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Generation Warfare is Brewing

May 12, 2014 by Honey Leveen Leave a Comment

In her April 9, 2014 column, one of my heroines, Terry Savage, describes looming Generation Warfare.

In a nutshell, our government is spending far more than it takes in. Check out Truth in Accounting, a nonprofit that keeps track of both our current national debt and the burden of future government payment promises. We now have an “official” national debt of more than $17.4 Trillion. The ticking clock on their website shows that we have promised to pay a total of $76 trillion to future Social Security and Medicare recipients, not to mention interest on our debt, along with military retirement benefits, etc.

In other words, we owe a lot of money! More than the government can raise in taxes.

In the meantime, Washington is playing a shell game. Instead of figuring out how to grow the economic pie, they are obsessed with dividing up the existing pie.

Generational warfare is brewing. Young people are enticed to take out student loans at interest rates many times what the government pays to borrow — and then graduate into an economy that is not providing jobs so they can repay those loans.

Younger workers pay into a Social Security “trust fund” that is scheduled to move onto shaky ground long before they can expect to receive benefits. They’ll be supporting government retirement benefits for someone else’s parents and grandparents.

And from the seniors’ side, isn’t it generation warfare for the Fed to keep interest rates low (depriving seniors of the opportunity to earn interest in their retirement years), so that the government’s unprecedented borrowing (a burden on the young) can continue?

And isn’t it generation warfare to reduce the government’s support for Medicare Advantage plans and limit Medicare reimbursements to physicians and hospitals, just when seniors most need the care?

Here’s another article about oncoming Generation Warfare that came out about the same time Terry Savage’s column did. It echoes what Terry predicts.

My April 9, 2014 blog is about how astonishingly huge and unsustainable our national debt is. Tax collection doesn’t put a dent in it. Medicare and Medicaid, the primary ways long-term care is paid in the US, are on the firing line and already suffering cutbacks. The giant bulge of Baby Boomers, most of whom are wholly unprepared to pay for their long-term care, is just beginning to hit our system.

At age 65, there’s a 70% chance any of us will need long-term care during our lives. I urge you not to depend on the government to provide your long-term care.

Nursing Home Murders: Connecting the Dots with Medicaid-Paid LTC

May 1, 2014 by Honey Leveen Leave a Comment

With permission from The Center for Long-Term Care Reform, I republish their Monday, April 28, 2014 post about my prior blog.

The reason I chose to cover the horrific nursing home murders still in the headlines here in Houston, is because there is a link between failing to plan responsibly for long-term care well in advance and tragic outcomes, whether or not they’re of the magnitude of the Lexington Place murders.

Many who can afford reasonably priced long-term care insurance simply won’t entertain it. They make excuses to avoid such conversations. It’s an uncomfortable conversation to have.

The horror and negligence that occurred at Lexington Place Nursing Home may be isolated (or maybe not since most of us choose to turn our heads away from this type of event). Even so, the importance of these posts is to understand that such events may be indicative of a widespread trend that’s just beginning.

I’ve chosen to cover these tragic murders because to me, they’re the tip of the iceberg. The industrialized warehousing of the indigent who need care will increase as our national debt grows, Medicaid and Medicare reimbursements continue to drop, and the partisan stalemate in Washington continues. And this financial catastrophe is approaching at an increasingly rapid rate as government programs are deluged with unprepared Baby Boomers who need long-term care but did not plan for it when they were able to afford and obtain reasonably priced long-term care insurance (LTCi). Sadly, events like the Lexington Place murders may become more common.

This blog and the one before it are meant to educate. If these tragic posts help even one person wake up and decide to defer their purchase of a new flatscreen TV or more expensive car in favor of buying a reasonably priced LTCi policy, they’ll be worth it.

LTC E-Alert #14-014: The Nursing Home Murders and LTC News and Comment

Monday, April 28, 2014

Seattle –

LTC Comment: Did you see the news coverage last week about two nursing home residents bludgeoned to death by their roommate in Houston? We opted not to cover it then, but the story does illustrate an important point. Nursing homes, especially those in poorer areas, are heavily dependent on Medicaid which pays them less than the cost of providing the care. Generous Medicare reimbursements help to make up part of the shortfall (at least for now), but the nursing homes most heavily dependent on Medicaid resort to cutting caregiver staff to a minimum and paying extremely low wages in order to operate.

