Tuesday November 16, 1999
LTC Bullets subscribers may recall a recent Bullet titled, "Is Medicaid Planning Ethical?" The Bullet (sent 10/26/99 and reprinted below) excerpted and responded to a column in The New York Times Magazine in which the columnist, Randy Cohen, argued that the practice of Medicaid Planning was perfectly ethical. How did New York Times readers react? Here are the two printed responses to Mr. Cohen's "The Ethicist" column printed in this Sunday's (11/14/99) New York Times Magazine:
"Randy Cohen (The Ethicist, Oct 24) offered questionable advice to the writer who asked if it was ethical to transfer her mother's assets so that she could qualify for Medicaid. It may be legal. Whether it is ethical is another matter. Transferring assets was done to impose the cost of caring for the older person on taxpayers. Cohen did not deal with that aspect of the issue. If the question had been, "Is it ethical to benefit the children of an affluent older person at the taxpayers' expense?" I suspect that his answer would have been different."
Jonathan J. Margolis
"As an administrator of the Medicaid program, I have heard many stories and seen many justifications for transferring funds and 'giving gifts.' What it comes down to is that relatives do not like to see money they regard as their inheritance paid to a nursing home.
We often hear politicians ranting about welfare fraud, referring to those who receive Aid to Families With Dependent Children. Those payments per family are several hundred dollars a month. A greater source of welfare fraud exists in the Medicaid nursing-home program, where payments of thousands of dollars per person per month are made. And those doing the defrauding are our more well-to-do citizens, aided by well-paid lawyers. Politicians do not wish to offend this group, and many, like your so-called Ethicist, do not see anything wrong with it.