LTC Bullet:  LTC Awareness:  Easier Said than Done

Friday, October 17, 2014


LTC Comment:  We examine why long-term care awareness still lags after the ***news.*** 

*** LTC CLIPPINGS AND LTC E-ALERTS.  We send our LTC Clippings subscribers three links per day to articles, reports, videos or statistics they need to know.  Following are three examples.  We hope they helped their recipients to fare better in the competitive marketplace. Did you catch them?  For a free trial or to subscribe to LTC Clippings, contact Damon at 206-283-7036 or

10/16/2014, “Without Social Security Income, A Majority of U.S. Seniors Would Be Poor,” by Neil Shah, Wall Street Journal
Quote:  “If Census were to exclude Social Security benefits from income, the poverty rate for American seniors would jump from 14.6% to a whopping 52.6%—roughly 23.4 million people.”
LTC Comment:  Social Security, with its $25 trillion unfunded liability, is a weak reed to lean on.  

10/16/2014, “Per-day rate for skilled nursing hit $280 at mid-year, report says,” by Tim Mullaney, McKnight's LTC News
Quote:  “As of the middle of the year, the average per-day rate for a nursing home bed was about $280, the report states. This should hit $284 by the end of 2014, representing a 3.6% increase compared with a year ago. There also should be a ‘small increase’ in occupancy, as inventory growth slows while demand for services remains.”
LTC Comment:  Fewer new beds, higher occupancy, and increasing private-pay and Medicaid rates bode well for the nursing home business but will challenge private consumers to plan better for LTC.

10/12/2014, “U.S. Finds Many Failures in Medicare Health Plans,” by Robert Pear, New York Times
Quote:  “Federal officials say they have repeatedly criticized, and in many cases penalized, Medicare health plans for serious deficiencies, including the improper rejection of claims for medical services and unjustified limits on coverage of prescription drugs.”
LTC Comment:  Hmmm.  Medicare criticizing private insurers is like the pot calling the kettle black. ***



LTC Comment:  We’d like to thank Center Bronze sponsor United Security Assurance for commissioning the following article.  Despite the heroic efforts of so many for so long, LTC awareness still trails our hopes and expectations.  Redoubling our efforts may help, but recognizing the cause of the problem and solving it is the permanent solution.  Toward that end, we offer . . . 

“LTC Awareness:  Easier Said than Done”
Stephen A. Moses

Another November Long-Term Care Awareness Month is just around the corner.  Yet surveys and studies continue to show that the public is in denial about LTC risk and cost.  What gives?

The “3 in 4 Need More” campaign has promoted a major bus tour and many public service announcements (PSAs) on the subject.  Creative publicity by the American Association for Long-Term Care Insurance (AALTCI) comes out like clockwork including an annual spread in Kiplinger’s Personal Finance magazine.  We did our part at the Center for Long-Term Care Reform.  I spent the whole year of 2008 and a good portion of 2009 on the road for our “National Long-Term Care Consciousness Tour” in the Silver Bullet of Long-Term Care.  Unlike earlier years, the national media is full of articles about the need for health and long-term care planning. 

Still, you can almost hear Americans snoring when it comes to long-term care.  Why and what’s it going to take to wake them up?

I think the answers are pretty simple and grounded both in human nature and public policy.  No one wants to think about growing old, becoming feeble or infirm, and needing help with dressing and using the toilet.  No wonder people evade thinking about long-term care.

But families would not have the luxury of ignoring LTC risk and cost if it were not for well-intentioned but counter-productive public policy.  Medicaid and Medicare pay for the vast majority of all expensive long-term care in the USA.  Social Security pays indirectly for half of private “out-of-pocket” LTC expenditures, because Medicaid recipients must contribute all but a pittance of their Social Security checks to offset the cost of their care.

But, you might argue, Medicaid is welfare and it has a terrible reputation for problems of access, quality and institutional bias.  Who in their right minds would plan to go on Medicaid?

But, that’s the point.  They don’t plan.  They don’t think about LTC until it’s too late to plan.  Then, the path of least resistance is to rely on Medicaid, which often looks more attractive to heirs protecting their inheritances than to elders who by then may be cognitively impaired and unable to make their own decisions.

Public policy impedes LTC awareness and planning in other ways too.  By forcing interest rates down to near zero, the Federal Reserve has prevented insurance carriers from making the actuarially anticipated level of return on reserves.  This policy has forced carriers to raise rates on new and existing policies making LTC insurance less affordable and harder to market.

What’s the solution?  The long-term care insurance industry should support changes in public policy that target scarce Medicaid LTC resources to people genuinely in need.  Longer and stronger transfer of assets restrictions; more aggressive Medicaid liens and estate recovery; closing egregious eligibility loopholes like the Medicaid-compliant annuity dodge; and publicizing these stricter policies would not only save Medicaid money, but it would greatly increase voluntary LTC planning and LTC insurance sales.

You may not have long to wait for that solution to occur.  Government fiscal (spending) and monetary (money printing) policies have failed.  Sooner or later, skyrocketing debt and unfunded entitlement liabilities will compel changes like those we’ve recommended. 

But what should you do in the meantime?  Don’t let the public’s blasé attitude toward LTC planning discourage you.  Look at it as an opportunity instead of a disadvantage.  Do you really think generous commissions would still be in the offing if LTC insurance were already a commodity that everyone buys?

The trick, I think, is to reconceptualize your mission.  Become the “Paul (or Paulette) Revere” of long-term care.  Wake the public up about LTC risk and cost.  Hammer the message home.  Show them why avoiding long-term care planning was never a good idea, but it is a terrible idea today.  Use facts, logic, and the best possible sources to back you up.

By the way, providing those facts, logic, and sources is our job at the Center for Long-Term Care Reform and we welcome you to our website at to find them anytime.  Our LTC Clippings, LTC Bullets, and LTC E-Alerts supply your ammunition.  Fire when ready!