Archives for January 2014

Knocking on Heaven’s Door, a “Must Read”

January 30, 2014 by Honey Leveen Leave a Comment

I recently finished “Knocking on Heaven’s Door”. I recommend this book to anyone who is not afraid of the truth. It had a huge effect on me. This book was recommended to me, and I have in turn recommended it to many, and have bought copies as gifts for a few friends.

Knocking on Heaven’s Door is about how we deal with death in the United States. It also an intimate, intensely personal memoir. It quotes facts and figures that are irrefutable and impeccably researched.

Here is the link to it on Amazon: http://www.amazon.com/Knocking-Heavens-Door-Better-Death/dp/1451641974/

There are only 3 reviews of this book that are not 4 or 5 stars. Most reviewers give it 5 stars, as do I.

Here is just one review of many:

“This is a book so honest, so insightful and so achingly beautiful that its poetic essence transcends even the anguished story that it tells. Katy Butler’s perceptive intellect has probed deeply, and seen into the many troubling aspects of our nation’s inability to deal with the reality of dying in the 21st century: emotional, spiritual, medical, financial, social, historical and even political. And yet, though such valuable insights are presented with a journalist’s clear eye, they are so skillfully woven into the narrative of her beloved parents’ deaths that every sentence seems to come from the very wellspring of the human spirit that is in her. This elegiac volume is required reading for every American adult; it has about it a sense of the universal.” ~ Dr. Sherwin B. Nuland, author of How We Die: Reflections of Life’s Final Chapter

Here’s another:

“This is the most important book you and I can read. It is not just about dying, it is about life, our political and medical system, and how to face and address the profound ethical and personal issues that we encounter as we care for those facing dying and death. You will not be able to put this book down. Its tenderness, beauty, and heart-breaking honesty matches the stunning data on dying in the West. A splendid and compassionate endeavor.” ~ Joan Halifax, PhD, Founding Abbot, Upaya Institute/Zen Center and Director, Project on Being with Dying: Cultivating Compassion and Fearlessness in the Presence of Death

Obamacare Doesn’t Cover Long-Term Care

January 21, 2014 by Honey Leveen Leave a Comment

I thank the Motley Fool. Again, they have demonstrated that they have keen insight into the cost and odds of needing long-term care. They go above and beyond most other finance advisors by urging their readers to prepare responsibly for possibly needing expensive long-term care.

In their January 18, 2014 column they (almost stridently) report that The Affordable Care Act (AKA Obamacare) does not pay for long-term care. They offer a two-minute video warning the public about the risk of needing expensive long-term care and not being prepared, especially later in life.

Dan Caplinger (featured in the video) is correct; long-term care insurance (LTCi) has become more expensive and the LTCi marketplace has contracted over these past few years. But reasonably priced LTCi policies are still available, the key to finding such policies is to not put off buying one.

People often complain to me that LTCi is expensive. It’s not. What’s expensive (financially, emotionally, physically) is needing long-term care for anything but a short period of time and not owning LTCi.

If long-term care is needed, LTCi policy holders normally collect back every dollar of premium they spent over the years in six months or less.

For other blogs I’ve done on the pervasiveness and irrational state of denial when it comes to reasonable, responsible long-term care planning, click here: /?s=denial

Mainstream Media Ignores the Elephant in the Room Again

January 13, 2014 by Honey Leveen Leave a Comment

I was momentarily excited when I read the following headline, “The World Braces for Retirement Crisis” on an AP article published December 30, 2013. I optimistically expected a story that would at the very least mention the possibility that catastrophic medical and long-term care costs would be part of the coming retirement crisis. No such luck.

Once again, I was disappointed (but not entirely surprised). The article only reported on shrinking, no longer existing retirement and pension plans that will force people to have to work longer. It didn’t make even a tiny, tangential connection between shrinking pensions, longer work lives, and how much these factors will exacerbate the existing high odds and costs of needing long-term care.

As I have reported in this blog time and time again, mainstream media usually fails to address this 5,000 pound elephant in the room: the impending Silver Tsunami of Baby Boomers in first-world countries throughout the globe, who will have long-term care expenses that they are pitifully unprepared for (see the italicized footnote below).

It’s very frustrating. The public tries at every opportunity to deny the compelling, high odds they might need long-term care. Mainstream media too often aids and abets these efforts, as this article does.

