LTC Bullet:  Book Review--Harley Gordon's Latest 

Wednesday, September 26, 2007 


LTC Comment:  Sixteen years ago, if you'd told me I'd write a review praising and recommending a book by Harley Gordon, I'd have said "no way," but here goes, after the ***news.*** 

*** THE SAVAGE TRUTH.  Terry Savage, best-selling author and Chicago Sun-Times nationally syndicated financial columnist, holds forth on long-term care planning and insurance in her September 24 column titled "Long-Term Care Insurance a Good Hedge:  Don't Put it Off Too Long" at,CST-FIN-50Terry24.article. *** 

*** NEW WEBSITE FOR LTCI PRODUCERS.  Check out, a new resource provided by Jesse Slome and the American Association for Long-Term Care Insurance.  You'll find free sales tools, short educational audios, information on next year's "National LTC Producers Summit," and much more.  If you appreciate this content, join the AALTCI.  The dues are nominal and helpful materials like these don't invent themselves.  They come from the kind of dedication and passion you share and they need your support. *** 

*** MOSES AUDIO.  And speaking of short educational audios at, Slome recorded an interview with me this week and the next day it was "on the air."  Check it out at  While you're at it, listen to five minutes of Marsh's Steve Cain explaining "Tips on Tax Advantaged LTCi" or LTCI Partners' Lauren Johnson describing "Why the LTCI Sale is Easier Today."  There's much more audio info already and far more coming.  Download this stuff for drive time listening on your MP3.  Isn't the technology great (when it works)? *** 



LTC Comment:  I first met Harley Gordon at the second annual NAELA (National Academy of Elder Law Attorneys) conference in San Diego in 1991.  The Public Broadcasting System program "Frontline" planned to follow me around that meeting and expose the practice and practitioners of Medicaid planning.  But an ever-charismatic Gordon swept the young PBS producer off her feet.  Next thing I knew the show was as much about Harley's vision of elder law as it was about my critique of Medicaid planning. 

After that, Harley and I butted heads for several years.  We debated at conferences.  We critiqued each other in print.  We argued vehemently in person.  But somehow, over time, mutual respect, common interests, and shared goals emerged from this relationship.  Nowadays, Harley's Corporation for Long-Term Care Certification is a powerhouse for responsible LTC planning AND a corporate member of the Center for Long-Term Care Reform.  Furthermore, I'm about to tell you why you should buy his new book.  We've come a long way, my friend!  

But don't buy the book on my say so; buy it on its merits, recounted below.  I'll close with a little tweak reminiscent of a time when we disagreed on more things, and much more fervently at that. 

The book is: 

Harley Gordon, In Sickness & in Health:  Your Sickness--Your Family's Health, Financial Strategies Press, West Bridgewater, Massachusetts, 2007.  To learn more or to place an order for the book, go to or call toll-free:  866-257-5215. 

The book's sub-title is a good summary of its content and approach.  To wit:  "How to Discuss and Create a Plan for Long-Term care and the Consequences to Your Family and Finances if You Don't." 

Or, as a promotional piece about the volume puts it:  "This is not a book about ENDLESS STATISTICS telling you about the risk of needing care; it's about the emotional, physical and financial consequences of ENDLESS CARE."  In other words, the focus is on consequences, rather than--or in addition to--risk. 

Besides the obligatory content describing long-term care, explaining Medicaid, and recounting why private insurance is the best plan, chapters also cover "Understanding the Consequences of Needing Long-Term Care," "Choosing a Long-Term Care Professional," and what to do if you don't qualify for LTC insurance.  

As always, I paid special attention to the chapter on "Medicaid."  Gordon describes Medicaid eligibility and explains the program's purpose.  He gives examples of two inappropriate Medicaid planning advertisements.  Then he explains some of the downsides of relying on Medicaid or Medicaid planning.  For example: 

"Since Medicaid's long-term care benefits typically only cover care in a skilled nursing facility, the attorney's advice will focus on nursing-home care."  (p. 96) 

"Medicaid is not free:  Transferring qualified funds (assets held in tax-deferred accounts) creates an immediate tax liability."  (p. 96) 

"Medicaid planning can protect assets . . . [but] Lawyers cannot protect income."  (p. 97) 

"In short, Medicaid planning is counterproductive to a plan to protect the emotional and physical well-being of a family and the retirement portfolio on which it will depend."  (p. 103) 

So far so, good but then Gordon says: 

"Some professionals in the long-term care insurance industry believe Medicaid should never be used when a person has any assets or a home."  Why did I feel like I was wearing a bulls-eye when I read that? 

Actually, I don't go so far.  I think Medicaid is perfectly appropriate for people who meet the prescribed income and asset guidelines, including the generous spousal impoverishment protections we fought for and won in the Medicare Catastrophic Coverage Act of 1988.  As long as they don't use Medicaid planning to evade estate recovery, Medicaid works for such people exactly as it should, as a temporary loan to avoid financial devastation. 

Where Medicaid planning is not appropriate is when it takes advantage of loopholes and elasticities in the law to protect income and assets far beyond the letter and the intent of the law--no matter how great the need or desirable the purpose.  And cleverly dodging estate recovery turns Medicaid into free inheritance insurance for heirs. 

Why such "tough love"?  Because Medicaid can't survive as the LTC payor for everyone.  It can't be used to insulate people's businesses or protect large home equities and also provide quality long-term care for people who have no other resources.  The proof of that is in the history of Medicaid LTC and its dismal reputation for problems of access, quality, reimbursement, discrimination and institutional bias. 

But other than this one point, on which we can agree amicably to disagree, I recommend Harley Gordon's new book unreservedly.  Buy it for yourself.  And use it to open the eyes of prospects and clients who might otherwise remain behind the veil of denial.