So what? Well, Honey Leveen, the self-proclaimed “Queen of Long-Term Care” and the Center’s Regional Representative in Houston, draws out the ramifications in her recent blog post here. We encourage you to read it and to follow her links to more of the background. Honey points out that the nursing home in which the murders occurred has “nearly all” Medicaid residents. She opines that inadequate revenue led to dysfunctional management which resulted in poor care and finally in this awful crime. She links to an earlier article she wrote for LifeHealthPRO questioning the value of “Partnership” policies that leave people dependent on Medicaid’s mostly nursing-home based care.

This is sad stuff, but information all LTCI producers should consider as they advise clients on long-term care planning.

Long-Term Care Insurance is Good for America!

April 9, 2014 by Honey Leveen Leave a Comment

I want to share part of a powerful address that Tom McInerney delivered at the recent Society of Actuaries Long-Term Care Conference. His talk had great impact on me.

Mr. McInerney is the CEO of Genworth Financial, a leader in the long-term care insurance (LTCi) marketplace. He stated the federal government faces at least $40-70 trillion in entitlement liabilities (Medicare, Social Security and Medicaid). A 2009 GAO Report supports a $45 trillion number. A more recent Heritage Foundation report estimates $45 trillion for Social Security and Medicare alone. All three of these programs are “Pay-As-You-Go”, which means they need to be paid for through current payroll or income taxes.

Our current federal tax revenues are $2.7T per year (see CBO Report FY 2013 estimate). If you add $40 – 70 trillion of entitlement to our existing $17 trillion deficit, even a doubling of taxes, which would further slow our economy, wouldn’t put much of a dent on the public sector’s true liabilities of $60 – 80 trillion! To add to this dilemma, we currently have a ratio of fewer than three workers per retiree supporting Social Security. According to the Social Security Administration, this ratio gets worse every day.

Let me add that our legislators know that Medicare, Social Security, and Medicaid need reform urgently. But for their own reasons, neither party will broach this subject. I have blogged about this here and here. With each passing day, the entitlement crisis grows worse, and Mr. McInerney states that counseling that we should rely exclusively on a taxpayer-funded solution to pay for long-term care in the US is irresponsible. I don’t think it’s irresponsible. I think it is off-the-deep end unrealistic and irrational to believe publicly paid long-term care is possible! Yet such irrational, “feel good” solutions seem to prevail.

Here’s a blog that gives an example of the prevalence of such irrational points of view. It’s called “Reaming Diane Rehm“. During her show on long-term care, Diane Rehm paid most of her attention to a supporter of government paid long-term care. She did not have a single representative of the insurance industry on this show, yet plenty of time was spent smashing and bashing LTCi. I pointed out some of the many false and irrational statements made on this show in a professionally written letter I sent to Diane Rehm by surface mail and email; I never even got an acknowledgement from her or her staff.

Meanwhile, Americans haven’t saved enough to cover their long-term care costs. The private long-term care insurance market can’t cover everybody, but it can cover some of us. The more LTCi policies issued, the less pressure on Medicaid budgets and other entitlement spending in the future.

Many of Us Are Setting Ourselves Up for Undignified, Bleak Final Years

March 17, 2014 by Honey Leveen Leave a Comment

In my March 6, 2014 blog, I reported that TX ranks third in the country in the incidence of Alzheimer’s Disease (AD) and second in the country for number of Alzheimer’s deaths. It turns out, this could be wrong.

A provocative new study reported in the March 12, 2014 New York Times, suggests that Alzheimer’s disease causes six times as many deaths as the official statistics would indicate!

Here’s a quote from the new study:

“Alzheimer’s disease and other dementias are under-reported on death certificates and medical records,” said study author Bryan D. James, PhD, of Rush University Medical Center in Chicago. “Death certificates often list the immediate cause of death, such as pneumonia, rather than listing dementia as an underlying cause.” James added that attempting to identify a single cause of death does not always capture the reality of the process of dying for most elderly people, as multiple health issues often contribute.”

People with AD need more expensive long-term care than anyone else. According to the American Association for Long-Term Care Insurance (www.aaltci.org), the number one reason people collect from long-term care insurance (LTCi) is due to Alzheimer’s Disease (AD). Insurance companies pay out more money on AD claims than for any other cause.

Unfortunately, most people don’t own long-term care insurance. Most people figure out how expensive, stressful, and time consuming caring for an AD patient is, the hard way.

Here’s additional news that does not bode well for most of us, who are woefully unprepared for retirement and long-term care.

It is unrealistic to expect the government to pay for long-term care. That’s the subject of a different blog.

Here’s a link to Terry Savage’s February 25, 2014 Huffington Post column describing why retirement is becoming a luxury fewer and fewer people can enjoy.

