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LTC Bullet:

Three Cheers... but One from the Bronx!

Friday December 3, 1999


by Stephen A. Moses, President, Center for Long-Term Care Financing

(Heads up: Don't miss the second half of this article where Center President Steve Moses updates last year's "Certifiable Suckers" critique of the Medicaid planners' LTC insurance certification program.)

Three cheers for Greg Luque's "LTC Forums." Unfortunately, one's a Bronx cheer. Here's the story... After 25 years of marketing for the pharmaceutical industry, Greg Luque burned out on pushing (legal) drugs. In 1994, he heard a lecturer proclaim that long-term care insurance was a great new field about to explode. He did some research and couldn't believe his luck. "No one had done any large-scale marketing and education in this fertile new field," he says. So Luque prepared a business plan based on (1) offering regional LTC insurance training sessions and (2) developing a professional certification program for LTC insurance agents. The rest is history.

G. J. Luque and Co. offered their first LTC Forum in Connecticut in May 1996. Almost 600 people attended this low-cost training program for long-term care insurance agents. That popular, loss leader quickly led to a long series of pricier, but equally successful events. By 1998, Luque was doing seven regional forums per year. As of 1999, he's averaging 350 agents per program; he's attracted 13 full time corporate sponsors; and he's completed LTC Forums in 24 states. Luque attributes his success to staying at arm's length from the industry and offering top notch, affordable training to agents in their own states.

What's a Luque LTC Forum like? I've not seen the local version, but I've attended or visited both of his National Forums. They included provocative keynoters, practical workshops, eager exhibitors, entertaining events, and creative extra-curricular activities. All 16 small-group, hands-on, sales-oriented training sessions were repeated twice per day so every conferee could attend each one. Last year, attendees voted on controversial LTC policy issues in a Congressional hearing room on Capitol Hill using members' own, hand-held, electronic voting machines. This year, the National LTC Forum included a Mardi Gras party in New Orleans and thirteen insurance carriers hosted hospitality, networking "functions." I asked several attendees and exhibitors what they thought of the program. Without exception, the LTC Forum received high marks.

According to Luque, two-thirds of the agents who attend his programs are new to the business, while only a third are experienced LTC insurance salespeople. He believes, and we agree, that the LTC Forums are contributing significantly to the education, competency and reputation of LTC insurance agents. Luque also says that more and more "centers of influence," such as attorneys, CPAs, employee benefit managers, and health care administrators, attend his programs. The local and regional LTC Forums are certified for several kinds of continuing education credits, whereas the focus for the National Forum is on marketing and sales training with an opening session devoted to public policy. So, hip...hip...hooray...two unmitigated cheers for Greg Luque's LTC Forum!

Now for the Bronx cheer. Greg Luque dropped his plan to develop an independent, objective, professional certification program for LTC insurance agents. Instead, he serves on the Board of Directors of the for-profit Corporation for LTC Certification (CLTC), a NAELA-endorsed and proctored training and certification program. According to Luque, fellow board member and NAELA-founding-member Harley Gordon is responsible for the substantive content of the training while he (Luque) has responsibility for marketing the certification program. Luque has provided Mr. Gordon and two Presidents of NAELA important speaking opportunities as keynoters at his National LTC Forums. In fact, the Forums have become a primary marketing tool for the Corporation for LTC Certification's program. Opposing views have not yet been permitted any exposure.

Now, here's the problem. The CLTC course condones Medicaid planning and NAELA is the National Academy of Elder Law Attorneys, the trade association of the Medicaid estate planning attorneys. According to the CLTC's web site, Medicaid planning is all right for people who cannot afford LTC insurance or who have pre-existing medical conditions that preclude coverage. Fine and good for the truly poor, but Medicaid planners manipulate income and assets to qualify clients with hundreds of thousands of dollars for benefits so that virtually anyone can wait until after the insurable event occurs and still get long-term care without spending down. Medicaid planners seek to collaborate with long-term care insurance agents as a way to generate Medicaid planning leads, but they have no incentive to refer healthy, prosperous clients to insurance agents, because everyone with LTC insurance is a lost Medicaid planning client for the future. The CLTC certification is a "no-brainer" for the Medicaid planners, but it assumes cynically that LTC insurance agents are willing to condemn prospects they cannot insure to the fate of dying, prematurely impoverished, in a welfare nursing home.

As the Center for Long-Term Care Financing has explained many times, the long-term care insurance industry cannot sell a product the government is giving away. When Medicaid planners qualify the non-poor for public benefits, the result is that (1) the needy have a harder time finding quality care under Medicaid, (2) the public is anesthetized to the risk of LTC and hardened in their denial of the need for private insurance, (3) the Medicaid planners' clients lose the ability to purchase quality home care and assisted living in the private marketplace when their life savings are expropriated, (4) the Medicaid program and tax-payers are overburdened by having to cover people for whom the program was never intended, and (5) long-term care providers are forced into bankruptcy by inadequate Medicaid reimbursements. For all these reasons, Congress and President Clinton did their best to criminalize Medicaid estate planning, but the Medicaid planners dodged that bullet and they're back at it in full force. The Center for Long-Term Care Financing has proposed a responsible, positive, public policy (called LTC Choice) based on insuring most people early, giving others a line of credit on their estates, and saving Medicaid for the genuinely needy. Unless and until NAELA eschews Medicaid planning and endorses LTC Choice or some other viable solution, the LTC insurance industry is cutting its own throat by collaborating with that organization.

The NAELA-sponsored CLTC certification program is a great deal for Medicaid planners, but suicidal for LTC insurers, brokers and agents. At a recent NAELA conference in Chicago, numerous speakers pooh-poohed LTC insurance and promoted Medicaid planning. No one warned of the dangerous access and quality problems associated with depending on Medicaid nursing home benefits. No one commented on the high-quality home care, assisted living and nursing home care available to any consumer who pays out of pocket or has LTC insurance to pay the bills. As usual, the training sessions on how to impoverish affluent clients while collecting big fees were packed with hundreds of people (literally sitting in the aisles), whereas a lonely session on elder abuse drew only 30 attendees. We'll stay on top of this problem and keep you posted.

In the meantime, here's our advice...

To Greg Luque: sever all ties with the Medicaid planners and foster relationships with responsible attorneys, accountants and financial planners.

To LTC insurers: sponsor Luque's LTC Forums, but withhold support for the certification program (CLTC) sponsored by the Medicaid planners.

To LTC agents and brokers: attend a local or national LTC Forum, but save yourself $850 by passing up the CLTC certification scheme.

To the LTC industry: sponsor an objective, non-profit LTC insurance certification program at a reasonable price to fill the void that NAELA is trying to occupy.

Finally, I challenge Mr. Luque to sponsor a point/counterpoint program between myself and a defender of Medicaid estate planning. That would be a great debate...if there is anyone willing to defend Medicaid planning in public.