LTC Bullet: The Jacksonville LTCI Conference

Thursday, March 20, 2008

Apalachicola, Florida--

LTC Comment: The 8th Annual Intercompany Long-Term Care Insurance Conference met its usual high standard again this year. Details after the ***news.***

*** LTC TOUR UPDATE. I wrote this whole LTC Bullet while riding in the Silver Bullet. Don't worry, the Center's Administrative Coordinator (and my son) Damon is with me to do the driving. Momentarily, we'll shift. I'll drive while he posts this Bullet to you and uploads it to 

The Silver Bullet had great visibility at the Jacksonville LTCI conference, parked right in front of the Hyatt. I stocked the fridge with beer, put out a bowl of pretzels, and opened our "hospitality suite" for visitors. Feedback has been wonderfully positive. Coming soon, a picture of the Silver Bullet in front of the state capitol building in Tallahassee. We'll weekend on the Gulf Coast, then hustle to events in Pensacola on Monday, Baton Rouge on Tuesday. Wednesday is a 508 mile drive to Texas where I'll speak Thursday in San Antonio, Friday in Austin, the following Monday in Houston, Tuesday in Dallas and Thursday/Friday back in Houston. Whew! Good thing we have a restful, seaside campground for this weekend. ***

*** LTC COMPENDIUM. Juxtapose these stories and see if you don't think a public in denial about LTC risk and cost is about to get a very rude awakening.

"Approximately one out of every eight baby boomers in the United States - or roughly 10 million people - will develop Alzheimer's disease, says a new report from the Alzheimer's Association." Source: Daily Update, March 20, 2008, 

"About one-third of all people over the age of 71 (5.4 million) experience some degree of mental decline, according to a study published today in the Annals of Internal Medicine. Diminished mental capacity is as common as diabetes, said lead researcher, Brenda L. Plassman, of Duke University." Source: AHCA / NCAL Gazette - Tuesday, March 18, 2008,  

"States' budget crises will hurt millions . . . An Associated Press review of the budgets in all 50 states has found that nearly a third of state legislatures are working on plans to cut Medicaid coverage for more than 10 million Americans. Cuts to doctors' reimbursements could affect a total of 20 million people. Source: AHCA / NCAL Gazette - Tuesday, March 18, 2008,  

"In a growing trend, Minnesota nursing homes are closing. Following a three year freeze on reimbursement levels (2002 - 2005) . . . In all likelihood, there will be no increase in COLA for this year. Source: AHCA / NCAL Gazette - Tuesday, March 18, 2008, ***


LTC Comment: More than 800 long-term care insurance leaders met March 16-19 at the riverfront Hyatt Hotel in Jacksonville, Florida. The 8th Annual Intercompany Long-Term Care Insurance Conference achieved its customary high standard. Kudos to Jim Glickman for a long run of excellent meetings and to this year's conference chair Dan Cathcart.

Best of all, this year's meeting wasn't greeted by a fusillade of negative coverage in the national media. Maybe our return fire, correcting the more egregious shortcomings in past published attacks, is making a difference.

The right people were at the Jacksonville conference, with few key players missing, which makes the most important aspect of such meetings--networking--successful. The educational sessions were plentiful, competently presented, and well-attended. My reflections on the meeting's substantive content follow in a moment.

The venue was excellent. Hotel and meeting logistics were flawless. The food and drink, provided by sponsors, was abundant, above average, and free. Entertainment, including live music and dancing, was only one block away at the "Jacksonville Landing." One company provided free river-taxi service to a "hospitality suite" on the other bank, drawing a good crowd.

Usually, I take extensive notes at numerous conference sessions and report in detail to you about each session. This year I'm doing something different. I took no notes and just let the experience of each session flow over me. Following are some general impressions and reflections.

Two highlights of the conference for me came from Vince Bodnar. Vince is an actuary with the DaVinci Consulting Group. He has chaired the conference in the past, serves on its board of directors, and presented at several sessions this year. Two in particular captured my attention.

