LTC Bullet:  The Brave New World of Long-Term Care 

Wednesday, June 27, 2007 

Raleigh, NC-- 

LTC Comment:  Read the scintillating conclusion of Steve Moses's speech at the Notre Dame Law School, after the ***news.*** 

*** TODAY'S LTC BULLET is sponsored by Ralph Leisle and LTCi Decision Systems, long-time supporters of the Center for LTC Reform.  Ralph is creator of the "LTC Economic Impact Planning Model" (TM) and "LTCia POM (Pool of Money) Calculator" (TM).  He strongly believes LTC planning is equally appropriate for high net worth and traditional clients.  He advocates a "holistic" or "estate planning" approach for all clients, which provides objective, factual information enabling more informed decisions.  Prior to founding LTCi Decision Systems, Inc., Ralph Leisle was a senior financial advisor focused on fee-based estate planning, retirement planning and long term care financing.  For more information on software or consulting services, contact Ralph Leisle (email, call toll-free at 1-800-360-9853, or visit LTCi Decision Systems online at ***  

*** TODAY'S BULLET is our 700th since opening the Center in April 1998.  We thank Ralph Leisle and LTCi Decision Systems for helping us celebrate by sponsoring this Bullet.  If you'd like to do the same, please contact or to make the arrangements. *** 

*** FREE FINANCIAL PLANNING CLINIC:  We pass on the following announcement at the request of the CFP Board:  Answers from the Experts!  CFP Board invites you to attend a free Financial Planning Clinic on Saturday, August 4, 2007, from 10:00 a.m. to 2:00 p.m. at the Sheraton Hotel in Boston, where Certified Financial Planner(tm) professionals from around the country will volunteer their time and expertise to answer your financial questions for free.  You will be able to speak with volunteer CFP(r) professionals regarding any questions or concerns you might have about long-term care planning, estate planning, retirement planning, investments, tax planning, employee benefits planning, and many other financial topics.  For more information and to register for free, visit *** 



LTC Comment:  On November 9, 2006, I spoke at an "Aging America Symposium" sponsored by the Notre Dame Law School.  My remarks, titled "The Brave New World of Long-Term Care," were published in the latest issue of the Notre Dame Journal of Law, Ethics & Public Policy.  To read the whole article, go to  Here's the conclusion (footnotes omitted): 

"Finally, what is wrong with other proposals commonly offered to solve [the long-term care] problem?  Many seek to solve the problems of long-term care service delivery and financing with compulsion.  They want to force people to pay for long-term care insurance or load up Medicare with a long-term care benefit.  That won't work, and it hasn't worked.  If excessive public financing has caused the problems we have now, then trying to solve them by adding more government financing would be like trying to put out a fire by dousing it with gasoline.  Social Security and Medicare have unfunded liabilities totaling $86 trillion, at latest count [$91 trillion now].  To fix this, we would have to double payroll taxes or halve the benefits of these programs.  Neither option is politically popular.  The more likely outcome is that these programs will be means-tested.  In other words, they will be turned into welfare programs.  In time, they will lose political support in the same way Medicaid already has.  Adding long-term care to Medicare, therefore, would be like adding deck chairs to the Titanic after the incident with the iceberg. 

"Here is the irony:  our problems in long-term care are self-inflicted by well-intentioned but perversely counterproductive public policy.  The good news is that the problems are easy to fix.  We can do it responsibly through public policy, or we can just stand by and let the existing social insurance and welfare house of cards collapse.  The Brave New World of Long-Term Care is here. 

"My advice to you as individuals, families, and citizens is to take responsibility for your own long-term care.  Plan early, and save, invest, or insure.  Maybe you can't solve the public policy problem alone, but you can protect yourselves and your families.  Doing so is an important contribution.  After all, as a wag once said:  'The best way to help the poor is not to become one of them.' 

"Politically, my advice to you is to support targeting Medicaid to the poor, in order to save the fraying safety net, and supplementing long-term care with private financing sources.  Do you wonder how the new Democratic majority in Congress will lean?  Remember:  some of the most stringent controls on Medicaid long-term care eligibility in the past came under Democratic presidents and Congresses.  Besides, for Democrats, this is a 'fairness' issue.  Why use scarce public resources to indemnify well-to-do heirs of affluent seniors?  They're probably all Republicans anyway! 

"Thank you for your attention."