LTC Bullet: The Dementia of Political Economy

Thursday, May 23, 2019

Seattle—

LTC Comment:  If you think the political economy of dementia is a problem, consider the dementia of political economy, after the ***news.***

*** LTC CLIPPINGS bring you one or two daily updates on critical information you need to know to stay at the forefront of professional knowledge. Steve Moses scans the news and LTC literature. He chooses reports, articles, stories and data that LTCI agents, financial advisors, and anyone involved in aging issues need to know. He provides the title, author, source, a hyperlink to the original, and a sentence or two of commentary. As a bonus to LTC Clippings subscribers, Steve will answer questions by phone or email usually within 24 hours. Hook yourself into this reliable source and you can safely spend less time scanning for information and more time doing what you do best professionally. Contact Damon at 206-283-7036 or damon@centerltc.com to subscribe or learn more. Sample clipping:

5/22/2019, “5 insights from NIC’s Middle Market Investor Summit,” by Lois A. Bowers, McKnight’s Senior Living

Quote: “Several panelists shared insights about current and potential efforts to meet middle-income older adults’ senior housing and care needs on Tuesday at the National Investment Center for Seniors Housing & Care’s Middle Market Investor Summit in New York City. The event came as NIC released an analysis showing that reducing the annual cost of senior living by $10,000 could enable 2.3 million more older Americans to afford it, and reducing it by an additional $5,000 on top of that would enable 3.6 million more people to afford it. Here are a few insights that caught our attention.”

LTC Comment: Click through to see their insights. But here’s a key insight from Center member and LTCI producer Romeo Raabe: “This shows that many people only need a small (affordable) LTCi policy to be able to pay for their care!”

------------------------------

5/6/2019, “5 unexpected trends in today’s long-term care,” by Karen Christopher,

Quote: “The words ‘nursing home’ often bring to mind thoughts of colorless, sterile and depressing environments. This stereotype couldn’t be further from the truth — especially when you consider the emergence of a new model of long-term care designed to maximize independence, dignity and personal choice among residents. How, specifically, are senior living communities raising the bar when it comes to positive aging?”

LTC Comment: Wouldn’t prospects and clients be more likely to buy or retain LTCI knowing this information? ***

LTC BULLET: THE DEMENTIA OF POLITICAL ECONOMY

LTC Comment: Political economy “is the study of production and trade and their relations with law, custom and government; and with the distribution of national income and wealth.” 

Much could be and has been written about the political economy of dementia. A rising wave of aging Americans will succumb to cognitive decline raising difficult questions about their long-term care and how to pay for it. But that’s not my topic today.

Rather, I’m thinking about the dementia of political economy. It seems to me we can discern symptoms of dementia in political economy itself. Especially as applies to long-term care financing. Common symptoms of various forms of dementia include memory loss, delusions, agitation, indifference, impulsivity, disinhibition, and severe depression. So, consider these observations: 

Memory loss: How else to explain widespread failure to remember what caused the Great Depression, the Great Recession, currency collapses in Weimar Germany, Argentina and Venezuela, and just about all remaining economic misery in the world after centuries of industrial progress? Want something you can’t afford? Charge it. Or if you’re a country, tax, borrow, or print more money. Damn the consequences until they overwhelm you.
LTC Corollary: Grandpa and Grandma ended up in welfare-financed nursing homes because Medicaid is the dominant payer for most expensive long-term care? Forget that. Why worry?

Delusions: How else to describe the attitude of people, especially politicians, that you can have something for nothing, the proverbial free lunch? Health care and housing are rights that others must give you? That works until the professionals you’ve enslaved rebel. Or paraphrasing Margaret Thatcher: “Socialism works until you run out of other people’s money.”
LTC Corollary: More and more old people, including our own parents and grandparents need expensive long-term care? So what? It won’t happen to me. I’d never go to a nursing home. Shoot myself first. Anyhow, somebody must pay. You don’t see Alzheimer’s patients dying in the gutter. AKA denial. 

Agitation: How else to account for the anger and frustration in today’s politics? Politicians don’t just disagree and argue, they dig in and cast aspersions. The dialogue is demented.
LTC Corollary: Too few caregivers? Not enough free services? Too many nursing homes; too little home and community-based care? Don’t like what is available? Demand more. At the top of your lungs. Politicians won’t provide? Throw the bums out and elect ones that will give you what you want.

Indifference: How else to comprehend the lack of concern about a national debt of $22.3 trillion and unfunded liabilities of $124 trillion, exceeding $1 million per tax payer? Government insolvency? Who cares?
LTC Corollary: Medicaid pays for most LTC at less than the cost of care while heavily dependent on income offsets from recipients’ Social Security and higher provider reimbursements from Medicare to make up the difference. Yet Social Security and Medicare cuts are coming when their trust funds run out in 2035 and 2026 respectively. Who will make up the difference? Who knows or cares?

Impulsivity: How else to explain the automatic reflex to rely on government? Have a problem of any kind? Don’t ask why or how. Ignore the cause. Attack the symptoms. Ask the government to fix what government interference itself caused.
LTC Corollary: Too many old people needing too much housing and long-term care with too little savings and no private insurance?  Call for more government financing as the knee-jerk solution. Don’t ask why we’ve ignored the problem for decades. Don’t ask how government funding crowded out a private market for home and community based care and private insurance to pay for it. Just do more of the same and expect a different result. That’s not just demented; it’s the definition of crazy.

Disinhibition: How else to explain the disinclination to think twice before demanding someone else solve your problem? Eighty-four years of Social Security and 54 years of Medicare and Medicaid have eroded self-reliance to the point where relying on government is uninhibited.
LTC Corollary: Don’t think about long-term care. Don’t worry. Just wait and see what happens. 

Severe Depression: How else to explain the mood of a country enjoying unparalleled prosperity but sunk in despair because everyone doesn’t yet have everything anyone wants paid for by somebody else.
LTC Corollary: Eat, drink and be merry for tomorrow we … check into a nursing home.