15, booked for a morning event on 4/15 but with some time available between now and then. I have some free time in Memphis, Tennessee late afternoon on April 15 and early morning on the 16^th. Then I detour by air to Miami through the 19^th. Some time might be free on the 17^th or 18^th in Miami depending on what Regional Representative George Braddock already has planned for those days. In other words, check with me at smoses@centerltc.com or 425-891-3640 if you have something in mind that might fit into the schedule.

ATTENTION: TN, KY, OH, MI

As of now my days between April 20 and April 30 are wide open except for driving from Memphis, TN to Toronto, Ontario via Jackson Center, Ohio (the Airstream trailer factory.) Get out your map; plot my course; and if I'm coming through your town (or close by) let's get the LTC Tour in front of your group, your local paper, your Rotary Club, whatever! It looks like my late-April route will take me through Nashville, TN; Louisville, KY; Cincinnati, OH; Cleveland, OH; Detroit, MI and on to Toronto.

ATTENTION: NM, WA, OH, PA, WV, DC

From May 5 to 9, I'm in Santa Fe, New Mexico with time available but without the Silver Bullet. From May 12 to 16, I'm in Seattle, WA for R&R, still without the Silver Bullet, but available. By May 21, I'm back in Toronto and headed toward Washington, DC. via Jackson Center, OH where I'll pick up the Silver Bullet again, after factory servicing. From there, between May 23 and 29, it looks like my path will take me through Columbus, OH; Wheeling, WV; either Pittsburgh, PA or Morgantown, WV; and points in between.

TO BOOK ME

If you'd like to plan something along that itinerary, let me know at smoses@centerltc.com or 425-891-3640. For later dates and times, check the LTC Tour Calendar at http://www.centerltc.com/TourCalendar/General.htm#April and consult with me. If we can work your town and event in, we will. Keep in mind, however, that Regional Representatives of the Center, who have ponied up $500 of earnest money, get first call on the schedule as do all corporate sponsors of the LTC Tour.

Now, assuming you have a time and location that works, what shall we do and how do we set it up? You'll need to do most of the work, but Damon can help. Call him at 206-283-7036 or email him at damon@centerltc.com.

HOW WE SUPPORT YOU

Damon has been trained in PR by an expert--author, speaker and LTCmonth.com founder, Marilee Driscoll, the LTC Tour's national consultant for public relations and marketing.

Next, consult the Regional Representatives Tool Kit at http://www.centerltc.com/Regional_Rep_ToolKit/index.htm. Even if you're not a full-fledged Regional Rep for the LTC Tour sponsoring a full day of events, you should find this resource helpful for many purposes.

You'll find a draft press release announcing the LTC Tour's visit. Add details on your event and send it to local newspapers, radio and TV.

How do you know whom to send the press release to? Check out "Organizations to Contact," also in the Regional Rep's Tool Kit. You'll find lists of websites to help you locate the right reporters at your local media. You'll also find lots of ideas on organizations that might be willing to host the LTC Tour for a speaking event.

Reach out to local LTC providers, especially the ones most dependent on private payers such as Continuing Care Retirement Communities and Assisted Living Facilities. They understand the need for private financing and they're also wonderful potential sources of prospects in need of LTC protection. Their residents' families know first hand why they need LTC insurance having just put their loved one in care.

If you have time to plan, consider sponsoring a Long-Term Care Graduate Seminar, either the two hour mini-version or the full-day program. You'll find the two-hour version described in the Regional Rep's Tool Kit and details on the full-day version at www.centerltc.com.

Check out "Planning Your LTC Tour Event" in the Tool Kit for more ideas.

You'll also find my professional bio, a picture of the Silver Bullet, and the "LTC Pledge for Baby Boomers" in the Regional Representatives Tool Kit.

HOW TO HELP THE LTC TOUR, IDEA #2

Now, let's say I'm not going to be in your area for awhile, but you'd like to get involved and help the LTC Tour achieve our goals. Is there anything you can do right now?

Absolutely. Help us reach potential corporate LTC Tour sponsors. Who should sponsor the LTC Tour? Any organization or company active in long-term care service delivery or financing. For example, LTC providers, LTC insurers (carriers, brokers and/or producers) and reverse mortgage lenders.

How do you know if the company you have in mind already sponsors the LTC Tour?

Major sponsors at the Platinum, Gold or Silver levels with signage on the Silver Bullet include:

-- GoldenCareUSA
-- Bankers Life and Casualty
-- OneAmerica
-- Prudential
-- MetLife
-- Marilee Driscoll's LTCMonth.com
-- The American Association for Long-Term Care Insurance (AALTCI)
-- Penn Treaty
-- LTCI Partners
-- Long-Term Care Financial Partners

HOW TO BECOME A MAJOR SPONSOR OF THE LTC TOUR

If the company you have in mind is not on that list, find out why not! Ask them to support the LTC Tour. The benefits are many including signage on the Silver Bullet, ads in our elegant Presentation Packets, and the right to schedule speaking engagements for Steve Moses at no extra charge.

