LTC Bullet: The Long-Term Care Dilemma

Wednesday, September 15, 2004


LTC Comment: The Council for Affordable Health Insurance and the American Legislative Exchange Council have released a new report titled "The Long-Term Care Dilemma: What States Are Doing Right - and Wrong." More after the ***news.***

*** We apologize in advance for the length of today's ***news*** section. Please read it though. Most of this section explains various ways to support the Center financially while benefiting yourself professionally. We depend largely on your tax-deductible contributions to continue the Center's research and advocacy. Please attend our classes, sponsor the bullets, join the donor-only zone, or just send a spur-of-moment spontaneous donation. Thanks for your support.***

*** THIS BULLET is sponsored by Target Insurance Services and Claude Thau, who serve LTCI producers nationwide. They say "Target has unique capabilities in helping brokers find and service sponsored markets -- carve-out, association, financial institution, etc. Contact Claude Thau at or 800-999-3026, x2241 to discuss opportunities." Thanks so much, Target and Claude, for your 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 "embed" reports) by contacting Amy Marohn-McDougall at 425-377-9500 or .***

*** 4,000 HITS. The Center's newest report--The Realist’s Guide to Medicaid and Long-Term Care--is proving very popular at . Want a hard copy of your own? Send a new tax-deductible contribution to the Center of $250 or more, mention the report, and we’ll send you one. For your contribution, you will also receive one year of our daily donor-only email publications and personal access to the Donor-Only Zone portion on our website. Mail your check to the Center for Long-Term Care Financing at 2212 Queen Anne Avenue North, #110, Seattle, WA 98109 or contribute online at . In one easy online transaction you can pay the full amount at once or in increments of $21/month or $63/quarter. Email and tell him your check is in the mail or that you’ve contributed online and he’ll process your membership and send you your copy of the report ASAP. Increase your LTC expertise and support our common mission to ensure quality long-term care for all Americans by making your contribution today! ***

*** ENROLL NOW. Time is running out to sign up for the most advanced class on long-term care planning available anywhere. The Center's LTC Graduate Seminar is ideal for financial advisors, elder law attorneys, LTC insurance agents, long-term care providers, geriatric care managers and anyone else who advises the public about long-term care. Pre-registration is required. Call or email Amy McDougall at or 425-377-9500. For a syllabus, testimonials and more details, jump to . We offer this class only sporadically as Steve Moses' schedule permits. If you have to fly in and/or overnight in a hotel to be able to attend these California programs, present your airfare or hotel receipt when the class meets to receive a $50 refund of the $225 course fee. Grab one of these opportunities now:

Date: Friday, October 8, 2004
Time: 8 a.m. - 4:15 p.m.
Location: University of Phoenix; 2860 Gateway Oaks Drive, Room 113, Sacramento, CA 95833
Cost: $225 per person

Date: Wednesday, October 13, 2004
Time: 8 a.m. - 4:15 p.m.
Location: University of Phoenix, South Coast Learning Center, 3150 Bristol Street, Room 312 Costa Mesa, CA 92626
Cost: $225 per person

Special sponsored luncheon speaker this class only: Ralph Leisle, founder and President of LTCi Decision Systems, Inc., will address the topic "Why LTCi in High Net Households and Executive Markets?" For more information about their LTC Economic Impact Planning software, visit: ."

FLY-INS for the Costa Mesa (Los Angeles) program will find the Orange County (John Wayne) Airport most convenient.***

*** LTCi CONFERENCE. The 2004 National LTCi Producers Summit (November 7-9, 2004, San Francisco) program is available online: This annual event, organized by Jesse Slome of Sales Creators sold-out to 700 attendees last year. This year's 3-day program is targeted toward LTCi agents but would be a valuable learning experience for anyone who cares about long-term care service delivery and financing. For more details, visit the Summit website or call Sales Creators for a brochure (888) 599-5997. Save $75 when registering: simply write "Center LTC" in the Discount Code box on the online registration form. Then deduct $75 from the cost. Early registration ends September 24.***

*** LATEST DONOR-ONLY ZONE CONTENT: Here's the latest Zone content followed by instructions on how to subscribe so you can receive these critical epistles daily by email.

