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LTC Bullet:

Chairman Grassley Voices Open Secret

Since its founding in April 1998, the Center for Long-Term Care Financing has warned about major dangers to and from the public financing of long-term care.

In the Center's "LTC Choice" white paper, in a long series of "LTC Bullets," and in numerous published articles, we have pointed out the deficiencies of access, quality, reimbursement, discrimination and institutional bias that plague the publicly funded programs.

We have disclosed the abuses of Medicaid estate planning attorneys who artificially impoverish affluent clients to get them into welfare-financed nursing homes and then sue the resource-starved facilities for providing inferior care.

Recently, we have reported on the financial emergency facing major nursing home chains because of deficient reimbursements from Medicaid and Medicare.

Finally, the message appears to be getting through to the right people. A few weeks ago, Federal Medicaid Director Sally Richardson urged state Medicaid directors to prepare contingency plans to protect Medicaid-financed residents in case major nursing home providers collapse financially ("LTC Bullet: HCFA Tells States to Prepare for Looming Crisis," Friday, May 21, 1999).

The following quote from Senator Charles Grassley, Chairman of the Senate Special Committee on Aging, is further evidence that key public officials share our concern that public financing of long-term care is inadequate to assure access to quality care:

"I think it's an open secret that Medicare and Medicaid reimbursements are not truly adequate for any of our health care providers, including skilled nursing facilities. Both insurance programs are really stuck between a rock and a hard place; we keep ratcheting down provider payments lower and lower, but both programs are fiscally unsustainable even at current low levels of reimbursement. And with Medicare, we're facing a huge increase in the number of beneficiaries in just a few years, compounding our current problems. So we all need to figure out ways to reimburse our facilities and health care professionals better-and the only way that can happen, in my opinion, is for us to put the federal programs on a sound and sustainable fiscal footing."

Source: ______, "Enforcement is Not Working: An Interview with Senator Charles Grassley," McKnight's Long-Term Care News, Vol. 20, No. 7, May 26, 1999, p. 16.

There is only one way to put the federal programs on a "sound and sustainable fiscal footing." We must target scarce public resources to the genuinely needy while providing stronger incentives for everyone else to plan early and insure fully for long-term care. That is the primary goal of the Center for Long-Term Care Financing in raising these alarms and in proposing creative solutions.

The Center's white paper--"LTC Choice: A Simple, Cost-Free Solution to the Long-Term Care Financing Puzzle"--explains what is wrong with the current system and proposes a solution based on targeting public financing more narrowly and expanding private financing of long-term care more widely.

Our forthcoming white paper--"The Myth of Unaffordability: How Most Americans Should, Could and Would Buy Private Long-Term Care Insurance"--will lay to rest forever the misconception that most Americans cannot afford adequate private insurance against the risk of long-term care.

To order "LTC Choice" ($24.95) or to pre-order "The Myth of Unaffordability" (available September 1, 1999; $34.95): contact us at 206-447-1340, or click here.