2030 stands as a critical year in the vision of our nation's development. As we enter the new millennium no one is certain how our society will be transformed by technological, medical, economic and social developments. We do know, however, that the current government services which provide for society's most fragile, the aged and those with disabilities, will not be able to meet their obligations; in fact by 2030, unless reform is enacted, most if not all services will be bankrupt. As our country's population ages, America has yet to adequately prepare for the new demographic realities that 77 million baby boomers will have upon social and economic policies. Americans have begun to address several of these problems in the form of Social Security and Medicare reform, yet long term care financing -a potentially devastating cost for tens of millions of Americans, and a critical component of retirement security has not received the attention and scrutiny necessary to begin solving this problem. As people prepare for their golden years they are entering the 21st century with financing programs invented in 1935 and 1965 that are now made obsolete by expense and demographics. We need to find a better way!

The purpose of CLTC is to raise the need for comprehensive long term care financing reform within the public debate at all levels of government and business so that nonpartisan reform becomes a priority among public and private leaders with leadership and support from the President of the United States.

The need for long term care can be sudden and unexpected as the result of an accident or medical event. It can also be the result of a chronic illness or years of age related illness. Whatever the cause, studies show that 40% of all Americans will need some sort of long term care in their lives. Despite this sobering fact Americans and their elected leaders ignore long term care financing issues. An overwhelming number of Americans mistakenly believe long term care is covered by Medicare. It isn't.

The cost of long term care, which averages $51,000 per year nationally has the potential to bankrupt most families very quickly. Nationally, two thirds of all recipients of long term care utilize Medicaid, the state-federal welfare program to pay for their care. The current Medicaid based financing of long term care is an ineffective system that does not meet its current needs nor can it be expected to remain operable, as the baby boomers require long term care. Using Medicaid as the primary payer for long term care is a demeaning outdated approach to As the baby boomers begin to utilize Medicaid, we will see a dramatic increase in government expenditures to pay for long term care.

Unless the financing system is reformed federal and state Medicaid budgets will threaten resources needed for education, defense, criminal justice, infrastructure and other services. Federal government planners already foresee the day in the next 30 years when the costs of entitlements will meet or exceed revenues. How then will we finance the exploding government borne cost of long term care?

The process to get there

In March of 1999 former Senator David Durenberger called together a representative group of key individuals who were interested in the development of long-term care issues. After several meetings, a steering committee was appointed that met in order to decide how to proceed. The individuals attending the meeting felt there was a unique opportunity based on the front-loaded presidential primary system to inject the issue into several key early state primaries. The effect of concentrating on the early states where retail politics are more important provides the ability to shape the issues prior to large media driven states where a campaign without significant resources would fail.

The members of this collaborative effort represent all segments of the long term care spectrum each of whom would like to see a different solution to long term care financing. They agreed that this effort would be solely committed to raising the issue, not proposing solutions.

The decision to use the election of the President in the year 2000 as a springboard for the issue of long term care financing reform is a recognition that this issue has been buried in Washington, governor's and state legislative policy debate circles. It has been put on the back burner behind Social Security and Medicare reform, both of which appear poised to dominate the federal debate in 1999.

While long term care financing reform and delivery is crucial to both Social Security and Medicare reform, and could possibly be raised as an adjunct issue, it is more likely to be ignored because of the complexity of all these issues, and the inability of Washington to do more than one reform at a time.

The election strategy required that we treat long term care financing reform as a candidate for purposes of the early primaries. The strategy developed a campaign style effort, replete with a series of campaign style tactics: theme development, spokesperson recruitment, media endorsements, delegate targeting and recruitment. By establishing a presence in Iowa and New Hampshire we were a constant force, which forced candidates to respond to this issue. Long term care financing is a personal issue and it is in these retail states where politicians are swayed and respond by individual voters that we sought to gain attention for the issue.

Our goal was to raise the issue of long term care financing within the public debate to the point that the next President takes ownership of the issue and names reform beginning in the year 2001 as one of the his priorities.

Post-Primary Efforts

After concluding our activities in the early primary states Citizens For Long Term Care began focusing its efforts on assembling a core groups of "champions" who would be the leaders of reform at different levels of government and industry. We found leaders among local legislators, Governors, Members of Congress and various segments of industry who shared our belief in the need for long term care financing reform. Through individual and small group meetings; a series of closed briefings for Members of Congress and their staffs; presentations to trade associations; and constant contact with the Presidential campaigns we increased awareness of the need for reform.

Legislative vehicles such as a family caregiver tax credit; tax incentives for the purchase of long term care insurance; higher reimbursement rates; and issues around staffing ratios helped heighten the awareness of long term care issues.

"Welfare reform, health care reform, long-term care for seniors, greater opportunities for the disabled, helping the poor find work, and helping the working-poor find rewards in their efforts, biotechnology and scientific research: I am absolutely passionate about these issues."

Health and Human Services Secretary-Designate Tommy Thompson

Upon being nominated by President-elect George W. Bush, Health and Human Services Secretary-Designate Tommy Thompson's comments indicated success in getting President-elect George W. Bush to recognize the importance of long term care issues. As the leader of the Department of Health and Human Services Secretary Thomspon will have the opportunity to continue his leadership in long term care financing reform that he began as Governor of Wisconsin.

As Citizens enters 2001 we are preparing for an active year that includes releasing a "white paper" that our members feel can serve as a framework within which all debate on long term care financing reform can take place. We are preparing for a summit of long term care's champions to help build the national dialogue on financing reform. We are working with our members to produce a series of forums to expand education and scholarship on long term care financing and we hope to build towards a national summit on financing reform in 2002.

The effort headed by Senator Durenberger is a collaborative effort of many different groups representing all segments of the long term care debate. It includes: consumer groups; the disability community; care providers; insurers; unions; women's groups; and business interests. We anticipate this group to continue to grow and welcome all interested parties as more Americans become aware of the need for long term care financing reform.

If you wish to join Citizens For Long Term Care or learn more about our efforts please contact The Honorable David Durenberger or Patrick Brady at 1001 Pennsylvania Avenue, N.W., Suite 850N, Washington DC 20004. The phone number is 202.347.2582.