On the heels of a new SCAN Foundation data-dump (hundreds of long-term care (LTC) studies released at once, sound and fury so far signifying… a paperweight?) the eternal question among industry-watchers remains, "After CLASS, what?"
As I've written before, a private long-term care insurance (LTCi) market which disenfranchises 1 out of 5 invited guests will always have its "viability" questioned, or at the very least, must partner with an entity willing to insure that other 20 percent. Enter public insurance.
In the meantime, our attention has been distracted like a magician by the repeal of CLASS and the tangential ways in which the Affordable Care Act (ACA) intersects with LTC (e.g., creation of The National Plan and a plethora of mostly pilot programs in long-term care supports and services (LTSS) aimed at re-balancing resources from institutions to home care).
But, in the magician's other hand, something very significant has been concealed from view…
Until I attended the ILTCI Conference in Dallas last month and happened upon a presentation entitled, "Financing Framework for Social LTC Security System," I might have never heard of the "LTC Financing Collaborative," nor been sufficiently informed to call it to your attention.
I've not met a single person who has previously heard of it, yet the LTCFC is apparently staffed with a Who's Who of inside the Beltway thought leaders.
On the panel that day were Stuart Butler (distinguished fellow and director, Center for Policy Innovation, The Heritage Foundation), Howard Gleckman (resident fellow, The Urban Institute), and Jonathan Westin (health policy director, The Jewish Federations of North America). Mr. Butler was the first to describe the Collaborative's behind-the-scenes think-tanking.
He began with historical comparisons to both "Welfare Reform" and "Coverage for the Uninsured." Both seemingly-intractable American problems that spanned decades, while attracting opposing, entrenched idealogues. Finally, a watershed moment occurred—a dam burst—and major legislation was passed which ushered in a new era. Why?
It turns out—and this may be news to some of us—that both processes were enabled by professional, skilled mediators. These facilitators used the same techniques as arms control negotiations.
Mr. Butler explained how it was necessary in each case to bring the right people—the top people (those with decision-making authority, not "third or fourth level" in an organization). He stressed the importance of working without a timeline (unlike, for example, the much-maligned National LTC Committee), since trust must be built organically and personal stories must be shared.