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Life Health > Long-Term Care Planning

LTCI Watch: Names

By Allison Bell

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The new American Taxpayer Relief Act of 2012 (ATRA) is creating a 15-member Commission on Long-Term Care.

The new LTC Commission is supposed to try (not necessarily to succeed, but to try) to come up with a bipartisan proposal for fixing the U.S. long-term care (LTC) system.

Earlier, I came up with a list of 15 ideas for people who could possibly serve on the commission. Because some of you readers actually started commenting on and responding to the article, I then asked readers to send me their ideas. 

Here are the replies that have come in so far, either through e-mails or through comments to earlier articles.

Who knows how federal officials will come up with their commission candidates, but maybe this exercise is a way for the LTC community to come up with ideas for its own team for fixing what ails the U.S. LTC system.

LTC Commission: Bad 

Some readers say the commission will be either pointless or actively bad for society. 

One Wisconsin agent who said he has sold private long-term care insurance (LTCI) exclusively for many years is in this camp.

“I predict the Commission on LTC will be just another completely useless exercise in government futility,” the agent said.

A very loyal reader and active commenter, Sunforester, posted that, “Having an LTC commission implies that our government is going into the LTC business, but wants people who don’t run insurance companies to help reinvent the wheel.”

“How many times do we have to beat our heads against the wall of our government, telling them that they are wasting huge amounts of taxpayer money to provide a product that is already available in the free market, if the free market could only be left alone to flourish?” Sunforester said. “Our political elite is dead set on taking our money and handing it out to greedy, irresponsible people who love it in exchange for their votes. Those who want LTC should buy it for themselves, instead of simply taking it from the rest of us.”

Those “so-called commission” will surely focus more on “putting together an LTC patronage package that all the freeloaders will love than allowing the free market to revive,” Sunforester said.

General thoughts (from people who think having a commission could possibly be helpful)

Steve Schoonveld commented that, to be successful, the commission either should include members of Congress and members of the Obama administration “with enough knowledge and courage to accomplish the task,” or, “a cross-functional team of long-term care experts who strongly appreciate the roles of welfare based programs, social insurance programs and the potential of private insurance solutions.”

Another commenter, wkb4447 said the first question for any potential commission member should be, “Do you own long-term care insurance?”

The second question, for commenters who have no LTCI coverage, would be, “Why not?”

“It could be that they didn’t qualify medically,” wkb4447 said. “That would probably be my first nominee!”

Reaction from someone I proposed

I suggested that Bonnie Burns, a longtime California health advocate who has been active in speaking for seniors in proceedings at the National Association of Insurance Commissioners (NAIC), might be a good commission member.

Burns wrote to thank us but express some surprise that she was mentioned.

“I doubt I am on anyone’s short list of appointees,” Burns said.

But “I would love to be part of a real, honest discussion on how to design a comprehensive long-term care system for this country,” Burns said. “We have a million pieces of the long-term care puzzle but no system.”

To get anything done, the commission will need strong leadership, a sense of urgency, and a willingness to work together to make many different pieces of the puzzle fit inside a framework that will serve the needs of the country, Burns said.

Names

Several commenters have suggested Claude Thau, an Overland Park, Kan., LTCI actuary who has been in charge of the LTCI operation at Transamerica Occidental Life Insurance Company, would be a great commission member.

Carroll Harper and George Braddock reminded me that I somehow forgot to list Stephen Moses, the co-founder of the Center for Long-Term Care Reform, a private think tank dedicated to preventing states from having Medicaid for LTC services for relatively affluent people who could and should be paying for their LTC services, to conserve Medicaid resources for people who are genuinely in need.

Phil McDonough said one of the people I proposed — Paul Krugman, a Nobel Prize-winning economist — would be a good LTC commission member. Krugman should be good at helping deal with the Medicaid nursing home liability, the “greatest drain on our social support safety net,” McDonough said.

LTC system reform proposals 

Another commenter, Citizen Jones, said insurers and producers like Citizen Jones who already work in the LTCI market could help the commission keep Congress and the U.S. Department of Health and Human Services from something silly.

“If we want to get serious, how about a real public-private partnership?” Citizen Jones asked.

Jones proposed that a solid partnership should involve an LTCI public awareness program, a one-time “open enrollment season” that would allow consumers to buy coverage from participating carriers on a guaranteed-issue basis, enrollment facilitated by certified agents who receive compensation, and use of graded premiums or graded benefits to mitigate the risk involved with insuring high-risk applicants.

Jones recommended that insurers issuing coverage during the open season be allowed to use underwriting to set rates but not to decide whether to issue coverage.

If the federal government were willing to spend money on the program, it could do so by guaranteeing a reinsurance pool that would help insurers handle high-risk insureds, Jones said. 

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