EXPERT OPINION: A Conversation with Larry Minnix

Jane Zarem, editor of Senior Living Business, caught up with AAHSA’s  president, Larry Minnix , at their annual fall conference. Here’s what he had to say about AAHSA’s proposal to dramatically alter the way America approaches and finances long-term health care for the elderly.

You can listen to the interview (click here, 6 minutes) or read the transcript below.

Jane Zarem
We’re talking with Larry Minnix, President and CEO of AAHSA, the American Association of Homes and Services for the Aging.

Larry, you’ve said that long-term care needs to be financed entirely differently than it is, or in most cases isn’t, financed today.  What’s the problem with long-term care financing?

Larry Minnix
The problem is that models, largely funded through Medicaid, are not sustainable.  And policy leaders, far and wide, and virtually every study I’ve seen says that [with] Medicaid, which is viewed as the number one payer for long-term care, we can’t afford to do what we’re doing.

Now, if you add to that the hidden burden that families are already sharing around paying out-of-pocket for long-term care, you’ve got a huge need.  The late Senator Claude Pepper and some of his work, his commission, concluded that long-term care is an insurable event.  And we’ve spent the last 30 years not insuring for it.

Jane Zarem
Why is addressing it so important now?

Larry Minnix
It’s so important now because, personally, in families, 80% of the nursing home care goes on in families’ homes.  And if you look at the staggering numbers of billions of dollars of lost cost associated with work, where families take off from work, if you look at the billions of dollars that families are paying out-of-pocket, it is time to address this issue.  We can’t keep letting this problem build.

Jane Zarem
Can you explain the solution that you have in mind, specifically, the National Insurance Trust, and tell us how that would work.

Larry Minnix
Well, the idea, and we’re far from the mechanics of it, is there would be an independent organization that would make sure that we have an actuarially sound approach that cannot be subject to political decisions or ideological decisions or I guess provider-centric decisions.  So the money ought to be put in trust and overseen by a group of people who do not have conflicts of interest about it.  And they need to be able to certify to the nation that there’s enough money coming in to cover the needs of people as they need to tap those benefits.

Jane Zarem
And individuals would contribute to this.

Larry Minnix
That’s right, every able-bodied person that’s working would contribute a little bit every day.  We say, for the cost of a cup of coffee, we can have a financially viable, actuarially sound program that’s fair—people are not excluded because of pre-existing conditions—and is fair in terms of the basic benefits that they receive.

Jane Zarem
How would the trust be administered?  Is it by the government, the federal government, the state government or private insurers?

Larry Minnix
Well, we think it should be an independent trust chartered by Congress, but set aside in a mechanism where the money cannot be politicized or used for other purposes.

Jane Zarem
And what kind of cultural transformation will be required for this idea to be accepted by consumers, by healthcare providers, insurers and the politicians?

Larry Minnix
Well, it’s a great question and that’s what we’re going to try to find out in the next couple of years. What we’re trying to do right now is define the problem, lay out a solution that we know we can back up. And then begin the consciousness-raising by the public. And there are studies and polls and so forth now that show that many, many families in this country understand this problem. They shoulder their responsibility. They don’t have the help that they need, but they don’t complain much. So what we want to do is tap into that experience to say, “Wait a minute, there’s a way to deal with this.”

It plays positively into the spirit in America of responsibility for self and family. So that’s very positive. It plays into our values about doing things in a fair and just way. It plays into our values about how communities want to take care of their own. And it plays into our self-determinism that we all have of “I want to live at home. I want things done my way.”

So we think the plan plays into everything that’s positive about the American spirit. Then you have to separate out anyone who’d say, “Oh, well, this is … ” and put some kind of characterization on it that it’s not.

So in the next couple of years, we want to get these issues on the table, in the national consciousness.

Jane Zarem
Okay, thank you, we’ll keep our eyes open for some positive activity on this in the near future.

Larry Minnix
I hope you will keep covering this issue. One of the ways we’re going to get it to the national consciousness is if people like you will stay tuned to it.

Jane Zarem
Okay, thank you very much.