LTC Bullet:  Long-Term Caring

Wednesday  April 18, 2001


 The following article by Center for Long-Term Care Financing President Stephen Moses was published in the Spring 2001 edition of "Staying Connected" newsletter.  "Staying Connected" is a client-contact newsletter published by three of the leading long-term care insurance agents in the United States:  Alan Levine, Gary Melnikoff, and Gene Cutler. The article demonstrates how savings, investment and insurance can ensure access to quality long-term care at the most appropriate level and can help save our scarce public resources for the truly needy.

Long-Term Caring


Stephen A. Moses

Most Americans want to be good providers for their families and good citizens.  Both responsibilities require forethought, vigilance and planning. Today, the least expected and most daunting challenge for ourselves and our country is to provide competent, humane and loving long-term care for our elders . . . and ultimately, for ourselves.  Yet, we are unprepared--as individuals and as a country--for this responsibility.

Few older Americans, and fewer-still baby boomers, have private long-term care insurance to help with the catastrophic cost of long-term care for chronic illness.  Consequently, most people end up in nursing homes on public welfare when they need professional care instead of paying privately for help in their own homes or assisted living.  Why does this remain true even as the age wave begins to crest and threatens to crash upon us soon?

For 35 years, our government has tried to provide long-term care services through Medicaid and Medicare.  This effort, while well intentioned, has never provided adequate care to enough people in the most desirable settings.  But it has, unintentionally, de-sensitized us to the risk and cost of long-term care.  Today, the government-financed, welfare-based, nursing-home-oriented system is falling apart, characterized by limited access, poor care, and widespread bankruptcies.

The government needs to act quickly to educate the public about the necessity to plan early and save, invest or insure fully for long-term care.  Will it?  There is hope.  The new Bush Administration supports and Congress has introduced legislation to provide above-the-line tax deductibility for private long-term care insurance.  If passed, that legislation would essentially give every American a discount on the insurance equal to his or her marginal tax bracket.  There is also strong support for a proposal to assist current long-term caregivers with a tax credit or additional exemption.

We will probably see measures of this kind passed by Congress and signed by the President sometime in the next year.  They will help, but they will not alone solve the problem.  As long as most people continue to ignore the risk of long-term care, avoid the premiums for private insurance, and rely on Medicaid and Medicare for benefits if and when they require expensive care, no amount of government-sponsored education or tax breaks will change the underlying behavior.

That is why the Center for Long-Term Care Financing has proposed a program called "LTC Choice."  The essence of LTC Choice is to encourage people to save, invest or insure for long-term care, but if they fail to prepare--give them a line of credit on their estates to pay for quality long-term care in the private marketplace at the most appropriate level, such as home care, assisted living, and the best nursing homes.  Giving people a supplemental income, secured by and recoverable from their estate, helps prevent the indignity of welfare dependency, relieves the burden on taxpayers, and encourages everyone, including heirs, to plan early and insure fully for long-term care.

Is LTC Choice likely to become law?  Perhaps, but not anytime soon.  The impending crisis, when the massive baby boomer generation starts taking out of Social Security and Medicare instead of paying in, will have to become much more serious before public officials will take action.  In the meantime, we can at least prepare for ourselves and for our own families, by making sure we are protected. 

By so doing, we also fulfill our responsibilities as citizens.  A wag once noted, "the best way to help the poor is not to become one of them."  The best way not to become poor is to take the risk of long-term care seriously and make sure you have adequate insurance protection for your own family.  Then encourage everyone you know to take similar action. 

Stephen A. Moses is President of the Center for Long-Term Care Financing in Bellevue, Washington.  The Center is a 501(c)(3) nonprofit charitable organization dedicated to ensuring quality long-term care for all Americans.  Visit the Center at and subscribe to their free online newsletter "LTC Bullets."   Contributions to the Center for Long-Term Care Financing are tax deductible.