LTCI Watch: Elbows

I recently wrote up some of the papers presented at the SCAN Foundation’s conference in Washington, and cool, beloved LifeHealthPro.com readers said, both in public posts and in private e-mails, that they found the papers disappointing.

I think, really, that that’s partly because the people who wrote the papers are respectable people and are limited by the reality that they have to say respectable, reasonably politically correct things, or they’ll get into huge trouble.

In theory, they may be very theoretical and idealistic and above the fray.

In the real world where budgets are tight and it’s hard to get a job, maybe, say, they’re just on their knees praying every night that the U.S. Department of Health and Human Services (HHS) will give them a grant involving Medicaid nursing benefits administration, or give them a nice, wonky job, or give some other organization that hires them a grant or a contract.

Meanwhile, the folks at HHS may fantasize about getting better-paid, somewhat wonkish jobs at private companies that like the current, Medicaid-based long-term care (LTC) financing system pretty well and don’t really want to go with a private system.

And, of course, a lot of folks in wonky jobs are, like me, Star Trek fans or the equivalent, and haven’t worked much, if at all, outside of government agencies, academia, big law firms, big consulting firms, or other types of wonkish entities. For those folks, the economy may seem, really, to work a lot like the Star Trek universe: The good guys work for Starfleet or research institutes, or possibly as traveling actors or musicians. The private-sector people mainly are brutish miners, at best, and, typically, pirates with a large inventory of green slave girls for sale.

But I think the biggest problem is just that the insurance companies that have been selling private long-term care insurance (LTCI) haven’t really been defending the commercial LTCI turf very well.

Of course, the heads of the commercial LTCI units are ferociously passionate about staying in the market.

But the chief executive and chief financial officers say a lot of wishy washy sounding things during the quarterly earnings calls.

I think one reason is just the Federal Reserve Board’s continuing war against insurance company general account investment returns.