Dayna Steele, my friend and client, author, entrepreneur and well known public figure, has written beautifully and accurately about the need for responsible long-term care (LTC) planning. Her just published blog poignantly illustrates the need for LTC insurance by describing the experiences of her friends. I hope you will take time to read her short piece.
Medcaid Loopholes Easily Exploited by Middle Class
Here’s a press release by Dale Krause, an advisor who appears to specialize in Medicaid planning. I have recently written about my qualms with Medicaid planning, which I consider “gaming the system.” By using glaring loopholes in current Medicaid laws to re-position, shield and preserve often extensive wealth, advisors like Mr. Krause are often successful at enabling their clients, people of means, to qualify for Medicaid.
Medicaid is a program that was set up to assist the indigent and handicapped: people with little or no wealth. In addition, Medicaid-paid LTC is typically inferior to non-Medicaid-paid LTC. With our country’s grave financial crisis and an oncoming Silver Tsunami of Baby Boomers who’ll need LTC, I predict Medicaid-paid LTC will get worse, not better. We the tax payers fund Medicaid and ultimately wind up paying for the schemes Mr. Krause & others like him derive their income from.
Here is the comment I emailed the author of the press release:
“Hi Dale
Sounds like you are involved with long-term care on an abstract basis and haven’t really thought through the reality of such things as the dignity and options your clients will want. I hope you will take a few moments to read the linked article I wrote on the undeserved glorification Partnership LTCi often gets. I also think it would be wise for you to create a Plan B for when the government inevitably eventually closes the loopholes your strategies depend upon.”
Gaming the System, Screwing the Country
It’s amazing but true: lawyers like Alice Reiter Feld in her newsletter, (Center for Asset Preservation and Long Term Care Planning, 5701 N. Pine Island Road, Suite 260, Tamarac, FL 33321) blatantly advertise how easy it is to shield, insulate and exempt assets from Medicaid spend down. Then the government (actually, we taxpayers) gets to pick up the tab for their long-term care (LTC) when people who follow Ms. Feld’s advice become eligible for Medicaid.
She writes, “At a recent meeting, the subject of nursing home care came up. One pastor in the group opined that, in order to get Medicaid to pay for such care, a person must have spent all his money. My husband (who’s been enlightened by his elder-law attorney/wife!) immediately corrected the pastor, advising him that this was not true. He then also advised him to get Nursing Home Medicaid advice from an elder law attorney.”
The truth is that Medicaid eligibility is riddled with loopholes, enabling many people to legally shield and divest their wealth, then get Medicaid to pay for their long-term care. I am all in favor of Medicaid-paid long-term care for those who are truly indigent. That is, after all, what Medicaid is supposed to be: a safety net for the poor. Nowadays, however, it’s taken advantage of by Medicaid planners like Ms. Feld, who make a nice living helping people with means gain access to Medicaid.
When people with home equity and other assets game the system as described, the federal government must find more revenue to meet the increased demand for Medicaid, which in turn increases our national debt or the tax burden on all of us.
Perhaps more importantly, Medicaid-paid long-term care is often very sub-standard. I strongly encourage Ms. Feld and her complicit husband, Rabbi Mitch, to visit a Medicaid-paid facility in a large city. They can then provide accurate, detailed descriptions of the Medicaid-paid long-term care facilities their clients are planning to spend their final years in. Perhaps Ms. Feld’s clients, including her husband, will consider alternative facilities before they divest and shield their assets.
Click here to see my recent article describing what Medicaid-paid nursing home care is like.
To Ms. Feld: I know you are making a good livelihood doing Medicaid planning, but I encourage you to expand your practice to other areas. You will sleep better. To me, you are a “bottom feeder,” doing what is legal, but is it ethical? To your husband and others enthusiastic about this approach, I urge them not only to consider the ethics of saddling the US taxpayer, including themselves, with the bills for this slight of hand, but also to become better educated about the lack of options and poor quality that have unfortunately become synonymous with Medicaid-paid LTC.
Entitlement Bandits Rob Medicaid/Medicare
A brief, new Cato Institue video explains the causes of high rates of Medicaid fraud.
The biggest reason is because Medicaid money is “other peoples’ money.” If Medicaid’s accounting were run more like private enterprise, like a credit card company, fraud would be cut down dramatically.
This video ties into long-term care (LTC) well because Medicaid pays for the majority of facility-based LTC in the US. As has been discussed in earlier LTCQueen blogs, if Americans want to “have their cake and eat it;” in other words, preserve wealth and have their loved one receive Medicaid-paid LTC, it is just not that difficult to “game the system.”
3in4needmore.com is on The Road
The 3in4NeedMore campaign is in high gear and it’s exciting!
Celebrity spokesperson the 71 year old Dr. Marion, a geriatric care manager is on a 9-week tour of the country in a 1967 converted Greyhound bus. At each stop, she alerts Americans to the need for each one of us to do responsible long-term term care planning. Her advice is, “it’s never too soon to start planning for long-term care needs and costs.” She is eloquent and passionate about the cause. She is infinitely credible.
Here’s a wonderful video describing Dr. Marion’s third week on the road. It’s about 10 mintues. It’s visually fun to watch. If you don’t have time for the visuals, scan to the talking parts, which have great content.
Click here for a link to Dr. Marion’s blog.
I have met Dr. Marion, who has a PhD in geriatric care management. She is eloquent and looks like everyone’s grandmother. She is infinitely credible.
I so hope Americans take her message to heart since not nearly enough of us own long-term care insurance (LTCi). When the Baby Boomers start approaching their 80’s and a great number of us need the care that LTCi pays for, those without LTCi will have few choices and options.
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