LTC Bullet: Hillary
February 7, 2008
Insurance Underwriter magazine published my article about Senator
Clinton's long-term care proposals.
Read it after the ***news.***
FIRST SPONSORS' LOGOS adorn the Silver Bullet of Long-Term Care.
Check out the pictures at http://www.centerltc.com/first_sponsors.htm
. You'll find logos for the
Center for Long-Term Care Reform; coordinating platinum sponsor
GoldenCareUSA; platinum sponsor Bankers Life and Casualty; Gold Sponsors
OneAmerica, Prudential, Marilee Driscoll's LTC Month, and the American
Association for Long-Term Care Insurance; Silver Sponsor LTCI Partners,
and special LTC Tour sponsor BatesRV of Tampa, Florida.
The National Long-Term Care Consciousness Tour has lots more
major sponsors; we just
don't have their logos in hand yet.
Next stop for adding signage is Atlanta in late February.
Sponsor the LTC Tour and get your logo on the Silver Bullet or
the public, producers, politicians and the media will wonder why you're
missing as we criss-cross the country to promote responsible long-term
care planning. Find all the
details at the top of www.centerltc.com
or contact firstname.lastname@example.org
or 206-283-7036. ***
CAPITAL FINANCIAL GROUP in Knoxville, Tennessee hosted the LTC Tour and
Steve Moses at their offices yesterday.
Feedback on our message of responsible long-term care planning
and rational LTC policy was excellent.
Here are a few of the comments:
a voice of sanity and a position based on principle and
compassion. Thank you!
May the seeds you sow bear much fruit!" Bill Halsey
"Eye-opening presentation on LTC.
Thank you." Daniel Pope
"Stephen has helped me to 'look forward to'
the future of long-term care."
I thank Capital Financial Group for a warm welcome,
an attentive audience, and a generous gift certificate to Cracker Barrel
restaurants to keep the human element of the Silver Bullet of Long-Term
Care well fueled also. ***
*** LTC TOUR ACTIVITIES.
Find out when the LTC Tour will be where in the LTC Tour Calendar
at the top of www.centerltc.com.
If the date isn't assigned, it's up for grabs.
Major LTC Tour sponsors get signage on the Silver Bullet,
information inserts in our elegant presentation packets, and the right
to schedule major events with Steve Moses and the Silver Bullet of
Long-Term Care. First come,
first served, folks, so get aboard soonest.
Tomorrow we have two events in Knoxville. On Thursday, Nashville Regional Rep Susan Baskett has
scheduled a valuable get together with LTCI professionals in the
morning. Regional Rep
Phyllis Shelton and I are meeting with the Director and Deputy Director
of TennCare (Tennessee's Medicaid program) in the afternoon.
Then comes a photo shoot and interview with The Tennessean,
the state's major daily. Kudos
to Phyllis for making that meeting and this media coverage happen.
Friday is another great face-to-face session with Tennessee
legislators in Nashville. Monday
and Tuesday I'm doing similar meetings with community and political
leaders in Chattanooga thanks to the successful organizational efforts
of Regional Representative Gail Lindsey.
Wednesday will find me in Columbus, South Carolina for the state
Association of Health Underwriters' annual "Day on the Hill"
to educate legislators in the capital about LTC planning and policy.
Many thanks to Regional Rep Barbara Franklin for facilitating
that opportunity. ***
BULLET: HILLARY ON LTC
Comment: The February 2008
issue of Health Insurance Underwriter, the monthly magazine of
the National Association of Health Underwriters (www.nahu.org),
contains my article "Hillary
Clinton on LTC."
to its website (http://www.nahu.org/media/index.cfm)
HIU magazine covers technology, legislation and product
news-everything that affects how health insurance professionals do
business. It is published
12 times a year with a circulation of at least 30,000 copies per month.
guess what, HIU wants to increase its circulation and is offering
free subscriptions (regularyly $40 per year) for the first time ever!
here's my opinion about . . .
Clinton on LTC
candidate Senator Hillary Clinton has promised a cornucopia of LTC
benefits if elected. Would our service delivery and financing system be
better or worse if she delivered?
Clinton announced her plans for long-term care public policy a few weeks
ago. (Check out the press release at www.hillaryclinton.com/news/release/view/?id=4592.)
Let's give due credit: none of the other presidential candidates have
committed themselves to anything like such a detailed plan. At least
she's on the record, with lots of ideas, some of which are very
a synopsis, then our comments:
Clinton's Long-Term Care Agenda
Seniors with Long-Term Care Needs, and The Invisible Army of Caregivers
That Support Them:
Enacting a new $3,000 Caregiving Tax Credit to provide financial relief
to millions of seniors, people with disabilities and their families.
Clinton will also invest more than $300 million per year to support
unpaid family caregivers.
Giving more seniors the ability to access long-term care services where
and when they need them, including in their homes.
Doubling the elderly standard deduction to provide additional financial
relief for 11 million elderly tax filers.
the Elderly Prepare for Long-Term Care Needs by Making Long-Term Care
Insurance More Secure and Affordable:
Requiring tough new consumer protections for long-term care insurance,
including ending discrimination against veterans and helping states
create consumer advocates for long-term care insurance.