LTC E-Alert #4-042--Romeo on Greenspan (Author, trainer, producer and Center supporter Romeo Raabe opines on the fate of Social Security, Medicaid and LTC.)

LTC E-Alert #4-043--Aging Cons May Crowd Nursing Homes (Here's a new worry that makes choice of facility and ability to pay privately more important than ever.)

The LTC Reader #4-032--Busted Boomers (Former Commerce Secretary Pete Peterson's new book "Running on Empty" is a must read for senior advisers.)

The LTC Data Update #4-034--2027 Medicare Co-Insurance, Deductibles and Premiums (What'll Medicare be charging when the first boomers turn 85?)

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: With parallel press releases, the American Legislative Exchange Council ( and the Council for Affordable Health Insurance ( unveiled a new report on September 8 titled "The Long-Term Care Dilemma: What States Are Doing Right - and Wrong." This report, authored by Center President Steve Moses, recounts the results of a study conducted by the Center for Long-Term Care Financing with financial support from CAHI and ALEC. "The Long-Term Care Dilemma" is targeted especially to state legislators and the media. It is a shorter, somewhat differently organized version of the Center's publication, released on September 7, titled "The Realist's Guide to Medicaid and Long-Term Care." The two reports have substantially identical content, but each presents the material in a different style and structure. "The Realist's Guide" is somewhat longer and more detailed than "The LTC Dilemma."

Following is the content of their parallel press releases announcing publication of "The Long-Term Care Dilemma" amended to include contact information for spokesmen at both ALEC and CAHI.


September 8, 2004


Report Addresses Problems and Provides New Solutions to Cure State Financial Woes

ALEXANDRIA, VA - The Council for Affordable Health Insurance (CAHI), in partnership with the American Legislative Exchange Council (ALEC), today released a new report, "The Long-Term Care Dilemma, What States Are Doing Right and Wrong," by Steve Moses of the Center for Long Term Care Financing.

(Washington, DC) The American Legislative Exchange Council (ALEC), in partnership with the Council for Affordable Health Insurance (CAHI), today released a new report, "The Long-Term Care Dilemma, What States Are Doing Right and Wrong," (PDF/244KB) by Steve Moses of the Center for Long Term Care Financing.

The Medicaid long-term care system is already on the verge of collapse, a decade before the baby boomers begin retiring. The report looks at the long-term care financing system, highlights its dysfunctions, and provides key solutions. Included in the paper are profiles of 10 states-five of which could be considered "pro-Medicaid" and five "pro-private pay" states-by looking at six variables and ranking them accordingly.

"Medicaid is being exploited by wealthier people, diverting resources away from the truly needy. This new report is exactly what the doctor ordered for states wrestling with massive and ever-growing Medicaid long-term care costs," said CAHI Director Dr. Merrill Matthews. "It explains the problem in an upfront manner and offers real solutions, not denials or platitudes."

Solutions included in the report:

* Target scarce public resources to the genuinely needy.

* Close the most egregious Medicaid eligibility loopholes, such as those related to annuities, trusts, asset transfers, and life care contracts.

* Implement a strong estate recovery program to generate alternative nontax revenue and make Medicaid a loan, not a grant, for the middle class as intended by federal law.

* Educate the public that Medicaid is no longer an entitlement and that long-term care requires savings, investment, and planning.

"The costs associated with providing institutional long-term care under Medicaid are absolutely unsustainable as the baby boomers approach retirement," said Jim Frogue, Director of ALEC's Health and Human Services Task Force. "Reverse mortgages are the key missing part of the long-term care financing puzzle. Up until now, state leaders have not explored this path assertively. States must address this problem now, or Medicaid will consume their entire state budgets within a generation, endangering resources for such spending priorities as education, highways, and law enforcement."

To schedule an interview with CAHI Director Dr. Merrill Matthews, or to obtain a copy of "The Long-Term Care Dilemma, What States Are Doing Right and Wrong," contact Tom Gardner, director of Communications at (703) 836-6200 x386 or

To schedule an interview with Jim Frogue about the report, or to obtain an electronic copy of "The Long-Term Care Dilemma, What States Are Doing Right and Wrong," contact Stella Harrison at (202) 742-8517 or email at