Posted On: March 15, 2009

Percentage of People Paying for Their Own Long-Term Care Is Growing

A late 2008 Avalere Health study and chart book commissioned by Long Beach healthcare nonprofit, The SCAN Foundation, contains information that appears to have surprised a lot of people connected with the long-term care industry. The analysis, “Long Term Care: an Essential Element of Healthcare Reform,” reported that seniors, people with disabilities and their families in the United States pay nearly 30 percent of LTC services out of their own pockets – nearly 10 percent more than previous estimates.

In dollars, that means that in 2006, the most recent year figures are available, individuals and their families provided $64 billion out of their own assets to pay for long-term care. Unpaid caregivers, usually family members sacrificing time and resources to care for loved ones at home, provided $350 billion worth of free care. In comparison, private health and LTC insurance contributed slightly more than $16 billion.

The study, which intended to look at Medicare and Medicaid contributions to long-term care in order to propose policy changes, included the private contributions because the figures was so startling to even seasoned policymakers.

“To finance these contributions, most seniors and their families rely on home equity, income from adult children, or retirement savings,” Avalere Health wrote in a press release earlier this month. “All of these asset classes have lost considerable value over the past year, resulting in diminishing funding capacity in the face of a rapidly growing long-term care population.”

The reason private insurance’s contribution to pay for long-term care is so low is twofold. Too few people purchase LTC coverage because it has been too expensive. During the past couple of years, states have partnered with LTC carriers to make coverage more affordable. These policies are worth considering.

The second reason is that insurers are experts at finding ways to delay and deny LTC benefits. If you are old or sick, they figure time is on their side. Some LTC carriers had undercapitalized or spun-off their LTC divisions in such a way that their funds may not outlast their pool of policyholders.

Yet despite these drawbacks, the alternative is far bleaker. Better to purchase LTC coverage now and fight the company for benefits later, than become part of that rapidly growing percentage of people exhausting their assets to pay for care.

Posted On: March 9, 2009

Insurer-Proposed Healthcare ‘Reforms’ Aren’t Worth Cheering About So Says L.A. Times

Los Angeles Times reporter Michael Hiltzik once again comes out fighting on the side of consumers in his March 9 column examining an insurance industry trade group’s policy brochure purporting to support universal healthcare and the Obama Administration’s plan to improve the system. “Health Insurers Pay Lip Service to Reform.”

But before inviting us to celebrate the industry’s 180-degree turnaround, Hiltzik examined the fine print and spoke to a number of industry observers who convinced him American Health Insurance Plans is only repackaging its same old proposals to transfer the cost of care for the sickest people to taxpayers and to gain freedom from “pesky state regulations limiting their freedom.”

“Veterans of earlier healthcare battles justly wonder if the industry is merely trying to get out in front of the parade, the better to lead it into a dead end,” Hiltzik writes.

Meanwhile, as Hiltzik reports, doctors “split their working hours 50-50 between seeing patients and dickering with insurance companies over claims and preauthorizations.” That’s a travesty!

We agree with Hiltzik that insurance industry healthcare “reforms” can’t be trusted. No matter what federal legislation eventually becomes law – and we’re not holding our breaths in anticipation – state regulators are charged with much more than standing on curb watching the parade. They need to get strong where they have been lax in regulating this industry and then stay on top of it.

During the next election cycle, California will elect a new insurance commissioner. Whoever is willing to take on the insurance industry and transform that office will likely be hailed as a hero all along Main Street. But he or she needs to act soon, before the sun sets and all the parade-goers straggle home.