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LTCI Watch: A burden?

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It’s easy (especially after watching several hours of blurry streaming Web video) to be skeptical about the value of “public involvement” in bodies like the Federal Commission on Long-Term Care.

Congress created the Federal LTC Commission as a kind of legislative consolation prize to start with, to give lawmakers with a lot of seniors in their communities something to say to voters angry about the demise of Ted Kennedy’s CLASS Act voluntery LTC benefits program.

The CLASS Act program might have died pretty quickly, but at least, supporters say, it might have done some good for some people for a few years, before a death spiral spirited all the cash away.

The Federal LTC Commission is supposed to try, if it can, to come up with bipartisan recommendations in September. There is no guarantee that the commission will come up with recommendations, that the recommendations will be any good, or that, if there are good recommendations, members of Congress will do anything other than recommendations but use them to create YouTube videos in which they explain how much they care about the needs of the elderly, and about how they have had to use their own aides to oversee the care of their own aged parents.

When members of the public, or even commissions representing diverse interests, speak at a commission meeting, it’s easy to assume that the results will either be dull or impractical, or both dull and impractical.

But, last week, it seemed as if commission members were saying something important that people in the commercial long-term care insurance (LTCI) community ought to think about it: That it’s really important that our country celebrate caregiving, make caregiving seem like something unavoidable, and, to whatever extent it’s possible, make caregiving seem cool, and not like something to be avoided.

Those kinds of comments seemed to startle a great marketing guy from the U.S. Department of Health and Human Services, and, of course, one of the main reason that moderately high income people buy LTCI is to avoid having to worry abuot “burdening their children” with unwanted, expensive caregiving duties.

But Native Americans, for example, are worried about the idea that well-intentioned LTC planning campaigns could disrupt caregiving traditions, and it me: The Native American tribal elders have a great point.

Unless we somehow do succeed at preventing or curing many cases of dementia within a couple of decades, we are going to have all of the caregiving work that private LTCI, Medicaid, family caregivers, nice neighbors, nice volunteers, and all other sources of help and financing can possibly handle.

Issuers of private LTCI, in particular, may want to avoid letting LTCI benefits become a slush fund for the insureds’ adult children.

But, at the same time, the issuers may find that they would much, much rather spend a few thousand dollars on respite care for an insured’s daughter every year than for the insured to file a full-blown home care claim.

A hundred years ago, many upper class women viewed child rearing as a bothersome task best left to paid help. Now, for many high-income women, being able to stay home and feed children organic kale smoothies while they are taking their Mandarin lessons is cool.

Maybe private LTCI issuers would do well to work to make caregiving a wonderful, cool thing to do, and also to position private LTCI as something that supports the glorious work of caregiving and kicks in when informal caregiving is no longer enough, not something that displaces informal caregiving.

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