The question I get asked most often after speaking engagements as I'm giving "tours" of the Silver Bullet, is "Why isn't Company X or Company Y on the Silver Bullet?" Good question. If your company isn't there, help us correct that oversight. Anyone interested can get all the details at the top of www.centerltc.com. Or send them directly to the "LTC Tour Sponsor Packet," which explains all costs and benefits in detail, at http://www.centerltc.com/LTC_Tour_Sponsor_Packet.pdf.

Why wouldn't any company that cares about the future of long-term care financing support the LTC Tour? Makes no sense not to . . .

Hundreds of thousands of people will see the Silver Bullet on the road. We'll reach millions through the radio, TV and newspapers. Another goal is to touch 15,000 financial advisors in person with the message that they have a moral and fiduciary responsibility to get their clients protected for LTC. (They don't have to sell LTCI, but if they don't, they do have to send their clients to someone who does.) We hope the LTC Tour will add heavily to the rolls of LTCI producers and LTC specialists all around the country.

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Recent feedback from Steve's presentations:

Van Gilbert: "I am a former nursing home administrator and now a financial advisor. Your message is dead on."

Nicholas Munoz: "Great first presentation in understanding the direction of Medicare/Medicaid and LTC."

Chuck Poole: "I wish Steve Moses was at one of these Q&A sessions with Barack and Hillary."

Donna Wrabel: "Great presentation, it needs to be heard in Washington, DC, where the real denial exists."

Christi Cheramie: "Excellent information. I market LTC to all my investment clients. Everyone needs an LTC policy!!"

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Updated: Thursday, April 10, 2008 11:45 AM (Central)

Dateline: Hot Springs, AR--

LTC Tour: Mile 8705, State #10

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NOT ONLY ELDERS NEED LONG-TERM CARE

LTC Comment: This article by Center for Long-Term Care Reform supporter, LTC Graduate Seminar alumnus, and old friend David Landwehr makes a good point. The piece deserves wider distribution, so here it is.

"Retiring Talk Show Host Reminds Us: Not Only Elders Need Long-term Care,"
by
David Landwehr (www.LTCareSolutions.com)
March 27, 2008

Montel Williams was diagnosed with Multiple Sclerosis in 1999. Earlier this year, CBS reported that this season of his daytime talk show, the 17th, will be the last. The reason is the declining health of the host.

His story is a teachable moment for long-term care planning. The lesson is this: none of us knows when our health will change, and we don't tend to get healthier as we age. Mr. Williams is 51 now, which would mean he was only 42 years old when he was diagnosed. A diagnosis of MS makes it next to impossible to get long-term care insurance (some workplace policies may offer some coverage to employees who are actively at work during a specific enrollment time, even if they are otherwise uninsurable).

Like another famous entertainer, Christopher Reeve, Mr. Williams' health changed for the worse at an age that he had no reason to expect that it would. By all appearances, Williams was someone who was fit, healthy, and physically active. He is a veteran and a graduate from the United States Naval Academy.

Christopher Reeve needed many years of long-term care before he died. While no one can know the future, it is likely that Montel Williams will also need extended long-term care. MS, in William's own words, "(means) excruciating pain and that eventually I could lose control of my body." MS is a potentially debilitating autoimmune disease that affects the brain and spinal cord.

Although celebrities may have the resources to weather the financial consequences of extended long- term care, most Americans find the financial implications can be devastating.

As Reeve's story and Williams' situation demonstrate to us, our best intentions to buy long-term care insurance in the future may be derailed by a health change at a relatively young age. There are many Americans who will need long-term care well before age 65, and even before age 50. The causes are many, from brain tumors to car accidents to debilitating illnesses such as MS and early Alzheimer's.

Since illness or injury can strike at any age, purchasing long-term care insurance by age 50 or even age 40 may be a very smart financial decision.

Learn more...

About LT Care Solutions

LT Care Solutions, Inc. specializes in LTC planning for both group programs for companies and for individuals since 1992. We believe that dabbling is dangerous and LTC is an important decision best made in consultation with an experienced LTCi advisor. Call us at 316-945-2011 or Go to www.LTCareSolutions.com for more info.

Website: http://www.LTCareSolutions.com
LT Care Solutions
David Landwehr CLTC
President
email: dlandwehr@ltcaresolutions.com
phone: 316-945-2011

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Updated: Wednesday, April 9, 2008 2:00 PM (Central)

Dateline: Hot Springs, AR--

LTC Tour: Mile 8705, State #10

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LTC BULLET: LTC PLANNING REQUIRES EMOTION AND THOUGHT

LTC Comment: A PBS special "Caring for Your Parents" engaged the heart but not the mind. Analysis after the ***news.***

*** LTC TOUR UPDATE. After weeks of constant travel, speaking engagements, and computer problems, the LTC Tour has hunkered down in Hot Springs, AR for a few days to catch up with research, scheduling and fund-raising. We've posted our recent progress and described the main Tour events in "LTC E-Alerts." So here are a few items to personalize the LTC Tour.

In Houston, hosted by Center for Long-Term Care Reform Regional Representative and LTCI specialist par excellence Honey Leveen, I gave several talks at The Forum, an outstanding Continuing Care Retirement Community. The Forum provided meeting rooms, a highly visible parking spot for the Silver Bullet and graciously offered me their comfortable guest quarters for two nights.

Here's a picture of The Forum's Director of Community Relations Kate Dowlen, Honey Leveen and myself beside the Silver Bullet.

Here's a picture of Lillie Pontello (posted with permission), a charming and thoughtful resident of The Forum, who attended my presentations and took the Silver Bullet "tour":

Finally, check out this interview with Kate Dowlen and her Forum colleague Natalie Rogers, who describe The Forum and explain why their company hosted the "National Long-Term Care Consciousness Tour." ***

*** CHECK OUT OUR YOU-TUBE CHANNEL. Finally overcoming some technical challenges, we're posting much more content to the Center for Long-Term Care Reform's 2008 LTC Tour YouTube Channel. Check it out at http://www.youtube.com/LTCconsciousnessTOUR. Then scroll down for more videos. Check the channel often for the latest videos from the National Long-Term Care Consciousness Tour. ***

*** CHARMAINE GOLSAN, Center for Long-Term Care Reform Regional Representative for Baton Rouge, Louisiana graces the cover of Life Insurance Selling magazine this month with her assistant Tawny Roberts and long-time client Pat Ketelson. See the cover here: http://www.centerltc.com/images/CharmaineGolsan.pdf. Check out editor Gordon Bess's excellent and moving article "A Lifetime of Caring" about Ms. Golsan and her LTCI practice in this month's issue. ***

*** GAIL LINDSEY, yet another Center Regional Rep, this time for Chattanooga, Tennessee, is in the news. Her website at http://lindseyassociatesltc.com/ cites links to five news stories she and assistant Jason Hilner made happen about the LTC Tour and the importance of responsible LTC planning and rational LTC public policy. ***

LTC BULLET: GOOD LTC PLANNING REQUIRES EMOTION AND THOUGHT

LTC Comment: "Caring for Your Parents," a Public Broadcasting System documentary, tracked five families coping with the challenge. It aired Wednesday, April 2, 2008. You can watch the program streamed, as I did last night, here

In the week between the show's broadcast and when I viewed it online, numerous "LTC Bullets" readers contacted me with the same criticism: "Caring for Your Parents," they said, was accurate and heart wrenching in its depiction of the problem. But the show did nothing, zero, to suggest solutions. Many of the emotional and financial problems depicted so movingly in the program could have been mitigated if the families had planned ahead, our readers suggested. Specifically, if they'd had long-term care insurance, they could have afforded high-quality, professional, and loving assistance with the caregiving challenges.

Here's an example of such criticism from Center member and LTCI producer Barbara Hanson of California: "Another lost opportunity for sane planning! Lots of need and no realistic relief . . .what will it take to get the media awake?" Barbara's message cited several examples from her own clients whose LTC experiences were easier thanks to their LTCI coverage.

My initial reaction to such criticism of the show was dismissive. Why does every program have to focus on planning? Why can't we just watch and feel and empathize? Wouldn't such emotional immersion also make us start to think? Does every program about caregiving have to focus on money, planning and insurance?

Then I watched the show. I felt their pain. My eyes welled. I compared the problems described in the program with LTC challenges in my own family. I let the show wash over me emotionally.

About half way through, however, my brain kicked in. Wait a minute, I thought, there is plenty in this program about planning, or rather, the lack of planning. There is plenty in this program about financing, only it is government funding, not private funds. There are plenty of clues in this program about what causes people to end up in the emotional and financial distress the program so movingly describes.

For example, consider these notes I took while watching the show. They aren't direct quotes, just paraphrases:

Nurses provided by the state put in four hours per day.

Man put both parents in a nursing home--guess who paid.

Medicaid pays for some in-home care, and Thelma makes up the difference.

I can't visit my parents as much as I want because of the money.

In a nutshell, lack of private funds to purchase home and respite care account for the worst of the emotional and financial strain of caregiving. Medicaid ameliorates the strain slightly, but not enough. By the time the families in the show reached the climactic caregiving portrayed, it was too late for private insurance to help.