“Congressional Budget Office, 11/07 [https://www.cbo.gov/sites/default/files/11-13-lt-health.pdf] *Total spending on health care would rise from 16% of gross domestic product today to consume nearly half of the GDP in 75 years. * Federal spending on Medicare and Medicaid would rise from 4% of GDP today to 19% in 2082. This new study shows significantly higher federal spending on Medicare and Medicaid under current law than other official projections do, which typically assume that spending grows much more slowly in the future than it has in the past. Although projections by CBO and by the Medicare trustees track each other relatively closely for the next two or three decades, by the end of 75 years, Medicare spending under CBO’s projections is about 50% higher. The study concludes that, without changes in federal law, federal spending on Medicare and Medicaid is on a path that cannot be sustained.” Source: Galen Institute, “Health Policy Matters” e-newsletter (11/16/7). Find in sources at: CBO on Health Spending Outlook 1107. URL: https://www.cbo.gov/sites/default/files/11-13-lt-health.pdf

I Am Scared about the Fate of Nursing Homes

January 6, 2014 by Honey Leveen Leave a Comment

It’s the end of the year, and I’m pelted with solicitations to donate to various charities. I feel bad enough having to make the visceral decision to toss most of the requests into the trash, even though I support just about all of the soliciting charities. I feel especially bad about the fate of one charity in particular: Seven Acres.

I gave a larger than average end-of-year donation to Seven Acres, the Jewish nursing home here in Houston. It has a reputation of being top notch. When I call Seven Acres top notch, I mean that only in relative terms. It is as top notch as possible for a Medicaid-accepting, money-losing nursing facility. I have heard from friends with loved ones at Seven Acres that there are too few caregivers so loved ones often wait a long time for help to come. Seven Acres staff strongly encourages families to hire their own, privately paid, additional caregiver.

Here are just a few of the blogs I’ve done on the unsustainable state of long-term care (LTC) finance in the US: /?s=nursing+home. Because Medicaid pays less than it actually costs to provide care, most facilities run in the red. This causes them to cut corners on the quantity and therefore, the quality of care they can provide.

In its annual solicitation letter, Seven Acres states that in 2013, it “provided over $8 million in charitable care to over 85% of its resident population who rely solely on inadequate Medicaid funding.”

I feel bad knowing that my donation is a drop in the bucket and will not help with Seven Acres’ over all financial problems. Increased demand will cause Seven Acres to continue to run in the red, in what may be a downward spiral. My donation will have no effect on making the changes, and reform, that will be necessary to preserve Medicaid-paid long-term care for our most vulnerable citizens. It will also have no effect on making political changes that are necessary to gain control over our country’s out-of-control Medicaid expenses.

The moral: take charge of your own future dignity and choices with a reasonably priced LTC insurance policy.

Veterans’ Admin Helps Pay for LTC

January 3, 2014 by Honey Leveen Leave a Comment

A December 23, 2013 New York Times article titled, “Winning Veterans’ Trust, and Profiting From It” describes a program that’s a darling to many trade contacts I have here in Houston in the long-term care industry because it helps fill vacant assisted-living apartments and nursing-home beds.

The program pays benefits that may be worth more than $20K/year per person from the Veterans Administration Aid and Attendance program. To qualify, you must have a low income, you or your spouse must be a World War II veteran, and there must be a need for long-term care.

One’s income may be naturally low, or made “artificially” low. I know a colleague who helps people qualify for this Veterans’ program. He works for one of the companies mentioned in the article. He makes most of his living offering free assistance with the VA Aid and Attendance program application process. To get applicants’ incomes low enough to qualify for the program, he can sell annuities that are exempt from inclusion in the qualification process, thereby enabling his client to qualify for VA Aid and Attendance benefits.

Quoting from the article, “For the advisers and retirement homes, the attractions are clear. The V.A. program paid $5.1 billion to 514,000 veterans or their survivors this year, up from $3.4 billion in 2007, according to the Department of Veterans Affairs. The number of veterans or their spouses receiving the aid and attendance benefits, the stipend for assisted living, has surged by 30 percent — leaping to 206,000 in 2012, from 158,000 in 2006.”

According to the article, qualifying for the VA Aid and Attendance program is not very difficult. Checking and monitoring for appropriate applications is lax (in other words, the VA is understaffed; we already knew this).

This is another example of bureaucratic ineptitude and economically unsustainable legalized theft.

It’s unwise to expect our government to be able to pay for your long-term care.

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Archives for January 2014

Knocking on Heaven’s Door, a “Must Read”

Obamacare Doesn’t Cover Long-Term Care

Mainstream Media Ignores the Elephant in the Room Again

I Am Scared about the Fate of Nursing Homes

Veterans’ Admin Helps Pay for LTC

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