LTC Bullet: No April Fools Joke

Tuesday, April 1, 2003


LTC Comment: It's no joke. We really did start the Center for Long-Term Care Financing on APRIL FIRST, 1998. Most said it would never happen. Few thought it would last. But we're still here fighting for rational public policy on long-term care. Five years and counting. Your feedback is invited. More after the *news*.

*** This Bullet is sponsored by the National LTC Network, "Partners in Long-Term Care Insurance Coverage, Design, Education and Distribution." Visit the Network online at . Contact Allen Mansfield, Executive Director, at 800-996-6789 or for more information. Thanks so much to Network members for their generous support of the Center. Won't you help too? Go to to sponsor an LTC Bullet. Find out how you can sponsor other Center activities (e.g., articles, speeches, conference exhibits) by contacting Amy Marohn at 425-377-9500 or . ***

*** Center President Steve Moses conducted the LTC Graduate Seminar to rave reviews in Green Bay and Milwaukee, Wisconsin and twice in New York City in the past few weeks. We're looking for sponsors to host the seminar anywhere in America. All we need you to provide is a conference room, flip chart or white board, VCR-TV, boom box, refreshments, lunch and a base number of attendees (at least a dozen at $225 each). We'll do everything else. Alternatively, a flat fee of $5,000 covers as many attendees as you care to invite (up to 40). Contact Amy McDougall at 425-377-9500 or to make arrangements. We're booking Wisconsin and environs for the week of June 2 and anywhere in Florida the week of August 4. Any other time, we'll go wherever you want the program. For details on the LTC Graduate Seminar, go to . This course is for people who already have a strong base of knowledge and experience in long-term care service delivery and/or financing. ***

*** Phyllis Shelton's "LTC Consultants" firm has two new videos to combat denial--the number one reason so many Americans fail to protect themselves from the financial risk of LTC. "Taking Care of You" updates a powerful 1998 video. "Protecting Your Future" is a byproduct of the PBS caregiving documentary "And Thou Shalt Honor," which aired October 9, 2002. For more information, go to . ***

*** Jesse Slome, president of Sales Creators, Inc., has announced the establishment of a national long-term care insurance sales achievement award. "The nation's top long-term care insurance professionals will be recognized . . .. Both career agents and independent brokers who sold a minimum of $50,000 in LTCi premium during 2002 are eligible. . . . The National LTCi Sales Achievement Award will be an annual recognition with awards distributed at the National LTCi Producers Summit that will be held in New Orleans later this year." Applications are available at . ***


The LTC Reader #3-013--Health Affairs on Nursing Home Litigation

The LTC Data Base #3-009--Update on State LTCI Tax Credits and Deductions

DON'T MISS OUR "VIRTUAL VISITS" TO: The Society of Actuaries' LTC Insurance Conference at AND The 16th Annual LTC Insurance Conference at . You'll find our comparison of the conferences, session summaries, interviews and pictures. Enjoy.

If you already qualify for The Zone, you can click the following link, enter your user name and password, and go directly to the latest donor zone content and the archives: . If you do not already qualify for The Zone, mail your tax-deductible contribution of $150 or more to the Center for Long-Term Care Financing, 2212 Queen Anne Avenue North, #110, Seattle, WA 98109. Then email your preferred user name and password (up to 10 characters each). You can also contribute online by credit card or direct withdrawal at . ***


Steve Moses and David Rosenfeld founded the Center for Long-Term Care Financing on April 1, 1998. The Center's mission was then and remains to ensure access to quality long-term care for all Americans. We pursue that mission by advocating public policy to target scarce public LTC resources to the genuinely needy and to encourage everyone else to plan early and save, invest or insure for the risk of long-term care. The Center for Long-Term Care Financing enters its sixth year under the executive directorship of Amy Marohn-McDougall. We've been blessed with a succession of excellent Administrative Coordinators, including Amanda, Sarah, and most recently Damon.

In an interview published on Martin Bayne's Mr. Long-Term Care website and announced in "LTC Bullet: Interview with Mr. Long-Term Care," Tuesday June 2, 1998, Steve Moses assessed the long-term care service delivery and financing situation this way:

"If the baby boom is the Titanic, long-term care is the iceberg. Thirty years of easy access to Medicaid nursing home benefits and, more recently, ample long-term home care from Medicare have lulled the American public into a false sense of security about long-term care. Today, Medicaid is on the verge of bankruptcy and suffers from a dismal reputation for problems of access, quality, reimbursement, discrimination and institutional bias. Medicare's fiscal crisis is closing like a vise and the program has already begun to squeeze the hemorrhage in home care costs with draconian vigor. Can you imagine what these programs are going to look like, if they even exist, in twenty or thirty years when the boomers start to need long-term care? It will not be pretty!

"Our only hope to prepare for the demographic onslaught of exponentially greater long-term care needs is to wean the public off the expectation that Medicaid, Medicare or any future publicly financed program is going to pay for long-term custodial care. We must offer a better and affordable alternative to people when they are still young, healthy, and affluent enough to qualify for it. That is the mission of the Center for Long-Term Care Financing. We will promote universal access to high-quality long-term care by encouraging private financing and discouraging welfare financing for most Americans. We will pursue this objective by warning the public about the risks of Medicaid planning (artificial self-impoverishment) and pointing out the benefits of good long-term care insurance."

Isn't it interesting how things have played out over the past half decade? The state and federal governments are in fiscal crisis severely exacerbated by exploding Medicaid long-term care costs. Medicare has cut nursing home and home health reimbursements precipitously driving thousands of nursing homes and home health agencies into bankruptcy. Medicaid estate planning attorneys continue to ply their lucrative trade of artificially impoverishing affluent clients to qualify them for government-financed long-term care. Our service delivery system remains welfare-financed and nursing-home based with an underdeveloped home and community-based infrastructure and drastic shortages of staff and capital. Yet the public is still asleep regarding long-term care risk, anesthetized by, now, almost forty years of easy access to publicly financed long-term care. In the meantime, private financing, the only hope for the future, remains minimal. Less than one dollar in five spent on home or nursing home care in the United States comes from people's assets. Home equity conversion and private long-term care insurance, the most promising sources of private financing for long-term care, languish for lack of demand.

The Center for Long-Term Care Financing's original analysis of the problem and prediction of further deterioration has proven accurate. One important thing has changed, however. Our proposed solution is gaining ground. All around the country, states are searching for ways to close the loopholes in their Medicaid eligibility systems. The Department of Health and Human Services (DHHS) has proposed Medicaid reform that would empower states to implement eligibility controls without waivers. The Centers for Medicare and Medicaid Services (CMS) are exploring ways to encourage the use of home equity as a private financing source for long-term care. The state and federal governments are giving more than lip service to encouraging private long-term care insurance by proposing or implementing tax credits, deductions, or employee coverage. Best of all, the Center's "LTC Choice" proposal, originally published on September 1, 1998 in our report titled "LTC Choice: A Simple, Cost-Free Solution to the Long-Term Care Financing Puzzle" ( ), has been introduced, albeit in diluted form, in the Washington State legislature--House version: and Senate version: .

So, progress is being made, but we have a long way to go. Thank you for your moral and financial support over the past five years. Stick with the Center for Long-Term Care Financing and we'll keep fighting for rational long-term care policy. Together, we can unleash the potential of private long-term care insurance and home equity conversion to save Medicaid for the needy and improve long-term care service delivery for everyone. Your feedback, positive or negative, and your suggestions for strategy, tactics, or services the Center should pursue are very welcome. Simply reply to this Bullet.