Bullet: Nursing Home Pot
Calling LTCi Kettle Black?
Wednesday, August 8, 2007
LTC Comment: LTC
providers and insurers need to understand each other's challenges and
opportunities better and cooperate more.
A case in point, after the ***news.***
*** INTERNATIONAL PRAISE for the Center's
"Almanac of Long-Term Care":
Canadian Patty Randall, the highly regarded author and speaker on
long-term care planning, wrote us about yesterday's "LTC
Almanac" update: "Stephen: Just
want to say that today's LTC E-Alert #7-101--outlining the newly
published reports and articles is worth the membership fee alone!!!
Thanks once again for doing such an amazing job of updating your
readers. Kindest Regards,
Patty Randall, National Consultant/Author."
And thank you, Patty, for many years of support for the Center
and for your advocacy on behalf of rational LTC public policy in Canada.
LTC ALMANAC. Want to know
"Long-Term Care Almanac" is a compendium of data, abstracts,
quotes and citations about long-term care service delivery and financing
listed chronologically by topic and ranging back as early as the 1980s.
The "Almanac" is available exclusively to dues-paying
members of the Center for Long-Term Care Reform and to affiliates of our
corporate members. Find it
in The Zone at http://www.centerltc.com/members/LTC_ALMANAC/Main.htm.
Topics covered are: Aging
Demographics; International LTC; Unfunded Liabilities--Social Security,
Medicare, and Budgets; Long-Term Care; Caregiving; Long-Term Care
Financing; Long-Term Care Insurance; Reverse Mortgages; Long-Term Care
Providers; Medicaid; and Medicaid Planning.
Periodically, we add material to the "Almanac of Long-Term
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We update Center members on all new additions to the "LTC
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LTC BULLET: NURSING
HOME POT CALLING LTCI KETTLE BLACK?
LTC Comment: One
of the Center for Long-Term Care Reform's favorite themes is that
private sector LTC stakeholders (providers, insurers and financiers)
should stick together.
Our "LTC Triathlon" study of a few years
ago documented the counterproductive misunderstanding and lack of
cooperation between those three groups and recommended solutions.
Read "The LTC Triathlon: Long-Term Care's Race for Survival" at http://www.centerltc.com/pubs/triathlon.pdf.
I compared competing LTC interest groups to the
blind men of the elephant allegory in "The Elephant, The Blind Men
and LTC," National Underwriter LTC E-Wire, Vol. 2, No. 3,
February 2003. Read that
one at: http://www.nationalunderwriter.com/LTC/articles/2003_02_elephant.asp.
why LTC service delivery and financing in the U.S.A. is so fouled up by
comparing the competing interests of government, senior advocates, the
public, providers, insurers and financiers is the primary goal of our
"Long-Term Care Graduate Seminar."
So when a
leading nursing home/LTC provider trade magazine reported uncritically
on that March 26 New York Times broadside at the LTC insurance
industry, I responded.
LTC providers how unfair national media coverage has been toward their
own profession and urged them to consider this key point:
providers and insurers get a bad rap.
The real culprit is excessive public financing of long-term care.
Medicaid especially has undercut access and quality of LTC with
low reimbursements and crowded out private financing by exempting huge
home equities and subsidizing welfare-financed care after the insurable
credit, McKnight's Long-Term Care News (www.McKnightsonline.com)
published my letter. It
follows. But first, let me
strongly encourage all readers of this newsletter and our "LTC Blog"
at www.centerltc.com to
subscribe to McKnight's and other LTC provider trade journals.
The more you understand what providers, especially nursing homes,
are up against, the more you'll appreciate their industry's good guys'
heroic efforts to give compassionate, high-quality care under extremely
difficult conditions. They're
comparable I assure you to the thankless labors of the AMGs (altruistic,
masochistic geniuses) who sell LTCi.
A. Moses, "Advocate Rips Newspaper About LTC Insurance Story,"
McKnight's Long-Term Care News, July 2007, pps. 40-41.
recent New York Times article (as reported on in McKnight's:
"Analysis rips LTC insurers," May 2007, p. 12) is on a par
with the attacks in USA Today and Consumer Reports on
nursing homes - i.e., some real problems exist, but the criticism is out
of all proportion and directed at the victims of the real problem: too
much reliance on public financing, which undercuts nursing homes and
crowds out private insurance.
of long-term care insurance is good. I'll let people in that business
defend their product. But to be fair, what happens if people don't have
private LTC insurance? Most likely, they end up on Medicaid, which is a
means-tested public assistance program. Although it is welfare, Medicaid
for LTC is easy to get. Income is rarely an obstacle and most assets are
protected, a home (up to $500,000) plus a business, car, home
furnishings, personal belongings, term life insurance and prepaid
burials of unlimited value.
long-term care? What's not to like? First of all, it isn't free. You'll
have to contribute all but a pittance of your income toward your cost of
care. Then consider that Medicaid is tax-payer-financed. It's always
short of funds. Medicaid pays nursing homes $13.10 per bed-day less than
their cost of providing the care. So what?
has a dismal reputation for problems of access, quality, reimbursement,
discrimination and institutional bias. Depend on Medicaid and you'll
probably end up in an under-financed nursing home, if you can find one
at all that will accept low reimbursement. The main reason to have
private LTC insurance is so you can keep control of your life and
receive red-carpet access to top quality long-term care at the most
appropriate level: home care or assisted living and a top-notch nursing
home, but only if you need it.
Medicaid-financed long-term care is problematical now, just wait a
couple decades when baby boomers need LTC. By then, Social Security and
Medicare will be in big trouble. By the time most boomers need LTC,
those supports will be long gone.
consumers should use caution when selecting a private LTC insurance
policy, but they should also apply similar scrutiny toward Medicaid.
Because, without private insurance, that's where they'll likely end up.