LTC Bullet:  Provider Praises LTC Insurance

Friday, July 12, 2002


*** Register now for August LTC Graduate Seminars in Seattle and Portland.  Go to for dates, times, locations, a detailed syllabus, testimonials, and much more.  Call (425-377-9500) or email Amy Marohn ( to hold a place. ***

*** New donor-only zone content posted today includes:

LTC Week in Review July 8-12, 2002:  LTC E-Alerts #171-#175

LTC E-Alert #171--Pay-or-Go Nursing Homes

LTC E-Alert #171A (Bonus)--NAIC and AARP on LTCI Rate Stability

LTC E-Alert #172--Alzheimer's is a Major Business Expense

LTC E-Alert #173--Latest Survey of LTC Insurance Carriers Available

LTC E-Alert #174--California Dreamin', Consumers Asleep Re LTC

LTC E-Alert #175--Are LTCI Sales Lagging?

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*** An online "newspaper" in Hawaii picked up our critique of that state's "CarePlus" program (LTC Bullet:  Hawaii's CarePlus Program, Friday, June 28, 2002, and published a story based on it:  "Washington-based Think Tank Says Compulsory Hawaii Long-Term Care Program Doomed to Failure," by Malia Zimmerman; you can find the story at: ***

*** Ken Workman, an LTCI producer in Georgia, is running for the state legislature.  He writes "if you know anyone that might like to see an LTC professional in a position to affect policy in GA . . . perhaps you can let them know . . . and maybe, just maybe, some money can flow this way . . . believe me I need it . . . (Checks payable to 'Committee to Elect Ken Workman')."  Contact him at  The Center does not endorse political candidates and we don't even know this one's political affiliation, but we thought readers might like to know he's running. ***


LTC Comment:  The Center for Long-Term Care Financing encourages mutual understanding and cooperation between long-term care providers and insurers.  Our "LTC Choice" report ( traced the history of long-term care and explained how and why LTC service delivery became an institutionally-biased, virtual public utility financed by welfare (Medicaid) rather than private insurance.  In our "LTC Triathlon" report (, we documented the lack of communication and common purpose between long-term care's major private sector stakeholder groups:  the financiers, providers and insurers of long-term care.  We have consistently advocated research, articles and conferences that cross-cut the long-term care service delivery and financing sectors of the industry.  That's why we're so pleased to draw your attention to an excellent article on LTCI in the July 2002 issue of Provider magazine, the journal of the American Health Care Association, a major provider-industry trade association.  Excerpts follow the citation below.

Lynn Wagner, "Sowing the Seeds of Long Term Care Insurance Growth," Provider, July 2002, pps. 22-40.  You should be able to access this July cover story sooner or later online at, although it had not yet been posted as of the publication of this Bullet.  If you would like to follow LTC news from the providers' perspective, you can get information on subscriptions to Provider at or 1-800-321-0343.

"At a time when long term care providers are battling deep funding cuts in Medicare and Medicaid, there is growing momentum behind expansion of the private long term care insurance market.  The movement could ultimately ease dependence on public programs for the financing of long term care services, say insurance industry and public policy experts."   (p. 22)

"What has been lacking is a 'more definite indication from government that [consumers] need to go out and look at long term care insurance,' says Arthur Stein, a certified financial planner . . ..  'A lot of people think the government is going to take care of them.  They don't know about long term care insurance.'"  (p. 24)

[The article provides detailed accounts of the new Federal LTCI plan, of the proposed legislation for above-the-line tax deductibility, and of the long-term care partnership programs, all of which are supported by Provider's parent, the AHCA.  LTC Bullets readers will have assimilated this information elsewhere, so we won't repeat it here.  The import of this coverage is that Provider goes to thousands of nursing home, assisted living, and home care providers throughout the United States.  Those readers need to learn about LTCI, why it has not been a major financing source in the past, and what must be done in public policy to make it a bigger financing source in the future.]

Dueling Analysts:  An especially interesting portion of the article has Joshua Wiener of the Urban Institute debunking LTCI while advocating public financing and Stephen Moses of the Center for Long-Term Care Financing defending LTCI and critiquing government financing.  Here's a sampling:

Wiener's perspective: 

"When people are young enough to afford [LTCI] coverage, they aren't interested, and by the time they need it they can no longer afford it."  (p. 32)

"'I don't know that large percentages [of consumers] will ever be willing to buy policies, [Wiener] adds.  Ultimately, the only way to improve long term care financing is to improve public programs that are now, and will likely be in the future, the main funding source for services, says Wiener.  'Public programs are the overwhelming way long term care is financed in this country and every other country in the world,' he adds.  'There is no country where private insurance is a major source of financing long term care.'"  (p. 32)

Moses' perspective:

"Moses says the federal program demonstrates that government is taking long term care seriously and that the educational campaign will be a 'major public relations coup for the insurance industry because people all across the country will be getting information.'"

[Then, Moses turns Wiener's argument on its head, making the case that the government monopsony (single buyer, i.e. government) in long-term care has squeezed out private financing, especially LTC insurance.]

"'It is a myth that you have to be poor to get Medicaid,' he says.  Until the program is reserved as a true safety net for the poor and the government sends a strong message that assets will be at risk for those seeking Medicaid coverage, the public won't buy long term care insurance [in large enough numbers], Moses says."  (p. 32)

[For a fuller explanation of the problem and the Center for Long-Term Care Financing's proposed solution, see the reports referenced above and "The Myth of Unaffordability:  How Most Americans Should, Could and Would Buy Long-Term Care Insurance" (]