By now we are all familiar with the origins of the federal Commission on Long-Term Care (LTC).
Established by Congress as part of its Jan. 2 "fiscal cliff" deal, the commission arose literally as CLASS was being repealed. Tasked with advising Congress how to reform our nation's access to, delivery of, and funding for long-term care, the 15-member bipartisan panel just released its findings last month.
The precious balloon which had been afloat all summer did not so much "pop" with excitement at the news, as deflate with a "pffft."
No one held the commission to high expectations– strapped as it was by a six-month deadline and $500,000 budget — but it still managed to attract sustained coverage in the press even as Syria and our government shutdown threatened the steal the spotlight.
I disagree with the suggestion from my colleague Tom Koziol that revolutionary legislation may emerge.
"We didn't have the resources or time to get that done," admitted Commissioner Grace-Marie Turner (president of the Galen Institute, a Speaker Boehner appointee).
Had commission members gotten that done, the proposal would have had to be introduced in the U.S. House and Senate.
On the other hand, it was easy to reach consensus on softball topics such as eliminating Medicare's onerous three-day prior hospital stay requirement (which private long-term care insurance (LTCI) eliminated over 15 years ago), calling for background checks on LTC workers, ensuring that family caregivers are included in the planning process, or grandstanding for increased use of technology.
In fact, one of the commissioners has just released a statement optimistically predicting that the panel's budget-neutral recommendations will be adopted by Congress within a year.
But any casual observer could see the commission was doomed.
The witness list
If we agree that the road ahead will rely upon a partnership of public and private funding sources, why was no one from private LTCI invited to testify before the commission?
One can't very well talk about questions of "access" without eventually, recursively, talking about money to pay for services.
No one has a better track record — not Medicaid, not Medicare, not the VA — than private insurance. No one knows more about claims and utilization than private insurance.
So why were private insurance company representatives not allowed to speak and respond to questions from the 15 members of the commission?
Some were permitted to submit written statements, but on the list of the 36 participants invited to testify before the panel over four all-day sessions, private insurance industry participants were glaringly absent — even from the session entitled "Strengthening Private Long-term Care Insurance."
Vocabulary
As I've written in the past, words are powerful framing instruments.