Offering consumers the same secure long-term care insurance options that
members of Congress enjoy.
Providing a new Long-Term Care Insurance Tax Credit to make secure,
high-quality insurance plans affordable.
Our Seniors by Improving the Quality of Our Nursing Homes:
Tripling federal support for nursing home ombudsmen programs to protect
consumers of long-term care.
Directing the Department of Justice and the Federal Trade Commission to
assist state consumer advocates and prosecutors to tackle persistent
abuses and new challenges in the long-term care industry.
Reversing the inexcusable policy of the Centers for Medicare and
Medicaid Services (CMS) of withholding information on poor-performing
nursing homes and giving seniors full access to usable data on nursing
homes, including data on nursing home ownership structures.
Strengthening our nursing and direct care workforce with a national
system of background checks for long-term care workers and $125 million
investment in Workforce Improvement Programs.
Senator Clinton's laundry list of LTC promises includes something for
nearly everyone -- a tax credit for caregivers, a tax credit for LTC
insurance, new LTC insurance options, tough new LTCI consumer
protections, expanded home and community-based care and tougher nursing
home regulation. Well, nothing in there for the much-maligned nursing
homes, but they're supposed to be the problem that schemes like this are
intended to fix. So, no surprise in that.
the flaw in this and any similar grab bag of uncoordinated proposals:
They do not derive from analysis of what caused the problems they seek
to fix. Consequently, they run the risk of making the problems worse
instead of better. So, to evaluate the Senator's plan, let's begin by
summarizing why America has such a dysfunctional LTC system in the first
place. Then we'll be able to see if her proposals are compatible and
progressive or contradictory and self-defeating.
is a mess in the U.S.A. because the government made nursing home care
free in 1965 by paying for it through Medicaid and Medicare. That's why
the public is in denial today about LTC risk and cost. That's why the
system has a nursing home bias. That's why a private home and
community-based services infrastructure never developed. That's why the
long-term care insurance market remains stunted. It's a big reason why
Medicaid and Medicare costs have exploded. And that's why state and
federal budgets are too tight to fund access to quality long-term care
reliably through public programs.
does anything in Senator Clinton's LTC plan address this underlying
dysfunction? No. If anything, her plan would exacerbate all of the
underlying causes of the problems. For example:
Expand Medicaid-financed home and community-based care? That makes
Medicaid LTC even more attractive than it already is. It would increase
Medicaid estate planning and ruin the LTCI market unless combined with
strict eligibility controls, which the Clinton plan lacks.
A $3,000 tax credit for caregivers? That also sends the wrong message:
don't worry about long-term care. Not only will Medicaid pay for it, but
you'll get a check from the government if you provide the care yourself.
Furthermore, it's an open invitation to elder abuse. Find an elderly
person to put in the basement and cut your taxes $3,000.
Give a tax credit for LTC insurance? Great idea, but it won't help much
if combined, as it is in Senator Clinton's plan, with so many expensive
new initiatives to make publicly financed LTC more attractive and
responsible LTC planning less necessary than ever.
Improve nursing home care by adding more regulations and enforcement?
Dream on. The problem with nursing home care is that it is underfunded
by parsimonious public programs, not that it is under-regulated. Nursing
homes are already as regulated as the nuclear industry.
is tempting for politicians to throw a lot of money and popular
proposals at problems. But too often, as in this case, their proposals
treat the symptoms of social problems instead of the causes. That's why
the unintended consequences of their well-intentioned ideas often make
worse the very problems they are trying to solve. Then will come another
set of politicians who propose more of the same. After 40 years of this
we find ourselves in a quagmire of conflicting policies and funding
sources so complicated it takes serious analysis to unravel and correct.
But serious analysis is something no politician has the time or
inclination to attempt.
what about the cost? Five billion dollars per year! For what? To add
more government interference in the LTC marketplace which is exactly
what caused the problems in the first place. Just think what $5 billion
could do left in the hands of consumers if they had real incentives to
prepare responsibly for long-term care risk and cost.
the other hand, there is no chance Senator Clinton's proposals will come
to pass, whether she becomes president or not. Before long, the fiscal
tide will turn (it may be turning already); Social Security and Medicare
will shirk their unfunded liabilities by becoming means-tested welfare
programs like Medicaid; Medicaid will sink further into red ink; public
financing of long-term care will retrench if not disappear altogether;
the burgeoning boomer generation will tap their home equity (if any
remains) to pay for long-term care; their heirs will get the message and
start to buy LTC insurance; and the marketplace will work things out in
the long run.
so very sad, however, is that a lot of poor people for whom we could
have preserved a social safety net will be hurt as this scenario
unfolds. And here's the irony. The very politicians who claim to care
most about the needy and underprivileged are the same ones who propose
the policies that do the most harm. But that is no defense for the other
political side, which errs by omission almost as seriously as their
opposition seeks to do by commission.
The next 20 years will tell the tale.