LTC Bullet: LTC Catch Up

Wednesday, October 8, 2008

Palo Alto, California (LTC Tour Mile 20,600; State # 31)

LTC Comment: Today's LTC Bullet is a grab bag of news and views that have been backing up for a week or so. Don't miss any of the tantalizing tidbits after the ***news.***

*** CONSULTING GIG: I'm in Palo Alto, California today preparing to brief some Wall Street investors on the state of the long-term care financing system. I'll fly back to Nashville in the morning, and head for Cleveland, Ohio where the Silver Bullet, the LTC Tour and I have our next event, a two-hour CE-approved Long-Term Care Graduate Seminar for the local NAHU (National Association of Health Underwriters) affiliate. ***

*** SUPPORT THE LTC TOUR. It's not too late to be aboard the Silver Bullet with your corporate logo during LTC Awareness Month ( Contact Damon at 206-283-7036 or for details. Plan your LTC Tour event with Steve Moses at 425-891-3640. ***

*** BAD NEWS, BIG OPPORTUNITIES. We've been warning here for years that the LTC funding crisis will devastate America's social safety net. You'll find below ample evidence that the crisis is mounting. We've not only highlighted the problem. We've offered the solution all across America this year on the National Long-Term Care Consciousness Tour. Support the Center for Long-Term Care Reform and our LTC Tour by becoming an individual member of the Center ($150 per year), a corporate member (starting as low as $1,000) or by sponsoring the LTC Tour (from $500 as a "Regional Representative of the Center to $25,000 for a Platinum Sponsorship.) Special: Finish the LTC Tour year as a Silver, Gold or Platinum sponsor and you're cost will be only one-third the original investment. ***



LTC Comment: A couple weeks ago, Steve Moses appeared on Bryan Herdt's radio show in Phoenix, Arizona. Herdt is Director of Long-Term Care for IPG (Independent Planners Group). For a good overview of the problem and likely outcome of America's long-term care financing crisis, listen to these two brief radio segments from KFNN 1510 ( "Business for Lunch! with Julie Dougherty" in Phoenix on September 23, 2008:

Part one:

Part two:

Marc Kaye, the Center for Long-Term Care Reform's New York Regional Representative, is at it again. You'll recall that Marc, an associate of LTC Tour Gold Sponsor LTC Financial Partners (, was the force behind a professionally produced video that reached thousands of CPAs with the LTC Tour's message of responsible long-term care planning. Read about it at "LTC Bullet: We Touch Thousands of CPAs with Professional Video" ( Watch it at|10494.

Now Marc's made a new contribution. Check out this letter from influential Congressman Charles W. Boustany, Jr., M.D. (R, Louisiana) supporting LTC Awareness Month: . Congressman Boustany was also the key to that extraordinary and long-overdue admission by the Social Security Administration that Medicare DOES NOT cover long-term care and that citizens SHOULD consider purchasing private long-term care insurance. Check it out here:

Tennessee Regional Representative Phyllis Shelton, who hosted the LTC Tour during our first visit to Nashville in February, recently garnered some important "earned media." Check out her story in the Wall Street. Journal's "Marketwatch" about the new LTC Partnership Program in Tennessee here.

Now, let's emphasize why all this earned (i.e., free) media and positive coverage is so important. Following is a long list of news with links that support our LTC Tour warnings about the coming LTC crisis and the public's need to plan early for LTC risk. In a nutshell, Medicaid, Medicare and Social Security, the traditional safety net programs, for the poor, but also for the middle class and affluent, are on their way down, and maybe out. Smart consumers are planning now to take more of the responsibility on themselves for their financial, health care and long-term care security.


States See Rising Enrollment in Medicaid as Economy Falters, Survey Finds. The eighth annual 50-state survey of state officials released this week by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) finds enrollment in Medicaid began to rise in fiscal year 2008 as they confront a weakening economy. The survey finds that Medicaid enrollment across the country grew 2.1 percent in fiscal year 2008. States also experienced spending growth of 5.3 percent, up significantly from the previous two years. For fiscal year 2009, states expect to see even larger increases in Medicaid enrollment and spending, raising the potential for program cutbacks as states face the combined impact of more enrollees and fewer available resources. Conducted by researchers at Kaiser and Health Management Associates, the survey found that more states made or planned restorations, enhancements or expansions to their Medicaid programs than made cuts for fiscal years 2008 and 2009. These include changes to provider reimbursement levels, Medicaid eligibility requirements and enrollment processes, benefits, and home- and community-based services for long- term care. Full survey results are available online at

Source: Kaiser Weekly Update, 10/3/8


State workers face bleak budget picture By Pauline Vu, Staff Writer (Updated 11:40 a.m. EST, Oct. 3, 2008) The economic downturn has hit states hard, and among those feeling the effects are state employees, whose salaries are being frozen, who are retiring before they wanted to, who are being asked to take furloughs, or unpaid days off, and who, in an estimated 7,000 cases, have been laid off. Read More:

Source: Daily - Oct. 3, 2008


Medicaid long-term health care costs to soar in US By Will Durham, Reuters. Sep 30, 2008 According to a recent report released by America's Health Insurance Plans, Medicaid spending for long-term care for the disabled and elderly will total in the neighborhood of $3.7 trillion in the next 20 years ( These figures include individual state spending, projected at $1.6 trillion, and $2.1 trillion in federal money. In a separate report released by the Kaiser Family foundation health policy organization, Medicaid enrollment grew by 2.1 percent in the 2008 fiscal year after showing a decline in the prior fiscal year.

Physician Payments May Take Hit as Medicaid Enrollment Swells in Declining Economy By Emily P. Walker, Washington Correspondent, MedPage Today. MedPage Today. Sep 29, 2008

Long-term care insurance: pricey but necessary? By Dave Carpenter - AP Business Writer. Reporter News - Abiline, TX. Sep 29, 2008 - Link

Source: AHCA / NCAL Gazette - Tuesday, September 30, 2008


Violations reported at 94% of nursing homes By Robert Pear. New York Times. Sept 29, 2008 A report, to be released tomorrow by Daniel R. Levinson, the inspector general of the Department of Health and Human Services, asserts that over 90 percent of the nation's nursing homes were cited for violations last year and that 17 percent of homes had deficiencies that caused "actual harm or immediate jeopardy" to patients. AHCA President and CEO, Bruce A. Yarwood, said: "We know we have to do a better job. We have been doing a better job, in treating pressure sores, managing pain and reducing the use of physical restraints." However, said Yarwood, the inspection system is faulty. "It does not reliably measure quality. It does not create any positive incentives. Inspectors are subjective and inconsistent. They interpret federal standards in different ways," he said. Link

Source: AHCA / NCAL Gazette - Monday, September 29, 2008


Ohio: Programs for Poor Face $80 Million in Budget Cuts By The Associated Press. New York Times. Sep 25, 2008 In order to comply with an order by Gov. Ted Strickland to cut 4.75 percent from state agency budgets, the Ohio Department of Job and Family Services, is cutting $80 million from the state's welfare program, adoption services, Medicaid fraud detection and the state's child support program. Not included in the cuts are $9.3 billion the state sets aside to provide Medicaid to Ohioans until receiving a federal reimbursement, and $25 million for disability assistance. Link

UT: Medicaid funds on chopping block By Lisa Rosetta. Salt Lake Tribune. Sep 24, 2008 Just as more Utahans are lining up for Medicaid benefits, Medicaid director Michael Hales is preparing to present two budget-cutting scenarios to lawmakers.

Source: AHCA / NCAL Gazette - Thursday, September 25, 2008