Mutually dependent and interdependent. The relationship that cannot be severed or ignored is between aging adult children and their senior parents. What you cannot choose to do any longer is to only view the problem as if the concerns of those already in care, or living in fear of the financial implications of the possibility of the need for care, are simply fuel for the buying decisions of the adult children participating in the care of a parent and therefore clearly understanding the need to plan and be prepared for future risk contingencies for themselves. Consumer surveys across many disciplines have historically identified those who can intelligently “plan ahead” without the experiential need of being directly and personally involved. This argument had been frequently proposed as it relates to the need for extended care originating from a chronic illness. Consumers, when surveyed, would wish us to believe that they make wise financial decisions in a vacuum purely to protect their assets. My father’s favorite response to this would have been “horse hockey.” I’m equally sure if the FBI were to investigate this frequent allegation they would find that virtually every buyer was somehow somewhere “Touched by an Angel” and had seen first hand or observed from a distance the real financial and emotional impact of not being ready to deal with the “cost” of care in America. The Boomers are of course no longer coming, they are fiercely here among us, and in fact their numbers peak in just three years.
Statistics are often used to excess and frequently stand in the way of consumers wrapping their minds around the commitment necessary to be ready for their own care receiving journey. I have decided however to show you, dear reader, no mercy in that regard.
- Older Americans are experiencing an absolute firestorm of chronic illness with four out of five of those over 50 suffering from at least one chronic condition.
- Chronic illness is being fueled by medical advances, additional longevity, and a booming pharmaceutical cornucopia sustaining the treatment of chronic conditions. This of course stems from a population increasingly cursed by its own lifestyle choices creating escalating rates of obesity, diabetes and high blood pressure.
- The share of Medicare patients with more than five chronic illness conditions has increased to over 50 percent.
- Middle-aged Americans have a 90 percent chance of developing high blood pressure.
- The relationship between chronic illness and the inability to perform ADL’s is the most direct, certain and immutable.
- The financial spending associated with chronic conditions is six times higher than for those people that are without the underlying health concerns.
The relationship between chronic conditions and the need for additional medical intervention and, eventually, extended care should be hard wired into any conversation with a prospect and the number one reason to initiate a policy review on those already looking to you for guidance. Death and taxes may be the only certains but chronic illness is coming up the back stretch and approaching the finish line closely behind.
Think of chronic illness risk as the catalyst for any sales conversation, because this risk falls across all generations. Boomers are, for the most part, our almost exclusive source of buyers and currently represent the primary source of sustenance to a private insurance market long in retreat. In addition, the numbers emerging from LIMRA should have everyone’s attention riveted to the obvious. Four out of the last five years combo life sales showed double digit growth, and if you considered all LTCI stand-alone with combo life and annuity, 80 percent were combo life. All other sales categories would require a mirror under the nose to see if they were still breathing.
The fuel for the fire is outlined above and “yes” the pot is on the boil. The sermon this month is that it is not one pot, it is two welded together simply receiving heat from the same burner. It is impossible to separate the Boomer buyer from the parent currently in need of care or staring off into that financial abyss.
- There are 70 million Boomers but 71 percent of them have a living parent! It is our primary Boomer insurance buyers who find themselves under attack from multiple directions including inadequate savings, not yet independent children, and parents needing care and attention.
- The picture is bleak at the far end of the caregiving spectrum—10 percent entering a nursing home will live five or more years, two-thirds will die within the first year. In 2010 25 percent died at a nursing home but that number is rising to an anticipated 40 percent by 2020.
- Three-fourths wish to receive care at home!
- A recent company consumer survey indicated that three-fourths of Americans know that an unplanned health or care scenario is their greatest fear to destroy money for an inheritance.
It is however recent analysis from AARP Across the States 2018 that may have the most complete current analysis of what I am asking you to integrate into your practice. Our aging population being cared for by their Boomer adult children is the only fuel for your sales and marketing tanks that makes any sense. The ratio between those 45 to 64 able to help with caregiving is currently seven to one, but the ratio will drop to three to one by 2050 as progressively Boomers will need care. The 85 plus population will triple during the same period of time.
