LTC Bullet:  LTC Embed Report from the ILTCI Conference in Las Vegas

Friday, March 23, 2012

Seattle—

LTC Comment:  The big annual Intercompany Long-Term Care Insurance Conference was well attended and a great value in spite of the industry’s recent travails.  Highlights follow.

LTC BULLET:  LTC EMBED REPORT FROM THE ILTCI CONFERENCE IN LAS VEGAS

LTC Comment:  This year’s Intercompany Long-Term Care Insurance Conference in Las Vegas (Mar. 18-21) was another hit in a long series (12 already) of top-notch professional meetings.  With registrations over 800 and more than 700 actual attendees, the program attracted a very respectable attendance despite concerns that recent turmoil in the industry might diminish participation.  No way.  The energy level was high and the tone optimistic.

I’ll touch on some of my favorite parts of the program and then give you details of the heavy-weight intellectual battle that many folks considered the high point of the whole conference.

DAY ONE opened with a keynote address by “futurologist” David Smith.  His presentation demonstrated “the powerful impact that glimpses of the future afford business and government alike as they seek to achieve their strategic goals.”  Smith captivated the audience with humorous historical references, worrisome predictions and thoughtful analysis.  For example, he pooh-poohed the use of focus groups to learn what consumers want, citing Steve Jobs:  “People don’t know what they want until you show them.”  So much for the research value of asking people why they don’t buy LTC insurance.

The first break-out session I attended was “How to Become a Billion Dollar Industry Again,” produced by National LTC Network President Terry Truesdell.  The highlight of this presentation was Louis Brownstone’s trenchant critique of LTC politics and his conclusion that “Government can’t do it, so we’ll have to.”  Also on the panel were LTCI Partners’ Steve Cain, Hancock’s Marianne Harrington and Genworth’s Buck Stinson.  Note that you can find the presentation materials for this and all 50 of the conference’s sessions here:  http://iltciconf.org/Powerpoints.php.

Next came lunch in the exhibit hall, which was packed with booths of companies offering services spanning the full range of long-term care delivery and financing options.  Incidentally, more than one person told me the food at this meeting was the best of any so far.  Alas, I arrived too late at one meal time and found the sushi “boat” nearly empty.  Many thanks to the corporate sponsors of the conference whose investment helped make it such a success.  Find a list of them from Diamond to Silver level here:  http://www.iltciconf.org/sponsors.php.

During the lunch hour, Jonas Roeser provided an update on the “3in4 Need More” campaign.  The non-profit’s 21 board members and 15+ supporting companies and organizations had a great start-up year in 2011.  The campaign to raise consciousness about the importance of LTC planning garnered earned media value of $2.8 million with a cash expenditure of only $228,000.  Some planned activities for 2012 include another 12-week bus tour, a “reality TV pilot,” and a national contest with a prize of one free year’s rent in an Emeritus assisted living facility.  Go “3in4 Need More”!  Margie Barrie and Sally Leimbach reported on their successful development of a 50-minute presentation for NAHU local chapters.  The “Bright Idea Award” went to producer Tony Prince of ACSIA.

DAY TWO of the conference began with an excellent overview of the likely impact of health reform (“ObamaCare” to many) on long-term care.  Gary Jacobs, Senior Vice President of Universal American and a frequent participant in LTCI conferences over the years, gave an excellent summary of the issues and likely outcomes.  Check out his 25 slides here:  http://iltciconf.org/index_htm_files/HR-HealthcareReform-Jacobs.pdf.  Following Gary came former-Kansas-Governor Mark Parkinson, President and CEO of the American Health Care Association, who hammered home the point that aging demographics being what they are government cannot meet LTC financing needs so private LTC insurance is critical.  Most depressing was Jeff Ellis’s presentation.  He’s Vice President of MGM Resorts International, which employees 53,000 people averaging 47 years of age, yet he said no one has even tried to interest him in offering LTC insurance since his company dropped the coverage in 2008 due to minimal participation.  He explained that LTC insurance isn’t even on his radar screen because health insurance costs and the threat of growing expenses due to health reform are already consuming all of his time and his company’s money. 

Moderated by American Health Care’s Karl Polzer, lobbyists Sam Morgante and Bob Blancato presented their annual update, titled “Washington Watch,” on what’s happening in the nation’s capital.  Check out their slides here:  http://iltciconf.org/index_htm_files/27-WashingtonWatch.pdf.  After their presentations, I asked this question:  “You fellows have been working the Hill for decades.  Every year you tell us what’s going on and for that, thank you very much.  But it’s always just process, never results.  Can you give us any hope that your efforts will someday produce something that benefits the LTC insurance industry?”  Their answer:  nothing’s going to happen between now and the presidential election.  Nor do they hold out much hope for anything helpful thereafter.

