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LTC Strategies From The White House Conference On Aging

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The 2005 White House Conference on Aging, held Dec. 11 to 14 in Washington, may lead to a foundation for better quality lives for a new generation of seniors.

The conference occurred at a time when we are witnessing fundamental changes in the way we think about and deliver health care, including long term care.

White House Conferences on Aging have convened decennially since 1961, providing the framework for the creation of major social policy programs for older Americans, including Medicare, Medicaid and the Older Americans Act.

Because of its unique nature as the initial conference of the 21st century, the 2005 conference was the first to deal with the aging of 78 million baby boomers who began to turn 60 on Jan. 1, 2006.

The 1,200 delegates to the conference worked together to adopt 50 resolutions and, for the first time ever, develop implementation strategies to help guide policy-makers and citizens toward a secure and healthy aging future.

Long term care and services emerged as a recurring theme throughout the conference. Seven of the top 10 resolutions adopted spoke to some aspect of long term care–more specifically, the elimination of the bias for institutional care and the opportunity to have more control over how and where we live as we age.

The delegates affirmed that Americans want to have a full array of choices for LTC services and support, from skilled nursing facilities to assisted living to home- and community-based care. They also want to provide choices of support for family caregivers across the life span of their loved ones. All these choices can be supported through long term care insurance options that are affordable, creative and integrated.

Many delegates believed this broad theme was a key goal of the conference–to send a strong signal to policy-makers that Americans want an integrated long term care support and services strategy. They wanted this strategy translated to actions that blend the public and private sectors as well as individual recognition and responsibility for our own futures.

Many discussions on long term care during the conference were focused on LTC insurance, a relatively new product and one that does present some challenges.

In the 1990s, when I was assisting John Hancock in its launch of an LTC insurance product, much of the industry’s attention was focused on institutional care. Now, with our vocal desire for choice and options, the industry has responded with creative home-based and community-based options. Still, challenges remain.

Strategies to aid in meeting those challenges suggested by the delegates included tax code changes; national and state tax credits and incentives; allowing the purchase of LTC insurance though IRAs and 401(k)s; incentives to employers, such as the use of health savings accounts and cafeteria plans to purchase LTC insurance; and reciprocity across states.

The conference delegates also proposed to expand and standardize the LTC partnership programs–as well as promote and advance public education and awareness programs on LTC insurance. The LTC partnership program has allowed specially tailored long term care insurance policies for more than a decade. With the passage of the Deficit Reduction Act of 2005 shortly after the conference, the partnerships now will be able to expand into all the states.

The LTC insurance industry needs to play a key role with state insurance commissioners in facilitating the expansion as quickly as possible. I know many in the industry will be involved as that expansion is implemented.

The main message of the DRA is very important to note. With the new Medicaid estate-planning rules, we may have reached a point where society has to face the fact that individuals must–to the best of their ability–take responsibility for their own LTC needs. To do that, they need education and options.

There are still challenges, such as how to make buying LTC insurance attractive to a younger person. We know boomers are having a difficult time saving for retirement, let alone for their LTC needs. As it relates to LTC insurance, we basically are asking 40-year-olds to plan for their 80s. This is not easy to fathom when you are younger, have a family and are juggling many responsibilities. It seems to me that there are several major challenges faced including:

1. Making it easier to understand why it is important to be covered;

2. Making LTC insurance more affordable; and,

3. Promoting even more product innovation, such as a package of disability and LTC insurance–disability insurance during one’s working years, followed by LTC insurance upon retirement.

I would be very pleased if a greater understanding about and increased options for LTC insurance resulted from the 2005 conference. This would make a difference in the lives of so many people. The legacy of the 2005 conference is that we will make a difference appropriate to the 21st century–not defined by new or expansive federal entitlements or programs but by a sense of the future. Melding the present with what we have learned in the past will lead to innovations in integrated service delivery and wider choices for all Americans. This is our challenge and our opportunity.