The conclusion to the sermon now follows. The relationship between those in need of care, immediate or pending, and the adult children caught up in the process are symbiotically mutually interdependent. Boomers understanding of the need to leverage their own risk originates from, in my humble opinion, only one source. That is the experience of parents’ or loved ones’ own trouble with point of need care funding. These insurance needs and sales opportunities are irretrievably now and forever bound together. You cannot separate your fiduciary responsibilities or the clear and present needs of your clients one need from the other. How can you possibly help one and ignore the other regardless from which end of the spectrum your conversation began?
The sales mantra that requires repetition is that there are three sales permanently intertwined with chronic illness risk abatement and amelioration, each with the same critically important goal: Remain a private pay care consumer! 1) Those with sufficient health and wealth should continue to leverage as much of the catastrophic risk as possible. Help them choose which financial instrument or combination of policies best fits their circumstance; 2) Help as many as possible supplement their future retirement income with additional insurance resources to maintain personal control of their own imminent care claim. Just help them fill in the “gap” between existing or prospective income during a time of need for care; 3) Do all in your power to help those already experiencing or anticipating reduced ADL performance with medically underwritten SPIAs, professional secondary market analysis of no longer needed life policies for care and income options, possible reverse mortgages, and potential Veterans benefits. There are over 50 million who we know refused our help over the last 20 years. They still need your help and concern. This should become one fluid conversation across the generations. Only one goal for all concerned: Freedom of choice, quality of care and the personal dignity that comes with control.
Other than that I have no opinion on the subject.
Confusion
Recently an industry publication offered a headline that even State Regulators were confused about regarding chronic illness combo/hybrid policy offerings. That same confusion is rampant through the ranks of all concerned. As has been suggested previously in this column, there is little if any consensus on the balance of pricing assumptions. We do seem to have come to understand that mortality and morbidity are both at play in one financial instrument. Some early SPWL product with limited chronic illness riders were based solely on mortality. Furthermore, it is accepted that premium, underwriting and administration expenses must be considered for either contingency. The persistent low interest environment has seemed to help point the market in the direction of the intrinsic value of whole life promises guaranteeing premium and predictable benefit.
No company wants to go into battle with a sword but no shield. Unfortunately some of the shields look good from a distance but are made of very soft wood. Caution is necessary when suiting up. Insurance distribution is often a little sloppy in their use of popular terminology. Chronic illness riders do not pay long term care benefits! All so-called living benefit riders are not created equal. The only way to be less confused is to educate yourself as to what the rider pays, and where and when. Are there any limitations of benefit—specifically as to location of care or how the money can be spent? The confusion as to product structure will not clear up any time soon, but if we keep asking the right questions our expectations as to what we need to offer our clients and the reality of what is available can improve dramatically.
The opposite of confusion is structural clarity. Recent consumer surveys have again confirmed the size and shape of the risk itself. This sale begins and ends with an understanding of caregiving. The most definitive analysis of the problem that creates the incentive to buy was just released by The Associated Press NORC Center for Public Affairs and funded by the SCANN Foundation: “Long-Term CareGIving: The True Cost of Caring For Aging Adults.” We will never succeed without a clear perception of the reality of the problem:
Product choices are confusing and that problem will not go away overnight—although product design including clarity of cost and benefit will improve. Just make sure you understand what the cost will be now and forever. Make certain you understand exactly what benefits will be paid when and in what form. If you cannot guarantee cost or benefit you have some serious explaining to do! What must not be confusing is the source of the motivation to buy for potential care recipients. We swim every day in an ocean of chronic risk currently in place, or pending, with strong winds and rough seas originating from the financial and emotional cost of caregiving. Frankly, there is no one else lining up to offer any form of life raft for current or future storms. Carefully examine the quality of your safety equipment and get busy lining up your clients for mandatory lifeboat drills. Confusion is its own form of cowardice.
Other than that I have no opinion on the subject.