Here’s a March 12, 2014 New York Times article describing why income inequality often disables wealth transfers at death. From the article, “The top 1 percent of households owns about 35 percent of American wealth, more than the entire bottom 90 percent does.” At death, the wealth of the 1% is not trickling down to the rest of us.

Long-term care insurance (LTCi) can be reasonable in cost. To me, what’s not reasonable, is needing long-term care for anything but a short time, and not owning LTCi.

My advice is to read, heed, and be honest about your future by preparing responsibly for your long-term care.

Moving Story About How Long-Term Care Insurance Works

March 14, 2014 by Honey Leveen Leave a Comment

What follows is a true story about a friend and colleague. An extraordinary health event occurred. My friend’s long-term care insurance (LTCi) kicked in, exactly as planned. LTCi has provided dignity for my friend and her family, plus choices and options that would otherwise not be possible.

My Story: Talking the Talk and Walking the Walk

by Allan Shoff

This is the story of my wife, Karen Shoff, and the role long-term care insurance has played in our lives.

Karen is the love of my life. We’ve been married for 33 years. She was active, passionate and accomplished in her varied life endeavors. Our rich family life was a huge source of satisfaction to Karen. We have two grown children, 12 grandchildren and one great grandchild. Our daughter, son-in-law, and five of our grandchildren have now moved back from Israel to help with Karen’s care.

In 2009, Karen had some tingling in her left arm. We went to Cedars Sinai Hospital’s emergency room where they did several examinations, including a brain scan. There were problems with the machine’s calibration—and with the technician giving the brain scan. Karen got eight times the recommended radiation dosage. Within a short time, she began to experience memory loss. We were part of a class-action lawsuit and received a fairly paltry settlement, which only paid for about eight months of Karen’s care.

Over the past four years, Karen has continued to lose function. She no longer speaks to people or interacts with anyone at a personal level. She has some pain, but more discomfort and fear of falling. Music therapy has been helpful to her, but over the past few weeks, she has become more and more withdrawn, spending virtually the whole day with her eyes closed, and communicating very little with anyone.

Many readers of this newsletter know of Karen. Karen was one of the most passionate, knowledgeable, reputable, accomplished long-term care insurance specialists in the country. She was a visionary and a true leader. She was a featured speaker at NAHU’s 2001 National Convention and a long-time member of the Million Dollar Round Table. She was always seeking ways to give back to the insurance profession and the world. She did whatever she could to foster interest in long-term care insurance education and responsible financial planning.

Karen has her undergraduate degree from Cornell, a master’s from Smith College School for social work, and a master’s from the Leonard Davis School of Gerontology at USC. The early part of her career was spent as a social worker at a nursing home.

Karen’s experience as a nursing home social worker made a huge impression on her. In addition, her own experience with her father compelled her to write her widely acclaimed book, “There’s No Place Like [A Nursing] Home”. You can learn about this book and buy a copy at www.longtermcarela.com or email me at shoffandshoff@earthlink.net. Many advisors have found the book to be a powerful tool in their practice.

The book intimately tells the story of our experience caring for my father-in-law at home. At age 97, my father-in-law suffered a massive stroke. His doctors told us they did not expect him to survive more than a week. Against all odds and advice, but with the wholehearted support of our family, we flew Karen’s father from New York to our home in Santa Monica, CA, and provided him with 24-hour care for the last 11 months of his life. Due to the excellent care Karen arranged for her father at home, he exceeded all expectations and regained his speech. Although he would not re-gain other skills, he found pleasure reminiscing and participating in other facets of family life. Karen publicly expressed, as often as she could, how precious to us all his last few months were.

Thank goodness Karen talked the talk and walked the walk by placing ample long-term care insurance on herself.

Karen has been using caregivers since August 2011. At present, she has 24-hour care with three regular caregivers. One is a nurse who spends about 15 hours a day here, plus two additional part-time caregivers. In addition, our daughter, son-in-law and grandchildren all help in various ways. I do what I can, but the whole situation is very trying for me.

Karen owns two CNA LTCI policies, each with lifetime benefit periods and 5% annual compound growth increases. These policies cover about 85-90% of Karen’s care expenses. Without her LTCI, the necessary, dignified, loving level of care Karen receives would be entirely impossible.

Nursing Home Murders: Connecting the Dots with Medicaid-Paid LTC

Many of Us Are Setting Ourselves Up for Undignified, Bleak Final Years

Moving Story About How Long-Term Care Insurance Works

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Podcast Illuminates LTC Need

LTCI is Magical at Time of Need!

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