Monday, January 28, 2008

LTC partnerships: could they help relieve filial responsibility?

Recently, a visitor to my blogs provided a link for Long Term Care Insurance information, and to begin this post I thought I would repeat the link. There is a tremendous volume of varied information about the long term care issue here, one important fact that only about a third of long term claims are actually to put people in nursing homes. A large amount has to do with help with custodial care at home.

The comment mentioned activity to form LTC partnerships in a number of states, besides the six I listed in my post.

One question comes to mind. Could long term care partnerships bear any relationship to filial responsibility laws? On the surface, they do not appear to yet, but there is obviously an opportunity for synergy. A state could set up a partnership, pass a mandatory long term care insurance law for younger workers, and then say something like this to the worker: “If you take care of yourself with respect to possible future long term care claims, and then your parents become indigent, we will relieve you of the financial responsibility for them and allow them to use Medicaid and welfare services.” As public policy, that could make sense. Remember, long term care can happen to younger people, because of accidents or, rarely, congenital or genetic diseases. Karen Schiavo was relatively young and her tragic case probably started with accidental causes (check Wikipedia).

I covered the subject of filial responsibility laws or “poor laws” in some detail in July, 2007 and examined a number of states on this blog, with detailed links. (Check monthly archive links here.) I have received some email correspondence about it. So far, states have rarely enforced these except in the context of pre-Medicaid “giveaways.” As budgetary pressures increase (even more so with the subprime crisis) that could change. LTC partnerships could be a very effective policy step for states, but they may only work with people young enough and healthy enough now to qualify, apparently. They won’t work for everyone.

The major 2008 presidential candidates have remained asleep on eldercare and long term care issues. I'm surprised about this, unless they don't have any proposals, and feel that anything they say will drive away potential voters. Hillary, Barack, John (both of you), Rudy, Michael: where are you on this?

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