A Blind Eye

In a distant past presentation I would begin by suggesting that you could take a prospect gently by the hand, lead them to the edge of a bottomless pit of risk and they would invariably ignore the obvious. The situation may have gotten a little better in 20 years but not much. A recently published consumer survey on the Affordability of Long Term Services and Supports from KFF Health news and the New York Times, November 14, 2023, again lays bare Americans’ stunning and at this point legendary ability to avoid what remains as our largest unprotected risk. We know the real burden falls on the caregivers yet half of those surveyed had ever talked to an aging loved one as to who will care for them when the time comes. Even fewer had ever discussed how in the hell that care would be paid for and 43 percent were unsure how they would pay when it does hit. I know many of us have grown hoarse screaming about the frustration of dug in consumer resistance. This research pours a large quantity of salt into that open wound.

“The overwhelming majority of adults say that it would be impossible to pay.” Ninety percent regard the estimated $100,000 for a nursing home or $60,000 from assisted living cost as a bill they have little chance of paying!

And to put a fine point on it the survey also concludes:

  • As has been repeated over and over again almost half of those surveyed still believe Medicare will pay.
  • 62 percent had difficulty even finding a facility to meet their needs.
  • A substantial number were unhappy with the care they could locate.
  • Half of those surveyed outlined the cost that splashed back on the family or loved ones providing care.
  • Much of the care provided in America is delivered with love but without compensation.

The truth blazed across the sky is Americans remain unprepared. Perhaps we need to reiterate the obvious in some form of financial braille. Why do we continue to hear a cane tapping down an empty hallway? The brick wall is real. What must be done to expose the solidity of that barrier? Medicare pays a very limited amount and the balance is shared between private sources and state run Medicaid. Consumers know they are unprepared and that the burden is likely to fall on them directly. Four in ten surveyed lacked confidence that they would be able to pay. Fewer than half surveyed had ever even had a conversation with their loved ones about who would care for them or how it would be paid. Two-thirds surveyed felt anxious about affording care when needed. There was a clear socioeconomic component to the findings suggesting the obvious that as average income fell, anxiety and stress compounded. The “statistic” we know all too well is that fewer than half were doing anything to even try to plan ahead.

What rattles me the most is that we could have, exactly like a brilliant contestant on Jeopardy, anticipated these responses . There are no revelations here we have not seen before. I am not going to give in, without some reservation, to the temptation that we may have always been plagued by the blind leading the blind. From reinsurance to claims adjudication a handy blind eye may have impaired our ability to see the true nature of the risk or unveil the depth of perception required to avoid the obstacles we know remain in our path.

Other than that I have no immediately visible opinions on the matter.

Ronald R. Hagelman, CLTC, CSA, LTCP, has been a teacher, cattle rancher, agent, brokerage general agent, corporate consultant and home office executive. As a consultant he has created numerous individual and group insurance products.

A nationally recognized motivational speaker, Hagelman has served on the LIMRA, Society of Actuaries, and ILTCI committees. He is past president of the American Association for Long Term Care Insurance and continues to work with LTCI company advisory boards. He remains a contributing “friend” of the SOA LTCI Section Council and the SOA Future of LTCI committee. Hagelman and his partner Barry J. Fisher are principles of Ice Floe Consulting, providing consulting services for Chronic Illness/LTC product development and brokerage distribution strategies.

Hagelman can be reached at Ice Floe Consulting, 156 N. Solms Rd., New Braunfels, TX 78132 Telephone: 830-620-4066. Email: ron@icefloeconsulting.com.