LTC Bullet:  Should Presidential Hopefuls Address Long-Term Care?

Friday, May 29, 2015


LTC Comment:  Is LTC the “third rail of politics” as much as Social Security or Medicare?  Asked and answered after the ***news.***

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*** LTC CLIPPINGS.  A very special way to team up with the Center for LTC Reform is by becoming a Premium Member and receiving a subscription to our LTC Clippings service.  National LTCI and home equity conversion expert Barbara Franklin renewed her Premium membership recently saying “The clipping service definitely keeps us on the forefront of LTC knowledge.  We could not function without it.”  Find out why.  Contact Damon at 206-283-7036 or, join the Center, and/or upgrade to a Premium membership with LTC Clippings.  Here’s a sample sent this morning: 

5/27/2015, “A Charge To Presidential Hopefuls: A Plan For Alzheimer's,” by Bill Frist, Forbes

Quote:  “One in five Americans are obese. One in four has a risk of dying from cancer in their lifetime. But one in three that live beyond 65 will die with Alzheimer’s or another type of dementia. All these ailments have significant health impacts. The difference? We have solutions to treat obesity and can cure some cancers. Alzheimer’s is the only disease among the top 10 causes of death in America that cannot be prevented, cured, or even slowed.”

LTC Comment:  Former Senate Majority Leader Bill Frist shares our eagerness to attract the presidential contenders’ attention to long-term care. ***



LTC Comment:  There’s an obvious answer to the title question:  Of course presidential candidates should talk about long-term care services and financing.  How America can care for its frail and infirm elderly as the age wave washes over us is as important and daunting as any question facing the country.

So why don’t the candidates talk about long-term care and how to pay for it?  Simple.  There’s nothing to be gained for them by tackling the topic.  If they propose more public spending on LTC, the right will lambaste them for fiscal irresponsibility.  If they advocate constraints on public financing to encourage personal responsibility, the left will excoriate them for throwing Grandma under the bus.  Damned if they do and damned if they don’t.

But these facts don’t stop us from trying, right?  The Center for Long-Term Care Reform launched a 2007 effort in Iowa and New Hampshire we called the LTC Gadfly project:  LTC Bullet:  LTC Gadflies, January 23, 2007 and LTC Bullet:  First LTC Gadfly Brigade Mobilizes, April 12, 2007.  Our goal was to pull together a cadre of like-minded citizens to pester the candidates with LTC questions until they answered.  We couldn’t get many people interested, much less the candidates.  Once burned, twice cautious?  Well, no.  Like Edison who didn’t fail repeatedly to invent the light bulb, but only found 10,000 ways it would not work first—we forge on with a new approach.

In LTC Bullet:  How Great is Medicaid’s Unfunded LTC Liability?, April 24, 2015, we announced the Center’s latest research project titled “Soften the Boom:  Preparing Medicaid for Aging Americans’ Long Term Care Needs.”  We told you all about this new study except the state in which it will be carried out.  We’re now ready to reveal that critical fact.  The state is New Hampshire, home of the first-in-the-nation presidential primary.

I’m on my way there in the Silver Bullet of Long-Term Care as I write this in North Platt, Nebraska.  Details on the itinerary are in LTC Bullet:  On the LTC Road Again, May 1, 2015.  I’m stopping off in Bismarck, North Dakota to research the large and growing problem of Medicaid-compliant annuities with the help of Center corporate member SIA Marketing (Gene and Pamela Schmidt).  But I’ll be on site in the state capital of Concord, New Hampshire from June 24 to July 15.

I’ve already begun to contact savvy local experts about the key issues and questions we’ll address during my site visit.  We’ll convene a meeting for LTC insurance and reverse mortgage producers to share their views.  But most of our work will be studying the demographics of aging in New Hampshire and interviewing think tank researchers, Medicaid officials, politicians, long-term care providers and senior advocates.  In the course of our research, we’ll take every opportunity to reach out to visiting presidential candidates and their staffs.

After our report is published, probably in September, our partner in this project, the State Budget Solutions think tank will convene a conference, prepare op-eds for publication, and keep the heat on presidential contenders to address the challenge of long-term care.  Here’s an overview of our New Hampshire project:

Preparing for Aging Americans’ Long-Term Care Needs in New Hampshire:

A Study by the Center for Long-Term Care Reform and State Budget Solutions

The issue:  America faces a major challenge to sustain the retirement income and health security of its aging population.  No aspect of the problem is more serious than the delivery and financing of long-term care for frail or infirm elderly people.  In no place is that challenge more daunting than New Hampshire where the age wave and the birth dearth blend with unique severity to create economic and political danger.

The project:  State Budget Solutions (SBS) retained the Center for Long-Term Care Reform (CLTCR) to review the current status and likely future prospects for long-term care (LTC) service delivery and financing in the Granite State.  The Center has conducted many similar studies at the national and state level whose reports are available here:  We will assess the vulnerability of New Hampshire’s LTC system over the next thirty years, which period encompasses the worst of the coming demographic Age Wave.

Specifically we will (1) review state and federal laws and regulations bearing on long-term care, (2) seek interviews with key stakeholder groups including LTC providers and insurers, Medicaid and other public officials, senior advocates, elder lawyers, etc., and (3) refine and apply the Center’s “Index of Long-Term Care Vulnerability”[1] to assess the future social, economic, and political prospects for LTC services and financing in New Hampshire.  State Budget Solutions will publish our report, convene a conference to review and challenge its findings, prepare draft state and federal legislation, and publicize the issue and proposals through the media.

Time frame:

Center president Stephen Moses is currently doing the documentary research for this project and will visit New Hampshire from late June until mid-July of 2015 to conduct the onsite interviews and reviews.  His report will be published in September 2015.  We expect that SBS’s conference will occur in October or November 2015 and that draft legislation, media articles, and op-eds will be available thereafter.

Request:  State Budget Solutions and the Center for Long-Term Care Reform request your cooperation and assistance with this project.  Please make your staff and documentary resources available for consultation and review.  We will take everyone’s facts, analysis and opinions under objective consideration and do our level best to produce a fair assessment of the challenges and reasonable proposals for their resolution.

[1] For a preliminary application of CLTCR’s “Index of LTC Vulnerability” to New Hampshire, see “Apply the LTC Vulnerability Index to Your State:  The New Hampshire Example” (2014) here: