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Medicaid Planning Quotes
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Updated: Wednesday, October 1, 2008 1:30 PM (Eastern)
Dateline: Indianapolis, Indiana (LTC Tour Mile 20,190; State #30)--
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LTC BULLET: WHAT'S YOUR LTC PLAN?
LTC Comment: LTC Planning Month has arrived. Read all about it in
today's LTC Bullet, written by LTCMonth.com founder, LTC Tour Gold
Sponsor, and national PR and Marketing consultant Marilee Driscoll. After
the ***news.***
*** LIMRA "THINKING OUTLOUD" PODCAST WITH STEVE MOSES. I keynoted a
special event for LIMRA (formerly the Life Insurance Marketing and
Research Association) at the organization's headquarters in Windsor,
Connecticut on July 31. Read all about it in "LTC Bullet: LIMRA on the LTC
Tour" at
http://www.centerltc.com/bullets/latest/769.htm. But now you can
listen too. Public Relations Director Howard Drescher interviewed me about
the Center for Long-Term Care Reform's 2008 LTC Tour for LIMRA's very
first podcast in a new series titled "Thinking Outloud with LIMRA." Check
it out at
http://www.limra.com/outloud/default.aspx. ***
*** GOLLY, WHERE HAVE WE HEARD THIS BEFORE? 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 (http://www.ahip.org/content/default.aspx?docid=24597).
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
http://www.kff.org/medicaid/7815.cfm, Medicaid enrollment grew by 2.1
percent in the 2008 fiscal year after showing a decline in the prior
fiscal year.
Read article. Source: AHCA / NCAL Gazette – Tuesday, September 30,
2008 ***
*** SO WHAT? Why are exploding Medicaid LTC costs so critical? Research
by Jeff Brown and Amy Finkelstein--reported here and published on
www.nber.org--shows Medicaid crowds out
two-thirds to 90 percent of the potential market for LTC insurance. (See
our interview with Professor Brown at
http://www.youtube.com/watch?v=buQfyhzBa0E.) If and when Medicaid LTC
financing collapses, as it is certainly threatening to do in the
foreseeable future, the market for private long-term care insurance will
increase dramatically. Don't hold your breath, but keep a close eye on
this issue. Unfortunately, as we've been warning for years, many poor
people will be hurt and middle class and affluent people, who had routine
access to Medicaid in the past, won't in the future. But as Medicaid's
financial problems force more and more people to self-fund their LTC from
savings and home equity, the public will finally begin to buy more private
insurance for this risk. I just hope it's not too late to salvage some
kind of safety net for people truly in need. ***
*** LTC TOUR UPDATE. Two grueling but great LTC Tour days are now
behind us. Gold LTC Tour Sponsor OneAmerica's Marketing Vice President
Bruce Moon rode shotgun with me in the Silver Bullet of LTC round trip
from Indianapolis to St. Louis, nigh on to 600 miles. We met with Life
Insurance Selling editor Gordon Bess, presented to an audience of
financial advisors affiliated with OneAmerica, and addressed consumers at
an RSVP (Retired Service Volunteers Program). On the way back to Indy,
Bruce snapped this shot of the
Silver
Bullet's odometer with his Blackberry's camera. That's 20,000 miles of
hard driving and heavy exposure of the LTC Tour's message of responsible
long-term care planning and rational LTC public policy. None of this could
happen without the LTC Tour's generous sponsors, whom we thank here again
and always. ***
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LTC BULLET: WHAT'S YOUR LTC PLAN?
LTC Comment: Welcome to LTC Planning Month, which begins today. And
special thanks to Marilee Driscoll for lifting the burden of writing from
my shoulders today with the following essay. I asked Marilee to tell us
more about LTC Planning Month and this is what she sent:
"What's Your Long-Term Care Plan?"
"What's your long-term care plan?" This open-ended question is the
heart and soul of Long-Term Care Planning Month. Founded in 2001 by
long-term care speaker and author Marilee Driscoll, LTC Planning Month is
the first event dedicated to LTC planning ever listed in Chase's Calendar.
Chase's Calendar (www.Chases.com) is the official reference guide found on
library reference shelves and on the desks of media producers and bookers.
The event philosophy is that the focus needs to be on action. Every
month, of every year, until someone can answer the question "What's your
long-term care plan?" So, Long-term care Planning Month is much more than
just an event in October. Every month of the year it is supported and
promoted by: 1) a web site (www.LTCmonth.com);
2) a free monthly newsletter for consumers (subscribe here
http://www.ltcmonth.com/contact.asp); 3) a weekly newspaper column
written for Gatehouse Media by Marilee Driscoll, (named LTC123); 4) and
other writing and speaking by Marilee. The website was recommended in
USA Weekend magazine to 23 million readers, among many other media
hits.
Readers of this newsletter will want to sign up for the free newsletter
at www.LTCmonth.com, as Marilee has planned a blitz of publishing during
the month of October. All of the information is aimed toward the aging
public, baby boomer adult children, and their legal and financial
advisors. The messaging is simple: What's your long-term care plan? To
explain further, "If you don't have a realistic plan, that plan isn't
funded, and your family, doctors and key advisors don't know about the
plan, you're playing a dangerous game with your future. In other words,
without proper planning, the likelihood of having the lifestyle you desire
if you need long-term care is slim to none," according to Marilee
Driscoll.
Long-term Care Planning Month takes an interdisciplinary approach to
the topic. The event, website and its local listings, and consumer
newsletter continue to generate a lot of interest as an objective,
credible source of the overall topic of LTC planning. All of this effort
was done by Marilee for two reasons, as she explains on LTCmonth.com:
"1) to provide up-to-date, unbiased, objective information and
perspective on the many aspects of long-term care planning, and;
2) to help the many consumers who have written (Marilee) asking for
local help, by providing on the site a directory of associations,
businesses and agents who can help at a local level."
It's not too late to become a sponsor. Sponsors receive a laundry list
of tools and benefits to raise the visibility of LTC planning, and their
organization, in their community. From labels, to presentations, to
monthly newsletter text, logos, the website listing, a 35-page marketing
manual and more, the value of sponsorship makes the decision to sponsor a
no-brainer! New listings are normally set up within 2 business days of
receiving your order. Become a sponsor during the month of October, and
Marilee has agreed to waive your set-up fee, and donate your first month's
fee ($29 for a local listing) to the Center for Long-term Care Reform.
Request sponsorship information here:
http://www.ltcmonth.com/sponsors.asp. Become a sponsor before the next
big media hit happens!
The website has recently been enhanced to display government listing
results below sponsor listings in the Local Help results pages. Go to the
Local Listings area of the site to get links to each state's Office of
Elder Affairs and Divisions of Insurance.
Marilee Driscoll is known to most of us as the author of "The Complete
Idiot's Guide to Long-term Care Planning." She is also Creative Director
and Principal at FollowUpSystems.net, an electronic and print newsletter
company that makes it easy for LTCi agents to stay in touch with their
contacts.
Marilee Driscoll is a gold sponsor of the LTC Consciousness Tour, and
has been a friend of the Center and subscriber for several years. She is
also the marketing and PR consultant to the tour, and the brain behind our
YouTube channel, beautiful "on the road" themed full-color ads, and many
other tremendously effective strategies that otherwise wouldn't have been
possible.
#############################
Updated: Tuesday, September 30, 2008 12:53 PM (Eastern)
Dateline: Indianapolis, Indiana (LTC Tour Mile 19,645; State # 29)--
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LTC TOUR UPDATE
LTC Comment: As the LTC Tour ends its ninth month, we've truly caught a
stride. I'm so busy that two days of work over the weekend broken by two
12-hour nights of sleep didn't catch me up on either. But, boy are we
getting the word out about responsible LTC planning!
Here's an update on last week in Arizona followed by a preview of this
week in St. Louis and Indianapolis and closing with the thrilling
conclusion to the saga of the Silver Bullet's mechanical travails.
A week ago Saturday night, I parked the trailer in storage,
disconnected the tow vehicle, and hunkered down for the night. I woke up
Sunday morning in the dark with a dead battery, drove a half mile to the
camp's showers, loaded up the truck and drove to Indy International
Airport. Leaving the FJ Cruiser in economy parking, I caught US Air
flights to Charlotte, NC and on to Phoenix, AZ. (Did you know US Air
charges for water now!? Two bucks for a bottle of it. Ask for plain old
water and you get a wisecrack about "plane" water being flown in from a
Mississippi swamp.)
Arriving in Phoenix, I connected to a shuttle that carried me on a
couple hours further to Prescott, AZ, a charming town in the hills north
of and 20 degrees cooler than Phoenix. There I was met by Center for
Long-Term Care Reform Regional Representative Patti Spencer. Last week's
LTC E-Alert #8-092: LTC Tour in the News and an Update at
http://www.centerltc.com/members/e-alerts/ltc_ea8-092.htm recounts the
story of Patti's exceptional work, our successful public meeting, and the
newspaper coverage of the LTC Tour and our message. (You'll need your user
name and password to access archives of the LTC E-Alerts. Hit reply to
this message if you want a reminder from Damon. LTC Bullets archives are
available free on the Center's public website.)
Picking up where the last E-Alert left off, I shuttled back to Phoenix
Tuesday morning. Regional Representative Mari Rose of LTC Tour sponsor
Western Asset Protection picked me up and drove me to our first event of a
series in the sunny southwestern city (afternoon temperatures up to 105
degrees F.) We met up with local LTCI specialist Bryan Herdt and proceeded
to the studios of KFNN where he interviewed me for his weekly radio show.
Mari "filmed" us in the broadcast booth with the LTC Tour's trusty "FlipVideo"
camera. If Damon can patch together some clips, we'll post a vignette of
the radio show on the LTC Tour's YouTube channel at
www.youtube.com/LTCConsciousnessTour. Later that afternoon, I
presented the two-hour mini-version of our Long-Term Care Graduate Seminar
for local financial advisers at CUE, a local financial powerhouse. Sample
feedback:
"Very eye opening and this stirs me to educate my baby boomer clients
to buy LTC! Be ready." Kris Hanson
"Loved it--terrific information! Wow! You are the 'cry in the
darkness,'" Kristi Gorgia
"Excellent historical perspective on the issue and looming financial
crisis." Nicole Gurley
Wednesday began with another radio show, this time with Phil Grossman,
another well known LTCI specialist in Phoenix. This time I did the show as
a call in. In the afternoon, I presented a program for the public at Mesa
Community College arranged by Reverse Mortgage Specialist Robin Faison.
Sample feedback:
"Thank you for your efforts on educating the public to this huge
concern." Ed Shockley
"Really helpful. Wish more people could hear it. R. Spatti
"Good explanation of a complex issue." Jean Burda
On Thursday morning, I delivered the keynote address at Western Asset
Protection's Annual Workshop, where I was joined by excellent speakers on
long-term care insurance and Medicare Advantage. Western Asset Protection
(WAP) is an extraordinary family-run business operated by father Mel Rose
and twins Paul Rose and Mari Rose Tautimes. These exceptional people and
their company have been a mainstay of support for the Center for Long-Term
Care Reform and the LTC Tour. We thank them for their sponsorship of my
Phoenix visit and for their financial support, collegiality, friendship
and encouragement.
Sample feedback from the WAP Annual Workshop:
"I'm currently a member [of the Center for Long-Term Care Reform] and
love the wealth of information." Diane Forshee
"Great job of explaining how the Medicaid safety net will disappear if
changes aren't made." Robert "Bob" A , [illegible name]
"Very good-lots of information." Shirley Boniface
Finishing in Phoenix on Thursday afternoon, I flew back to Indianapolis
arriving a little before midnight. A quick drive back to the darkened
Silver Bullet, followed by a check of the defrosted refrigerator which
hadn't leaked after all, and then some preparation for the next morning by
flashlight. Waking at 6AM to my cell phone's alarm, I drove to the
showers, suited up in the dark, loaded the truck, and headed to the
OneAmerica Tower downtown. There I delivered our two-hour LTC Graduate
Seminar to 100 attendees at a meeting of the Financial Planning
Association of Greater Indiana. Feedback was excellent and a summary is
pending.
Finishing with the FPA, I rushed back to the campground where mechanics
from the Airstream factory (2.5 hours away in tiny Jackson Center, Ohio)
met me at the trailer. By the time I arrived at 12:30 PM, they had
trouble-shot the trailer's problem and replaced the defective battery
which had only been taking a "surface charge" thus leaving me with no
juice after only a few hours. They changed a fuse in the tow vehicle,
tinkered with the refrigerator, and declared me good to go. What a relief
to have the Silver Bullet of Long-Term Care back in full operating
condition and ready for the coming week of heavy travel and frequent
presentations.
Later today (Monday, though you'll read this on Tuesday), I meet Bruce
Moon, a Vice President with Gold LTC Tour Sponsor OneAmerica, for the 271
mile drive to St. Louis. There we'll dine and do an interview with Gordon
Bess, editor of Life Insurance Selling magazine. On Tuesday, I
speak at a OneAmerica event in St. Louis followed by a presentation to an
audience of 300 at a Retired Senior Volunteer Program (RSVP) gathering.
Then Bruce and I will drive back to Indianapolis where I'll speak at a
major OneAmerica event on Wednesday and Thursday. Friday, I'm the featured
speaker at a NAIFA (National Association of Insurance and Financial
Advisors) in Indianapolis.
Come the weekend, it's off to Nashville, Tennessee and the Annual
Convention of the American Health Care Association, a major national trade
association for nursing homes and assisted living facilities. There I'm
meeting up with Gold LTC Tour Sponsor Long-Term Living magazine to
join them in telling the LTC Tour's story to long-term care providers.
We'll do "tours" of the Silver Bullet too.
So, as you can see, the LTC Tour has really taken off. I'm so busy
doing programs and planning future events, with the able assistance of
Damon in Seattle and our wonderful coordinating sponsor GoldenCareUSA out
of Minneapolis, that I hardly know which way is up. Thank you all for your
interest and support. And if we miss a few more of our "daily"
publications, please understand and forgive. We won't fail to communicate
every bit of news and analysis that seems critical for you to know.
And don't forget. It's not too late to sponsor the LTC Tour, at an
exceptional discount, in time to have your company represented on the
Silver Bullet and in our elegant presentation packets for LTC Planning
Month in October (www.LTCMonth.com)
and LTC Awareness Month in November (www.aaltci.org/aware).
Just contact Damon at 206-283-7036 or
damon@centerltc.com for details.
#############################
Updated: Wednesday, September 24, 2008 11:00 AM (Pacific)
Dateline: Phoenix, Arizona--
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LTC BULLET: WE TOUCH THOUSANDS OF CPAS WITH PROFESSIONAL VIDEO
LTC Comment: If you can't use this professionally produced video to
persuade more CPA's to help you protect their clients for long-term care
risk and cost, then you just aren't trying! Details and a link after the
***news.***
*** HOME CARE ON MEDICAID? THINK AGAIN: Medicaid long-term care lawsuit
erupts in Florida. By Matt Sedensky, Associated Press. Miami Herald.
Sep 19, 2008 A group of Florida Medicaid patients is challenging the
state, saying they are being illegally forced to live in nursing homes in
order to receive Medicaid benefits. A federal class-action suit has been
filed on behalf of 8,500 Florida residents who would rather live under the
care of relatives or friends than in the nursing homes where they
currently reside. In many cases, the costs of allowing patients to live in
the community are lower than those of keeping them in nursing facilities,
but in many states getting Medicaid-supported services at home is much
more difficult and requires a longer wait. There are also concerns over
how to determine which residents are truly capable of living outside of a
nursing facility, and the safety issues involved. AHCA spokeswoman Susan
Feeney noted, "You don't want to be there (in a nursing facility) but
sometimes for health reasons beyond your control, you have to be."
http://www.miamiherald.com/news/florida/AP/story/693478.html
Source: AHCA / NCAL Gazette - Monday, September 22, 2008 ***
*** PRESCOTT PROGRAM a big success. Northern Arizona Regional
Representative Patricia Spencer, president of Autumn Solutions (www.autumnsolutions.com),
worked with Geriatric Care Manager Suzy Anderson of the Yavapai County
Coalition of Care for the Aging to organize and sponsor our LTC Graduate
Seminar yesterday in Prescott, Arizona. It was a hit. Half the audience
were consumers, attending because of an article in the local newspaper
referenced in yesterday's LTC E-Alert. The other half were professional
financial advisors. Here's a sampling of the audience feedback:
"Best public policy presentation I've seen in 30 plus years. My eyes
are open--and my wife and I will ACT on what we've just heard." Edward
Hamilton
"Your words will get us off the dime and we'll get some type of [LTC]
insurance." John Davidson
"An excellent insight into not only LTC issues but the
Medicare/Medicaid dilemma." Scott Holland
"Fantastic; thank you for the opportunity." Cynthia DeGeorge ***
*** BONUS WEBSITE. All you have to do to have your very own LTC website
designed by LTC Connection is to join the Center for Long-Term Care
Reform. That's right, join the Center for $150 per year, get all our
publications and access to The Zone, including our "Almanac of Long-Term
Care," and on top of that LTC Connection will design your website and
waive their usual $149 fee. Or look at it this way, buy your website from
LTC Connection through the Center and get a year of membership in the
Center for only $1 more. Sure, you'll have to pay LTC Connection's $39 per
month website maintenance fee, but you'll get a whole year of LTC
Bullets and LTC E-Alerts for no extra charge. So, what do you
have to do? Just contact Damon at 206-283-7036 or
damon@centerltc.com, join the Center, pay your membership
fee, and say "I want my website." We'll connect you with the right person
at LTC Connection and you'll be on your way. Great content from the Center
and a great website from LTC Connection. How can you beat it? Already a
member of the Center but want your free website? No problem. Renew your
annual membership early and get the same deal. ***
LTC BULLET: WE TOUCH THOUSANDS OF CPAS WITH PROFESSIONAL VIDEO
LTC Comment: Read no further!
Go straight to this link and watch the 23-minute video:
http://marty.smartpros.com/videoview/player.html?40530|10494.
Then come back here and I'll explain.
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Not bad, huh? Here's the story.
When the Silver Bullet and I were in New York on the LTC Tour in July,
we were hosted by Center for Long-Term Care Reform Regional Representative
Marc Kaye. Kaye is affiliated with LTC Tour Silver Sponsor Long-Term Care
Financial Partners (www.ltcfp.com) and
is president of Long-Term Care Funding of New York (www.ltcnyc.com).
He beat the bushes looking for media and speaking opportunities for me in
the New York City area.
Thanks to Marc's efforts, we received an invitation from Jeff Jacobs,
Vice President & Publisher of SmartPros Ltd. to shoot a video explaining
to Certified Public Accountants (CPAs) why planning for long-term care
risk and cost is so important. What you see at the video link provided
above is an abbreviated version of the DVD that SmartPros distributed to
their thousands of subscribers, mostly CPAs, all around the country.
Here's the cover note Mr. Jacobs sent along with the link including his
expressed "permission for you and/or your firm to use the link for
marketing, practice development, or any non-commercial purpose. (In other
words, don't charge people to view it.)" Use it with our good wishes to
reach out to CPAs, other financial advisors, and their clients about the
importance of planning responsibly for long-term care risk and cost.
September 22, 2008
To: Stephen Moses and Marc Kaye
On behalf of CPA Report (as well as our parent company, SmartPros
Ltd.), I want to express my appreciation for your participation as a
member of our "news team." We hear, over and over, from our subscribers
that the strength of our program - and the perceived value of our update
service - is the quality of our expert commentators, like you.
I hope you enjoyed viewing the DVD production of your "performance" on
the need for long-term care planning. You will not be surprised to learn
that the initial reaction to your appearance, and to your topic, has
already been quite favorable. Please do not hesitate to let me know if you
would like additional copies.
While it is not as fast-moving as the DVD production, you may be
interested in the online version of your program. Here is a "link" that
you can use (you may have to "cut-and-paste" it):
http://marty.smartpros.com/videoview/player.html?40530|10494
Please consider this email to be our permission for you and/or your
firm to use the link for marketing, practice development, or any
non-commercial purpose. (In other words, don't charge people to view it.)
Once again, I look forward to collaborating with you again in the future.
Regards,
Jeff Jacobs
Vice President & Publisher
SmartPros Ltd.
The following information about SmartPros is from their website at
http://corporate.smartpros.com/about/about.html:
"Founded in 1981, SmartPros Ltd. is an industry leader in the field of
accredited professional education and corporate training. Its products and
services are primarily focused in the accredited professional areas of
corporate accounting, financial management, public accounting,
governmental and not-for-profit accounting, financial services training,
banking, engineering, legal, and ethics and compliance."
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Updated: Tuesday, September 23, 2008 10:38 AM (Pacific)
Dateline: Phoenix, Arizona--
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LTC TOUR IN THE NEWS AND AN UPDATE
LTC Comment: I was in Prescott, Arizona yesterday working with Center
for Long-Term Care Reform Regional Representative Patti Spencer, President
and CEO of Autumn Solutions Long-Term Care Insurance Specialists (www.autumnsolutions.com).
Patti teamed up with the Yavapai County Coalition of Care for the Aging
to sponsor my two-hour Long-Term Care Graduate Seminar Monday afternoon at
the "Adult Center of Prescott."
What's more, she persuaded the Daily Courier to cover the story.
Read T.M. Schultz's September 20th article titled
"Plan ahead for the day you'll need help."
Here's a clip from the piece:
"By 2020, 12 million older Americans will need long-term care,
according to the federal government.
"The question is, who is going to pay for it?
"That is what Stephen Moses, president of the Center for Long-Term Care
Reform in Seattle, wants people to begin thinking about.
"As part of a yearlong national tour to raise awareness about the
issue, Moses will be in Prescott Monday speaking from 2:30 to 4:30 p.m. at
the Prescott Adult Center, 1280 E. Rosser St.
"Autumn Solutions Long-Term Care Insurance Specialists and the Yavapai
County Coalition of Care for the Aging are sponsoring the free public
event.
"Patricia Spencer, president of Autumn Solutions, says the old way of
thinking about long-term care - that the government will take care of you
and pay your expenses - must end, especially now that the baby boomer
generation is aging.
"'It's a paradigm shift,' Spencer said. 'There just isn't enough money
to go around.' . . .
"Because so many people whom the government did not mean to help are
now getting help [from Medicaid], there soon will not be any money left in
the system, [Moses] said.
"'My message to the public is that when it comes to long-term care,
you've got to be thinking 10 to 15 years ahead,' he added. . . ."
LTC Tour Update: Special thanks to Regional Rep Patti Spencer for
organizing and publicizing yesterday's event.
Now here's the latest on the LTC Tour. It's pretty clear the logistics
of the Tour are a challenge. Thankfully I have the assistance of a lot of
dedicated people including the always-helpful Damon at the Center's
headquarters in Seattle, Marilee Driscoll our intrepid PR and marketing
consultant, the wonderful people at our "coordinating sponsor"
GoldenCareUSA in Minnesota, and of course our highly dedicated Regional
Representatives who plan and organize LTC Tour events all across the
country.
Once in awhile, however, I'm asked to say a little about the other
logistical aspects of the LTC Tour: getting from place to place and living
in the Silver Bullet of Long-Term Care. Usually that aspect is no more of
a problem than the time-consuming process of driving from campground to
campground, hitching and unhitching the trailer, and dealing in new and
strange places with the simple challenges of everyday life, such as buying
groceries, getting shirts and suits laundered, finding post offices, etc.,
etc.
But sometimes it gets complicated. Like now. I had the Silver Bullet
into the Airstream factory in tiny Jackson Center, Ohio on Friday for
warranty work and its second servicing (20,000 miles.) Late Friday
afternoon, I drove it to Indianapolis. I spent Saturday washing clothes at
the campground's coin-op laundry, cleaning the rig at a high-pressure,
self-service "car" wash (it's always a challenge to find one with a
10-foot clearance pull-through), and packing for my forthcoming week in
Arizona.
Alas, overnight the trailer's battery unexpectedly ran down leaving me
with almost no light Sunday morning to prepare for my trip. As I'd moved
the trailer into the campground's storage area the night before (keeping
the camp's charge to $20 for the week instead of $33 per day), I had no
access to "city" electricity. With no electricity and a dead battery, the
refrigerator won't run even on propane, so it'll defrost while I'm away,
perhaps flooding the floor where I have my supply of presentation packets
stored. Worst of all, for the first time, when I hooked the tow vehicle up
to the trailer's electrical system, it didn't start charging the battery,
so still no lights and the power jack that raises the hitch to connect to
the tow vehicle doesn't work. With a 9:15 departure for Phoenix, I had no
time to deal with any of this before heading off to the airport.
That's what I have to come back to in Indianapolis from Phoenix on
Thursday night at midnight with a speech scheduled in downtown Indy for
9:00 AM, Friday morning.
Thankfully, the Airstream factory service folks are rising to the
challenge. They're sending a mechanic to Indianapolis (2.5 hour drive) to
meet me Friday afternoon, after my speech, to figure out what's wrong with
the trailer's electrical system and (hopefully) fix it.
Don't get me wrong. I'm not whining. The LTC Tour has been and
continues to be a wonderful adventure. I fully expected some serious
challenges and they've happened along the way. (Someday I'll tell you
about a really big, expensive problem we solved that I chose not to
disclose before.)
But we've done scores of programs, met with thousands of people, and
touched so many lives on the road with the LTC Tour's message of
responsible LTC planning. The rewards far outweigh the challenges.
For those of you who asked, however, there's a little glimpse at some
of the difficulties we road-weary LTC Tourists face. Thanks as always for
your support and encouragement.
#############################
Updated: Monday, September 22, 2008 11:15 AM (Pacific)
Dateline: Prescott, Arizona (Fly in; LTC Tour Mile 19,560; State #29)--
#############################
REST IN PEACE, MR. ROONEY
LTC Comment: Pat Rooney died last Monday. He was a staunch supporter of
consumer-driven health care and responsible long-term care planning. Read
Greg Scandlen's eulogy first. Then I'll add a personal anecdote and
comment.
#############################
The following is borrowed from Greg Scandlen's Consumer Power Report,
CPR# 145, September 17, 2008:
We lost a giant this week. J. Patrick Rooney passed away on September
15 in Indianapolis. More than anyone else, Mr. Rooney was responsible for
moving the political agenda in favor of consumer driven health care, first
by working with Andy Jacobs (D-IN), chairman of the Health Subcommittee of
Ways and Means and then with Bill Archer (R-TX), Chairman of the entire
Committee after the Republican revolution of 1994, to get Medical Savings
Accounts enacted into law in 1996.
Pat continued to work on consumer empowerment until his death. He
helped get HSAs enacted in 2003, and more recently has been working on
fair hospital pricing for self-pay patients through his Fairness
Foundation. Only four months ago he had his first book published with
co-author Dan Perrin, "America's Health Care Crisis Solved." (see our
review in CPR #129, May 28, 2008)
The opponents of consumer empowerment used Pat as a whipping boy, with
Pete Stark calling him "that crazy old man in Indianapolis" (looked in the
mirror lately, Pete?), but Pat was resolute, and not just on health care
issues. He was a complete vegetarian and wouldn't even use animal products
in clothing. He was as anti-racist as anyone I've ever met. He belonged to
a mostly black Catholic church and was a vehement opponent of racial bias
in educational testing. He was one of the preeminent backers of vouchers
for poor children and helped create private scholarship programs for inner
city kids around the country.
I am grateful that we at Consumers for Health Care Choices were able to
give Pat a small smidgeon of the recognition he deserved by presenting him
with our Lifetime Achievement Award in December, 2006. See his
presentation at --
http://health.scribemedia.org/2007/03/05/lifetime-achievement-award-patrick-rooney/
God doesn't send us many people of the caliber of J. Patrick Rooney,
but we should appreciate the gift when he does.
-- Greg Scandlen
#############################
LTC Comment: I first became aware of Pat Rooney about 15 years ago. I
was researching acute care health policy and came across one of his
articles or speeches. It was excellent so I wrote him a complimentary
letter and said I'd like to meet with him someday. When I received no
reply, I didn't give it a second thought.
But then, years later, I got a call at work one day. It was Pat Rooney.
"Mr. Moses," he said, "I came across an old briefcase of mine that I
haven't used for a long time. Inside, I found your thoughtful letter. I'm
traveling to Seattle soon and I hoped you'd let me take you to dinner to
talk about our common interest in health policy."
Well, he came to Seattle; we had that dinner; and I've been a fan of
Patrick Rooney and an admirer of his campaign to improve health care
financing ever since.
Rooney's influence stretched beyond acute care policy into long-term
care as well. In the words of Marketing Vice President Bruce Moon of State
Life Insurance Company (a OneAmerica company): "[I]t was Pat that took
Golden Rule (now OneAmerica) down the LTC path of providing guaranteed
premiums for LTC coverage through the use of life insurance and
annuities." (OneAmerica is a Gold Sponsor of the National Long-Term Care
Consciousness Tour.)
Pat Rooney will be missed but his inspiration lives on: Oh, what one
person can do by working hard and persevering against obstacles!
#############################
Updated: Thursday, September 18, 2008 2:10 PM (Eastern)
Dateline: Dayton, Ohio (LTC Tour Mile 19,290; State #27)--
#############################
LTC BULLET: WHAT RUINS THE LTCI MARKET?
LTC Comment: Why do as many as 90 percent of potential LTC insurance
purchasers fail to buy? Find out in print and video from a well-respected
scholar, after the ***news.***
*** LTC TOUR AT ILLINOIS CAPITOL. Yesterday, the Silver Bullet of
Long-Term Care visited the state capitol building in Springfield,
Illinois, home of America's 16th president, Abraham Lincoln.
Check out the Silver Bullet in the land of Lincoln
here.
*** HURRICANE HONEY. The Center for Long-Term Care Reform's Regional
Representative in Houston, Texas, who organized several super events when
the Silver Bullet and the LTC Tour passed through that city in April, has
a new blog. Check it out at
www.ltcqueen.com. Honey's on the warpath about poor media coverage of
long-term care issues. And five days without electricity in the aftermath
of Ike hasn't calmed her criticism of Oprah or journalist Jean Chatsky.
***
*** AIRSTREAMING LTC. Everywhere I go on the 2008 National Long-Term
Care Consciousness Tour, people stop me to ask about the Silver Bullet.
Sometimes they're curious about long-term care. As often as not, they're
interested in the Airstream trailer. But whatever starts the conversation,
it ends up being about why folks need to plan early and responsibly for
LTC risk and cost. Just in case YOU'RE curious about Airstream trailers
and living in one full time, you may enjoy the article
here. ***
LTC BULLET: WHAT RUINS THE LTCI MARKET?
LTC Comment: People have all sorts of opinions about why LTC insurance
remains stunted around 10-percent market penetration.
Some say it costs too much, but cost is relative. If you don't believe
you need something, any price is too high.
Some say the public is in denial about LTC risk. Sure, but LTC risk and
cost is objectively high, so the real question is: What enables the
public's denial?
Some say LTCI products are too complicated. Well, so are taxes, but we
all get them paid each year one way or the other. That's why we have
specialists and advisors.
No, something else is going on here and Jeffrey R. Brown, PhD, the
William G. Karnes Professor of Finance in the College of Business at the
University of Illinois at Urbana-Champaign, thinks he knows what it is.
I spent an hour with Dr. Brown at his office on the UI campus
yesterday. To make his position as clear and accessible to you as
possible, check out this interview with him that we posted today on the
LTC Tour's YouTube channel
here.
Now that you've heard it from the horse's mouth, as it were, I invite
you to take a closer look at Professor Brown's analysis. In a series of
scholarly publications co-authored with economics professor Amy
Finkelstein of the Massachusetts Institute of Technology (and others), the
two scholars have explained their research and conclusions in detail.
You can find their papers on the National Bureau of Economic Research's
website at www.nber.org. I'll give you
some quotes and citations in a moment, but first my . . .
LTC Comment: Brown and Finkelstein explain Medicaid's "crowd out"
effect as being caused by the "implicit tax" Medicaid imposes on the
purchase of private long-term care insurance. In other words, they argue
that the Medicaid benefits lost to someone who buys LTC insurance instead
of going on public assistance are in effect an extra charge for the
private insurance which makes it unattractive to most consumers.
In our conversation at his office yesterday, I agreed with Brown and
Finkelstein's "implicit tax" argument but explained from my perspective
how I think that "tax" actually works in practice. Because Medicaid LTC
benefits are much easier for middle class and affluent people to obtain
than is commonly understood, the program's "implicit tax" on LTCI is
magnified many-fold beyond what it would be if people really had to spend
down all their assets, including home equity, before receiving public LTC
assistance. If Medicaid required a real asset spend down, many more people
would buy private LTC insurance, because their spend down liability would
offset the implicit tax of their Medicaid benefits.
Now, here are a couple quotes and citations to give you the flavor of
the Brown/Finkelstein argument. Check out the papers themselves at the
hyperlinks provided:
"Abstract: We show that the provision of even incomplete public
insurance can substantially crowd out private insurance demand. We examine
the interaction of the public Medicaid program with the private market for
long-term care insurance and estimate that Medicaid can explain the lack
of private insurance purchases for at least two-thirds and as much as 90
percent of the wealth distribution, even if comprehensive, actuarially
fair private policies were available. Medicaid's large crowd out effect
stems from the very large implicit tax (on the order of 60 to 75 percent
for a median wealth individual) that Medicaid imposes on the benefits paid
from private insurance policies. Importantly, Medicaid itself provides an
inadequate mechanism for smoothing consumption for most individuals, so
that its crowd out effect has important implications for overall risk
exposure. An implication of our findings is that public policies designed
to stimulate private insurance demand will be of limited efficacy as long
as Medicaid continues to impose this large implicit tax."
Source: Jeffrey R. Brown, University of Illinois and NBER and Amy
Finkelstein
Harvard University and NBER, "The Interaction of Public and Private
Insurance: Medicaid and the Long-Term Care Insurance Market," December
2004:
http://www.nber.org/~afinkels/papers/Brown_Finkelstein_Medicaid_Dec_04.pdf
#############################
"The Medicaid 'implicit tax' arises because private insurance protects
one’s assets, which in turn lowers the probability of meeting Medicaid’s
means-tested asset eligibility threshold. In addition, even if an
individual is Medicaid eligible, if he has private insurance the private
insurance must pay first, with Medicaid only covering whatever expenses
are not covered by the private policy. As a result, a large portion of the
premiums paid for private insurance policies pay for benefits that simply
replace benefits that would otherwise have been provided by Medicaid if
the individual had not had private insurance." (p. 25)
Source: Jeffrey R. Brown, University of Illinois and NBER and Amy
Finkelstein, MIT and NBER, "Why is the Market for Long-Term Care Insurance
So Small," February 2007:
http://www.nber.org/~afinkels/papers/Brown_Finkelstein_Small_Feb07.pdf.
#############################
Updated: Wednesday, September 17, 2008 12:51 PM (Eastern)
Dateline: Indianapolis, Indiana (LTC Tour Mile 19,370; State #27)--
#############################
TEAM MEINERS UPDATE AND THANK YOU
LTC Comment: Many of you will remember "LTC Bullet: LTC Touches One of
Our Own," published July 29 and archived at
http://www.centerltc.com/bullets/latest/768.htm.
That Bullet told the story of a fight against cancer. The patient is
the son (Matthew Meiners) of a dear friend of and advocate for long-term
care. We asked for Center members to lend their support, emotional and
financial, to "Team Meiners."
You came through as the following thank-you note from Amy Meiners
(Matt's wife) makes clear. After her note, we'll repeat the original
message in case you missed it and would like to add your vote of support
and encouragement.
Let me add my personal thanks to all the Center members and readers who
stepped forward to help in this worthy cause.
Steve Moses
------------------
Dear Mr. Moses,
We wanted to thank you for including the Team Meiners cancer journey in
the July LTC newsletter as well as your $250 personal contribution to our
"treatment fund." It is truly appreciated. Words alone cannot express our
gratitude. The response was overwhelming. We received 13 donations
totaling nearly $1400. These contributions also included wonderful words
of encouragement and personal cancer stories - all from strangers. People
have also started following our journey via the CarePages site. The
supportive words left on the site by the LTC folks are just as appreciated
as any monetary donation. I am in the process of sending letters to each
of the contributors and will also be posting a few words of gratitude on
our webpage. Please know that all the money will definitely be put to good
use. As you are probably well aware, insurance doesn't cover all the costs
involved in treating a complex cancer diagnosis. The money will help us
cover the cost of purchasing a wheelchair, durable home medical goods such
as: gloves, alcohol pads, syringes, co-pays for the expensive supportive
cancer medications, as well as other various medical expenses. Again,
thank you for your kindness and support. It helps give us the strength
that we need to keep fighting so we can beat this horrible monster called
cancer.
With hope, love, and gratitude,
Amy & Matthew Meiners
(Team Meiners)
------------------
LTC Bullet: LTC Touches One of Our Own
Tuesday, July 29, 2008
Seattle--
Today's is a very special LTC Bullet.
Many Center supporters and subscribers know the name Mark Meiners. Mark
is the key man behind the Long-Term Care Partnership program. He and many
others working with, through and sometimes for him have persisted through
decades of difficult challenges to make the LTC Partnership into the
remarkable national program it is becoming today.
But that's not why I'm writing now.
Last December, Mark's 29-year-old son Matthew was diagnosed with a rare
and aggressive pediatric cancer called Alveolar Rhabdomyosarcoma (soft
tissue cancer). It started as a tumor in his left sinuses and metastasized
to his lymph nodes and spine. At first, he thought it was sinusitis and
possibly his wisdom teeth. It is hard to believe how sick he truly is
because just a couple weeks earlier he was scouting a basketball game (he
is a scout and analyst for the Los Angeles Clippers) at the Verizon Center
in DC.
That's how Mark explained his son's condition to me when I inquired.
Since then I've subscribed to Matthew's "CarePages" updates. That's where
his wife Amy periodically reports on Matthew's treatment, his heroic
struggle, and their mutual commitment of extraordinary faith, persistence
and optimism. Go "TeamMeiners!"
From one of those CarePages updates, I learned that some of Dr. Meiners'
students at George Mason University had pooled their resources to make a
substantial, unsolicited contribution toward the staggering and rapidly
increasing costs of Matthew's care. That gave me an idea.
Who understands better or cares more about the financial and emotional
stress of long-term health care than the readers of these LTC Bullets?
Nearly no one, I'd wager. So, I'm inviting each and every one of you to
help Matthew and Amy in their battle against this disease. I'll "prime the
pump" with a personal contribution of $250. If you'd like to help, please
send your own contribution to:
Matt and Amy Meiners
c/o Team Meiners
1255 S. Michigan Ave. Apt. 2506
Chicago, Illinois 60605
To follow Matthew and Amy's story, you can subscribe to CarePages at
www.carepages.org. It is under "TeamMeiners"
and requires a little sign-in but is not difficult.
Following is more detail from his Dad on Matthew's condition:
"Although Matt is an adult, we transferred his care from Illinois
Masonic Adult Hospital over to the University of Chicago's Pediatric
Hematology/Oncology Department. The Pediatric doctors are the most
familiar with this disease and we are hoping they can provide the best
possible treatment and care. There have been numerous tumor boards and
pathology conferences to review his case and we were finally given the
course of treatment on Christmas Eve [2007]. Matt will be part of a
year-long clinical trial specifically targeted for his diagnosis. The
protocol for the trial is intense. He began his first high-dose
chemotherapy December 26th. He was at Chicago Comer Children's Hospital
for the next five days. A few weeks later they added radiation therapy to
his treatment. He will be in and out of the hospital for a long while.
Luckily, since it is a children's hospital, his surroundings are a bit
more cheerful."
Those of us who care so much about long-term care know it can touch
anyone, anytime and at any age. But it never hurts or costs more than when
it strikes the young and vigorous. All they've asked for is prayers and
kind thoughts. But we can honor the spirit and fight of these tough young
people by helping out with some cash as well. I hope you'll all join me in
such a worthwhile investment.
#############################
Updated: Tuesday, September 16, 2008 11:59 AM (Central)
Dateline: Urbana-Champaign, Illinois (LTC Tour Mile 19,140; State
#27)--
#############################
LTC TOUR PUBLICITY AND FEEDBACK
LTC Comment: Media attention on the Center and our LTC Tour is picking
up momentum. After being cited in financial writer Terry Savage's
nationally syndicated column on Sunday, we bring you the piece below from
Friday's Dayton Daily News. Read it and ask yourself:
"Why isn't my company sponsoring one of these LTC Tour events during
LTC Planning Month in October (LTCMonth.com) or LTC Awareness Month in
November (www.aaltci.org/aware)?
If you don't have a good answer, then get on board the Silver Bullet and
the LTC Tour. For details, contact Damon at 206-283-7036 or
damon@centerltc.com. He'll help
you pick a date and place that fits into the LTC Tour itinerary.
But first, here's some feedback from the programs I delivered last week
in South Bend, Indiana and Lake Forest, Illinois.
I spoke for an hour to the South Bend, Indiana affiliate of the
National Association of Health Underwriters on September 10:
"Great presentation. We, as insurance agents, really need to start
informing our clients/prospects about LTC and how important it is! It is
our job." Lisa Heintzberger
"Having been involved in this [LTCI] market since 1984, I greatly
appreciated the tremendous information that was given that will allow me
to better serve my clients. I learned so much. Even with my experience in
this area. Thank you so much." Larry E. Sanders
"I couldn't help but imagine how different things could be if
politicians told the truth story as Steve Moses does." Robert J. Reese
"Mr. Moses' presentation was fantastic. He is telling us what the
politicians won't." Dennis Rhoads
I delivered two one-hour presentations at LTC Tour Silver Sponsor LTCI
Partners in Lake Forest, Illinois on September 11:
"Steve provides the 'silver bullet' to help us see the huge unfunded
deficit that is awaiting our aging population, and how we need to deal
with it before it is too late." Doug Schuetz
"Thanks for your leadership educating us in the larger scope that gives
me hope regarding long-term care. There will be huge growth in the near
future. Keep on pressing your hard work." Rene' Apack
"Great job. Important information for the public to hear." Vija Mavarro
#############################
The following is from the Sept. 12 edition of the Dayton Daily News,
also
here.
Speaker to warn about long-term care
By Kevin Lamb
Staff Writer
Friday, September 12, 2008
DAYTON - Stephen Moses will talk about shifting the tab for nursing
homes and other long-term care from government to private insurance and
home equity when he speaks to the National Association of Insurance and
Financial Advisors, Dayton Association Thursday, Sept. 18.
The president of the Center for Long-term Care Reform will headline
NAIFA-Dayton's noon luncheon meeting at the NCR Country Club, 4435 Dogwood
Trail in Kettering. Nonmembers can attend and reservations are required.
For more info., contact Melissa Bowling at (937) 298-5558 or adminoffice@erinet.com.
Making a year-long National LTC Consciousness Tour, Moses lives in an
Airstream trailer that's called The Silver Bullet and decorated with the
logos of sponsoring insurance companies.
Long-term care expenses are straining state and federal Medicaid
budgets even before most Baby Boomers retire. The problem, Moses says, is
that government programs pay too readily for people without LTC insurance
or sufficient wealth of their own. He described his solution in his Aug.
27 posting at www.centerltc.com:
"Target public financing of long-term care to the truly needy," Moses
wrote, "and use the savings to incentivize responsible long-term care
planning through private financing alternatives like insurance and home
equity conversion."
- Kevin Lamb, Staff Writer
#############################
Updated: Monday, September 15, 2008 12:26 PM (Central)
Dateline: Springfield, Illinois (LTC Tour Mile 18,932; State #27)--
#############################
LTC BULLET: THE SAVAGE TRUTH ON LTCI
LTC Comment: Nationally syndicated financial columnist and author Terry
Savage reflects today on the meaning of LTC insurance price hikes. Details
and a link to her Chicago Sun-Times column, after the ***news.***
*** LTC TOUR TELLS LTC STORY. Read today's LTC Bullet and you'll
understand why the Center for Long-Term Care Reform's 2008 National
Long-Term Care Consciousness Tour is so important to get the truth to
consumers, policy makers and the media about the crisis in long-term care
financing. Best news of all: LTC Tour sponsorships are now available for
one-third the original cost. Get your company's signage on the Silver
Bullet of Long-Term Care. Get your two-sided color ad in our elegant
presentation packet. Sponsor speaking engagements for Steve Moses at no
additional cost. Read all about it in "LTC Bullet: LTC Tour End-of-Year
Special" at
http://www.centerltc.com/bullets/latest/776.htm. Then contact Damon at
206-283-7036 or damon@centerltc.com
for details. Your company's logo can be on the Silver Bullet at the next
"Fast Signs" franchise we pass in plenty of time for LTC Planning Month in
October (www.LTCMonth.com) and LTC
Awareness Month in November (www.aaltci.org/aware).
***
*** REGIONAL REPRESENTATIVES of the Center for Long-Term Care Reform
are the mainstays supporting and benefiting from the National Long-Term
Care Consciousness Tour. They organize speaking engagements for Steve
Moses; they attract media attention to the LTC Tour; they gain exposure as
LTC planning leaders in their communities and markets. Put up $500 of
"earnest money" to show you're serious and I'll commit to bring the Silver
Bullet of LTC to your town and spend a day with you promoting responsible
long-term care planning. Check with Damon first at 206-283-7036 or
damon@centerltc.com to see where
you'll fit in the LTC Tour's schedule and itinerary. He'll put you in
touch with me to firm up our plans. If you're not located on the LTC
Tour's remaining geographical path, you can still sponsor LTC Tour events
in your town. Ask how. ***
*** LTC GADFLIES. The LTC Tour idea started last year with our
invitation to serious LTC planning specialists to become LTC Gadflies. In
other words, don’t take it lying down. Stand up and fight for responsible
long-term care planning and rational LTC public policy. Here's what I said
in "LTC Bullet: LTC Gadflies" on January 23, 2007:
http://www.centerltc.com/bullets/archives2007/672.htm.
"Don't you think it's about time somebody upset the long-term care
status quo by asking some tough questions and speaking truth to power?
Join the Center for Long-Term Care Reform's 'LTC Gadfly' brigade. Here's
what we have in mind.
"I'm going to 'take the show on the road' in 2008. Call it the
'National Long-Term Care Consciousness Tour.' Details will follow in the
months ahead. But here's the basic idea:
"I'll visit each of six zones of the continental United States for a
month or two during the presidential election year. While there, I'll work
with Regional Representatives of the Center for Long-Term Care Reform to
raise the long-term care issue with politicians, policy makers, the public
and the media.
"We'll ask the tough POLICY questions. Who should pay for long-term
care? How can Medicaid be a safety net for the poor AND the main LTC payor
for nearly everyone? Where will the money come from for public financing
when boomers retire and draw down Social Security, Medicare and Medicaid?
"We'll ask the tough PERSONAL questions. Who will pay for YOUR
long-term care? Are you insured for that risk? Have your parents or
grandparents used Medicaid for LTC? Did you or they consult a Medicaid
planner? Did you pay Medicaid back out of the estate or take the windfall
for yourself? . . .
"We'll rock the boat but we'll do it with HUMOR and GOOD WILL."
I've done exactly what I said I'd do. But the LTC Tour still needs your
help. If you believe in the LTC Tour and what we're trying to achieve,
please vote for its success by sending a check to the Center for Long-Term
Care Reform, 2212 Queen Anne Avenue North, #110, Seattle, Washington,
98109. Be a LTC Gadfly! ***
#############################
LTC BULLET: THE SAVAGE TRUTH ON LTCI
LTC Comment: Terry Savage is a highly regarded financial columnist and
the author of several best-selling books on retirement planning. She may
be the strongest advocate in the national media for responsible long-term
care planning.
So if she "savaged" private long-term care insurance in her column, it
would be a disaster for that sputtering business, the only reliable
alternative to public welfare dependency for most aging Americans.
By the end of last week, however, Terry Savage was about to do just
that. She was livid about the latest premium increases on in-place
business declared by leading LTCI companies.
You can see what she actually wrote in her weekly Chicago Sun-Times
"Savage truth" column today
here.
Here's a taste:
"Just when America was warming up to the idea of purchasing long-term
care insurance to protect family assets from the devastating costs of
custodial care, the three largest insurance companies have shaken up the
market by raising prices on existing policies, not just on policies to be
sold in the future. . . .
"Those who bought early to 'lock in' lower prices are now being
surprised by significant premium increases. . . .
"In effect, the insurers are admitting they made a pricing mistake. The
only other explanation is that they priced policies artificially low to
compete for business. . . .
"It's quite likely that state insurance commissioners will approve the
requested increases. Unfortunately, a side effect is likely to be that
fewer people will buy long-term care insurance. Then, when the real burden
of caring for aging baby boomers hits in the next 10 or 15 years, the
states will have to shoulder the cost through their Medicaid programs as
boomers run out of their own money."
This column could have been a devastating indictment of private
long-term care insurance. But Terry Savage is a consummate professional.
She did not publish her first emotion-laden response. Rather, she sought
an explanation for why LTCI premiums are increasing.
She asked David Acselrod, MetLife vice president, long-term care and
critical illness insurance, who said: "Quite simply, we expect to pay out
substantially more in claims than we originally anticipated. Some of the
assumptions that drive LTCi pricing include policy lapses, interest rates,
the number of people requiring care and the duration of care, to name a
few. Following a review of our experience, we concluded that we had to
make changes to ensure that we are pricing the products appropriately on
behalf of all of our policyholders."
She asked Jesse Slome, executive director of the American Association
for Long-Term Care Insurance (www.AALTCI.org),
who emphasized the important role LTCI plays in funding long-term care:
"The total value of claims paid in 2007 [for 180,000 beneficiaries] was
$3.5 billion -- money that families didn't have to pay, and money that
taxpayers didn't have to pay for impoverished seniors."
Finally, the Silver Bullet of Long-Term Care and Steve Moses were
passing through Chicago on the Center for Long-Term Care Reform's 2008
National Long-Term Care Consciousness Tour when Ms. Savage was preparing
this column. She asked me for comment on rising LTCI premiums and included
this in her column:
"Steve Moses, president of the Center for Long Term Care reform, a
national policy think tank, defends private insurers, saying: "The
government has not set aside any money for the future to back up
its promises that Medicaid will care for frail seniors. At least, the
private insurance industry has bitten the bullet and is increasing prices
so they will have adequate reserves to pay the claims when they start
coming in."
"Moses suggests the market for private LTC insurance will never expand,
as long as the government is 'giving away' the same service insurers are
trying to sell. He points out that the middle class and even the affluent
have learned the tricks of qualifying for Medicaid nursing home coverage.
"They'll be surprised when they learn that Medicaid provides care
primarily in nursing homes that will only become more underfunded and
understaffed. Moses says the burden of long-term care needs will crush the
system, wiping out the possibility of such government-provided benefits in
the future."
Bottom line, as usual, Terry Savage delivered a very thoughtful column,
warning of real risks, but providing excellent advice:
"Buying long-term care insurance still makes sense. . . . Don't bury
your head in the sand about the very real possibility that in your old age
you'll need help dressing or bathing or getting out of bed. Can you count
on your children to be there for you? Would you even want them to do that?
Or will you run out of money trying to pay for care on your own? Those are
questions to ask yourself as you consider the value of long-term care
insurance. And that's the Savage Truth."
#############################
Updated: Thursday, September 11, 2008 11:53 AM (Central)
Dateline: Chicago, Illinois (LTC Tour Mile 18,425; State #27)--
#############################
NEVER BASH THE COMPETITION
LTC Comment: According to scholars Jeff Brown and Amy Finkelstein,
writing in an article originally published by the National Bureau of
Economic Research (you can find it at
www.nber.org), Medicaid crowds out between two-thirds and 90 percent
of the potential market for private long-term care insurance.
That's competition!
But a fundamental tenet of salesmanship is "Never Bash the
Competition."
Hmmm. That creates a problem. Medicaid pays for most expensive
long-term care in the United States and it has since 1965. People don't
plan to go on Medicaid. Most just don't plan for long-term care at all.
Then, after a crisis occurs, they slide down the slippery slope to
Medicaid eligibility and nursing home institutionalization. In other
words, Medicaid enables the public's denial of long-term care risk by
mitigating the worst financial liability of LTC for those who fail to
plan.
Here's the problem. Medicaid can't go on being the long-term care
safety net for the middle class and affluent, as well as the poor. It
doesn't pay adequately now to ensure access to quality nursing home care,
much less good home care or assisted living. Most people don't discover
that fact until it's too late for them to save, invest or insure for LTC.
That's the trap public policy has set for aging Americans.
So, if we aren't supposed to tell the truth about problems with
Medicaid-financed LTC, how can we ever wake the public up to the true
risks they face? I say the moral and fiduciary responsibility to tell
prospects and clients the whole truth trumps the advice "Don't Criticize
Medicaid." Tell it like it is.
Here's how it is, state by state, as reported recently in the news:
AR: Funds are low for Medicaid, legislators told By Michael R. Wickline.
Arkansas Democrat & Gazette. Sep 5, 2008 "Unless we get additional state
general revenue, we won't be able to operate the program as we see it now.
There would have to be significant cuts," said Kyleen Hawkins, chief
financial officer for the state Department of Human Services' Medical
Services Division.
http://www.nwanews.com/adg/News/236394/
GA: Georgia budget cuts force delay of Medicaid reimbursements By
Debbie Gilbert. Gainesville Times. Sep 5, 2008 Georgia's hospitals and
doctors won't be getting a long-awaited increase in Medicaid reimbursement
this year. Furthermore, nursing homes will not receive a hoped-for 2.5
percent funding increase that would have given them $6.7 million.
http://www.gainesvilletimes.com/news/article/8463/
NH: Nursing home gives residents eviction notice Alice Peck Day cites
Medicaid aid cuts By Martin F. Downs The Valley News. Sep 5, 2008 Alice
Peck Day Memorial Hospital has advised residents in its Extended Care
Facility that they will be closing the facility in 18 months, due to
Medicaid cuts. Part of a nationwide trend, New Hampshire cut the
facility's Medicaid reimbursement rate this year by 7 percent, for an
average payment of about $140 per patient per day. "It's very difficult
for nursing homes at this point in time," said Paul Gardent, former
executive vice president at Dartmouth-Hitchcock Medical Center and a
senior faculty associate at Dartmouth Medical School.
READ ARTICLE
PA: State sets hearings on reforming Medicaid payment process
Pittsburgh Business Times. Sep 5, 2008 Pennsylvania is preparing a
sweeping overhaul in its Medicaid payment system for hospitals. Although
funding will increase by $40 million annually, Medicaid reimbursement will
not keep up with hospital costs. The state plans to track severity of
patients' conditions, paying only for care that is actually needed.
READ ARTICLE
R.I. Seeks Limits on Medicaid Spending By Lori Montgomery. The
Washington Post. Sep 5, 2008 Facing a severe budget shortfall, Rhode
Island officials are proposing a drastic shift in funding. While federal
spending would increase each year by a set amount -- 9.2 percent -- the
state contribution would be capped at 23 percent of the state's general
fund budget -- or about $754 million next year. The state estimates that
the funding gap would grow from $231 million next year to nearly $500
million in fiscal 2013. The state hopes to cover the gap by "delivering
health care more efficiently," shifting much of its long-term care from
nursing homes to in-home and community-based care.
READ ARTICLE
Source of the above: AHCA / NCAL Gazette - Friday, September 5, 2
CA: Medi-Cal providers stage protest By Aurelio Rojas. Sacramento Bee.
Sep 6, 2008 California state lawmakers are being accused of "criminal
negligence" by healthcare providers struggling to stay open. In their
failure to reach an agreement on the budget, the lawmakers have put many
hospitals, nursing homes, adult care centers and community clinics in
jeopardy of going out of business. With these facilities relying on Medi-Cal
to cover necessary expenses, many are at great risk after 68 days without
payment.
http://www.sacbee.com/111/story/1214801.html
NJ: Assisted-Living Concepts inquiry grows Some residents may have been
forced out, advocate alleges. By Trish G. Graber. The Epress-Times. Sep 8,
2008 Multiple residents of eight assisted living facilities in New Jersey
were allegedly evicted after switching from private-pay to Medicaid. About
122 past and present residents have asked to have their cases reviewed in
the investigation. All eight facilities are owned by Wisconsin-based
Assisted Living Concepts.
READ ARTICLE
SC: Medicaid provider payback to be cut By Liv Osby. The Greenville
News. Sep 6, 2008 South Carolina has cut all state agency budgets by 3
percent to cover a projected shortfall in the state's budget. This will
mean a cut in state Medicaid reimbursements which could make it more
difficult for those dependant on the program to find providers willing to
take Medicaid.
READ ARTICLE
Source: AHCA / NCAL Gazette - Monday, September 8, 2008
#############################
Updated: Wednesday, September 10, 2008 1:09 PM (Eastern)
Dateline: South Bend, Indiana (LTC Tour Mile 18,350; State # 25)--
#############################
LTC BULLET: THE LTC PROMISE
LTC Comment: What is the most common "LTC Promise" and how does it fall
short? Find out after the ***news.***
*** LTC TOUR END-OF-YEAR SPECIAL: Get the best of the benefits of being
an LTC Tour Sponsor at 1/3 the original price. That's right, with 1/3 of
the LTC Tour year remaining, we still have 2/3 of the country to cover and
½ of all the miles to drive. That's major exposure for your company and
message in RV Parks, on the highway, and in our highly rated speaking
engagements. So get your logo on the Silver Bullet of Long-Term Care and
your message in our elegant presentation packet, but pay only 1/3 the
original cost. Can't beat it. Read all about it in "LTC Bullet: LTC Tour
End-of-Year Special" at
http://www.centerltc.com/bullets/latest/776.htm. ***
*** AIRSTREAM LIFE MAGAZINE covers the LTC Tour in its Fall 2008 issue:
Hi Rich (letter to the editor): I'm on a year-long "National Long-Term
Care Consciousness Tour" in an Airstream [trailer]. The purpose of the LTC
Tour is to reach the media, public policy makers, consumers and financial
advisors with a critical message: long-term care planning is a personal
responsibility; the government's safety net for long-term care funding is
frayed and will break; the Age Wave is about to crest and crash on a
demographically challenged America; consumers need to wake up to the risk
and prepare. The tour's schedule and calendar is on our website. Where I
go when within the broad confines of the six geographical areas for two
months each depends entirely on who invites me where and when. See
www.centerltc.com. Regards, Steve
Moses
Source: "Long-Term Tour for Long-Term Care," Airstream Life,
Fall 2008, p. 8. ***
*** WESTERN KENTUCKY HEALTH UNDERWRITERS in Owensboro, KY had Steve
Moses and the Center's 2008 LTC Tour in for a two-hour "LTC Graduate
Seminar" presentation on September 3, 2008. Here's some of the feedback
from that program:
"Extremely informative session! The issue of LTC is so important we
must increase our efforts to get folks protected." L. Stuart Augenstein
"Very inspirational speaker for a difficult subject." Kimbra Blandford
"This was a very informative meeting. I will have to study and try to
digest this information." Robbie M. Miller
The National Long-Term Care Consciousness Tour can make presentations
like this one available at no cost to NAHU, NAIFA, Financial Planning
Associations, Estate Planning Councils and other organizations. All you
have to do is schedule the session to fit into the LTC Tour's schedule and
itinerary. See the LTC Tour Calendar at
http://www.centerltc.com/TourCalendar/General.htm#September.
Proprietary events can be booked for a nominal contribution to support the
LTC Tour. Contact Damon at 206-283-7036 or
damon@centerltc.com for details.
***
LTC BULLET: THE LTC PROMISE
LTC Comment: The most common LTC promise made by an adult child to an
aging parent is "I'll never put you in a nursing home." But too few people
who make that promise ever ask themselves the key "LTC question": how will
I keep that promise?
That's the "hook" in the following marketing letter by Center member
and supporter Mari Tautimes. Mari, her father, Mel Rose, and her brother
Paul Rose are the brains, drive and compassion behind Western Asset
Protection of Phoenix, Arizona.
They're very much in my thoughts because the National Long-Term Care
Consciousness Tour is headed to Phoenix soon for a round of activities,
media and speaking engagements sponsored by Western Asset Protection.
So when I saw the following piece by Mari, it seemed to me like
something others should see as well. Ms. Tautimes concurred. So here it is
with footnotes omitted for brevity.
#############################
Greetings Friends and Colleagues,
When you open this email, you might think, "I don't have time right now
to read this obviously long email." I'm asking you to please just take the
less than 5 minutes it will take to digest what I think is so important
for you to know.
This email is to invite you to help me raise awareness about the fact
that people need to plan ahead of time financially for their family's
long-term care events. This seems obvious right? The reality is that the
depth of the average conversation about this topic is a promise in passing
to mom or dad that they will never put them into a nursing home.
What an excellent promise to make! Most people however, don't take the
necessary steps to ensure they can keep that promise. What are the
necessary steps?
The same steps one takes to plan for future life stage events such as
college or retirement. People don't assume what the cost of college will
be when their kids hit that stage of life; they research it and put a plan
in place to make sure the funds are there when college becomes a reality,
sometimes through savings, sometimes through a vehicle such as a 529 plan.
When planning for retirement, people don't assume what size nest egg
they'll need to create their ideal retirement; instead, they look up the
average age at death to understand how many years from the date they
retire they'll need income for. They research inflationary factors and
what investment vehicles their nest egg should comprise of to ensure a
steady income stream to make their retirement dreams a reality. So why is
planning for long-term care any different?
The Main Issue
According to an article published by the Institute of Gerontology, "a
2001 survey of adults aged 45 and older revealed that 55% believed that
Medicare covered extended nursing home stays for "age-related or other
chronic conditions," when in fact it does not (AARP, 2001)." In addition,
41% of respondents erroneously believed that Medigap (Medicare
Supplemental) insurance covered such care." Because of poor planning, the
approximately $50,000 on average per year will ultimately result in the
spending down of personal assets requiring baby boomers to resort to
Medicaid as their resource to pay for their long-term care needs. Equally
significant is the inflation factor which according to a recent study by
Prudential financial, is increasing between 5% and 13% annually.
People run the opposite direction of anyone who utters the words
"long-term care" because they erroneously envision a horrific image of a
place that feels like a hospital with hallways filled with moans and the
smell of urine. No wonder why no one wants to "plan" for something like
that. The truth is however that a nursing home is an unlikely scenario for
people who financially prepare in advance. Studies show that people who
need assistance with their activities of daily living and can afford
private pay STAY AT HOME which is actually the more costly form of care.
People who DON'T plan and end up on Medicaid are required to receive care
at a facility where it is less expensive for the state to administer care.
This isn't an issue to plan for when long-term care becomes a reality,
it's something to plan for ahead of time, just like any other financially
significant life stage affair.
If you agree that this is an important issue too, please forward this
to the people you care about to help me raise the awareness. To learn more
on how to plan for long-term care, you can of course contact me, but I
also recommend www.LongTermCare.gov or take the quiz and hear other
people's stories at www.MyLifeMyFamily.com, both great places to go to
learn about methods and financial vehicles for planning.
I sincerely thank you for taking the time to read about an issue that
is so important to me.
Thank you,
Mari Tautimes, LTCP
Western Asset Protection, Inc.
11811 N. Tatum Blvd., Suite P125
Phoenix, AZ 85028
(602) 955-5353 ext.4
(602) 955-5583 fax
(800) 955-5390 toll free
#############################
Updated: Tuesday, September 9, 2008 10:40 AM (Mountain)
Dateline: Albuquerque, New Mexico--
#############################
FISCAL WAKE-UP APPEAL
LTC Comment: Out here on the National Long-Term Care Consciousness Tour
I often tell audiences about Dave Walker and his Fiscal Wake-Up Tour. The
two Tours are connected at the hip in some ways.
Walker is the former Comptroller General of the United States, i.e. the
director of GAO, the Government Accountability Office. He quit that job
midway through a 15-year appointment so he could speak more openly and
forcefully about America's massive problem of unfunded entitlement
liabilities.
Dave Walker now heads the new Peter G. Peterson Foundation and he's
taking his Fiscal Wake-Up Tour to a whole new level. Read his recent press
release which follows and reflect on the connection with long-term care
financing.
To wit, Medicaid is the major funder of LTC in the U.S.A. It's
underwater financially already and pays inadequately to ensure quality
care. But Medicaid survives even in its deficient current form because of
support from Social Security (spend-through of Social Security income of
people on Medicaid) and Medicare (generous Medicare payments for nursing
home and home care relieve the financial pressure on Medicaid.)
If Walker is right, however, Social Security and Medicare are in a deep
financial hole. They can't go on propping up Medicaid. That's the
connection between these programs. As Social Security and Medicare pull
back, Medicaid LTC financing will collapse. When that happens, the poor
will suffer, the middle class will turn to their home equity for LTC
funding, home equity conversion options for LTC financing will explode,
and finally long-term care insurance will become a mainstream product.
That's a lot to glean from these early signs, but the evidence supports
the conclusion. See what you think.
#############################
September 5, 2008 email from Dave Walker and the Peter G. Peterson
Foundation:
Dear Friend,
Can "we the people" really save our economy? Can we really force our
government to face the inconvenient truth of the $53 trillion hole we're
in? That's the sum of all the US government's current financial
obligations including unfunded promises for Social Security and Medicare -
a $455,000 bill for every household in this country.
The answer is "YES" - there IS something each of us can do.
Click here
to add your signature to a letter we're publishing in the New York
Times (more on the letter below).
This new movement for fiscal responsibility is just a few weeks old.
And yet, thanks to folks like you, we've already made significant strides:
- Over 100,000 of you have already signed on to help us fight for
fiscal responsibility in Washington and at home
- Our effort already has been covered extensively by the media,
ranging from the New York Times, ABC News and CNN to literally
thousands of blog mentions (source: Technorati)
- "I.O.U.S.A.," our feature documentary about the impending fiscal
crisis, has made an incredible splash. Not only did the film get three
and a half stars from Roger Ebert, and rave reviews from the New York
Times and other critics, but it set an opening-day record for a
documentary, thanks to a bonus post-screening town hall, and is about to
break into the ranks of the top 100 highest-grossing documentaries of
all time (source: BoxOffice Mojo).
That's right - a documentary about fiscal responsibility is
about the break into the top 100! And the film is still in theaters in
selected cities;
check
here for listings.
We've taken the first step together, and we've begun to build the
movement that cynics claimed was impossible. We're sounding the alarm and
America is waking up. Now, it's time to take it to the next level. Here's
how you can help:
This Sunday, we'll be publishing a letter across two full pages in the
New York Times calling upon the presidential nominees to move
beyond the "denial" stage, recognize that America has a $53 trillion
problem, and start taking steps to solve it. This letter will be signed by
a bipartisan group of some of the country's most prominent leaders in
finance and fiscal policy-making, and by representatives of young people's
organizations around the country.
You can add
YOUR name by visiting www.PGPF.org today. Please help us make this
letter one our next President can't ignore.
Are you on Facebook? If so, please visit the
Peter G. Peterson Foundation and
I.O.U.S.A. pages and become a fan today.
And finally, spread the word! Forward this e-mail to your 10,000
closest friends.
We've started a movement for fiscal responsibility - a movement few
thought possible. And with your help, we will wake up America and set the
nation on a course toward a more secure future and a brighter tomorrow.
All the best,
Dave Walker
President and CEO, Peter G. Peterson Foundation
PS, For more about "I.O.U.S.A,"
click here to see the trailer, bonus clips, and my polite disagreement
with Warren Buffett!
#############################
Updated: Monday, September 8, 2008 11:14 AM (Mountain)
Dateline: Santa Fe, New Mexico--
#############################
THE LTC STORM IS COMING
LTC Comment: With hurricanes and tropical storms in the news these
days, the following short article is apt. Written by Center member and
supporter, Ross Schriftman, the piece draws an obvious insurance analogy.
But there are aspects to this analogy that are not so obvious. We've
explained them in earlier Center for Long-Term Care Reform publications.
While you're contemplating this subject, check out these articles too:
-- "LTC Bullet: John Stossel on LTCi . . . Oops, Flood Insurance,"
Tuesday, March 2, 2004:
http://www.centerltc.com/bullets/archives2004/488.htm
-- "LTC Bullet: Of Floods, Insurance and Long-Term Care," Monday July
31, 2000,
http://www.centerltc.com/bullets/archives2000/floods.htm
Read those two pieces and you'll have the answer to Mr. Schriftman's
query below. People fail to buy LTCI for the same reason few purchase
flood insurance. The government gives away (after the insurable event
occurs) what the private sector is trying to sell (before the insurable
event when potential insureds are in denial).
The good news is the solution is easy. Stop subsidizing irresponsible
behavior, whether it's people building and re-building on a flood plain
with government assistance, or going bare for LTC protection.
#############################
"The Storm Is Coming"
By Ross Schriftman, RHU, LUTCF, ACBC, MSAA
Long Term Care and Medicare Supplement Specialist
Tel. 215-682-7075
Suppose, a hurricane is approaching and you still have time to buy
flood insurance. You decide it is too much money or maybe you could wait
because it may not happen after all. Would this be a prudent decision?
And yet, there is an approaching storm we all should face. It is the
devastating disaster of long term care expenses that can amount to
hundreds of thousands of dollars and easily wipe out a family's lifetime
of savings. It will hit about one out of every two Americans and yet as
this storm approaches few people plan for it. They think it will never hit
them or they think somehow the government will bail them out. But, the
government is drowning in debt and can't even afford to pay for those
already in the water of Medicaid dependency.
A few thousand dollars a year in premiums for your own insurance
protection is a small price to pay for hundreds of thousands of dollars of
protection. Help me out. Why wouldn't you insure?
#############################
Updated: Friday, September 5, 2008 12:15 PM (Central)
Dateline: Chesterton, Indiana (LTC Tour Mile 18,100; State #25)--
#############################
PRESIDENTIAL CANDIDATES ON LONG-TERM CARE
LTC Comment: Both candidates for President and their parties' platforms
finally have positions on long-term care financing. Both advocate more
funding of home and community-based care by Medicaid. Neither has much
good to say about private insurance or home equity conversion as LTC
funding alternatives.
Here's the irony and the problem: Medicaid can't afford to pay for
nursing home care--which most people prefer to avoid--much less home and
community-based services (HCBS)--which most people prefer to get when they
need care. When politicians, parties and policy makers lead the public to
believe that Medicaid will pay for HCBS in the future--when it can't and
won't for most people--they further anesthetize a public already asleep
about LTC risk and cost. And a public in government-induced somnolence
regarding LTC does not create a large market for private financing
alternatives.
So that's the bind we're in. The same well-intentioned, but perversely
counterproductive public policy that encourages the public to believe
government will pay for long-term care (especially, HCBS), also impedes
the markets for private LTC insurance and home equity conversion that
could otherwise save the now-collapsing service delivery and financing
system.
Ugh! What a mess. Following are some news stories that press home the
point that Medicaid is in a world of hurt. Stay tuned for big news about
the National Long-Term Care Consciousness Tour, one of the strongest tools
we have right now to turn this mess around.
#############################
MD: County to write off nearly $600K in bad debt for nursing home. By
Kevin Spradlin. Cumberland Times-News. Aug 27, 2008 Allegany County
Nursing Home and Rehabilitation Center, one of only three remaining
county-run nursing homes in Pennsylvania, will be rescued this time, but
the county sees the necessity to follow the lead of other counties in
getting out of the nursing home business by selling the facility.
Access story
Source: AHCA / NCAL Gazette - Thursday, 8/28/2008
#############################
Kaiser Daily Health Policy Report Highlights Recent Medicaid News in
Six States
Access this story and related links online
Summaries of recent news about Medicaid programs in Florida, Georgia,
Massachusetts, Mississippi, South Carolina and West Virginia appear below.
Florida
Three insurance companies that cover 60% of people enrolled in Florida
"Medicaid Reform" plans have said they will leave the project and have
asked to be assigned no new members, a move suspected to be a result of
reductions in Medicaid payments to the plans, Florida Health News reports.
The reform plan, which began in 2006 and operates in five counties,
requires that most non-institutionalized Medicaid beneficiaries be
enrolled in private plans carrying the risk of providing their care.
Letters from Amerigroup Florida, UnitedHealthcare of Florida and WellCare
Health Plans' HealthEase of Florida and WellCare of Florida did not
indicate why they chose to leave the program, but Amerigroup spokesperson
Kate Jenkins cited the 5% reduction in Medicaid payments scheduled for
Sept. 1 as the reason. She said, "We understand Florida has budget
issues," adding, "We want to work with them. But the hard fact is, it will
lower our revenues at a time when health care costs are going up across
the board" (Gentry/Jordan Sexton, Florida Health News, 8/27).
UnitedHealthcare spokesperson Steve Matthews said, "What it comes down to
is a question of revenue and expenses" (LaMendola, South Florida
Sun-Sentinel, 8/28). Florida Community Health Action Information Network
Executive Director Laura Goodhue said, "Medicaid consumers, evaluators and
advocates have been saying all along that the program isn't living up to
its promise, and now it appears that the private market is agreeing"
(Florida Health News, 8/27). State officials did not indicate how
beneficiaries enrolled in these plans will be covered after the plans stop
participating in the program on Dec. 1. Medicaid officials with the
Florida Agency on Health Care Administration will meet on Thursday to
discuss options, according to spokesperson Fernando Serna (Galnor, Florida
Times-Union, 8/28). Agency spokesperson Doc Kokol said Medicaid officials
are "confident" that they will be able to continue coverage for the more
than 100,000 beneficiaries affected by the pending withdrawal of the three
companies from the program (Gentry/Jordan Sexton, Florida Health News,
8/28).
Georgia
Georgia Medicaid and PeachCare beneficiaries should not be affected by
spending cuts aimed at closing a $1.6 billion budget gap for the current
fiscal year, according to spending recommendations adopted Thursday by
state health officials, the AP/Augusta Chronicle reports. However,
hospitals and health care providers likely will be affected by a delay in
a planned Medicaid rate increase. PeachCare is the state's version of
SCHIP (Augusta Chronicle, 8/29). Overall, the plan would cut Medicaid
funding by 5%, which includes delaying a planned provider payment increase
(Macon Telegraph, 8/29).State officials also are recommending that the
state take advantage of a federal rule change and implement an additional
fee on commercial insurers that operate managed care plans. State health
commissioner Rhonda Meadows said benefits and enrollment for PeachCare
would have to be frozen without the fee expansion. The fee currently is
charged only to Medicaid managed care plans and generates about $90
million in annual revenue. The expansion is expected to face opposition
from the state insurance lobby (AP/Augusta Chronicle, 8/29).
Massachusetts
The administration of Gov. Deval Patrick (D) on Friday announced that
the federal government has granted Massachusetts a fifth Medicaid waiver
extension in negotiations that aim to continue the state's health
insurance law, the AP/Boston Globe reports. The waiver will be in effect
until Sept. 8. According to the AP/Globe, Massachusetts needs the $385
million annual waiver to continue using federal funds as it shifts
coverage from no-cost emergency care for uninsured residents to its
private-public coverage system for all workers (AP/Boston Globe, 8/22).
Mississippi
A proposal by Gov. Haley Barbour (R) to increase hospital taxes to
bridge a $90 million funding gap in the state Medicaid budget could force
hospitals in the state to close, reduce services or eliminate staff
positions, according to hospital officials who spoke Tuesday during a
public comment session on the plan, the Jackson Clarion-Ledger reports.
The plan is scheduled to take effect Monday. In addition to the tax
increase, Barbour has proposed cutting state Medicaid reimbursement rates
and replacing those cut with federal funds. A group of 14 state Senate
Democrats on Tuesday filed court documents in Hinds County challenging the
proposal. In July, Judge William Singletary ruled that only the state
Legislature has the authority to set taxes or fees paid by hospitals.
State Rep. David Baria (D) wrote, "The circumstance that the legislative
process has not yet produced full funding, or that the governor's
preference in the method of funding has been frustrated in the
Legislature, does not grant the governor constitutional license to bypass
the Legislature and impose his tax plan by executive degree" (Chandler,
Jackson Clarion-Ledger, 8/26). Attorneys representing several hospitals
opposed to the tax plan at a hearing on Wednesday said that the proposal
is similar to a plan Barbour tried to pass in 2006, which a judge
rejected. A ruling on the case was expected on Thursday (Washington Times,
8/28).
South Carolina
The state's Medicaid program plans to stop reimbursing providers for
medical errors, the Columbia State reports. Before the change can occur,
state officials must resolve some technical issues, according to state
Health and Human Services Department spokesperson Jeff Stensland. Rick
Foster of the South Carolina Hospital Association said the group already
has adopted principles encouraging hospitals not to bill for certain
errors (Higgins/Hinshaw, Columbia State, 8/23).
West Virginia
Nearly 60% of West Virginia Medicaid beneficiaries do not know whether
they are enrolled in the state's basic Medicaid plan or the enhanced
version, according to a survey released Tuesday, the Charleston Gazette
reports. The Direct Action Welfare Group, which conducted the survey, said
Medicaid beneficiaries do not understand recent changes to the Mountain
Health Choices program, which allows residents to receive "enhanced"
benefits if they visit a doctor and sign a "personal responsibility"
pledge. The basic plan has fewer benefits than traditional Medicaid.
According to the survey, nearly 50% of parents of children enrolled in
Medicaid do not know which level of coverage their children have. Eighty
percent of the program's beneficiaries are children. In addition, the
survey found that two-thirds of state Medicaid beneficiaries said they
have not received a letter informing them of their coverage status (Eyre,
Charleston Gazette, 8/27). The survey is available online.
Source: Kaiser Daily Health Policy Report - Friday, August 29, 2008
#############################
IA: Heartland nursing homes close. By Jill Kasparie. KTVO.com. Sept 2,
2008 6:03 PM Rising costs and low Medicaid reimbursement rates have pushed
the closing of the Ottumwa Manor nursing home, owned by Ottumwa
Developments, Inc., in Iowa. Other area skilled nursing facilities are at
capacity, meaning that many residents will have to move up to 30 miles
from the Ottumwa location. The employees and residents will have to find
new jobs and homes before the closing of Ottumwa Manor on September 30th.
The Fairfield based Nelson Nursing Home will also be shutting its doors
for financial reasons. http://www.ktvo.com/news/news_story.aspx?id=184527
Source: AHCA / NCAL Gazette - Wednesday, September 3, 2008
#############################
Updated: Thursday, September 4, 2008 11:42 AM (Central)
Dateline: A Rest Area in Northern Indiana (LTC Tour Mile 18,050; State
#25)
#############################
SPECIAL ALERT: The LTC Tour needs your help. PLEASE READ THIS NOW
LTC DEPUTIES
LTC Comment: I am officially deputizing all dues-paying Center for
Long-Term Care Reform individual and corporate members today.
Being an LTC DEPUTY is not an onerous responsibility. I'm only asking
for an hour (or less) of your time.
Please forward yesterday's LTC Bullet, titled "LTC Tour End-of-Year
Special," to everyone you know who might conceivably become a sponsor of
the National Long-Term Care Consciousness Tour. (If you can't find
yesterday's Bullet in your email in-box, archive or deleted file, send
this link to the Bullet from our archives instead:
http://www.centerltc.com/bullets/latest/776.htm).
Who might you send the "LTC Tour End-of-Year Special" Bullet to? Your
favorite LTC insurance carrier; your principal broker or general agent;
long-term care providers such as Continuing Care Retirement Communities,
nursing home or assisted living companies. Really, anyone, any
organization, or any company that you know cares about the future of
long-term care service delivery and financing.
Tell them why you support the Center and why you believe in the 2008
LTC Tour. Ask them to join our special year-long campaign to promote
responsible LTC planning. Have them contact me directly at 425-891-3640 or
smoses@centerltc.com or go to
Damon at 206-283-7036 or
damon@centerltc.com if they want more information.
Why am I asking for your assistance?
Last December I plunked down $70,000 of my own money to buy the Silver
Bullet of Long-Term Care (pictures at
SM_with_the_SilverBullet.htm and
Silver_Bullet_at_State_Capitols.htm.)
It seemed to me a wonderful time to take the show on the road, to bring
the Center's message of responsible long-term care planning to the grass
roots, to the people, to legislators, to policy makers, to the media and,
especially, to financial advisors, too few of whom are urging their
clients to plan for long-term care.
So far, the LTC Tour has exceeded all my hopes and expectations. Our
message has reached thousands of key people directly and hundreds of
thousands indirectly through the media and by exposure of the Silver
Bullet in 100 campgrounds and over 18,000 miles of highway.
There's only one way the 2008 National Long-Term Care Consciousness
Tour has fallen short. We really need more sponsors and the financial
support they bring. That's why I made the special offer in yesterday's LTC
Bullet showing potential sponsors how they can get on board the Silver
Bullet and the LTC Tour for one-third the original cost.
Think of it!
- Two-thirds of the country remains to cover. The Midwest and West are
by far our biggest regions.
- Half the highway miles the Silver Bullet will cover still lie ahead.
- Signage on the Silver Bullet for Platinum, Gold and Silver Sponsors
at 1/3 the cost
- Recognition in the LTC Tour's elegant presentation packet
distributed at all events
- Think of the marketing opportunities during those critical months
for the LTC issue and the business!
- Dozens of great dates remain for sponsors to schedule speaking and
media events for me and them at no extra cost.
- All this right now for only 1/3 the original investment.
Yesterday's LTC Bullet explains it all:
http://www.centerltc.com/bullets/latest/776.htm. Please help us reach
out to more sponsors. Send the Bullet or the link to anyone and everyone
you think might want to join our grass roots campaign to raise public
consciousness about long-term care planning.
If you'd like to get more involved yourself, become a Regional
Representative of the Center for Long-Term Care Reform and help us plan
and schedule an event and Silver Bullet visit in your city.
And of course, we're always happy to receive your votes of confidence
and encouragement, especially when they come in the form of checks made
out to the Center for Long-Term Care Reform. (Smile)
Thanks for your time and consideration. Special thanks to our
Coordinating Sponsors and the many Platinum, Gold, Silver, Bronze and
other sponsors and Regional Representatives who answered the original call
to support the Center for Long-Term Care Reform's 2008 National Long-Term
Care Consciousness Tour.
My very best regards,
Steve Moses
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Updated: Wednesday, September 3, 2008 12:15 PM (Central)
Dateline: Owensboro, Kentucky (LTC Tour Mile 17,764; State #25)--
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LTC BULLET: LTC TOUR END-OF-YEAR SPECIAL
SPECIAL ALERT: Sponsor the LTC Tour for one-third the original cost;
get most of the original benefits; and be on board for LTC Planning Month
and LTC Awareness Month! Read on after the ***news.***
*** SILVER BULLET AT THE CAPITOL in Charleston, West Virginia. Check it
out here
http://www.centerltc.com/TourPictures/Silver_Bullet_at_State_Capitols.htm
***
***
NEW PR HELP from Marilee Driscoll, the LTC Tour's national PR and
marketing consultant. Learn how best to promote and publicize events and
media coverage for the National Long-Term Care Consciousness Tour. ***
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LTC BULLET: LTC TOUR END-OF-YEAR SPECIAL
LTC Comment: You might think the Center for Long-Term Care Reform's
2008 National Long-Term Care Consciousness Tour would be starting to wind
down. You'd be dead wrong.
In several respects, most of the LTC Tour still lies ahead. After
reading today's LTC Bullet, you'll see how you can get aboard the Silver
Bullet of Long-Term Care for the best and biggest part of the LTC Tour.
While only one-third of 2008 remains, you can see from the
map of
where we've been so far that two-thirds of the country remains to cover.
Our Midwest and Western regions of the Tour are the most expansive, so
fully half of all the miles we'll cover remain ahead.
What that means for you and your company is that, if you are
represented as a Platinum, Gold, or Silver sponsor on the Silver Bullet of
Long-Term Care (click
for picture), your logo or message will be seen by many thousands of
people. They'll see you in person on the highway and in the campgrounds.
And they'll see you online, in the new | 
