Quarterly Nails the LTC Issue
Monday, October 23, 2006
LTC Comment: Sloppy,
ideologically biased reporting on the long-term care issue is endemic in
the media. A welcome
exception follows the ***news.***
*** WSJ MISSES ON THE LTC ISSUE. Speaking of misguided media, here's an example on the front
page of today's Wall Street Journal:
"Olden Days: Seniors
in Vermont Are Finding They Can Go Home Again; In Shift From Nursing
Homes, State Has Family Members Care for Elderly Relatives; Helping Gram
at $9.25 an Hour," by Lucette Lagnado.
If you subscribe to the WSJ Online, read it at http://online.wsj.com/article/SB116137590566399273.html.
Otherwise, pick up a hard copy.
You won't find a single mention of long-term care insurance or
home equity conversion, the only hopes for saving long-term care
financing. Instead, read
how Vermont is digging its LTC financing hole deeper than ever by
diverting scarce public welfare dollars toward paying families to
provide care they've been giving for free heretofore.
It won't save money, economists say, and it will further
anesthetize the public to the real risk, cost and emotional strain of
long-term care. ***
ALZHEIMER'S DISEASE: CAREGIVING
IMPACT. A recent MetLife
study found that those caring for an individual with Alzheimer's disease
or a similar dementia were 45% more likely than those caring for a loved
one with a physical impairment to report that caregiving had caused
their health to worsen. Caring
for someone with Alzheimer's disease added 13.5% to the caregiver's
stress. See "The
MetLife Study of Alzheimer's Disease:
The Caregiving Experience"
by the MetLife Mature Market Institute in conjunction with
LifePlans, Inc., August 2006, http://www.metlife.com/WPSAssets/25324075001158943637V1FAlzheimerCaregivingExperience.pdf.
UCS SELECTS GOLDENCARE USA. Unified
Capital Solutions, a leading provider of employee-paid voluntary plans,
has selected GoldenCare USA as provider of long-term care solutions for
their clients. GoldenCare
USA, based in Plymouth, Minn., is widely known for its long-term care
expertise and, together with its western affiliate (American Independent
Marketing), operates in 50 states, has 11,000 agents, with over $500
million in written premium. Contact: Gerald
O. Summers, 1-888-533-7503. ***
LTC BULLET: CONGRESSIONAL
QUARTERLY NAILS THE LTC ISSUE
LTC Comment: We're
very pleased to point you today to an excellent, 23-page report titled
"Caring for the Elderly."
It was written by Marcia Clemmitt and published in CQ
by CQ Press (www.cqpress.com), a
division of Congressional Quarterly, Inc. (www.cq.com).
Single copies of this and other CQ Researcher reports can
be purchased for $15 each at www.cqpress.com
or by calling 866-427-7737.
Here's what we found on a website about CQ
award-winning CQ Researcher explores a single 'hot' issue in the
news in depth each week. Topics
range from social and teen issues to environment, health, education and
science and technology. There
are 44 reports produced each year including four expanded reports. The CQ Researcher's hallmark is scrupulous objectivity
and balance. Every
12,000-word report is written by an experienced journalist and features
comments from experts, lawmakers and citizens on all sides of every
issue. Numerous charts, graphs and sidebar articles -- plus a
pro-con feature, a chronology, lengthy bibliographies and a list of
contacts -- round out each report."
are excerpts (a few of our favorite quotes) from CQ Researcher's
"Caring for the Elderly," published October 13, 2006.
LTC Bullets subscribers are also quoted in this paper including
professor Richard Kaplan of the University of Illinois, Joshua Wiener of
the Research Triangle Institute, Mark Meiners of George Mason
University's Center for Health Policy, Research and Ethics, Jodi Anatole
of MetLife, Professor Stephen Golant of the University of Florida, Bill
Thomas of the Eden Alternative, and Medicaid planner Bernard Krooks.
