Wednesday March 8, 2000
Ten years ago, academic writers in peer-reviewed journals--especially lawyers in law journals and physicians in medical journals--routinely denigrated private long-term care insurance and advocated social insurance approaches instead.
Times are changing. As public financing programs like Medicaid and Medicare have fallen into serious fiscal difficulties and private long-term care insurance has improved significantly and burnished its image, more and more academics have begun to acknowledge the benefits of private market solutions to social problems.
Here is a case in point. The following excerpt comes from an article by Marshall B. Kapp, J.D., M.P.H. entitled "Health Care in the Marketplace: Implications for Decisionally Impaired Consumers and Their Surrogates and Advocates," published in the Southern Illinois University Law Journal, Vol. 24, Fall 1999, pages 1-51. Dr. Kapp is the Frederick A. White Distinguished Professor of Service at Wright State University School of Medicine and served as the 1998-99 Dr. Arthur Grayson Memorial Distinguished Visiting Professor of Law and Medicine at Southern Illinois University. According to Dr. Kapp:
"...within the past several years the private sector has seriously undertaken a much larger role in creating and marketing LTC insurance products covering NF [nursing facility] and home care needs. To the extent that these products are successful in affordably supplementing or replacing Medicare and/or Medicaid LTC coverage for a large part of the older and disabled populations, they will offer consumers valuable individual choice among packages competing on the basis of coverage and price. Such choice should act as an attractive alternative to continued dependence on centrally regulated public programs that dictate conditions of service coverage and exclusion and (in the case of Medicaid) financial eligibility. Although private LTC insurance is still in a fairly incipient state of evolution for a variety of reasons...the importance of this sector is likely to increase considerably in the foreseeable future." (p. 17)
As support for this conclusion, Professor Kapp cites the "Center for Long-Term Care Financing, LTC Choice: A Simple, Cost-Free Solution to the Long-Term Care Financing Puzzle (1998)." The Center congratulates Marshall Kapp for a thoughtful article on a critical subject.