At the "Distributors' Roundtable" on the first day of the conference, Bodnar moderated and asked a key question "If you could decide, what would you have the government do about long-term care." To my amazement, everyone on the panel who commented said, basically, that the government should "stop giving away what we're trying to sell." 

The reason that answer was so important is that it's right, of course, but more significantly it's different than the usual approach of the LTC insurance industry to government. The usual approach is to ask for expensive subsidies and programs that are completely unrealistic to achieve, given the fiscal problems government faces.

The key to getting above-the-line tax deductibility and bigger LTC education campaigns is to save the government enough money to pay for those benefits. Ironically, we can improve Medicaid for the poor, save that program lots of money, and fund tax incentives for long-term care insurance by getting the government to stop giving away what the LTCI industry is trying to sell. And that was what the Distributors' Roundtable panel proposed. 

The other time Vince Bodnar "nailed it" was in a session titled "Crystal Balls and LTC," part of the Actuarial track. He explained that only 18 percent of the total cost of long-term care in the United States is paid "out of pocket." I clarified in a comment that over half of that 18 percent is really just Social Security income of people already on Medicaid! No wonder the public's in denial about LTC; less than 10 percent of the cost of LTC comes out of their private income and assets. Vince continued to explain the impossibly steep increases in Social Security, Medicare, and Medicaid that will leave those programs consuming the entire federal budget someday if nothing changes.

Obviously, something will change. As the late economist Herb Stein used to say, "trends that can't continue, won't." But here I part company with Vince. He concludes the system will veer toward socialism in response. I think America's unfunded entitlement programs will implode and that market capitalism will prevail. But whoever's right, one thing's for sure, whether the government is trying to pay for LTC for everyone or giving up altogether, the only way to obtain quality LTC at the most appropriate level in the future will be to pay privately. And the only way to pay privately without spending one's own money or home equity is to have private LTC insurance.

Another highlight of the conference for me was the keynote address by Dr. Paul Nussbaum on "Brain Health." Nussbaum presents his message intelligently, passionately and with humor. The message is that we need to understand the brain, accept its critical importance, and keep it healthy. Can we actually prevent or postpone Alzheimer's Disease by practicing healthy brain habits? Well, at the very least it can't hurt.

There were at least two sessions at the conference dealing with LTC Partnerships. I attended one, but I also heard a lot of Partnership "buzz" throughout the meeting. Mostly, attendees are excited and hopeful about the expansion of LTC Partnerships. But I heard more criticism of the Partnerships than at previous meetings. Implementation challenges, confusion over requirements, variations between state Medicaid programs, worries about access to and quality of care when policy holders transition to Medicaid, worries that Medicaid will renege altogether on its part of the LTC Partnership bargain. Such are the concerns that balance the hopeful expectation that the Partnerships will help with education, awareness of LTC risk, and urgency.

The CEO Forum on the last day of the conference is probably the most popular session. This year's version had an interesting twist. "Instant polling" wireless devices allowed the audience to vote on answers to questions. After the audience vote, the CEOs gave their perspectives. 

Unfortunately, my reaction to this year's CEO Forum is the same as in past years: "same old, same old." The questions are the same; the answers are the same; and the audience's frustration remains the same. When will we see bold new approaches to LTCI marketing? When will the industry mobilize a better media defense and offense? When will CEOs confront the real problem: government gives away what their companies are trying to sell. 

Let me make one humble suggestion. How about supporting the "National Long-Term Care Consciousness Tour?" The Silver Bullet of Long-Term Care is criss-crossing the country with a message of personal responsibility for long-term care and rational LTC public policy. We're drawing attention from the media, the public, and policy makers. Don't want to advertise on a trailer? No worries. Support the tour, get your information in our elegant presentation packets, and schedule speaking events for me with your current and potential producers. But please don't fail to support the only dramatic, ground-level, LTC advocacy campaign going. We need you!