It is well-known that people most likely to buy long-term care insurance--and avoid some of the worst problems of LTC for their own families in the future--are people who have been through a difficult caregiving experience themselves.

Older boomers are going through such experiences with their own parents today. So the average age of purchase of private LTCI is declining toward the average age of the front cusp of the boomer generation.

If we wait 18 years for the boomer generation to run its course, maybe everyone will wake up to the need for responsible and early long-term care planning. But if we wait that long, a great many people will suffer needlessly.

So, when I apply my mind and not just my heart to "Caring for Your Parents," I come away with the same bottom line as our readers. This fine program was an opportunity lost.

For a much better treatment of the problem AND the solution, read nationally syndicated Chicago Sun Times financial columnist Terry Savage's article titled "Who'll look after you? The Savage Truth: If you're counting on long-term government aid for the elderly, think again." Published just two days before the PBS special aired, this article gives sound advice:

"If you can pay for your care, there will be many alternatives ranging from home care to assisted living to nursing homes that accept only privately paying patients. But typically this cost can devastate a family's retirement savings -- and leave a surviving spouse without any assets.

"The first step is to consider the purchase of long-term care insurance. It may be too expensive for everyone, but those who can afford at least some coverage will ensure that they do not spend their last years in an underfunded, overcrowded nursing home. . . .

"And what if you never use your policy? Congratulations. I hope you never need it -- or your homeowner's insurance in case of a fire. But the chances are 10 times as great after age 65 that you'll need some form of care than that your house will burn down.

"Insurance is always a bet against the odds. But you can't collect if you don't bet. And that's The Savage Truth."

The subject families in "Caring for Your Parents" didn't bet and they lost big.

(Thanks to Center member and LTCI veteran Murray Gordon for bringing this Terry Savage article to our attention.)

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Updated: Tuesday, April 8, 2008 1:00 PM (Central)

Dateline: Hot Springs, AR--

LTC Tour: Mile 8495, State #10

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LTC STUFF YOU SHOULD KNOW

LTC Comment: Today is the first I've had in a full month without driving or speaking responsibilities and WITH email and internet access. So I'm catching up on reading and research. Here is some interesting LTC miscellany to help catch you up too.

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LTC Comment: Here's the latest from the Heritage Foundation on the entitlement funding crisis.

CHARTS AND SLIDESHOWS

2008 Federal Revenue and Spending Book of Charts

41 information graphics are provided in this online resource including key charts on mandatory spending and entitlement burdens: http://www.heritage.org/research/features/BudgetChartBook/

Some key charts:

Mandatory Spending Consumes Growing Share of Total Spending (chart)

Entitlement Reforms are Needed to Control Spending (chart)

Entitlement Spending Will More Than Double by 2050 (chart)

Federal Budget Deficit Will Reach Levels Never Seen Before in U.S. (chart)

Future Burden of Medicare

A PDF slideshow by Dr. Tom R. Saving, Director of the Private Enterprise Research Center at Texas A&M University and a trustee of the Social Security and Medicare Trust Funds from 2000 to 2007: HERE

HERITAGE RESEARCH

Medicare and Social Security: The Challenge of Giant Entitlement Costs

by David C. John and Robert E. Moffit, Ph.D.

WebMemo #1857

March 25, 2008

Social Security and Medicare have promised $42.9 trillion more in benefits to senior and disabled workers than the programs will be able to pay, according to a new report. The 2008 annual report of the trustees of the Social Security and Medicare trust funds concludes that both programs will require progressively larger transfers from general revenues to maintain the projected levels of spending. The burden from Social Security and Medicare will fall directly on younger generations and this report affirms the need for Congress to begin a serious overhaul of both of these vital programs.

www.heritage.org/Research/Budget/wm1867.cfm

2008 Social Security Trustees Report Continues to Show the Urgent Need for Reform

by David C. John

WebMemo #1868

March 26, 2008

The 2008 Social Security Trustees Report was released on March 25. This WebMemo explains the important facts and answers the frequently asked questions about Social Security's financial outlook.

www.heritage.org/Research/SocialSecurity/wm1868.cfm

Congress Must Not Ignore the Medicare Trustees' Warning

by Greg D'Angelo and Robert E. Moffit, Ph.D.

WebMemo #1869

March 26, 2008

Congress needs to get serious about Medicare reform. On March 25, the Medicare Trustees issued a Medicare funding warning that triggers presidential and congressional action to reduce the Medicare's excessive dependence on general revenues as part of its overall financing. Congress enacted the Medicare "trigger" to call congressional and public attention to the enormous financial challenge the Medicare program faces. As the baby boomer generation starts retiring and health costs continue to escalate, the Medicare Trustees urge decisive congressional action.