The last session I attended was a post-mortem on CLASS titled “Meeting the Needs that CLASS Intended,” moderated by Prudential’s Malcolm Cheung with presentations by Bob Yee, lately CLASS’s actuary; Yair Babab from the University of Illinois, Chicago; and Mark Meiners, the father of the LTC Partnership Program.  Their slides are here:  http://iltciconf.org/index_htm_files/33-MeetingtheNeedsClassIntended.pdf.  I came away convinced less-than-ever that anything about CLASS is salvageable and more convinced than ever that LTC financing solutions must come from reducing government interference in the market, not increasing it.  Stop giving away LTC to people who should, could and would buy LTCI and the market will work its magic.

CLASH OF TITANS

Now to recount the most fun that was had at the conference.  In the afternoon of DAY ONE, a great debate ensued titled “Clash of the Titans:  Moses vs Gordon on Medicaid and Other Dark Matter.”  Ably produced and moderated by Federal Long-Term Care Insurance Program CEO Paul Forte, the program included a dramatic “fight poster” inviting the audience to attend, slides featuring great debates of the past, e.g. Lincoln/Douglas, etc., and a dual-podium presidential-style debate format. 

Moses and Gordon each began with 3-minute opening statements.  (Find a transcript of the “fable” I began with at the end of today’s Bullet.)  After a coin flip to see who would get the first question, Forte pummeled the combatants in turn with six queries ranging from why the LTCI market languishes to what they’d advise presidential candidates to say about LTC financing.  Answers were strictly enforced to no more than two minutes, with a one-minute rebuttal, and a final 30-second “re-direct” by the original answerer. 

The program moved fast with lots of humor and more than just a little gentlemanly confrontation.  In the second phase of the debate, the participants asked each other questions, with the same time limits applying.  Neither knew what the other would ask so the questions and responses were totally spontaneous.  Finally, the audience submitted written queries pinning down the debaters with new and different viewpoints.  Bruised, bloodied, but upright, Moses and Gordon shook hands at the end and affirmed they remain friends.  They look forward to continue pursuing their different paths toward the common goal to improve long-term care for all. 

Who won?  Just between you, me and the lamppost, here’s how LTCI producer and author Craig McCormick, a former college debater himself, scored the match up:  13 to 4, for Moses.  Now, I acknowledge that Mr. McCormick may have a bias in my favor.  So I invite any of you faithful readers out there who may have attended the debate to weigh in with your own scoring of the event.  I’d particularly like to hear from anyone who gave the win to Harley instead of me.  Well, I want to hear from anyone except you, Harley!  I’ll publish any thoughtful comments or analysis of the debate in a future LTC Bullet.  Let us hear from you.

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The Elephant, the Blind Men and Long-Term Care:  Three-Minute Opening Statement” by Stephen A. Moses for the Debate with Harley Gordon at The 12th Annual Intercompany Long-Term Care Insurance Conference in Las Vegas, Nevada on Monday, March 19, 2012

Once upon a time, some blind men approached an elephant.

The first blind man grasped the elephant’s tail and exclaimed:  “This is a rope.”

The next blind man patted the elephant’s flank and said:  “This is the side of a barn.”

A third blind man clutched the elephant’s trunk and stated confidently:  “This is a hose.”

The moral of this fable? 

You don’t know any complex thing until you comprehend its entirety, including all of its facets and their interrelationships.

Long-term care is like the elephant in this story and LTC interest groups are like the blind men.

Government is a blind man of long-term care.  It’s paid for most expensive LTC since 1965, but can no longer afford the cost.  The elephant of LTC gobbles budgets.

The public is a blind man of LTC.  Most people don’t worry about LTC despite the apparent risk and cost.  Somehow the elephant of long-term care provides.

Senior advocates blindly demand more and better long-term care from the government.  To them the elephant of LTC is a cornucopia of free benefits.

Home care and nursing home providers obsess over low government reimbursements.  They see the elephant as a stingy, but demanding customer.

What do long-term care insurers see when they look at the elephant of LTC?  A puzzle.  Why don’t consumers buy the product when they obviously need it?

If you want to understand the elephant of long-term care, you’d better be able to explain why those five blind men see the elephant so differently.

How can the government be bankrupt; the public, asleep; senior advocates, naïve; LTC providers, spoiled; and LTC insurers, befuddled?  All at the same time.

No new policy designs, nor tax incentives, nor education programs will sell more LTC insurance until we resolve that paradox.

Here’s how I see it:

Government pays for most expensive LTC which desensitizes consumers to LTC risk resulting in a lack of demand for LTC insurance.  But senior advocates and LTC providers are hooked on government money and dubious of private LTCI.

Nothing will end this stalemate short of weaning the elephant of long-term care away from the trough of public financing. 

That’s what’s about to happen, either on purpose or by default, and that’s why the future of LTC insurance is bright.