LTC Bullet: LTC is Number One Priority

Tuesday, September 23, 2003


LTC Comment: "LTC Bullets" is back with a bang! Long-term care is finally taking its proper place in the forefront of public policy issues. More after the ***news.***

*** Today's Bullet is sponsored by the American Association for Long-Term Care Insurance . AALTCI is the national non-profit professional organization established in 1999 to serve the needs of insurance and financial professionals who market LTC insurance. The Association co-developed the Long-Term Care Professional (LTCP) designation program. They offer either self-study programs or 2-day classroom review programs in New York (October 20-22), New Orleans (November 14-16) and San Antonio (October 13-15). For more information on the Long-Term Care Professional designation program, visit the AALTCI Website: or call Teri Burks at 866-763-3543. Thanks to AALTCI for their generous support of the Center. Won't you help too? Please 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-McDougall at 425-377-9500 or . ***

*** To celebrate "LTC Bullets" return from a brief sabbatical, we're extending everyone's subscription one month free of charge. The break was refreshing and productive; we worked but without publication deadlines. Our thanks to the many readers who emailed to say they missed their Bullets and to urge us to "hurry back." ***

*** NEW WEBSITE FEATURE. The experts at LTC Connection (James and Catherine Dove) tell us the Center for Long-Term Care Financing's website at contains over 2,000 pages of content. You will find there articles, reports, and speeches galore plus a full archive of LTC Bullets by date and by subject. Starting today, we also have a "Search" feature at that will help you pinpoint precisely the information you seek. Check it out. Just ignore the initial "No Matches Found" message, enter your search topic, and see what pops up. Please note that content in the Donor-Only Zone does require a user name and password available to all who contribute $150 or more annually to the Center (tax deductible). ***

*** LTC Bullets' readership includes hundreds of subscribers with professional designations of all kinds. One designation that we constantly hear positive feedback about is the "Certified Senior Advisor" or CSA. The CSA organization has offered to make a contribution to the Center for Long-Term Care Financing for every new enrollee to their program who mentions the Center and cites the "source code" number 8196. For information on the CSA course and certification, go to . If you enroll in the CSA program, please mention the Center for Long-Term Care Financing in your application and reference source code 8196. Drop us an email to and let us know you've enrolled. CSA classes are coming up in San Diego, CA on September 24-27; Houston, TX on October 22-25; Las Vegas, NV on November 5-8 and Newark, NJ on November 19-22. ***

*** LATEST DONOR-ONLY ZONE CONTENT: Here's the latest Zone content followed by instructions on how to subscribe.

LTC E-Alert #3-051--Medicaid Woes and LTCI Glows (Find out what happened to state Medicaid LTC programs in the past month and which state made a move toward tax credits for private LTC insurance.)

Don't miss our "virtual visits" to major LTC industry conferences in The Zone. You'll find our comparison of the conferences, session summaries, interviews and pictures at .

Individual donors of $150 or more and corporate donors to the Center for Long-Term Care Financing receive our daily email LTC Bullets, LTC E-Alerts, LTC Readers, and LTC Data Updates for a full year. You'll also get access to the donor-only zone where these publications are archived along with other donor-only features. 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 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 . ***


LTC Comment: Incoming National Governors Association (NGA) Chairman Dirk Kempthorne (Idaho Republican) announced recently that long-term care would be his "chief focus for the coming year." He's setting up two national forums plus regional workshops to develop policies intended to improve LTC both in nursing homes and community-based settings. Although "LTC Bullets" is thrilled to know the NGA is focusing on long-term care, we remind our readers of the adage: "Be careful what you wish for--you may get it." Government involvement in long-term care service delivery and financing up to now has not been uniformly beneficial. Easy eligibility for and gross underfinancing of Medicaid nursing home care has desensitized the public to long-term care risk, impeded the development of privately financed home and community- based services, chilled the market for private long-term care insurance, created a booming business of Medicaid estate planning, and led to a welfare-financed, nursing-home based long-term care system that pleases no one. Can we trust the Governors to improve the situation? Or will they give us more of the same?

From time to time, "LTC Bullets" publishes commentaries by Center supporters who help to carry the Center for Long-Term Care Financing's message to a wider audience. What follows is an op-ed piece published by "LTC Bullets" subscriber, Center financial supporter, and LTC Graduate Seminar attendee Dennis Rompala, a LTC insurance agent in Boise, Idaho.

Dennis Rompala, "Long-Term Health Care -- Can States Solve It?: No: The Nation Needs a Health Plan That's Thought Out," Idaho Statesman, September 9, 2003, .

Gov. Dirk Kempthorne has chosen as his main initiative for the year, "A lifetime of health and dignity: Confronting long-term care challenges in America."

I embrace the governor's tardy but welcome acceptance of the need for providing for long-term care. The personal situation his parents find themselves in, paying for long-term care services out-of-pocket, is the ultimate revelation. Unfortunately, the scenario has been repeated for thousands of Americans for years, and it will continue to repeat itself until an organized, well-thought-out plan for financing long-term health care expenses is adopted.

The NGA might do well to review the work Congress has been doing in the area of long-term care. Congress has been aware of the disastrous effect that paying for long-term care through the Medicaid program has on the revenues of our nation for years. Actions taken on the federal level point out that Medicaid cannot be permitted to become a new "middle-class entitlement." The federal government has its hands full with two entitlement programs already, Medicare and Social Security.

Both programs are large, growing, and represent enormous unfunded liabilities of the U.S. government. The feds know the solution lies in promoting personal responsibility for one's own long-term care expense, and returning Medicaid to the needy.

The focus on long-term care adopted by the governors appears to be the result of the commonly felt "fiscal squeeze" most states are experiencing due in great part to the ever-growing bite Medicaid is applying mercilessly to state budgets. And the long-term care component of Medicaid is growing the fastest. Many states, including Idaho, have already adopted tax incentives for the purchase of long-term health care policies. If states educate their citizens to help plan for the potential need of long-term care services, and personal responsibility is vigorously promoted, whether it be insurance, reverse mortgages, or consultations with professionals certified in the field of long-term care, the Medicaid "squeeze" can be alleviated.

I hope the purpose of the NGA´s decision to focus on the challenge of long-term care is not merely an attempt to shift the cost of long-term health care services to the federal government. That will not solve the problem.

Encouraging individuals to plan for long-term care expenses through saving and investing, promoting the purchase of private insurance with further tax deductions and providing generous credits for caregivers, as Sen. Larry Craig has suggested, will go a long way toward strengthening the Medicaid program.

Medicaid is America's health care safety net and we must give Medicaid back to the needy.

Visit for educational resources on long-term care and links to many other helpful web sites.