LTC Bullet: Who is the Lone Ranger of Long-Term Care?

Tuesday, March 29, 2005


LTC Comment: Who was that masked man with the "Silver Bullet" on long-term care? The answer after the ***news.***

*** GET CENTERED ON LTC. Congress and state legislatures across America are focused on controlling Medicaid expenditures without damaging long-term care services. That is precisely the Center for Long-Term Care Financing's mission. Bring in the Center to interview and brief key LTC stakeholders in your state. We'll explain what can be done to target Medicaid to the genuinely needy and to increase private financing in order to relieve the financial burden on Medicaid. For details, contact Center president Steve Moses at 206-283-7036 or . ***

*** MULTI-LIFE LTCI BOOT CAMP takes place May 1-3 at the Hilton Hotel at the Kansas City Airport. Jesse Slome informs us that early registration for the LTC insurance multi-life sales Boot Camp ($279) expires April 4th. Then the registration fee increases to $379. But, get this, Jesse says you can save $50 off either price by writing 'Center LTC' in the 'Discount Code' box when registering. If you have questions, go to or call (888) 599-5997. ***

*** 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.

The LTC Reader #5-014--LTCi Should Stand and Fight (How should the industry respond to state insurance commissioners who say LTCi should disappear?)

The LTC Reader #5-015--The Best LTC Insurance (Research shows the best LTCi is mental and physical exercise, but an insurance policy is a critical financial safety net.)

LTC E-Alert #5-020--False Hopes Undermine Real Possibilities (Want the "Ronald Reagan Alzheimer's Breakthrough Act" to pass? Show Congress how to pay for it.)

(Steve Moses's three "LTC Embed" reports on recent long-term care policy and legislative developments in DC received rave reviews from dozens of Donor-Zoners. Sign up today for access to the Donor Zone and read immediately about the latest give and take on Capitol Hill. Upon informing us that your $150 or greater annual contribution to the Center has been made online or mailed, Damon ( will email you your user name and password for immediate Donor Zone access.)

Special Alert: Donor Zoners can find many stories about the shortcomings of VA LTC benefits in our special donor-zone feature: "Reasons Why Veterans Should Not Depend on VA Benefits for Long-Term Care" at

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: Nursing Home/Long Term Care Management magazine's March 2005 feature article is titled "Long-Term Careís Lone Realist Rides Again: Interview with Stephen A. Moses, President, the Center for Long-Term Care Financing." The lead follows. Read the rest of the interview at .

"Remember those thunderous hoofs of yesteryear bearing the mysterious Lone Ranger? Or perhaps youíve heard of 'the voice crying in the wilderness.' Stephen A. Moses might be categorized both ways--or, if youíre inclined to disagree with him, as a misguided scout pointing in exactly the wrong direction. Thereís no disputing one thing: Right or wrong, Steve Moses has for years been the lone voice publicly discussing the macro-issues of long-term care financing. Starting in the early 1980s, when he was an employee of the then Health Care Financing Administration (HCFA) and wondering why Medicaid, a program to pay for the healthcare of the poor, seemed to be turning into a nursing home entitlement program for everyone, Moses has been addressing complicated LTC policy issues head-on. He says heís for expanding private financing of LTC, most particularly through private insurance, not because heís particularly antigovernment or beholden to private interests, but because there is no other way short of a national financial meltdown. In September 2004, his Center for Long-Term Care Financing published The Realistís Guide to Medicaid and Long-Term Care, an impressive review of ten statesí approaches to LTC financing. The report concludes that depending on several factors--most notably their Medicaid eligibility rules, estate recovery programs, and encouragement of private financing mechanisms--the states are at various stops along the way to financial disaster. Recently Moses discussed the Centerís findings and prescriptions for improvement--and his personal frustrations as a policy advocate--with Nursing Homes/Long Term Care Management Editor-in-Chief Richard L. Peck."

(Read the remainder of this interview at . For information on Nursing Homes/Long Term Care Management magazine, including how to subscribe, go to .)

LTC Comment: In 1995, LTC, Incorporated published Steve Moses's "The Magic Bullet: How to Pay for Universal Long-Term Care." That silver-colored report had a graphic of a cartridge on the cover. Ever since, people have referred to it as the "silver bullet" study. For a comprehensive analysis of the "phalanx of fallacies" obstructing progress on long-term care, read it at .

In 2000, the Center for Long-Term Care Financing published Moses's "The LTC Triathlon: Long-Term Care's Race for Survival," a study of why the leading private sector forces in long-term care (providers, insurers and financiers) have been unwilling or unable to compete with the leading public sector forces in long-term care (government, the entitlement lobby, and "enablers"). This report explains why long-term care in the U.S. is stuck in a dysfunctional, rapidly declining status quo. Read it at .

Finally, in 2004, the Center published "The Realist's Guide to Medicaid and Long-Term Care," the report featured in the Nursing Homes interview. It is a primer for legislators and the media on the bafflingly complex subject of long-term care service delivery and financing. In a nutshell, "what's wrong, how to fix it, and details on ten states, five of which are moving in the right direction and five that are sinking fast." Read the Realist's Guide at .

You'll find many more reports, articles, speeches and archives of 546 "LTC Bullets" at the Center for Long-Term Care Financing's website: . Check it out.