We wanted to pull all their quotes for you but the result would
have been much too long. By
all means, get a copy of this excellent article and read everyone's
comments in context.
see the futility of expanding the government's presence into LTC, 'you
have to look 20 years ahead, when Medicare and Social Security will be
in the last stages of collapse, and Medicaid will be history,' says
Stephen A. Moses, president of the Seattle-based Center for Long-Term
Care Reform, who advocates more private financing of LTC." (p. 846)
of private LTC insurance doubt public programs can ever hold down
spending. ‘Has anyone run
the numbers for the difference between promises made through Japan’s
social-insurance programs . . . and the country’s ability to keep
those promises?’ asks Stephen A. Moses, president of the Seattle-based
Center for Long-Term Care Reform, which advocates private LTC.
absence of a private market for services in which supply and demand set
prices and determine priorities, governments are hopelessly at a loss to
decide the best services to offer and the proper prices to charge for
them’ Moses says.” (p. 847)
“Medicaid’s rules allow adult children to
routinely commit what Moses, of the Center for Long-Term Care Reform,
calls ‘financial abuse’ on their elderly parents.
The children hire lawyers to deplete the parents’ estates of
enough assets to make them eligible for Medicaid while preserving the
children’s inheritance in financial trusts, he explains.
Moses advocates the voluntary purchase of private insurance, with
the government’s role confined to helping the very poor pay for LTC.”
"Should the federal government establish a
mandatory long-term care insurance program?
"Stephen A. Moses, President, Center for
Long-Term Care Reform, from speech to insurers posted at http://www.centerltc.com/speakers/what_i_believe_about_ltc.htm,
February 28, 2006
“The personal tragedy of long-term care for
individuals and families can be substantially relieved if people are
able to pay privately for high-quality personal and respite care.
The social tragedy of long-term care for America’s aging
population can be entirely averted by changing public policy so that
fewer people end up dependent on underfinanced public welfare programs.
“Friends and families provide most long-term care
at no charge, but under enormous financial and emotional stress.
The vast majority of all formal, compensated long-term-care
services are paid for by Medicaid (welfare) or Medicare (social
insurance). I believe that
Medicaid routinely pays less than the cost of providing long-term care
and that Medicare is slowly ratcheting down its reimbursement, while
both programs impose heavier and heavier regulation on providers.
“We’re in [this mess] because 40 years ago the
government started paying for nursing-home care without limiting its
free and subsidized services to people in financial need.
By making nursing-home care free, for all intents and purposes,
the government impeded the development of a private market place for
home- and community-based services.
By subsidizing long-term care for middle- and upper-class
Americans, the government impeded the development of a private insurance
market to help pay for the kinds of services people prefer.
“By becoming a single buyer of long-term care,
the government artificially increased the demand for and the price of
care beyond its ability to pay adequately.
The resulting cost containment caused quality of care to decline
and led directly to the overregulation that tied nursing homes and
home-health agencies in bureaucratic knots.
“If too much government financing has caused
excessive dependency on inadequately financed institutional care, then
the answer must lie in targeting scarce government resources to a
smaller number of people truly in need.
“When government programs have fewer people to
serve, they will be better able to provide adequate reimbursement of
higher quality. If they
cannot ignore the risk and cost of long-term care, most people will
save, invest and insure and thus be able to purchase red-carpet access
to care in the private marketplace.
When the government stops giving away what the long-term-care
insurance industry and reverse-mortgage lenders are trying to sell, more
people will buy those products.” (p. 857)
“‘The DRA was the culmination of a decade of
major work for me,’ says Moses, of the Center for Long-Term Care
Reform. He has been one of
the strongest voices urging lawmakers to make it harder for people to
qualify for Medicaid-funded LTC because it would spur development of a
strong, private LTC insurance market.
‘It’s a virtual miracle that we got as much as we did’ in
the DRA, ‘though it doesn’t go far enough,’ he says.” (p. 858)
[David Rosenfeld, co-founder of the Center for Long-Term Care
Reform, and later Chief Health Counsel to the House Energy and Commerce
Committee played a critical role in the design and passage of the DRA.]
“‘We have a lot of people on Medicaid for LTC
who would have, could have and should have been able to pay, had they
taken the steps to do so,’ says Moses.
“He acknowledges that there is ‘little
empirical research’ showing how many people illegitimately spend down
money to qualify for Medicaid LTC.
The phenomenon is ‘driven by adult children’ of cognitively
impaired parents who ‘hate to see their inheritance consumed’ paying
for private LTC, so they transfer and conceal their parents’ assets so
Medicaid will pay instead, Moses says.” (p. 858-859)
“But home-based care is generally more expensive than assisted living, and HCBS programs will only be as large as states can afford, some warn. The initiative ‘isn’t going to go very far, because there isn’t enough money,’ predicts Moses.” (p. 859)