Letters.

Dear Dr. Willging:

As a geriatrician with experience with community nursing homes and the aging population, I thought your article hit the nail on the head. As you may know, Consumer Reports had an article on long-term care insurance, and I was disappointed that they suggested if one's income was less than $200,000, one shouldn't get long-term care insurance, as Medicaid will eventually cover one's long-term care expenses. I thought that was fallacious, because: (1) Americans have a responsibility to plan for their long-term care expenses, just as they have a responsibility to plan for retirement and not be totally financially dependent upon the government; (2) Medicaid leaves one with few choices in long-term care planning, unlike long-term care insurance, which offers choices such as assisted living, home care, and nursing home care (in a desired nursing home); and, finally, (3) protecting financial assets may be important for many Americans.

I purchased long-term care insurance for myself and my family, and I now have peace of mind that I did not have before.

Dr. Nannette Hoffman Gainesville, Florida 

Dr. Willging Responds

Dr. Hoffman:

Many thanks for your comments on the long-term care insurance article. Actually, Consumer Reports' interest in this issue goes back a number of years, and from its very first article on the topic, its bias has been noted. Certainly, the editors seem never to have been fans of the concept, an aversion that appears throughout much of its work.

Look, for example, at its November 2003 article. No later than the fourth paragraph, the authors refer to a number of product "deficiencies": "You must keep paying to keep it in force. If premiums rise, you may have to drop the coverage, possibly losing everything that you've paid. The policy's benefits may cover only a portion of the total expense. Many policies are packed with catches that can keep you from collecting. Finally, there's no guarantee that long-term care insurers, some of which have weak balance sheets, will be around 20, 30, or 40 years from now when you need them to pay." Consequently, "long-term-care insurance may be a lousy deal." Well, using those arguments, any insurance product can be a "lousy deal."

Some have suggested that Consumer Reports' real goal is a universal, government-funded entitlement program for longterm care, and that movement toward private insurance might impede progress toward that goal. Be that as it may, its messages on the product need to be taken with a grain of salt. And, given Consumer Reports' wide readership, that's a real shame. Long-term care insurance needs publicity if it is to realize its true potential as a key element of the nation's long-term care financing program. Its use will free up scarce public funding for those who can neither afford nor become eligible for private sector support. But bad publicity, especially when unwarranted, can have the opposite effect. And that does no one a service--neither the consumer nor the nation.

Paul R. Willging, PhD

P.S. I have taken the liberty of forwarding this correspondence to Steve Moses, president of the Center for Long-Term Care Financing, whose interest in this issue (particularly our responsibility, as Americans, to plan for our own long-term care expenses) is well known. Thanks again for your comments.