LTC Bullet:  We're Not in Kansas Anymore 

Wednesday, August 3, 2005 


LTC Comment:  Dorothy's plaintive comment in "The Wizard of Oz" evokes the sense of worry and wonder we should all feel as the Age Wave finally begins to crest.  More after the ***news.*** 

***  THE MOSES LTC BLOG.  Have you checked it out at  In the last few days, we've taken gerontologist Robert Kane, M.D. to task for his new book "It Shouldn't Be Like This."  ("In Sure Shouldn't Be This Way," "LTC Blog," August 2, 2005) 

We've commented on a giant leap forward by LTC insurers and providers in their understanding of and advocacy for Medicaid reform.  ("Society of Actuaries Solves Long-Term Care Puzzle," "LTC Blog," August 1, 2005) 

And we've provided a detailed account of Center president Steve Moses's education and advocacy efforts toward rational LTC policy in Washington, DC.  ("Back Atcha:  LTC Embed Report from the Policy Front in Washington, DC," "LTC Blog," July 29, 2005) 

"The Moses LTC Blog" at is a good place to go every day for controversial tidbits and perceptive analysis, but if you want all the down-and-dirty details, you need to join the Center and receive our daily "LTC E-Alerts." 

To join our fight for rational long-term care policy and receive all the Center for Long-Term Care Reform's publications, call or email Damon at 206-283-7036 or .  Let him know your annual dues check for $150 is in the mail or that you've subscribed by credit card online.  He will give you a user name and password to our "Members Only" website zone and start your daily e-pistles coming. 

Zone in now!  Your membership dollars enable us to keep pushing for policy that will save Medicaid as a safety net for those in need by expanding the long-term care insurance and home equity conversion markets. *** 



LTC Comment:  All things considered, Kansas is better off than most states when it comes to funding long-term care.  The state has the second lowest Medicaid nursing-home census in the country and one of the highest long-term care insurance market penetrations.  So if little old Kansas, denigrated by the big Medicaid-spending states on the left and right coasts as "fly-over country," has a problem, then look out America! 

And the following op-ed, republished with permission, indicates that Kansas does indeed have a problem.  Fast forward a couple decades, and the "wizards" behind the curtains in Washington won't have a prayer of fixing it . . . not even for Kansas.  The author, Matt Hisrich, is a rising star among political commentators.  Watch for more articles from this young journalist, whose generation will have to pay the price for the folly of today's politicians. 


Matthew Hisrich, "Medicaid Could Swamp State Budget," The Wichita Eagle, July 26, 2005, .  This op-ed is also posted on the website of the Flint Hills Center for Public Policy at

This July marks an important milestone in American history.  The first wave of baby boomers turns 59 1/2 this month, which means they can begin to access retirement accounts without penalty.  In another 2 1/2 years, this group will be able to access Social Security funds. 

Combining this dramatic shift in demographics with an unsustainable Medicaid program and an unproductive tax system may very well prove devastating for future economic stability in Kansas. 

Today, Kansas remains above average in terms of its senior citizen population.  But this is only the tip of the iceberg. As the baby boomer generation ages, the number of elderly residents in Kansas will skyrocket. 

According to the Kansas Department on Aging, by the year 2025, the 65 and older population in the state will have nearly doubled to roughly 600,000 residents from its 1990 level of more than 300,000. 

To compound the problem, few citizens are adequately planning for these later years by purchasing long-term care insurance plans.  The July issue of Long-Term Care Insurance Sales Strategies magazine reports that only 7 million Americans are covered by such policies. 

Part of this is likely due to a shift in how Medicaid is perceived.  Created as a safety net for the poor, the program has become an entitlement for all, regardless of income.  Indeed, lawyers have developed a niche for training seniors and their children on how to spend down even substantial wealth and qualify for state assistance. 

The state's tax policies are not helping matters.  Research by economist Richard Vedder has shown a clear link between high taxes, low growth and residents who vote with their feet. 

During the boom years of the 1990s, the increase in real per capita general fund spending in Kansas exceeded the national average.  And the 2003 state and local tax burden in Kansas was greater than that in all neighboring states except Nebraska. 

The result?  From 1990 to 2000, the percentage of the Kansas population age 44 and under dropped from 68 percent to 65 percent.  And in the past four years alone, Kansas lost more than 5,000 residents between the ages of 15 and 44. 

In light of ongoing budget struggles in Kansas, who will be left to pay for the additional costs of education and an aging population when its most productive residents are heading elsewhere? 

Avoiding this coming crisis may not be simple, but it can be done.  If Kansas is to offer quality care to those in need while also ensuring its future economic prosperity, a policy of pushing Medicaid reform into the future while allowing the overall budget to swell is no longer tenable.  The time has come for policymakers to act. 

Matthew Hisrich is director of the Consumer Driven Health Care Project for the Flint Hills Center for Public Policy in Wichita.